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I’m Not a Junkie

I’m Not a Junkie

As a person who has never even experimented with hard drugs, it seems strange that I should find myself feeling defensive about my “drug habits,” yet recent interactions with my rheumatologist have left me feeling like I need to scream to him, his nurse, and to the world, “I am not a junkie!”

Diagnosed with rheumatoid arthritis 14 years ago, I’ve been prescribed somewhere between one and two dozen different medications to treat the disease and its symptoms. For ten of those years I was treated by a rheumatologist I loved. She couldn’t have been more compassionate, understanding, informative, and perceptive. Unfortunately, her office is 70 miles away and her office staff was so persistently disorganized that it was very difficult to get a human to answer the phone, let alone have the nurse return a call. Because I loved my doctor so much, for years I put up with having to repeatedly call the office for an hour straight before getting an answer, placing the same request 5-6 times before getting an adequate response, and waiting in the office for two-three hours before each exam. However, now that I have two small children who use up what little sick leave I’m ever able to accumulate with their tummy bugs and fevers, I just couldn’t make it work to stay with my beloved doctor, seeing as how every check up with her required six hours for the commute, wait time, and actual visit.

My former doctor never had any issues prescribing medications to increase my comfort. She suggested Lortab and Tramadol for pain, Flexeril for muscle spasms, and Trazadone for sleep. I have used these medications sparingly, and I frequently flush expired medications down the toilet and have refills available that go unfilled. If I can get by without them, I prefer not taking those medications. The side effects of painkillers and muscle relaxers reduce my productivity, leave me in a fog, and don’t allow me to be fully present while parenting. Therefore, I only take them if I’m in a lot of pain and my husband or a sitter is home to watch the kids (or at bedtime). All that being said, when I am in a flare, a painkiller or muscle relaxer can make the difference between agony and a bearable level of pain. Even if I’m not in a flare, RA aches often make it difficult to get comfortable enough to sleep, so about three times a week I take Trazadone to help ease me into slumber. These drugs are not an everyday regimen, but they can be very important during the times when I need them.

Unfortunately, my new rheumatologist doesn’t seem to understand that. I switched to him about a year ago, and in many ways I’ve been happy. He is knowledgeable about the newest RA research, is very attentive, his office is located 10 minutes from my house, and his office staff is exceptional and incredibly responsive. Yet, I don’t always find that he is as responsive. When I switched to his practice, I brought my entire medical records from my former rheumatologist (I didn’t trust her office staff to send them over, so I couriered them myself). My new doctor keeps medical records in an online format as well that I have access to, so for over a year I’ve seen Flexeril, Tramadol, and Trazadone listed as inactive prescriptions (because I don’t use these medications frequently, I had months of refills remaining, and had not had to request a prescription from him). However, once I needed these medications, it seemed like my medical history went out the window.

My new rheumatologist was willing to continue the Trazadone without complaint. Yet, when I requested Flexeril, he said that he couldn’t prescribe both the Flexeril and the Trazadone; I would have to choose one or the other, and should consider requesting one from my general practitioner. At the time, my sleep needs overshadowed my muscle spasms, so I continued with the Trazadone. However, a few weeks ago my shoulder and neck became so tight I could barely turn my head. This quickly led to pain in my shoulder and jaw joints on that side of my body. I alternated heat and ice, stretched, and went to the chiropractor, but my muscles just wouldn’t release. I called his office and said that my need for the Flexeril now exceeded the need for Trazadone, and asked if he could discontinue the latter in order to prescribe the muscle relaxer. He told me that he could not, and said I should go to my general practitioner for both of these medications. I was surprised that there was a problem prescribing meds that I have taken off and on for many years, and having to make an appointment with my GP added two days to my wait time before I got some relief. Fortunately, my GP was more responsive than he was and had no issues prescribing both meds, the Flexeril did indeed prevail in finally allowing my muscles to release and stop tugging on my joints, and I started to regain range of motion and comfort.

