Limbaugh admitted drug abuse.....seeks treatmentPosted by Richard, C.Ped on 10/10/03 at 15:53 (133492)
crap...now where am I gonna get my supplemental income?? I have another baby on the way. geeze...Thanx alot!!
sorry...still in my silly mood. :o)
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/10/03 at 15:58 (133496)
HAW HAW HAW... now are you sure you 'down't' need to go to the 'DOCTER'??
(Who the heck do you think that guy IS, anyway???)
Re: Limbaugh admitted drug abuse.....seeks treatmentPauline on 10/10/03 at 16:12 (133504)
I'm not a drug taker so it's difficult for me to understand how a person gets hooked on pain medication.
If a doctor is Rxing it doesn't he keep track of the amount the patient is taking and then try to wean them off the drugs as they get better?
Why would a doctor keep Rxing it if he knows the patient is hooked? Isn't it the doctors responsibility to remove the patient from the drugs?
How does one abuse something that the doctor won't RX anymore after weaning the patient off the drug? If you can't get it, how can you abuse it?
Re: Limbaugh admitted drug abuse.....seeks treatmentmarie on 10/10/03 at 16:25 (133506)
I'm not surprised one bit! Thanks for bringing it up.
I do wish him the best of luck at re-hab. This will be his third trip.
Re: Limbaugh admitted drug abuse.....seeks treatmentRichard, C.Ped on 10/10/03 at 16:28 (133508)
I have a friend who was hooked on the Oxycontin and got into trouble. The doctor has been investigated to prescription abuse. It's about the $$ I guess.
Re: Limbaugh admitted drug abuse.....seeks treatmentRichard, C.Ped on 10/10/03 at 16:31 (133510)
Third trip in rehab?
Re: Limbaugh admitted drug abuse.....seeks treatmentmarie on 10/10/03 at 16:37 (133512)
Yes I listened to an interview on the radio on the way home from work. He said he'd gotten adicted when he had some medical problems with his spinal chord. He's been taking pain killers illegally for a little over 5 years. He said he had tried re-hab on two other occasions but failed to overcome his addiction.
Re: Prescription drug abuse -- more complicated than you thinkSharon W on 10/10/03 at 17:15 (133520)
There is actually a lot more involved in it than most people realize.
These kinds of things can actually happen to anyone, even very nice people.
For example: a nice, likeable, and and intelligent lady, is in terrible pain with PF but can't afford to stop working. In order to stay on her feet in her deteriorating medical condition, she needs larger and larger amounts of painkillers. Her doctor -- LEGALLY -- prescribes her hydrocodone ('codeine') around the clock to keep her on her feet. But, finally, she just can't take it anymore, even with the painkillers... she has reached the point where she can't even walk.
As soon as she quits working, her doctor tells her that she will have to stop taking her pain pills, then declares that she is 'addicted' to codeine and 'red-flags' her chart, notifying all her other doctors never to prescribe it for her again and to watch out for her showing signs of 'addictive behavior,' etc.
So EVEN THOUGH SHE IS STILL IN HIDEOUS PAIN, her regular doctor says her PF should 'go away on its own' now that she's not on her feet so she shouldn't need anymore medicine, and because of the 'addiction' label she can't get ANY doctor to take her reports of pain seriously, or to agree to test her for nerve problems in her feet and ankles, or anything else!
FINALLY, she finds one doctor willing to do the tests, and he discovers (much to his amazement) that *GUESS WHAT??* she ALSO has a serious nerve condition!
The lady lives happily ever after in her wheelchair with her long-term chronic pain medications.
Re: Limbaugh admitted drug abuse.....seeks treatmentEd Davis, DPM on 10/10/03 at 17:51 (133533)
The problem is that many patients have chronic pain so their need for pain medication is long term. How are such patients weaned off medications when their need for those medications is continuous?
Re: Limbaugh admitted drug abuse.....seeks treatmentEd Davis, DPM on 10/10/03 at 17:52 (133535)
He has had disc surgery that failed so he is in chronic pain.
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/10/03 at 17:57 (133536)
There is also a problem with the TYPES of medications used. Unfortunately, there ARE doctors out there, usually PCPs, who will prescribe medications like codeine as the ONLY medication being used to control chronic pain -- not just for breakthrough pain. And then they will offer NOTHING as a replacement when that medication has to be withdrawn.
Honestly, what are these patients in terrible pain supposed to DO?????
Re: Limbaugh admitted drug abuse.....seeks treatmentmarie on 10/10/03 at 18:01 (133537)
Yes I heard that. The question is how will he manage his chronic pain without oxycontin? Why did his doctors take him off it originally? What alternatives were there? Why didn't he do the stand up thing and get himself in rehab and off this drug? Instead his housekeeper tattled on him.
