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A Debate On Pain Medication Delivery

Well, as this thread has been revived, a neighbor of mine just ran into this problem as well. He is a war vet and has been ‘blown up’ in his convoy over a dozen times. Quite obviously this has caused some permanent and painful side effects that require a rather constant dose of pain meds to control. The really sad part is that he had to switch providers and that led to a gap in his treatment cycle where he was off medication entirely. Normal people would not see this as a problem – just get more meds when he can but when he went to the doctor he was outright refused. The reason, because there WERE NO DRUGS IN HIS SYSTEM when they administered the urine test. Because HE WAS CLEAN! If that is not the most asinine statement that I have ever heard.

The supposition was that he might be selling the pills. The gap in treatment was documented and the reason known but yet the doc did not care. He wasn’t shy about it either – he came right out and told him that he was not going to risk his medical license to help him. NOT. GOING. TO. RISK. HIS. LICENSE!

As though that should ever even be in question. It is bad when the instance and cause is well documented and it STILL leads to a doctor running scared from his job. The government is getting out of hand.

Now, he did have a medical pain contract and I am not sure why this didn’t play a factor – possibly because the risk was selling and not seeking to abuse. He is currently demanding a new doctor through the VA and using the doctor’s statements as a claim of no faith in the ability and intent of the doctor to actually treat his conditions. I am not so sure that this will work though. While I am NOT getting into the ACA or anything like that here I can attest to one of the drawbacks to a socialized medical system like the military has with us – appealing a decision is sometimes completely pointless because they have ultimate power to say no and discard you completely. It has happened many times to me and others I know caught up in the terrible system that is our primary means of care. I only hope that he ends up with a reasonable person that has compassion for his circumstances in this case or he might not get any of the medication that he sacrificed body parts to get.

I'm no expert on the subject but it seems to me the above described patient should engage an attourney and sue or threaten to sue through the lawyer the doctor and the facility in question for dereliction of duty and for causing or prolonging the patients pain.

The reason I would sue is that no one illegally selling the pills would do that just so they could make 5-10 dollars a pill. Selling a hundred pills for $5 each would certainly not be enough to make it worth it to sue anyone.

It COULD be possible to sell enough pills to make enough money to make the risk worth it...but that would mean selling THOUSANDS of dollars worth every month. One would need to sell several hundred pills a month to make a living at it. If the patient had legitimate pain that would leave precious few pills to sell. No one is going to risk losing their pain prescription source to make just a few hundred dollars a month...and be ass out controlling their own pain.

I would sue their asses off.
In most instances, you cant. That socialized medicine again. This might be a little different dealing with the VA but in general, a uniformed or retired member cannot sue the government for anything related to duty or those executing it under that banner. It is a side effect of having the government administer the care. Everything is virtually free but your recourse when you are not pleased with services are diminished.

Further, this sounds very similar to the stories that you have been putting up as well - the doc fears governmental reprisal for actually helping the patient. that makes me believe that there is something from the regulators that he is falling back on. It is pathetic and sad. The government does not belong in between you and your doctor to combat drug abuse. The very idea is silly.

Again... I'm no expert. BUT there is a difference between suing and winning. Using the legal system to get attention is a valid weapon. There is no law or "implied contract" against FILING a claim in court. The street one can take running for cover as in the path taken by the doctor is "two way". I would even consider suing the DEA for conspiracy and collusion to defraud and cause harm to patients needing pain medication. All you would need is a judge that has a close family relative that suffers needlessly at the hands of the system. Costs could be defrayed by several patients combining their legal assault on the system under the same claim.

If the pain is not going to go away there is no need or excuse to just "give up". One thing about those that hide behind institutional cowardice is that they don't like the light of day exposing them. I would hit the media hard also..get a reporter(preferably one that has personal ties to someone wronged by the system in regards to pain treatment) on the case.
 
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I'm no expert on the subject but it seems to me the above described patient should engage an attourney and sue or threaten to sue through the lawyer the doctor and the facility in question for dereliction of duty and for causing or prolonging the patients pain.

The reason I would sue is that no one illegally selling the pills would do that just so they could make 5-10 dollars a pill. Selling a hundred pills for $5 each would certainly not be enough to make it worth it to sue anyone.

It COULD be possible to sell enough pills to make enough money to make the risk worth it...but that would mean selling THOUSANDS of dollars worth every month. One would need to sell several hundred pills a month to make a living at it. If the patient had legitimate pain that would leave precious few pills to sell. No one is going to risk losing their pain prescription source to make just a few hundred dollars a month...and be ass out controlling their own pain.

I would sue their asses off.
In most instances, you cant. That socialized medicine again. This might be a little different dealing with the VA but in general, a uniformed or retired member cannot sue the government for anything related to duty or those executing it under that banner. It is a side effect of having the government administer the care. Everything is virtually free but your recourse when you are not pleased with services are diminished.

Further, this sounds very similar to the stories that you have been putting up as well - the doc fears governmental reprisal for actually helping the patient. that makes me believe that there is something from the regulators that he is falling back on. It is pathetic and sad. The government does not belong in between you and your doctor to combat drug abuse. The very idea is silly.

Again... I'm no expert. BUT there is a difference between suing and winning. Using the legal system to get attention is a valid weapon. There is no law or "implied contract" against FILING a claim in court. The street one can take running for cover as in the path taken by the doctor is "two way". I would even consider suing the DEA for conspiracy and collusion to defraud and cause harm to patients needing pain medication. All you would need is a judge that has a close family relative that suffers needlessly at the hands of the system. Costs could be defrayed by several patients combining their legal assault on the system under the same claim.

