I'm nearly 27 years old. I've played sports my whole life. I've broken my nose and had surgery on it twice. I've had several other surgeries when I was little regarding an issue with my tear duct. I had my wisdom teeth removed. I had osgood schlatter's disease and patella tendinitis. I've severely sprained each ankle at least 3 times. I've had countless other minor to moderate ankle sprains. I've had thigh contusions that have caused my entire thigh to swell up. I've been hit in the jaw so hard that I couldn't chew food for 3 days. I sprained my left foot so badly that it took me over a month before I could walk on it without limping and over 2 months before I could jog normally on it. To this day, when I run my finger over the top of that foot, it sends a tingling sensation shooting down to my toes.
Despite all these surgeries and injuries, I've never taken a Vicodin. I've never taken Perococet. Nor Norco. Nor Lortab. Nor ANY hydrocodone or oxycodone product. The strongest pain medication I've ever felt the need to take is 800mg of ibuprofen.
Now, I don't think I have some great level of pain tolerance. Far from it. I'm just not a baby about pain. When you get injured, I realize that you're going to have a bit of discomfort, so I deal with it. I feel like a lot of people don't understand that concept. Moreover, I feel that a lot of prescribers jump to the controlled pain medications (mainly Vicodin and Percocet) far too quickly.
I realize that many people do need these medications. A ruptured disc can be excruciatingly painful and debilitating without pain meds. Knee and hip replacements, I can understand. You break your leg in 5 places, yes, you probably need some strong pain medication. And obviously, cancer patients need their pain meds.
However, most other instances shouldn't require anything stronger than ibuprofen, at least to start out. I'll give you an example... A friend of mine recently got into a car accident. The accident wasn't too major. A lot of damage was done to his vehicle, but he walked away from the accident just fine with only a couple minor bruises. Regardless, the police urged him to go to the hospital to get himself checked out just to make sure. He went to the hospital, told them he had a couple bruises but felt mostly fine. Know what they gave him? DILAUDID! For a couple minor bruises, he walked out of the emergency room with a prescription for Dilaudid!
It's those kind of prescribing habits that make pharmacists pause for a couple of extra seconds every time we come across a Percocet prescription. Those prescribing habits are what make it so easy for drug seekers to have access to prescriptions for their CII's of choice. Those kind of prescribing habits make us question even people who get pain meds regularly for legitimate reasons.
We all have those patients who have been getting a month's supply of Perocet (or similar narcotic) every month on the dot for years. You see them come into the pharmacy, and they walk just fine. They talk to you just fine. You try to find any sign of pain or discomfort, and you just can't do it. You're left wondering just what the hell they're getting all this Percocet for, but you can't even begin to guess. These are the patients that make us suspicious of everyone.
I guess my point in all this is that there should be no reason that we dispense as much Vicodin and Percocet as we do Lipitor and hydrochlorothiazide. There simply cannot be that many people that have such severe pain that they can't be treated with ibuprofen, naproxen, or even just Tylenol.