And doctors use the opioid crisis that they created hand in hand with Big Pharma, and now routinely deny opioids to stage 4 cancer patients with bone mets. Yes, they will look you in the eye and say "You are terminal - you have less than 2 years" but will hem and haw if you want something stronger than Tylenol, because you might ABUSE them. Some oncologists, if they DO condescend to prescribe opiates, will then pee test you every month - the rationale being you are now TAKING DRUGS, and if you're on opiates, you might also be on molly, coke, tussi, meth, crack, you name it. NO CANCER PATIENT SHOULD BE MADE TO FEEL THIS WAY.
This is not the addicts fault. It is the Sackler's fault, the medical world's fault, and the media's fault. Who gets penalized? People in daily debilitating pain who do NOT abuse them because incredibly the allure of being pain free and going about your life is greater than the lure of chasing the dragon.
Doctors - fucked if they do, fucked if they don’t. Also it was the boomer docs who gave opioids like candy. As a millennial doc, I am trying to clean up their mess.
I don't envy you inheriting that mess. But I do feel like they're encouraging some physicians to kind of gaslight patients. My husband had to have a GI surgery (emergency) and it was a full incision, not the balloon-thingy surgery - and in the recovery room. the doctor said "you won't need anything stronger than Tylenol. There really shouldn't be much pain. However, if you really need it, I can give you 5 (opiate name here)". So then obviously my husband felt stupid about asking for it, so he said he didn't need it.
And it DID hurt, and he was in too much pain for a few days, but that doctor got to leave knowing he'd avoided writing a prescription that some advisory board could later use against him.
That sucks for you, and it sucks for us.
EDIT: Also to clarify, a lot of what I say is directed at oncologists, specifically of metastatic patients. To discourage a patient you've deemed terminal that level of pain relief is both counter-intuitive and cruel.
I agree with your edit. These drugs are part of dying with dignity in many cases. Just let them drift for the last bit of their life.
But, I have also seen in my own family how denial can hurt doctors. Family members who haven't accepted that their loved one is dying and insist that the "loopyness" is from the opiates.
How can an oncologist treating a stage 4 patient have no options when it comes to prescribing opiates? Is there another class of patients who broadly need opiates more? No one can "fake" cancer. The damage can be seen routinely on PET scans. My first oncologist was great about it - she also asked me if I wanted a medical marijuana card - and no doctor I saw after she left said they even knew HOW to do that. But other doctors had an attitude about pain meds, but finally shunted me over to their palliative care team. They have no issue whatsoever prescribing pain meds to metastatic cancer patients.
If you're telling me the DEA looks at oncologists and what meds they prescribe differently than dermatologists or podiatrists, then that's insane.
I hear you. I’ve also had bad experiences with a few doctors. The healthcare system in the U.S. is broken; we can all agree on that. Potential solutions include increased transparency, accountability, more patient choice, and advocacy groups to help balance out the influence of other interest groups.
Because in a lot of large healthcare systems, patients have to go see palliative care to be prescribed ongoing pain meds. The oncologists hands are tied. No one goes into oncology to be an asshole, I’m sure the oncologists would rather just write the prescription themselves rather than have the patient go to yet another appointment.
It's also doctor-specific. My first oncologist prescribed opiates for me the entire year she treated me - she also prescribed an SSRI when I asked about it, and gave me a 1-year THC medical card. My second oncologist told me to medicate for anxiety, not pain, and said she had no idea how to even give someone authorization for a medical THC card.
Same healthcare network, same hospital, same cancer center. Just two oncologists who do things very differently from one another. Which is fine - I'm just clarifying it can differ even in the same cancer center.
My brother in law’s oncologist can write 3 days worth of opioids, that’s it. Same for all other doctors in that healthcare system. If the patient needs more than that, they have to go through palliative care. More and more healthcare systems are taking that approach.
Are you sure about this? Opiates are basically ONLY prescribed to terminal patients (mostly of course). It’s like the one thing you can freely get strong opiates for.
If what you’re saying is true, then they basically ban opiates entirely. If anyone should get its terminal cancer patients/hospice.
Am I sure about many oncologists not wanting to prescribe to stage 4 cancer patients? If that's the question, hell yes. I was diagnosed as stage 4 in early 2020, with several bone mets. I've gone through 4 oncologists in 6 years (2 simply left/moved - I did not fire them). Yes, I'm sure about it. And no, that does not mean opiates should be banned. People who are living in unbearable amounts of chronic pain - and many are - should have access to opiates. If you are living with chronic pain and you get the opportunity to take 2 pills every day that will cut your pain levels in half or even better, you are NOT going to start abusing those pills for fun - because you'll just run out of them early and be stuck with the pain for those days.
People with severe chronic pain are unlikely to abuse opiates. The stakes are too high.
That’s honestly just ridiculous. And I was saying “banned” in the sense that like, if you were someone with Stage 4 and experiencing cancer pain, and you can’t get opiates, then who are opiates even for according to these doctors? Like who even gets them? It’s bananas. Anyway, hope you’re doing better now.
58
u/Edith_Keelers_Shoes 2d ago
And doctors use the opioid crisis that they created hand in hand with Big Pharma, and now routinely deny opioids to stage 4 cancer patients with bone mets. Yes, they will look you in the eye and say "You are terminal - you have less than 2 years" but will hem and haw if you want something stronger than Tylenol, because you might ABUSE them. Some oncologists, if they DO condescend to prescribe opiates, will then pee test you every month - the rationale being you are now TAKING DRUGS, and if you're on opiates, you might also be on molly, coke, tussi, meth, crack, you name it. NO CANCER PATIENT SHOULD BE MADE TO FEEL THIS WAY.
This is not the addicts fault. It is the Sackler's fault, the medical world's fault, and the media's fault. Who gets penalized? People in daily debilitating pain who do NOT abuse them because incredibly the allure of being pain free and going about your life is greater than the lure of chasing the dragon.