There was another occasion when I was in a lot of pain, and I was in need of Tramadol. Fortunately, for several months I was able to cope with pain with only high doses of ibuprofen, and I hadn’t realized I had let my prescription for Tramadol lapse. When I called my pharmacy for a refill on my empty bottle, I was informed that it had been longer than six months since my last refill, so I needed a new prescription. I called my rheumatologist’s office and requested the medication, but was told that he couldn’t prescribe it without coming in for an exam (even though I had just been in two weeks prior), and the earliest available was the following week. I was in intense pain that day, and couldn’t wait a week, so I dug through my medicine cabinet and found a bottle of Lortab and took one of those. I experience much more significant side effects from Lortab than from Tramadol, so I only take it when the pain is excruciating. However, without an option available, I opted for the loathsome Lortab side effects.

My next appointment with my rheumatologist is in a few weeks, and I’m preparing myself for a conversation about the legitimacy of my need for the prescriptions I’ve requested. I want to understand his rationale, and I fear that his reluctance to prescribe palliative medications is due to my relatively young age. While I understand it is a doctor’s responsibility to factor in the potential reliance and abuse some patients develop with prescription drugs, and I am indeed still in my thirties, I think my disease activity and my history with these drugs has to be taken into consideration as well. When taking into account how rarely I take these medications, I feel like my current defensiveness about my need for them has nothing to do with potential abuse on my part, but rather about a lack of compassion on my doctor’s part.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • StillFlaring
    3 years ago

    2 years later than your post, but I think this is one most RA sufferers can find empathy with at any time! I have so many medications, from so many different doctors, I require a spreadsheet for them all! It literally lists medication name, dosage, when I take it, and doctor who prescribed it along with beginning date. When medications change, I simply gray out the line and cut & paste it to the bottom, along with why I stopped taking it. It also lists all my allergic reactions to meds.

    My first suggestion is to find a new rheumatologist; second, ask your GP for a referral to a pain management doctor. I have to travel over 300 miles each way to find a rheumatologist who I thought recognized my needs and issues. Thankfully, my pain management doctor is less than a mile away – and will wonders never cease? – they are all copying each other on my files!

  • Tamara Haag moderator author
    3 years ago

    Thanks so much for your comment and for sharing your experience and your tips! Yes, this issue certainly continues to be relevant for our RA community, perhaps even more so now than when I wrote the article, as the opioid epidemic continues to negatively impact lives and gain publicity. Thanks for sharing your suggestion about a pain management doctor, as I imagine they may be the most qualified to discern between individuals who are abusing pain medications and those who have a legitimate need for pain relief and are not at a high risk for dependency issues. Thanks for being part of our community!

  • Sue
    4 years ago

    I see a pattern here of Drs not wanting to give pain meds for RA relief. I was diagnosed in 2010 and my RA dr does not and will not order any pain meds for me. I was given a muscle relaxer but was told that I needed to feel pain so I did not overdo anything to hurt myself. I was seeing a sweet PA who actually listened and was the one who ran the testing with diagnoses finally. She also got me in to the RA dr sooner than the six months that they told me it would take. She ordered Tramadol for me. She wanted to give me Vicodin but it makes me sick. I had to change to another PCP that was in Ins. network. It is again a fight for Tramadol. How can a Dr really know what we are going through unless they feel our pain? I am getting discouraged about asking for pain relief because it is such a battle. I am not really young either (60)but I guess any age can be a junkie.

  • Tamara Haag moderator author
    4 years ago

    I’m so sorry you’re going through this too, Sue. The pain can be so intense that it seems laughable that we would overdo it if not experiencing it. Painkillers don’t eliminate pain (at least not for me), they reduce it.

  • Rhonda Scott
    4 years ago

    Hi Tamara, This has been a real issue for me as well. It took almost 10 years for me to get a diagnosis as the RA did not show up in my blood work. I felt crazy for a time however the day I was finally diagnosed I didn’t cry or feel sad I just felt relief. The stigmatism people have to indure who need medicine to get through each day is shameful. You should never have to feel chastised to get the medicine you need. I guarantee they do not have RA or have a clue what you feel like each day. There are so many stories like ours that need to be shared. Yes there is drug abuse in our country but to abuse patients who are ill and have chronic pain is a crime. I hope you can find a doctor who will treat you with compassion. Take care of yourself.

