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    Chronic pain treatment team
    An_251959 posted:
    I am looking for recommendations for a multidisciplinary pain management team to help wean a family member off high doses of opiates and transition to a multimodal approach to manage chronic pain following multiple surgical issues. Thanks
    ctbeth responded:
    Hello An_251959,

    Is the family member experiencing pain?
    Does he/ she want to "wean... off high doses"?

    Is it the family member who wants to discontinue high doses, or are others concerned?

    There is a vast difference between addiction and physical dependence.

    The person who can provide your family member with referrals to a "multimodal approach" would be the MD who is treating your family member for his/ her pain syndrome.

    Your family member would be welcome to discuss his/ her concerns on this pain management support community.

    Best wishes.
    An_251959 replied to ctbeth's response:
    My wife DOES WANT to be off of opiates and is aware that there are many other options to manage chronic pain. We are working together to try to find a team which will be a good fit for her. We are aware patient outcome studies show multidisciplinary teams have the best results.The physician who has been managing her has lost his lisence to prescribe controled substances. He is bitter and has little to offer,other than a weaning schedule.
    77grace replied to An_251959's response:
    Hi,It's good to know that your wife wants to get off these meds!I'm not saying that because I think they are bad Just that in answer to your post you mentioned that the treating Dr. dannot write for Opiates anymore !If he can and is willing to help wean f=her off ,that should be o.k.,Right??If not ask for a referal !
    By the way if she wants to share with otheers like herself this is a great site to do that!!
    ctbeth replied to An_251959's response:
    Hi again,

    The MD who can no longer prescribed opiate meds- is he/ she a pain management MD?

    If not, please try to find a pain management MD, as pain treatment is a specialty. A good pain management practice will offer your wife more-than just opiate pain meds.

    For many of us, we do have other treatment modalities, but at least for me, pain med is part of an overall pain management plan.

    At the end of the day, if her pain is intolerable without opiate pain med, please assure her that she has not failed.

    The goal of pain management is to get our pain-related function to a tolerable level. It does us no good to be opiate free if the pain is too much to tolerate without meds.

    Best wishes, and do let us know,
    cweinbl responded:
    What's wrong with high dosages of opioids? Is it no longer needed? The family member is experiencing less pain now? The medication is no longer efficacious?

    I hope that you do not fear addiction, because the rate of addiction among chronic pain patients without a history of addiction disorder is under 2% ( ) and ).
    Feardorcha68 replied to cweinbl's response:
    Hi cweinbl,
    I can't thank you enough for sharing that article.
    My friends and family are okay with my having to take Exalgo but, I know, that my mother has unfounded concerns about my becoming addicted to them.

    I've privately had some concerns, but not enough to want to stop because the pain is disabling without the med.

    With all of the fear hype in the media, why aren't studies and articles like this more widely distributed?


    sunsetdove32 replied to Feardorcha68's response:
    I am new to these kind of sites so please for give any mistakes...

    I too used to be concerned about becoming addicted to my pain meds at the time I was just on vicidian. I used to go off all my pain meds every other week for three days. Stupidly thinking that would stop that from happening.

    Of course I never told the dr because I didn't want him to think it was even something I worried about. I didn't want him to think I couldn't manage myself. Well it slipped during an appointment and the dr told me not to do that anymore, he said there was a difference between addiction and dependence. I mean absolutely no disrespect to anyone with what I am about to say...

    I let my guard down a bought into that theory yes I needed the medication to function. I wasn't getting high or creating a euphoria. I was just getting thru the day especially with all my medical problems.

    Well needless to say my meds have gone up I am now on Fentanyal and Fentora. Something about the new rules saying it can only be prescribed end of life cancer. End stage renal disease doesn't count. 2 months ago my dr didn't just tell me he was reducing my medication as I heard so many other people say, he told me he was dropping me as a patient.

    I have tried to find another pain dr about 1 1/2 yr ago and there weren't any in our area accepting patients. I have medicare and private insurance so that wasn't the reason. There are just fewer and fewer and when you add these kinds of meds with what is going on now days... well doc don't want to touch it. I have checked with other docs in the last 2 months and no one will take me.

    I have never had a complaint from a doc, never had a bad test just good bye!

    My point with this post is docs aren't prescribing the opioids anymore at least none that I know of and in two weeks when I am out of meds it isn't going to matter whether it was addiction or dependence the end result is still going to be the same.

    I wish now I had never listened to that doc all those years ago. Great job to your wife for looking for a better option! And best of luck to you.
    ctbeth replied to sunsetdove32's response:
    Hi sunsetdove~

    Pretty name.
    Since you have the diagnosis of ESRD, can your nephrologist not prescribe your fentanyl?

    I would imagine that you're monitored pretty closely and that you have extensive medical records and labs.

    I think you are spot on regarding opiates for function.
    Physical dependence is a bio-chemical phenomenon; addiction is an emotional disorder.

    I agree that it is important that we who require opiate pain management are quite aware of the difference.

    Thanks <3 and best wishes finding a new MD.
    If your nephrologist will not manage your pain meds, he/ she should be willing to refer you to someone who can do so.

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