Drug OD case: Airline pilot and wife

[Winemaker]

My leftover vicodin saved me last week from misery.

My back went out while we were in Arizona. We have no insurance there so had to drive home to Nevada to get to urgent care. That was the longest 3 hours ever!

Urgent care prescribed tramadol and prednisone. I took the tramadol when I got home and got zero pain relief. I had a full bottle of vicodin from surgery 2 years ago that I filled but never used so switched to them. I was worried about taking them but was in so much pain all it did was take the pain level down to a barely tolerable level.

Took them for 3 days then switched back to tramadol but stopped all pain meds on Friday. Seeing a back doctor tomorrow to find out why I have no feeling in my right foot. Afraid I did some nerve damage. Walking with a limp since I can't push off on that toe but at least I'm walking.

I can't imagine the 3 days without the vicodin but I'm afraid of them so stopped as soon as I could.

When I was given a script for tramadol by urgent care, the doc told me that it was one of the easiest to get addicted to, and not to use if not needed.

 

[HFWR]

I think part of the problem with opiods is that some doctors hand them out like candy...

https://www.cdc.gov/drugoverdose/data/prescribing.html

 

[Tadpole]

With all the discussion on opioid addiction what is someone to do if they have chronic pain? I have gone through 5 major surgeries in the last 5-6 years. Spinal nerve damage resulted in a lumbar fusion and right leg peripheral neuropathy with a limp. Rotator cuff surgery on both shoulders required drilling holes in bone to reattach muscle but couldn't help the progressive arthritis.
...
Discussing opioid addiction helps warn of a dangerous side effect and educate regarding a problem. However, I don't hear of anything being done to effectively address the problem of chronic pain management?

Cheers!

That's why I have been asking questions. My husband has numerous health issues including back, hip and foot pain (hammertoes). He has begun to make several trips back to the doctor for a new prescription for opioids. I don't think the doctor will renew the next time and I can't get him to react to feeling better by using other drugs, when needed, like Tylenol.

On the other hand I don't really see why, if the dose is controlled, people with chronic pain, especially those older than 70 can't be given whatever relieves them. I control his access to the pills, so, unless he only pretends to take those I give him he can't overdose.

I can't afford for him to become addicted since I can't write prescriptions so I have told him I will start reducing the number and I want him to switch to the Tylenol if he needs something. I can't give him NSAIDS since non-aspirin forms interfere with his baby aspirin for transient stroke.

On the other hand, I don't know how to get him to take pain medications when he needs them instead of trying to ward off the pain by taking them just in case he might need them.

We have seen pain experts and he is currently in therapy but, with Parkinson's, there is only so much strength or aerobic exercise can accomplish. He takes medicine for his Parkinson's that replaces dopamine lacking from receptors in his brain. What is the difference? Should we call this an addiction. He certainly needs that next dose and the dosage and frequency increases with progression of the disease.

How else can chronic pain be addressed when no good solutions can be found?

 

[Sojourner]

I don't think skydiving is as deadly as OD'ing on drugs, but still dangerous.

Of course sky-divers don't jump every day or two, if they did, I'll bet the death rates would go up as they became more casual and comfortable with jumping, due to less attention paid to checking stuff.

Sorry to stray OT here, but I think I disagree with this. As someone gets more and more into a dangerous sport, I would think they would develop an ever more professional attitude towards safety and protocol. If not, I think you'd see the skydiving death rate statistics go way up, since the vast majority of jumps are done by skydiving enthusiasts.

Personal experience about skydiving, I talked to a boss at work BBQ about the recent death from skydiving in the paper. Turns out about 5 years earlier, he and 4 others would go skydiving.
During the past 5 years:
# 1 went splat. (not his words).
# 2 went splat.
He quit skydiving as felt it was too dangerous.
# 3 went splat and was in the paper for me to mention to him as an interesting story

To me that is a 60% death rate, maybe most folks stop after a few jumps ?

One guy was still jumping, but it's lonely....

