Entering Pain Management in a Post Opioid-Epidemic World

I’ve been injured since December 2011; I long stopped keeping track of how long that is. Throughout this time I’ve largely declined pain medication because pain was a good indication of whether healing was taking place, and whether I was causing more damage to myself. I dealt with the pain in order to give conservative treatments a chance, and to prevent from developing an addiction to narcotics.
Around September 2015, four years after my initial injury and one month prior to my first surgery, I broke down literally and figuratively. I could no longer navigate my life around the constant pain. Through tears I explained the injury and how it had been managed to my primary care physician:

That I was initially told to have surgery but had been giving conservative treatments a chance instead. I’d completed physical therapy and two epidural injections. That I managed the past several years with frequent chiropractic treatments and continued physical therapy. Physical therapy was the reason I could still walk but I hadn’t improved so surgery was in my future. I was interviewing surgeons.

Instead of compassion and understanding I was treated with disdain. My request for pain medication from my primary care physician was denied because I “lack[ed] a history of needing pain meds.” Amongst other things I was told that “if it were really that bad [I] would have gotten them sooner,” and that I should have asked for pain medication from the surgeon. Nevermind the fact that I hadn’t yet chosen a surgeon. I was informed that new procedures had been implemented to keep narcotics ‘off the streets’ and I should see a Pain Management specialist.

I have never felt so horrified and alone. I had done everything right. Everything.

I tried conservative treatment.

I tried to live stronger than my pain.

I consulted several surgeons and never asked them for medication.

I did finally find a specialist and obtained a prescription but encountered even more frustration at the pharmacy. They didn’t have any of that particular medication in stock and couldn’t tell me when to come back because “procedures are in place to keep narcotics off the street.” They couldn’t accept the prescription for me come back another day; I was told to try another pharmacy or come back everyday to see if stock was replenished. I called other pharmacies but soon realized that staff can not discuss controlled substances over the phone. I was supposed to visit each store.

At the time I thought these were fairly isolated incidences; they really aren’t. Since entering our health-care system as a pain patient I’ve since discovered that primary care is routinely overshadowed by medication, and we’re are openly mocked by pharmacy professionals.

Like most people, I visit my Primary Care Physician for a variety of reasons; most visits are outside the scope of my injury and pain management. Still, my obvious awkward gait usually attracts the attention of staff. While they frequently ask whether my pain management provider gives me random drug tests; I’m rarely asked how I’m doing. Such interactions make me feel ignored as a patient because the actual reason for my visit gets pushed aside. There seems to be little concern for the actual cause of the pain, or mental and physical implications of it.

My experience at the pharmacy is still no better. I recently had to change pharmacies for insurance reasons. When I noticed my controlled substance was taking significantly longer to fill than the other medications I asked if there was a problem. I was informed that “sometimes this kind of medication takes awhile;” “no, they couldn’t give me an approximate time it’d be ready.”

Five hours, a phone call to them and another to my doctor later, someone finally told me the pharmacy was having trouble finding me in the state’s database. To me it’s absurd that a patient wouldn’t be called when there’s a problem with their prescription. But the common response is “well pain medication is highly abused so providers have to take precautions. Maybe they thought you were doctor shopping.” So it’s worth noting that this new pharmacy couldn’t find me in the database despite me having previously used the same pharmacy and doctor for several years.

What’s worse is walking into the pharmacy and knowing how pain patients are mocked, as shown in the two screenshots below:

Screenshot_20170224-105401

No other type of patient is so openly ridiculed.

As an athlete I never thought I’d become a chronic pain patient. Negotiating chronic pain is no fun; and it’s made more difficult by being trapped in an uncaring system.

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About Lynsey

When Lynsey became injured in 2011 she changed her focus from running long-distance to working behind the scenes as volunteer and crew chief. You can find me at various aid stations throughout Florida reminding the runners that "this is not a parking lot."
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1 Response to Entering Pain Management in a Post Opioid-Epidemic World

  1. What an honest, open explanation of your situation. My short term experience was exactly what your on going situation is. It’s hard enough to have chronic pain but the mental pain and anxiety over the way you know you’re going to be treated is devastating. Despite looking like shit, wearing a sling that tied my arm to my body, scabs from the surgery and inability to brush my hair, I was treated similarly to you-even with the outward signs of having recently had surgery. I can’t imagine how much worse you are treated since you “look normal”. Mother fuckers, all of them. The doctors, nurses, insurance companies, pharmacists and pharmacist assistants that can’t use their judgement and intuition to determine who is a drug seeker and who is not.

    What kills me is that people with chronic pain have proven alternatives that are not covered by insurance and are not readily affordable. I BEGGED for massage, acupuncture, estim, ultrasound or a sports medicine physical therapist. Nope. My ONLY alternative was to be treated like shit at the pharmacy and look like a crazy person. “Sure, we can give you 10 pills of the 90 BUT that’s your prescription. You’re fucked on the other 80 pills. You will have to take these 10 and get another script or wait an indeterminate amount of time before we can refill. You can sit outside with the smokers (on the ground) or come back and we’ll tell you when you come back that we now only have 4 pills of your 90. Take it or leave it?” This would leave me crying and hysterical. Mother fuckers didn’t have to drive a stick shift left handed to get to work, did they? If they had, they might have thought twice about telling me to come back.

    L, I hope that this surgery ends your pain and this horrible mistreatment by the medical community. We need you back out on the trails running ultras!! XXXOOO

    Like

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