  • Angie
    4 years ago

    I hate the stigma around pain medications, and am going through something similar myself, trying to mediate pain medication for a surgery I just had between my pain management doctor and my surgeon’s office. The surgeon’s nurse made rude comments and started our surgical followup with “how are you feeling?” I respond with “Nauseous and in pain.” Then I get, “Well I can tell you right now, we’re not giving you more pain meds.”

    First off, I didn’t even ASK for pains meds and they didn’t even give me any, my pain doctor did. Second, why is it because I’m on pain meds she assumes I’m there looking for pain medication? I’m there to have my wounds checked and get answers to some questions post op.

    This is one of many examples I (and likely many of you) go through on a regular basis. Why do we have to defend ourselves? We have legitimate documented health concerns and if there is no sign of any addiction or prior problems, why say such things?

    I find compassion from the doctor means everything, so I really understand where you’re coming from. When doctors brush us off and don’t help us, it’s invalidating. A little sympathy and compassion goes a long way. I’m sorry you’re struggling with this and wonder if maybe he’s not the doctor for you. I got a second opinoin when my first rheumatologist was rude to me and brushed me off saying he didn’t see any current issues in my blood work so there is nothing wrong with me. (That’s a whole other rant/topic).

    Is there anyone in the area you can get advice on finding a good rheumatologist? Even your family doctor, as he/she sounds helpful. I love my rheumatologist and recommend him to anyone who asks, but I know there are many out there that wouldn’t make me comfortable.

  • Tamara Haag moderator author
    4 years ago

    Thanks so much for sharing your experiences. Yes, why ask you how you’re doing if they don’t want the answer? And if pain meds are the concern, then instead of assuming patients are all looking for a high, doctors should learn the signs of addiction to watch for and respond accordingly. A prescription of 10 pills a month would meet my needs but not the needs of an addict. Unfortunately, there just aren’t many rheumatologists in my area, and this one came highly recommended. My kids are young (2 and 5) and I have to miss work when they have the fevers and bugs so common at that young age, so it’s tricky to take a half day off work every three months (or more often if I’m flaring) to go to the closest big city. I’m hoping that between my rheumatologist and GP I can get the meds I need, but it seems counterintuitive to be prescribed meds by the GP when she is not the one I see for my RA.

  • RHPass
    4 years ago

    I am new to this site, so HELLO from beautiful Downeast Maine!
    I was diagnosed 19 yrs ago and it has been a long,hard battle. with all the new Federal & State rulles re: opoid pain meds, every doctor visit stresses me right into a flare up. i have been on ‘heavy hitter’ pain meds for many years, and since I need both knees replaced (like, a year ago) i can’t function too well w/o them and they do still work. i am still on the same dose so I am not escalating usage…
    i had to sign a contract giving the doctor the right to call law enforcement if she feels i need refills too often, subject myself to ramdom drug screening, well you get the picture.

    the title of this post “I am not a junkie’ hits the nail right on the head! I have been made to FEEL like a criminal, because of all the addicts and failed DEA control of illegal sales & use.at my age, I do not need to be scrutinized. I am close to retirement age, have paid my ‘dues’ and just wish to be left to cope however I can.
    e must remember that the specialists now are almost forced to abdicate prescribing pain meds to primary care docs by laws and insurance companies.
    primary care docs are scrutinized by state & federal law enforcement for high prescription issues.
    in the end, those of us that truly NEED the help are barely able to get it.
    maybe we need to band together and present our ‘case’ as a group?!

  • Tamara Haag moderator author
    4 years ago

    Thank you for sharing your experience and the information regarding legal issues. I agree the addiction concerns need to be balanced against providing the relief some people require in order to function.