Obviously this falls under the category of anecdotal evidence. My anecdotal story involves two young relatives (cousins) who were killed in a terrible car crash years ago. And about 15 years prior, a great uncle of mine was also killed while driving due to DUI. Within our extended family, this gives a "lifetime chance of dying in a car accident" of about 1 in 12, whereas the actual number in the U.S. is 1 in 600. Also, I have to say I find it pretty hard to believe anyone knows of 2 or 3 separate incidents involving multiple people they know personally who have died skydiving, considering there are only about 20 skydiving deaths per year in the entire U.S. out of roughly 3 million individual jumps. This is about as likely as someone personally knowing 2 people who died in 2 separate commercial airliner crashes.

 

[Sunset]

That's why I have been asking questions. My husband has numerous health issues including back, hip and foot pain (hammertoes). He has begun to make several trips back to the doctor for a new prescription for opioids. I don't think the doctor will renew the next time and I can't get him to react to feeling better by using other drugs, when needed, like Tylenol.

On the other hand I don't really see why, if the dose is controlled, people with chronic pain, especially those older than 70 can't be given whatever relieves them. I control his access to the pills, so, unless he only pretends to take those I give him he can't overdose.

I can't afford for him to become addicted since I can't write prescriptions so I have told him I will start reducing the number and I want him to switch to the Tylenol if he needs something. I can't give him NSAIDS since non-aspirin forms interfere with his baby aspirin for transient stroke.

On the other hand, I don't know how to get him to take pain medications when he needs them instead of trying to ward off the pain by taking them just in case he might need them.

We have seen pain experts and he is currently in therapy but, with Parkinson's, there is only so much strength or aerobic exercise can accomplish. He takes medicine for his Parkinson's that replaces dopamine lacking from receptors in his brain. What is the difference? Should we call this an addiction. He certainly needs that next dose and the dosage and frequency increases with progression of the disease.

How else can chronic pain be addressed when no good solutions can be found?

Let's all not forget, that pain killers serve a very important function in modern medicine.

Some folks regardless of the known dangers decide to abuse the use of them, and later end up taking illegal drugs and they die.

Let's not use the deaths of drug users as an excuse to ban the use from everyone else of medically needed pain killers.

That is a poor reason, and about as stupid as banning auto's since they kill around 35,000 per year (USA) which is about 2->3 times higher than Opioid/heroin deaths (USA)

https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

 

[redduck]

<snip>
Obviously this falls under the category of anecdotal evidence. My anecdotal story involves two young relatives (cousins) who were killed in a terrible car crash years ago. And about 15 years prior, a great uncle of mine was also killed while driving due to DUI. Within our extended family, this gives a "lifetime chance of dying in a car accident" of about 1 in 12, whereas the actual number in the U.S. is 1 in 600. Also, I have to say I find it pretty hard to believe anyone knows of 2 or 3 separate incidents involving multiple people they know personally who have died skydiving, considering there are only about 20 skydiving deaths per year in the entire U.S. out of roughly 3 million individual jumps. This is about as likely as someone personally knowing 2 people who died in 2 separate commercial airliner crashes.

Not so obvious; certainly not evidence; perhaps anecdotal to something.

 

[Totoro]

Also, I have to say I find it pretty hard to believe anyone knows of 2 or 3 separate incidents involving multiple people they know personally who have died skydiving, considering there are only about 20 skydiving deaths per year in the entire U.S. out of roughly 3 million individual jumps. This is about as likely as someone personally knowing 2 people who died in 2 separate commercial airliner crashes.

Consider:

• Skydiving is concentrated, dozens of jumps a year, sometimes hundreds a year isn't that strange per person. The average is six, and that includes many one-timers.
• Skydiving clubs are pretty tightly knit. So the odds are more like two pilots from the same airline company knowing each other, and both crash (Malaysia airlines a recent example).
• This happened at the same facility, so there may be something wrong with the safety standards or culture there. There might even be a mass-murderer at work - we had a 'parachute-killer' here a while back.

