This is a rant. It's not politically correct. It's just a rant. I want my percocet! I'd certainly settle for vicodin, which doesn't even require a written prescription, it can be called into the pharmacy. I moved to Seattle two years ago with about 30 percocet left from a prescription that my doctor in Pennsylvania wrote about 3 years ago. I use them sparingly, responsibly, to get by, to get to work, to manage the chronic back pain that occasionally flares into immobility. I used my last one a few weeks ago. 

So I sent an email to my primary care doc asking for vicodin, a somewhat less potent opioid, assuming she would find this a more acceptable request than asking for percocet. She was aware of the chronic pain issue and knew how I had been managing it for many years, but her reply was this:

We discussed this when I first met you a year and a half ago and it doesn't look as if we've ever done any evaluation for it. Would you please make an appointment for review of the back/hip problem? I want to be sure we are not missing anything. 

I suppose I could go into the office and she might then give me some vicodin. But the response really rankled me.  I have no need to see the doctor. In this health care environment, does it really make sense to re-work up every pain issue every time a person changes doctors? 

Keep in mind that I know this is a rant. It's just a rant. 

                     ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

As a nurse practitioner, living in a state where I have full prescriptive privileges, I prescribe these drugs appropriately whenever a patient needs me to. I don't think about my license or drug abuse or local or national politics. I think about the patient, the situation, the best plan. I do not prescribe opioids without using good judgment. I don't prescribe opioids in a manner that would lead to misuse. But I am not afraid to treat pain. 

My attitude, I suspect, comes from working in palliative care, among colleagues who take pain seriously, and believe it is our mission to relieve suffering. At the end of life, most people think this is a noble mission. But what about on a Monday morning for a middle aged woman who can't get even crawl to work because of chronic back pain?  Or when I get to work, in my current job in woman's health, shouldn't I treat the cramps that come after an abortion or an IUD insertion? 

The attitude of my current doctor, comes, I suspect, from working in an environment that is more and more anti-opioid. A concern about deaths from prescription medications that invariably occur when these drugs are not used appropriately or mixed with alcohol or street drugs. Yes, they can be dangerous when misused. 

Let's be clear. I do my best to deal with pain.  I stretch and do yoga, I walk. I take non-narcotic pain medication every day that probably does me more harm than an opioid because it affects my blood pressure. Oh, I could stand to lose weight, sure that might help. But I know this problem is not ever going to go away. I have far fewer episodes of severe pain than I used to, but when I can't get out of bed without moaning, I want relief. I want to keep working and taking yoga classes, two of many things I cannot do when the pain is severe. 

But my doctor, that I've now known for almost two years, doesn't want to prescribe an opioid. She is protecting her own backside. I am hurting. And I'm pissed off. As a nurse, there is nothing I respond to as seriously as relieving other's pain. I feel abandoned by my provider in my own pain. 

We have now entered another era of drug suppression because it is currently fashionably to withhold opioids. 

So should I buy some on the street? 

This is a rant. This is just a rant.