I wish him the best in rehab and hope this time it works but I do not pity him what so ever.
Re: Limbaugh admitted drug abuse.....seeks treatmentLari S. on 10/10/03 at 18:26 (133542)
I would be willing to forward all the e-mail drug crap I get in my spam box to him. It seems like there are 15-20 ' xyz medicine, no RX needed' every day.
While I'm not a fan of his, I hope he gets help and sticks to it. As we all know, pain is a very hard thing to live with...
Re: Limbaugh admitted drug abuse.....seeks treatmentJohn H on 10/10/03 at 18:48 (133546)
Been there and done that Ed. I really never found med that would work for failed back surgery syndrome. I never took any of the really potent ones so do not know if they work or not. Did find that a Medrol Dose pack would help but little leary of taking the steriod long term. I really would not get on the case of anyone any chronic pain if they chose to take drugs of any sort. One has to have walked in those shoes to understand. Even people who are dying and in terrible pain find it difficult to get drugs for pain control. Our rules and regulations should be reviewed for people in chronic pain. Persons on chemo cannot get M except in one or two states to control their nausea. that seems crazy to me.
Re: Limbaugh admitted drug abuse.....seeks treatmentJohn H on 10/10/03 at 18:52 (133548)
People with rheumetoid arthrits who suffer very much are put on steriods long term. The results can be a puffing and rounding of the face and other things but the medical community accepts this. If someone in chronic pain finds oxycotin a relief and know the consequences of its use I say it is there choice. They are not doing this for some sort of high or recreation but to live a life from day to day.
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/10/03 at 19:08 (133552)
I agree with you. The antiepileptic drugs that I take for the pain caused my my peripheral neuropathy also cause very unpleasant side effects, but because they are not narcotics the side effects are considered acceptable. I think there is a rather absurd double standard here.
Studies have shown that when a person is truly in pain, if the amount of narcotic painkillers prescribed is appropriate it will NOT cause addiction.
But there are medications that really were never intended to be used as a primary medication to control chronic pain, and codeine is one of them. I attended a seminar on pain once, for continuing medical education. There were doctors there, too. These topics were discussed at length... I wonder how many of the doctors actually made use of what they learned?
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/10/03 at 20:07 (133562)
I'm with you on this one, Lari. I am NO fan of Rush Limbaugh, in fact I think he's disgusting. I am in fact a Republican, more or less, and I really resent him setting himself up as a representative for Republicans or 'conservatives'.
However, I have compassion for people with pain, and I know that doctors will sometimes withdraw pain medication that is still needed to control pain, because they are worried about addiction, and then NOT replace it with anything at all, or even provide the patient with 'rehab' to help them stop using the drug.
I don't know how successful rehab could be, though, if the pain is still there and they aren't doing anything about it.
Re: Limbaugh admitted drug abuse.....seeks treatmentEd Davis, DPM on 10/10/03 at 20:32 (133563)
There is one pain clinic in my county. They don't accept all insurances. I have injured workers in chronic pain and the Dept. of Labor and Industries (our state workers comp. carrier) has often refused to allow a referral to that clinic.
Options for treatment of chronic pain can be limited. Docs have a fear of being accused of addicting patients and often give patients too little pain medicine.
A doctor needs to be creative and I may use a combination of modalities including physical therapy, compounded topicals, steroids, Cox-2 inhibitors, TENs units, trigger point injections, some natural supplements based on the German commission E information as well as prescription narcotic pain meds. It is illegal but one can see why some patients try to get pain medications from non-prescription sources if not enough is being done for their chronic pain. I have seen docs get in trouble for prescribing too many controlled substances and also for not writing enough -- things are far from being clear in that area and better guidlines are needed.
Re: Limbaugh admitted drug abuse.....seeks treatmentPauline on 10/10/03 at 20:34 (133565)
Does anyone know the number of politician, their wives, performers, movie or T.V. stars, media people, lawyers, doctors, engineers, priest and plain Joes that are not addicted to anything?
Maybe this number would be less than those that are.
Re: Limbaugh admitted drug abuse.....seeks treatmentEd Davis, DPM on 10/10/03 at 20:40 (133566)
Rush is a Republican first and a conservative second. He has always stood up for the Republican establishment. I got annoyed with him when he bashed John McCain because McCain, to some extent, ran as a Republican but without the blessings of the Republican establishment.
Rush is an entertainer -- something he always maintained that he was above all. His bombast and hyperbole existed to stir up interest and controversy. He is, the 'father' of modern talk radio -- at least in its present form, whether people like it or not.