And last yet not least: statistics don't preclude strange odds from happening. Winning the lottery is statistically highly improbable, but it does happen.

 

[Taxman59]

When I had my TKR in December, the Oxycodone did NOTHING for pain. There was no benefit to it at all. The dilaudid on the other hand, that was some good s***! Unfortunately, the prescription was for the oxy, and no more of the good stuff after I left the hospital.

 

[Totoro]

From a link:

There is nearly 37,000 members of the United States Parachute Association, though not all of them are active skydivers as sometime people take a year or two off or retire, but remain members.

If one assumes that safety standards at 'try-out' locations (one-time jumpers) are higher due to insurance and commercial implications, it becomes a bit more plausible. Not that I'm trying to torture the data until it confesses, but still.

 

[MRG]

How else can chronic pain be addressed when no good solutions can be found?

I know there's stigma and sometimes legal issues, but MMJ is effective for pain.

With the right strain you can be very clear headed. I used a high CBD strain after a bad fall on the ice, pain relief was as good as opiods and my head was clear.

I have read MMJ has been shown to improve the symptoms of some people who have Parkinson's disease as well.

Whatever you choose good luck to you both.

 

[Sunset]

.......
Obviously this falls under the category of anecdotal evidence. My anecdotal story involves two young relatives (cousins) who were killed in a terrible car crash years ago. And about 15 years prior, a great uncle of mine was also killed while driving due to DUI. Within our extended family, this gives a "lifetime chance of dying in a car accident" of about 1 in 12, whereas the actual number in the U.S. is 1 in 600. Also, I have to say I find it pretty hard to believe anyone knows of 2 or 3 separate incidents involving multiple people they know personally who have died skydiving, considering there are only about 20 skydiving deaths per year in the entire U.S. out of roughly 3 million individual jumps. This is about as likely as someone personally knowing 2 people who died in 2 separate commercial airliner crashes.

Just because I knew someone in a bad luck group, does not mean the statistics apply to everyone, however this person certainly had no reason to lie to me, and would have lost some professional credibility by lying, since we worked together in a small company. In fact his story basically was stating he was a bit of a chicken/wimp for giving up skydiving compared to his buddies. Not exactly a situation of bravado.

As for the likelyhood, rare things do happen:
"Malaysia Airlines crash: Family who lost two members on flight MH370 have lost two more on MH17"
Malaysia Airlines crash: Family who lost two members on flight MH370 have lost two more on MH17 | The Independent


I think the deaths are more common than you portray them:
"Despite the perception of danger, fatalities are rare. About 21 skydivers are confirmed killed each year in the US, roughly one death for every 150,000 jumps (about 0.0007%).[4][5] "

 

[Sojourner]

I think the deaths are more common than you portray them:
"Despite the perception of danger, fatalities are rare. About 21 skydivers are confirmed killed each year in the US, roughly one death for every 150,000 jumps (about 0.0007%).[4][5] "

This is exactly the figure I have been quoting. One in 150,000 is equivalent to 20 out of 3 million.

Anyway, my original point was simply that the risk of death due to routine fentanyl abuse is far, far greater than that of skydiving, even though both produce an intense rush of euphoria (or adrenaline, etc.). Yet fentanyl abusers continue their virtually suicidal behavior in spite of these risks, whereas you'd have to make skydiving fatalities 1000x more common to do a fair comparison.

 

[aja8888]

If anyone wants to have a good look into the world of drugs, legal and mostly illegal, watch several sessions of "Drugs, Inc." on the National Geographical channel. Frightening....

 

[Keim]

You might suggest to your daughter she check and see if her locality has a drug court program. It's an alternative to the traditional legal system for people dealing with addictions. Highly effective, but difficult.

My daughter had DHR come down on her last July for child neglect, and they popped a drug test on her--which she failed. She has been very slow to go to her parenting classes and missed a drug screen or two with excuses given.

Late yesterday, she appeared in Family Court trying to get her 5 year old daughter back. The judge read her the riot act and sent her downstairs for a second drug test of the week--which she tested positive for meth and amphetamines.

