Yeah . . . maybe today. Ninety minutes ago, I took Ritalin 20 mg. It has some analgesic effect.
I thought of calling my PCP's office again today. But I hate to seem "needy" of my refill. I don't want to seem impatient, which they could take as a red flag.
It was my bf - bless his heart - who got the bright idea, a few years ago, of exaggerating his pain issue, so he would be prescribed a bigger monthly alotment of Vicodin tablets . . . that he could "share." Initially, I tried to discourage him doing that. Eventually, I didn't. So yesterday his VA nurse shows up for a visit. She asks him about pain. He denies having any. He has some dementia, which lately has worsened. So he forgets a lot. Of course, I jump in to remind him how beneficial he finds his prescription for Vicodin. He seems to not follow me. I experience a sense of dismay. When the nurse leaves, I try to cut through his mental fog and get him to recall how he has been helping me out over the past couple of years. I tell him that I am barely managing to cope with caring for him and how that's only possible, if I get enough pain med to get through a typical day. Plus, he genuinely does need some Vicodin available for himself.
It's not lost on me, Sarahsweets, that I am behaving with a measure of desperation. He does take enough Vicodin to cause him to always test positive on the pee test that the VA occasionally requests. Recently, in the ER, I asked them to include opiate testing in his bloodwork, since his PCP needs to verify he uses the stuff, and urine sampling can be tough to arrange. Well they were way ahead of me and said that was already ordered. I guess, if you have known access to opiates, the ER will tox-screen you automatically. I hadn't realized that. So, yes, as Sarah pointed out, you may be subject to drug testing, when you least expect it.
His PCP was talking about what I could expect, if he passes away at home, which is what we're hoping for. She said the coroner's office has someone designated to show up immediately and examine the controlled substances in the home. This person will count the tablets left in the vial, and take note of the date on it. I gather this is to explore whether the deceased person may have been deliberately overdosed. (If you're a client of a "hospice" provider, that doesn't get done.) So there's more opportunities to get into trouble than one might anticipate.
I never expected to be doing what I'm doing. I always figured that, as long as alcohol is legal, that would do me, as a soothing substance. Age changes us. One glass of wine with dinner is nice. Any more just makes me feel sick. Because I'm averse to inhaling smoke, weed has never interested me. Then there's opiates, which I think Heaven intended for the relief of human misery. But we're at a point in time where the hammer is coming down on years of careless prescribing. I think the Law has over-reacted. It's going to be easier to get an AK-47 than some pain pills. I think legislators are getting a bit hysterical. Last time I went to the pharmacy, my PCP had ordered me some inhalable Narcan. Probably good to get that stuff spread around in the community.
Some recent studies have been done on the use of opioids to treat depression. They were so used before other psych drugs got invented. Those newer drugs are proving less effective than was hoped. So opioids for depression are getting a new look. There's evidence they can have an antidepressant effect. No real surprise there. Obviously, if they didn't make people feel better, they wouldn't get abused. I wish Society could be more rational in regulating usage.
Some of what we hear is not rational. The opioid crisis is being blamed on drug manufacturers encouraging doctors to over-prescribe and not keeping doctors informed of the risks of opioid use. That is such crap. Opiates are a very old class of drugs. We knew a hundred years ago how addictive and lethal they were. I've heard nothing new about opiates that I wasn't told back in 1977 in nursing school. They depress the respiratory drive, which can easily be lethal. An eminent surgeon who helped found Johns Hopkins Hospital back in 1889 was addicted to morphine. He knew back then pretty much most of what we know now. He knew it first-hand, and his colleagues knew about his addiction. Doctors have always known about the lethality of opioids. But its trending these days to demonize the manufacturers. I'm not sure what that's about.
That's all part of the atmosphere that affects our access to opioid pain relievers. I just hope I don't lose something that makes my life seem better. I do see where losing an opioid makes life seem worse than if I had never used it. That is something to think about.