I too, wish him the best in his recovery. He has had his share of significant health problems. Beyond his back problems, he went deaf fairly rapidly a couple of years ago and underwent cochlear implants which were successful.
Re: Limbaugh admitted drug abuse.....seeks treatmentEd Davis, DPM on 10/10/03 at 20:46 (133569)
Those would be hard statistics to find out. It may depend, to an extent, on how loosely one defines addiction. Many of us Seattle-ites are caffeine/coffee addicts. So many have something that hurts somewhere in their bodies and have a degree of at least, habituation, if not addiction to medications.
Re: A perspective on treatment of chronic painEd Davis, DPM on 10/10/03 at 21:10 (133571)
Re: A perspective on treatment of chronic painSharon W on 10/10/03 at 21:28 (133573)
Very interesting article, Dr. Ed. And I do realize that doctors are increasingly up against the wall too because of this attitude that ANYONE who uses narcotic painkillers long-term (unless they are dying of cancer) is an 'addict' and needs to go to rehab and get 'clean'.
When if comes from the general public, this attitude is born of ignorance of course. When it comes from DOCTORS -- well, I don't know what to say then, except that I wish they could FEEL what chronic pain is like for a day; then they would have a very different opinion on the matter!!!
(And yes, Dr. Ed, I DO know that you are a compassionate man who would not just leave his patients in pain -- so please don't think I have been trying to nag at YOU, personally, or lecture you with all of this ranting and raving.)
The thing people do not understand is that chronic pain is not just minor aches and pains for everybody. For people with certain conditions, even conditions that are never fatal, chronic pain can be EXTREMELY intense.
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/11/03 at 08:12 (133593)
I know that I am addicted to coffee, and I don't even live in Seattle. (But I've sampled your coffee there... Mmmm... it would be easy to get spoiled!)
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/11/03 at 09:02 (133598)
Does the pain clinic in your county ever prescribe controlled substances, or are they basically a rehab facility to help patients learn to use other methods besides drugs to learn to live with their pain?
I have nothing against all of those other modalities you mentioned -- in fact, I am strongly in favor of them and I believe in most cases those modalites (at least some of them) should be used before controlled substances or even anti-epileptics are prescribed. (Aren't you the one who mentioned giving B-12 injections, too? I was very impressed by that, and I've since learned how wise it is...)
And PERSONALLY, I don't have an active prescription for any narcotic painkiller, breakthrough or otherwise, nor have I asked for one. I don't need it right now; my antiepileptic meds (unpleasant as they are) do keep my pain level at 5 or below. (That's on a 0-10 scale where 5 is 'I'm not going ANYWHERE today or doing ANYTHING so don't even ask' and 10 is 'AAAAAUUUUGGGGHHHH!')
I digress. My point is, while all of those other modalites are of value and will be successful in many cases, they simply will NOT work to keep extreme pain under control. And I think it is cruel, when they COULD be helped, to expect people to just 'live with' pain levels that keep them from being able to really function -- simply because our society has decided to pass judgement on the medications that would allow them to live more comfortably.
Through the internet (yes, I do visit other sites) I know a number of people with severe chronic pain who are taking narcotic painkillers, legally, on a regular basis, and are not dying of cancer. They are also nice, regular folks -- not crazy, but still in a fair amount of pain (most of them) even with these drugs. Some of them are in wheelchairs and will be there permanently. I will never condemn them as 'drug addicts' because they require medication to relieve their pain.
Re: Limbaugh admitted drug abuse.....seeks treatmentJohn H on 10/11/03 at 10:32 (133607)
Ed: There were some comments the other day his drug, which I presume was mainly Oxycoytin. could cause hearing problems. I have not looked that up Of course, there could be political motivation behind this. Everyday my email is full of sites that offer to sell any drug you want without a prescription. Some sites have on site Doctors who sign off on your order. Others are from foreign countries. Do not know how they get away with this and of course you face the risk of getting a sugar pill or worse.
Re: Limbaugh admitted drug abuse.....seeks treatmentJohn H on 10/11/03 at 10:37 (133608)
Good point Pauline. We can start with booze, smoking, various food addictions, sex, and on and on. Some of these are every bit as dangerous as some of the narcotics. My wife is addicted to shoes and that is dangerous to our bank account. People can get addicted to running (i was), climbing mountains. Some guys run 100 miles in the Sahara desert in 100 degree plus heat. they have to be addicted.
Re: Limbaugh admitted drug abuse.....seeks treatmentEd Davis, DPM on 10/11/03 at 11:50 (133622)
That clinic is run by an anesthesiologist so I have used them primarily for treatment of RSDS or CRPS. They lean heavily on non-narcotic solutions but they are far from a comprehensive rehab facility.