My wife and I are facing another 9 mos. to a year of taking care of an active 5 year old--or sending her to foster care. The judge ordered us to remove the daughter's car and have her cellphone disconnected. She's to have no contact with her 2 kids, and she's to enroll in institutional drug treatment.

Trouble is heavy drugs are illegal, very highly addictive and downright wrong. And those taking them are in complete denial--living a life that's a total lie. She appears to be trying to go underground to avoid going away for a month or so.

My wife's in hysterics--like it's something we did wrong. Our consciences are clear. It's our daughter's choice to do what's right, and it doesn't matter what we want for her in life. All we can do is take care of the child and take every day as it comes. If the daughter has to hit rock bottom, it's her choice. The judge will be issuing a bench warrant for her arrest for contempt we assume.

 

[Tadpole]

With the right strain you can be very clear headed. I used a high CBD strain after a bad fall on the ice, pain relief was as good as opiods and my head was clear.

I looked into this a couple of weeks ago and saw mixed reviews and also got confused when I ran into hemp vs MJ extracts. Do you remember what strain that was?

I have read MMJ has been shown to improve the symptoms of some people who have Parkinson's disease as well.

Yes, I've read that too. The people at Parkinson's forums don't seem as enthusiastic as I expected. It may be that not enough people have access to MJ to make a good sample.

Whatever you choose good luck to you both.

Thanks.

 

[Marita40]

I had surgery on my toe one year ago to remove a bone spur. After the block wore off I had about 6 hours of bad pain. I took two of the Percocet that evening, then no more. The next day regular Tylenol did the trick. Yet the prescription was for a full bottle of Percocet, enough it seemed for many days. I didn't count the pills because they were thrown out. Over prescription is rampant.
I also have a condition where I refuse antibiotics unless I'm literally dying. I've been through the toe surgery, dental surgery, a bad cat bite and several other things over the last years. Doctors look rather dire when I say no antibiotics but I've suffered no ill effects at all from refusing them. Given the increasing superbugs resistant to antibiotics it's another area where we need to rethink drugs.

 

[MRG]

I looked into this a couple of weeks ago and saw mixed reviews and also got confused when I ran into hemp vs MJ extracts. Do you remember what strain that was?



Yes, I've read that too. The people at Parkinson's forums don't seem as enthusiastic as I expected. It may be that not enough people have access to MJ to make a good sample.

Thanks.

You want MJ not hemp. I have only read MJ forums, obviously optimistic. I believe at this time we have to, sadly, rely on our own experience.

The strain I used was "Lucy", it's an Indica, CBD dominant strain. Leafly has a pretty accurate review. Probably any CBD dominant strain would be a good place to start. Obviously if you are in a legal state the dispensary is a great resource on the various strains.

You can use edibles or drinkables if inhaling is problematic. The drinkables hit you quickly. Start slowly and pay attention to the dosage. I hope there's a quality of life improvement.

Best wishes.


ETA: There's also companies selling tinctures, most CBD dominant for pain management. One I know of was turtle tinctures.

 

[Calico]

Substance abuse (primarily alcoholism) runs rampant in my family. My mother; my father; my older sister; maternal uncle; maternal aunt; two paternal great uncles; numerous cousins on both sides; and on and on and on.

I have never had a drop of alcohol in my life, or done any illegal drugs - I figure, why tempt fate?

Twelve years ago I had major surgery, followed by days of painful recovery, and weeks of severe discomfort. I told my PCP about the family history of addiction, and about my determination to avoid opioid pain meds at all cost. She said she understood my fear, and in her experience people like me who were/are terrified of addiction are at no risk of overusing the pain meds. She prescribed oxy or Tylenol with codeine (can't remember which). I took 1 or 2 per day for a couple of days, when the pain was severe, then destroyed the rest and made do with regular Tylenol.

