Most of the doctors where i live dont want to give you narcotic pain meds , which is fine by me,but i am looking for a list of non narcotic medications,can anyone out there give me a link or a list please,i am trying to help my new doctor out ,cause they do not believe in giving narcotic pain medicines ,can someone help ???
What happens when pain reaches the unbearable stage and all non-opioid options (the term "narcotic" is not used much any more with medical and pharmaceutical professionals)?
Many of us have been through pain clinics and pain management programs, have tried virtually everything and still have moderate to severe chronic pain. In these cases, predominently, only opoids can help.
If your doctor doesn't believe in using opioids (or more likely fears the FDA more than fears the wrath of chronic pain patients' unresolved severe pain), what happens when everything else fails? Do these doctors just dump you? Do they make you eat Tylenol like candy because they don't touch the pain?
The very first thing taught in medical school is "The Hippocratic Oath" (above all, do no harm). This goes right out the window when a physician refuses to prescribe an opioid when it is clearly called for.
Since you said, "It's fine with me," I can only assume that your pain is mild to moderate - not severe. But there are millions of chronic severe pain patients around the world and treating the pain without opioids is obviously inappropriate. What happens to those poor people?
night_stalker_2011, it is your drs job to know what to prescribe patients, not yours. If they have patients that are truly in pain, then they know what they will prescribe and what they will not. It seems like your not in much pain.
cweinbl, well said ! The drs don't have to worry about being sued if you eat too many tylenol and die. Or if you end up in a nursing home decades before you should because you can't care for yourself.
And with the hydrocodone combination products being made a Schedule II in 2014, this will only get worse.
Good for you night_stalker 2011. MD's do have to take 'eating too many tylenol' into consideration. Its the argument many present to an MD as 'risk vs. benefit' as too many Tylenol can affect one's liver badly. A patient who presents with pain which can only be relieved with large amounts of Tylenol or what have you, puts the MD in an ethical bind. Its unsafe for a patient so the MD has 'no choice' but to prescribe something stronger. Taking the time to research other pain relief options which work for you may be time consuming but wise. Good luck to you.
Just because a patient tells their dr they are eating tylenol, doesn't mean the dr will rx anything that may manage the pain. The dr doesn't have to write down in the pts chart that they said they were taking that much tylenol. And if they don't write it down in the pts medical records there is no proof that the dr knew about it. Even if the dr writes it down, they will also write down that they warned the pt of the risks.
If a patient is taking excessive amounts of acetaminophen/ Tylenol, the MD or RN who is interviewing the patient would definitely document this in the patient's chart. Non-Rx medicines are among the items that should be discussed in any discussion of pain management with any medical professional
In addition to discussion, this fact would be documented, liver enzyme studies (blood work) would be ordered, and the patient would be advised about safe dosage of this potentially -toxic medicine
If the patient admits to taking any med, be it OTC or Rx, it must legally be documented.
Whether an MD then prescribed addition or alternate pain medicine is subject to discussion, evaluation of pain and patients response, and other factors not relative to this particular discussion.
However, do know that all medicines and nutritional supplements (vitamins, minerals, OTC meds) that a patients admits to taking are, indeed, included in the patient permanent record/chart
I don't see how hydrocodone being classified as Schedule II controlled substance will change anything for pain management purposes.
The purpose of this change is in hope of lessening diversion of controlled meds into the world of drug abuse.
It should not effect hydrocodone being prescribed for pain management purposes.
The main difference that we may note is that the Rx must be picked up in person rather than phoned or faxed to the pharmacy. Heretofore, six months (original Rx plus five months of refills) was available at one MD visit. This is how it operates with Sch III.
As a Sch II med, the patient must be physically seen by the MD's office at least once every three months.
Access to six months worth of opiate without re-assessing for need, or having to be seen by an MD does make for higher risk of diversion
CTBeth, not all drs are responsible and write what they should in a patient's medical records. And not all drs care enough about their patients that they order the necessary labs. And since most patients don't get copies of their medical records on a regular basis, they have no way of knowing if the dr writes it down or not. Also, most patients aren't aware of the labs that need to be done, so they have no way of knowing it is something that should be done at intervals.
Regarding the hydrocodone, many drs are not comfortable rxing Schedule II's. And many of the drs that do rx it want to see their patients every 30 days as opposed to every 90 days. In addition there is more paper work and regulatory oversight for Schedule II's. This will make it harder for the patients that take hydrocodone combination products. On the other hand those that want to abuse these meds will continue to do so.
Neither what is morally or legally right will supersede free will. It is a legal and moral obligation for MDs to document these matters.
It would, however, seem, that if MDs are so wary and concerned about the legalities of prescribing anything, that practicing illegally regarding Tylenol would be so, well, weird. And also illegal. An MD who ignores overdosing of Tylenol would be practicing illegally. All meds taken by the patient (assuming that the patient gives an accurate report) must be documented. This is also an RN responsibility.
With the concern about drugs and documentation, it would seem really, really odd and tragic for an MD to lose his/ her license and or face a malpractice defendant action based on Tylenol
Regarding Schedule II substances- the DEA mandates MD visits every ninety days. Other states and/ or private practices may have other regulations, but the federal mandate is every ninety days.
Yup, addicts will get drugs no matter what. To me, it would appear that Schedule II meds are less likely to be diverted than Sch III. I don't know if the statistics prove or disprove this.
As an RN, and former APRN, I do know that an MD/PA/APRN failing to document a patient's Tylenol intake could lead to legal trouble, and I cannot imagine failure to document patients meds as being something that is a common occurrence,
Perhaps you've encountered a different level or care than is the standard. I think that my region of the USA has a very high standard of medical care, for various reasons related to demography.
Still, am MD's failure to document a patients excessive OTC med ingestion, which can lead to toxicity and death, would be opening his/herself up to major legal trouble.
If you're being treated by such an MD, this person is a dangerous practitioner and you need to find a new MD and file an official report with the state in which this MD practices
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