Ultimately, those who are in pain will need to stay on or go back to narcotic pain meds if their pain is not sufficiently mitigated by other means and that can oftern be the hard part.
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/11/03 at 11:56 (133623)
RSD (CRPS) is certainly an example of the kind of chronic pain I was talking about.
Re: "Addiction" or "tolerance"Sharon W on 10/11/03 at 13:39 (133632)
'Addiction' or 'tolerance'
This link to an article on the 'Painlaw' website helps to explain what I mean:
And these JHACO 'pain management monographs,' while they are long and EXTREMELY tedious to try to read, are the REAL McCOY, the actual guidelines that doctors and other health care professionals are supposed to be following (in case anybody is interested).
Re: OopsSharon W on 10/11/03 at 13:49 (133633)
That was the 'parent' Painlaw website.
The first URL should have been:
Re: Limbaugh admitted drug abuse.....seeks treatmentmarie on 10/11/03 at 18:26 (133652)
I heard the same report. That a side affect of Oxycontin is hearing loss.
Please don't make Limbaugh seem like a victim. He himself said he did not want that. He also said not to make him a role model for kicking his oxicontin addiction. There are pharmicists and patients who have been robbed and murdered for this drug. People who purchase it illegally support the crime associated with oxicontin. Instead Limbaugh would like to see orinary people who have been on oxicontin but chose not to become addicted to it as the real role models. There are many many people out there who live day to day in a great deal more pain then he that do not purchase drugs illegally.
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/11/03 at 20:29 (133670)
You are right about that, Marie. Giving money to the illegal drug trade is never the answer, and Limgaugh is not a very sympathetic character (in my opinion) to begin with.
I don't really care about Limbaugh either . I hope he gets over his addiction and I also hope he gets relief from his pain. Beyond that -- bah. Limbaugh doesn't matter.
But this issue is important to me.
I do think there is a difference between RECREATIONAL drug abuse and drug abuse to try to control pain, but any time you are buying prescription drugs ILLEGALLY then you are indeed abusing those drugs.
As far as Oxycontin is concerned: it actually IS a good/appropriate drug for long-term pain control in some cases, although the hearing loss side effect is certainly a concern, and hearing should obviously be monitored if you're taking it.
The reason oxycontin is so desirable to the scum-of-the-earth drug dealers and to thrill-seeking drug users is that one popular form of this drug has a controlled-release feature which allows the drug, when swallowed whole, to very gradually enter the bloodstream of the patient -- therefore the patient recieves a very constant dose of the drug, not a large amount when it first enters the bloodstream and then less and less as the time approaches for the next dose. This is very good for avoiding addiction, as long as the pill is swallowed whole as it is supposed to be, because the patient never has more pain medication in his body than is needed to control pain. But thrill-seekers BITE INTO these pills, releasing the time-release capusles all at once for what they say is a really big 'rush' (but unfortunately sometimes it is also a life-threatening high).
Re: "silver lining" to the Limbaugh situationEd Davis, DPM on 10/11/03 at 23:06 (133681)
I wish Rush the best. His predicament did do something very important -- it got us talking about treatment of chronic pain. So many issues are involved here: use vs. abuse of narcotic pain meds, overutilization and underutilization of such meds by physicians - and the reasons why, availability of treatments for chronic pain....
If we are talking, then so are others. It is a set of issues that needs more attention and this incident may have been a catalyst for bringing these issues to the attention of the public and goverment.
Re: "silver lining" to the Limbaugh situationSharon W on 10/12/03 at 08:03 (133698)
AMEN to that, Dr. Ed! It is something that needed to be talked about, not just perpetually swept under the rug.
Re: Limbaugh admitted drug abuse.....seeks treatmentSharon W on 10/12/03 at 08:44 (133705)
We have pretty well exhausted this topic, yet I see you never really got answers to your original questions! I know I'm not the expert, but I'll take a stab at it:
1) If a doctor is Rxing it doesn't he keep track of the amount the patient is taking and then try to wean them off the drugs as they get better?
They are supposed to, and most of them do. But of course, it depends on the circumstances, what the pain medication is FOR, what kind of medication it is, and how well the patient heals and/or responds to treatment. Sometimes the pain doesn't go away like it was supposed to, and the patient NEVER gets better. If painkillers were being given after surgery, someimes the surgery was botched and the patient ends up in chronic pain... Or sometimes complications happen that WEREN'T the surgeon's 'fault' but the patient still ends up with chronic pain -- we have certainly seen enough examples of both of these on Heelspurs!