  • Nancy McHugh
    4 years ago

    I have been diagnosed with RA since May 2012. On the flip side, my rheumatologist constantly wants to prescribe Hydrocodone (an opiate) for my pain. I politely decline and tell her I will take aspirin if I need it. The reason is back in the fall, we found out that our oldest daughter is an opiate addict stemming from a back injury suffered a few years ago and has gone to rehab and is 7 months clean. So to an extent I see the dr’s point of view. Tramadol is an opiate and can be abused; Trazadone is not. The opiate addiction crisis in this country sadly started out from doctors overprescribing opiate pain meds. Opiates are one of the only drugs that crosses the brain barrier and can cause you to become addicted. Tramadol, Hydrocodone, Oxycontin are all pharmaceutical versions of heroin. Try not to be frustrated with your doctor as he is being really cautious and looking out for your well being, and that is a good thing.

  • Tamara Haag moderator author
    4 years ago

    Thank you for sharing, and I’m sorry to hear of your daughter’s struggle. I think there are ways to address addiction concerns while still providing relief to patients. I have had RA for 15 years, and when I’m in a lot of pain I take 800mg of ibuprofen every 8 hours and it doesn’t even touch the pain. I have been having a rough time the past few months and have been taking flexeril at night. I have found that this actually helps reduce my symptoms during the day, and I haven’t had the need for prescription painkillers. Yet, I have to get the flexeril through my GP. I would rather be prescribed the drugs I need to thrive in spite of my RA from my RA specialist. The system of having to get prescriptions for my RA from two different doctors seems broken.

  • Danielle
    4 years ago

    It is beyond frustrating to be treated like your just looking for drugs when you are in pain. I have to take Tramadol 3 to 4 times a day to be able to function at work. I was told by my doctor when I was having a flare that I can take up to 6 tablets per day. But I’m not allowed to have a prescription for more than 4 times per day. So on my one day off from work per week I end up unable to get out of bed because I need to save my meds for work. At the end of the year I had my insurance company put a hold on my prescription because I refilled it one or two days ahead of the 30 day mark over the period of a few months, and I had to take a week off of work waiting for them to allow my prescription refill. It’s beyond frustrating, upsetting, and ridiculous.

  • Tamara Haag moderator author
    4 years ago

    Thank you for sharing your experience, Danielle!

  • Patricia
    4 years ago

    I notice you live in Athens GA. My rheumatologist is in Athens. I have been very pleased with him; you might check him out. Dr. Chafin’s office is on Baxter St.

  • Lisa Ann Detraz
    4 years ago

    I put a post in the forum a couple weeks ago titled I feel like a drug addict. This sounds so much like me. I lost my good rheumatologist and my new one doesn’t like to give a supply of meds to get you thru. I am calling his office so much I now cry at the thought and will go without. I cry at night from leg pain so bad I feel physically ill. We found a lot of damage and severe arthritis in my Sacroiliac joint (base of the spine). It is making my life hell at the moment. It hurts to walk, sit, stand and sleep is a nightmare. I had a muscle spasm in my back last month that took me out for 7 days. I couldnt even get out of bed. I cry a lot now. I am so very tired. But I just keep hoping we find a treatment that works, soon.

  • Tamara Haag moderator author
    4 years ago

    I’m so sorry you’re having such pain. Thank you for sharing your experience with us.

  • Chris
    4 years ago

    Tamara, I’m so sorry & frustrated for you to be put through all the hoops. I adore my rheumatologist as does my husband, who attends every visit with me. My sister started seeing him, and after they addressed all her joint issues she finally asked about the pain in her arm, below her shoulder. For seveal years she was told it was radiated pain from her shoulder, or that it was in her head. Dr Mabaquiao wouldn’t stop digging until he had an answer…she had a slow growing cancer in the bone!! How can I not live a doc who does that?!
    But I digress, in California, since rheumatologists write scripts for lots of pain meds, once a year patients are drug tested for scripts he writes. It’s measuring for therapeutic levels of the meds which can be checked against scripts written. This is a way to CYA & make sure they aren’t being sold. If I have a script for 180 Norco, there should be some in me at test time, unless I’ve been in a good RA place…
    I don’t know how you do it with younger kids, you are amazing!! Keep up your great efforts, and maybe more rheumatologists will move into your area.
    Stay strong, remember people that don’t have this diaease, even the docs have no clue what it’s like living in your body, again you are amazing!

  • Tamara Haag moderator author
    4 years ago

    Thanks so much for your thoughts and for sharing what things are like in California.

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