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[culture] Again with the meds - Lakeshore
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Jay Lake
Date: 2012-09-15 04:26
Subject: [culture] Again with the meds
Security: Public
Tags:cancer, healtcare, health, weird
You know the old problem of why hot dogs are ten to a pack but buns are eight to a pack? One thing I've noticed in medicine is a tendency to do that sort of thing with prescription drugs.

I had port implant surgery yesterday. I was given two Vicodin in the hospital during recovery. I was also given a Vicodin prescription for pain management at home. Since returning to Nuevo Rancho Lake from the hospital, I have taken exactly two more Vicodin. I am highly unlikely to take any further pills, and if I do, it will be one or two at the most.

My prescription is for fifty pills.

What the hell do I need fifty Vicodin for? Even if I were dreadfully pain-sensitive and tanking up on the damned things at every conceivable opportunity, that's a significant oversupply. Given my pain tolerance and my aversion to opiates, this is a multi-year ration of pills.

I don't really care. I just find it weird. And this kind of oversupply must be a contributing factor to healthcare cost overruns, however small it might be. So what is up with giving me fifty of these things?

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Jim Hetley: Powers
User: jhetley
Date: 2012-09-15 12:10 (UTC)
Subject: (no subject)
Keyword:Powers
They give you the larger prescription so you can sell the excess on the street and afford your other medications . . .
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hani: Kushiel (protect & service)
User: hani
Date: 2012-09-15 13:25 (UTC)
Subject: (no subject)
Keyword:Kushiel (protect & service)
My thought exactly!
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Gary Emenitove
User: garyomaha
Date: 2012-09-15 13:28 (UTC)
Subject: (no subject)
That's just what came to mind for me.
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Emma Bull: Cat in Specs
User: coffeeem
Date: 2012-09-15 14:55 (UTC)
Subject: (no subject)
Keyword:Cat in Specs
All true. See, managed care really is managed!
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Cairsten
User: kuangning
Date: 2012-09-15 17:15 (UTC)
Subject: (no subject)
That was exactly what I was going to suggest as an explanation.
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cathshaffer
User: cathshaffer
Date: 2012-09-15 12:24 (UTC)
Subject: (no subject)
Vicodin is pretty cheap, and experiences of pain are extremely variable. Pricing of pharmaceuticals is rarely tied to the physical amount of material you receive with your prescription, so, no, I wouldn't say the extra Vics are a waste of money. You can keep them on hand for your next surgery or next need, so it's all good.
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melissajm
User: melissajm
Date: 2012-09-15 13:19 (UTC)
Subject: (no subject)
Same thing happened to me. I got a whole bottle of Ultram, with a refill, and only used 1 pill. Since I've had suicidal thoughts in the past, it's kind of scary that it's so easy to have a surplus of heavy-duty drugs on hand.
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User: stfg
Date: 2012-09-15 15:50 (UTC)
Subject: (no subject)
Well, the physician who wrote the script decides how many you get. I'm guessing they wanted to give you enough that you would not have to call them back for more. If you DID call for more after using 50 pills, it would be a sign that your pain is not behaving as it should and you should be seen, or else that you are abusing narcotics.

In your particular case, you could ask your physician to give you 10 pills with 4 refills instead of 50 pills, but most patients don't like that because if they need the refills they have to pay a co-pay with each script of 10 pills. You could also tell the pharmacist to just give you 10 of the pills, but you might lose your ability to get the remaining 40 later if you needed them.
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Keikaimalu
User: keikaimalu
Date: 2012-09-15 16:24 (UTC)
Subject: (no subject)
We pretty much just bank extra pain pills against future occasions when we need them for something else. Maybe your doc wanted you to have some extras on hand if you needed them later on.

Or could it be a cancer-patient thing? Like, let's be nice to the poor guy because he has metastatic cancer?
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Dan/Дмитрий: The Sign at the End of the Universe
User: icedrake
Date: 2012-09-16 03:23 (UTC)
Subject: (no subject)
Keyword:The Sign at the End of the Universe
Do keep an eye on the expiry dates on your medication when you do that. The active ingredients tend to break down over time, and the least unpleasant scenario is that the breakdown products are ineffective in treating whatever you're hoping they will treat.
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Bob
User: yourbob
Date: 2012-09-15 16:35 (UTC)
Subject: (no subject)
When I had my wisdom removed I was given an Rx and used exactly one of the pain pills. A friend at that time had to beg her dentist for more.

Besides my weighing 150 lbs more, the difference? She lied to him about all the pot she smoked, which apparently reduced the effectiveness of her particular Rx pain reliever. </p>

But yes. I had about 29 pills to dispose of.

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martianmooncrab
User: martianmooncrab
Date: 2012-09-15 17:19 (UTC)
Subject: (no subject)
Bank the pills. Most of the docs in Oregon are now cutting folks off on their pain management drugs, so those who get their pills on a regular basis got no refills. Just a polite letter letting them know that their doctor will no longer be writing them script for pain meds.