2) Why would a doctor keep Rxing it if he knows the patient is hooked? Isn't it the doctors responsibility to remove the patient from the drugs?
Dr. Ed gave you a partial answer to that one. The doctor is not supposed to keep prescribing a 'controlled substance' if he knows the patient is addicted, but sometimes there are few alternatives that the doctor knows about or is willing to consider prescribing. Yes, of course it is the doctor's responsibility to remove the patient from the drugs. He/she is also supposed to notify the patient's other doctors about the addiction so that they don't ever (unknowingly) prescribe the same drug.
3) How does one abuse something that the doctor won't RX anymore after weaning the patient off the drug? If you can't get it, how can you abuse it?
There are 3 ways that I know of to continue getting a drug that your doctor will no longer prescribe. One (probably the most difficult, but maybe not for someone recognizable like Limbaugh) is to go to another doctor without bringing them your records (the records would be 'red-flagged' for addiction). The second way is risky but it may be the most common these days, and it's already been discussed here: buy them from the internet. The third way is to go to a country like Mexico, where the restrictions are generally somewhat more relaxed, and get a doctor there to prescribe them for you. (That third alternative is actually quite legal, although your US doctors would probably be very angry about it and refuse to treat you anymore!)
Hopefully, if I got any of this wrong, Dr. Ed or somebody will correct me...
Re: Why people need and become addicted to pain medication.The postive sideDr. Z on 10/12/03 at 09:39 (133713)
Finally pain relief!
Posted by kay on 10/12/03 at 08:19 View Thread
EPF surgery 7 years ago, Open release and TT release nearly a year and a half ago and my feet were worse than ever, scar tissue, nerve pain etc.
For years I have resisted narcotic pain relievers because of the side effects. When my new pain doctor suggested Vicodin two months ago I accepted the offer. I didn't like them because I was so dizzy and the pain relief was not that great and at best only lasted 3 hours.
I went back last week and the pain doc suggested Kadian. He said it was time released and I take it twice a day, one in the morning and one at night. I went home to look it up and found it was MS Contin(morphine) At this point I just didn't care I was going to try anything. I found that I cannot drive after dark taking it, but do ok during the day.....not sure why, but the big thing is it works! Thank the lord there is finally something that is helping me. Yes I would rather it be a cure but I have accepted that no cure is coming my way. With Kadian I can go to the grocery store and not come out 20 minutes later crying in pain. I feel like I have a little of my life back. Yesterday was the third day of using this drug. Around 3pm my husband and I were going out to the car to leave and I just felt like crying I was so happy with the lack of pain in my life.
For once I am posting here without whining. lol
I talked to my family doctor and we decided in January that I am going to get off the antidepressants. Right now I am cutting back on the neurontin a little to see how that goes.
Oh yeah more good news. My company I worked for didn't want to pay me my early disability pension, yet they refuse to give me a sit down job, so they sent me for a second opinion and the doc they sent me too agreed fully with my doctor! wooo hooo I will start getting my pension with in a month or two. It isn't much for only 15 years of service but it will be something.
I came here many times in the last couple years near tears and with thoughts of not wanting to live. I have always got really supportive post and I want to thank everyone for that. Life is not what it used to be but it is better. I know that I am a survivor and will go on fighting the fight of life.
hugs to you all, keep your chin up and LIVE!
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Re: Why people need and become addicted to pain medication.The postive sideSharon W on 10/12/03 at 10:30 (133720)
Thanks for pointing that one out to us, Dr. Z!
Kay is just one of MANY people who, because of intense chronic pain, really NEED 'controlled substances' to have any kind of quality of life.
I remember Kay fondly and I'm very glad she has finally found some relief.
Re: "silver lining" to the Limbaugh situationjohn h on 10/12/03 at 12:45 (133738)
Limbaugh and drugs should be more about drugs than Limbaugh. People who like Limbaugh will continue to like him and those that do not will continue to dislike him. The use of drugs in pain control is a very different subject. As I have posted JFK was known to use narcotics on a regular basis for control of back pain. I just do not know how you wihold pain meds from someone in terrible pain when they understand the risk. It is there life that is in ruin and their pain. Sort of like the debate of abortion rights in some sense when the abortion rights people say it is the womans body and her right. Not a complete parallel but similar. It is your body and your pain.
Re: "silver lining" to the Limbaugh situationEd Davis, DPM on 10/12/03 at 14:04 (133745)
Only the person feeling the pain and Bill Clinton can 'feel your pain.' ;)
Yes, I think the discussion will be about chronic pain, and we need to keep the discussion front and center until the issue is dealt with more effectively by the medical profession and government.