Six years ago I fell down the stairs and severely fractured my distal radius, resulting in an "open reduction internal fixation" surgery. I'm not sure I would have made it through the first 72 hours of pain post-op without the oxy my surgeon prescribed, but after that I destroyed the rest of the prescription.

Two years ago I had a dental implant, and to my amazement and horror the dental surgeon (who barely knew me) casually handed me a prescription for oxycodone "just in case I felt like I needed it" - and I think it had a refill or two on it! That was ludicrous - and I can only imagine he hands out prescriptions to every person who crosses his path. The implant didn't hurt any more than a normal toothache would have hurt. I didn't take any that time, and recently destroyed those pills (I had forgotten I had them).

I avoid this stuff like the plague, whenever possible, given my family history.

My sympathies to all who suffer from chronic pain (or whose loved ones do). I hope that each of you finds the relief you need.

 

[growing_older]

I think part of the problem with opiods is that some doctors hand them out like candy...

Maybe this used to be true, but they are clamping down hard. A friend in his late 70's with chronic pain and more than 20 years of successful treatment with opioid dosage that hasn't been increases in all that time, is now finding it nearly impossible to get his doctor to continue that treatment. Years ago, he went through all the options they could think of before finding that the opioid worked when other treatments did not or had bad side effects. Now doctors are insisting that he "prove" the other treatments won't work (again) before they will consider letting him continue the treatment that has worked for him, and worked long term.

There's a huge problem with drug addiction and over prescribed opiods, but the solution shouldn't be that everyone, including patients who need them for chronic pain cannot have them anymore.

 

[samclem]

There's a huge problem with drug addiction and over prescribed opiods, but the solution shouldn't be that everyone, including patients who need them for chronic pain cannot have them anymore.

As the "pill mills" got shut down, the folks hooked on prescription meds turned to the illicit opiods (especially heroin). Which is now, more than it already was before, Russian roulette due to the introduction of unknown amounts of fentanyl (and other, even more powerful and cheap, synthetics).

One other thing that I believe is contributing to the current round of addiction/deaths is the internet. There's a tremendous amount of highly technical and detailed information posted (on Reddit and elsewhere) by opiate users. Go take a look. It doesn't read like the ramblings of strung out junkies, but instead it is dispassionate info about the relative quality of the highs available from various combinations, the "need to be careful," exactly how to dose yourself with this poison (for those with and without a tolerance, etc), some tricks to get the best high, etc. People reading these posts can easily come to believe there's a safe way to go about using heroin and fentanyl, and that if they are "careful" it will be fine. They can't see the wreck on the other side of the keyboard, what he/she is doing to his/her life, the hell they are putting their families through--none of it. In the "old days", at least people using this stuff got to/had to see other users in person to get knowledge, and there was at least some hope that they'd see firsthand all the other stuff that this addiction brings with it. I assume when the "knowledgeable" posters wind up dead with a needle still in their arm, nobody goes online to tell everyone the end of the story. There are 10 more "pros" already there to take their place and offer helpful advice.

 

[Amethyst]

When I went to the ER with excruciating back pain (could not even climb into a car) the EMT put an IV in my hand and offered morphine, and I said I was afraid of it. He seemed determined to talk me into taking it and said he would only give me half a dose. When that helped the pain and did not seem to affect my mental clarity, he talked me into taking the rest of it. I guess that is why I was able to endure 7 hours on a gurney in the ER hallway.

I didn't feel the least bit euphoric, but at least I didn't hurt (except when I moved, LOL) Later, a nurse informed me it had been a good-sized dose, and was depressing my respiration. I hope I never need it again.

 

[AnIntentionalRoad]

One word: oxycontin. Once you get hooked on that from a surgery, you will eventually be buying heroin on the street corner once you oxycontin source runs out.

Healthy, well-adjusted people don't just decide to stick a needle in their arm on day.

I fortunately don't have personal experience with this but have seen it take over the lives of a few acquaintances.

 

[nobodyspecial]

Reminds me of the "Crack" epidemic of the 80's and 90's in the large cities. I don't recall the level of compassion being this high back then.