The uptick in OD's has been in the pain management sector in the state.
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Kari Sperring
User: la_marquise_de_
Date: 2012-09-15 17:51 (UTC)
Subject: (no subject)
My antidepressants come in packs of 28. Less than a month (apart from February). Now, if they were tricyclics, I might understand this -- you can OD on tricyclics. But they're SSRIs, on which you can OD and it makes you feel awful, but is unlikely to kill you. Tricyclics used to come in 50s.
I do not get the logic, not at all.
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llcoolvad: new
User: llcoolvad
Date: 2012-09-15 18:05 (UTC)
Subject: (no subject)
Keyword:new
My experience has been that the most they prescribe is 20, no refills. Maybe that's an east coast thing? They tend to be very stingy with pain meds after surgery.

I don't even tend to need them (ibuprofen is my drug of choice); I think I used one when I had my thyroid lobectomy, but that was because they drilled it into me that I needed to stay ahead of the pain. I never had much, so I didn't take more. Wisdom teeth? Ibuprofen. Knee surgery? Ibuprofen. I did use my percocet prescription when I had sciatica. Because MAN, that shit hurts. I think they gave me 10.

I've managed to use up some of them over the years since I have occasionally painful arthritis and like to get some sleep, but it does seem like a bad system. We're so puritanical about pain management. Be better if you could just get them when you need them.
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angiereedgarner
User: angiereedgarner
Date: 2012-09-15 21:03 (UTC)
Subject: (no subject)
It's getting hard to get pain meds here as well, the hospitals all have signs in the waiting rooms that you can't get opiates blah blah. I am so glad honestly that you are having this sort of problem. It's one of my nightmares, not being able to manage my own pain or a loved one's in extremis.
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angiereedgarner
User: angiereedgarner
Date: 2012-09-15 21:04 (UTC)
Subject: (no subject)
Sorry to append my blurt to your comment, llcoolvad, but I cosign what you said too.
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Ruth
User: roooof
Date: 2012-09-15 21:38 (UTC)
Subject: (no subject)
Working in the pharmacy I see this a lot - but I always tell patients who don't want the full amount to remember that you don't have to fill them all at once if you don't want to/don't have the cash. You can fill a lesser amount and then fill the remainder later as a "refill".

The number of fills per script & timeframe to do so can differ for a control by state but here we can fill up to 5 separate fills (not including the original fill) until 6 months from the written date provided that there are still pills left to be filled.

Edited at 2012-09-15 09:38 pm (UTC)
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matt_doyle
User: matt_doyle
Date: 2012-09-15 22:26 (UTC)
Subject: (no subject)
And here I was hearing the other day from a friend with chronic pain that she's been denied prescriptions because she didn't use up all of her pills from the previous round.
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Dave O'Neill
User: daveon
Date: 2012-09-15 23:17 (UTC)
Subject: (no subject)
Actualy I know the answerto this one.

It's to do with problems with renewing pain control scripts in WA and OR... I have a doctor friend who does heart surgery and he says this is routine for surgical teams now.

So you don't run the risk if running out and notbeing able to get more, they over prescribe when you have a valid need.

Yes, they think its stupid too.
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Keikaimalu
User: keikaimalu
Date: 2012-09-16 15:33 (UTC)
Subject: (no subject)
So it's harder to refill a pain-control script for 10 than to get a single script for 20? In what way -- will the doc not prescribe it, or will the pharmacy not fill it? Or is it just not legal to put refills on narcotic scripts?
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User: (Anonymous)
Date: 2012-09-16 16:52 (UTC)
Subject: (no subject)
As I understand it the pharmacy has to flag the refill and the doctor gets contacted and questioned. It's an attempt to clamp down on drug dealing but its having 'odd' effects.
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Passionately decaying organic matter
User: miintikwa
Date: 2012-09-16 01:12 (UTC)
Subject: (no subject)
I have the exact opposite problem. I have chronic pain due to arthritis and fibro, and can't get pain medication to save my life. Celebrex doesn't help enough to overcome the side effects, and the other medications that I've tried haven't helped either.

At some point, the pain will make the life not worth living. I am not looking forward to getting there and being unable to improve it because the doctors are afraid to prescribe pain medications.
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Swan Tower
User: swan_tower
Date: 2012-09-16 02:18 (UTC)
Subject: (no subject)
Same thing happened to me when I had ankle surgery. I don't remember how many pills they gave me, but it was WAY more Vicodin than I needed; it was more than I would have needed even if I had taken it regularly during my entire recovery, rather than weaning myself onto Advil the second day and only using it at night for maybe the next week. And I had a REFILL. What in god's name did they expect me to do with it all -- sell it on the Internet?
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