If the pain is not going to go away there is no need or excuse to just "give up". One thing about those that hide behind institutional cowardice is that they don't like the light of day exposing them. I would hit the media hard also..get a reporter(preferably one that has personal ties to someone wronged by the system in regards to pain treatment) on the case.

Oh he is not giving up – I assure you that. Like I said, he is currently appealing based on the idea that his medical practitioner is not looking out for his needs. You bring up a really good point though. We have a group here call the ‘problem solvers’ that is part of a media arm. They are VERY effective in getting asinine things changed through exposure. I think I’ll have to talk with him about something like that. A little attention to the issue would be a healthy thing and almost certainly get changed. I know that military members are a hot spot if they get screwed. The public is NOT kind to anyone fucking over military, particularly wounded soldiers.
 
I have (casually) noticed a growing reluctance on the part of physicians, to prescribe pain medications; at least not without a separate pain-clinic analysis to back up their judgment.

And, of course, we see less of this with temporary conditions, and more of this with chronic ones.

I had a knee-rebuild in mid-2010, but fortunately, my ortho-guy was a huge believer in pain control, as an aid to recovery, starting with the morphine pump for the first 24-48 hours, and Norco 10-525's (or -325's?) for weeks afterward, eventually graduating to Norco 5-325's, then eventually off the things altogether... always telling me: "Get ahead of the pain. Don't wait until it gets out of control before you take a dose, or it'll be 10 times as bad." Doubly-true right before a brutal physical therapy session.

He was right, and, God bless 'im, not afraid to write a scrip for such, pretty much so long as you needed them - although he kept a good track of consumption, keeping an eye out for an over-dependency or side-effects...

But I've had family members who've had to fight like hell just to get a scrip for a modest pain-reliever over-and-above those available over the counter.
 
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Something that has drawn My attention over the last several years... maybe a decade or more is a personal observation that more and more people are living with crippling pain and less and less is being done about it by the mecical community.

1. It is true that about twenty years ago more or less there were many cases of pain killer overdoses reported. At the time doctors were prescribing pills such as Oxycondon, Percocets and Morphine Sulphate and others somewhat loosely so the availability could be considered a factor in many of the deaths where pain killer was present.

I believe some of those cases were intentional suicides not reported as such.

I believe some of these cases were ruled "accidental" when a person not perscribed took the pills and died. I don't believe that when someone ..even if a teenager takes a handfull of pills stolen from a medicine cabinet or their mom's purse that it is an accident. It is NOT an accident. It is foolish behavior. Foolish behavior can be lethal.

I believe many of the deaths reported as overdose and unneccesary over-prescription was just fools and thieves dying from foolish behavior.

2. Recently the companies producing pain medication and the DEA have been systematically reducing the availability of pain medication to anyone by threatening doctors with their liscence to practice and in the case of the biggest manufacture of pain medication in the U S A getting on some weird conscience kick and attempting to find ways to reduce deaths by holding back manufacture of the pain medicine.

The DEA has a new and recently superfunded division just for the purpose of taking pain killer out of the hands of the public with NO regard for what many Americans go through from chronic pain.

3. Some of our largest universities specializing in medicine have bought into the myth that it is better the public wrack in chronic pain than a single person die from a drug overdose.

4. It is apparent from knowing several people directly and indirectly with life threatening disease such as cancer or AIDS that that group has no problem getting pain relief even if the "end" may be not in the near future. People who are going to die certainly within X months or years are treated with at least some modicom of compassion. If you are not going to die in a predictable fashion you are on your own with no pity or medication to make your pain bearable.

No one seems to be fighting back at the DEA and the preasure they put on the medical community to make it possible for people with genuine chronic pain to seek some relief with medicine.

I am going to start with this much and ask for comment.

Likely a lot cheaper and certainly more effective using cannabis if prescribed narcotic pain-relievers. Safer too. Can't od on cannabis. Can very easily od and die on oxycontin and such.
 
Well, as this thread has been revived, a neighbor of mine just ran into this problem as well. He is a war vet and has been ‘blown up’ in his convoy over a dozen times. Quite obviously this has caused some permanent and painful side effects that require a rather constant dose of pain meds to control. The really sad part is that he had to switch providers and that led to a gap in his treatment cycle where he was off medication entirely. Normal people would not see this as a problem – just get more meds when he can but when he went to the doctor he was outright refused. The reason, because there WERE NO DRUGS IN HIS SYSTEM when they administered the urine test. Because HE WAS CLEAN! If that is not the most asinine statement that I have ever heard.
The reason I would sue is that no one illegally selling the pills would do that just so they could make 5-10 dollars a pill. Selling a hundred pills for $5 each would certainly not be enough to make it worth it to sue anyone.
It COULD be possible to sell enough pills to make enough money to make the risk worth it...but that would mean selling THOUSANDS of dollars worth every month. One would need to sell several hundred pills a month to make a living at it. If the patient had legitimate pain that would leave precious few pills to sell. No one is going to risk losing their pain prescription source to make just a few hundred dollars a month...and be ass out controlling their own pain.
I would sue their asses off.

Part of the problem is due to mythology. Mr Doctor, who is giving me my meds. commented that a Roxy 30 has a street price of $45, thus 100 pills a month would give you a $4,500 income. I didn't correct him because, well, I don't want to explain why I know these things, but the actual value is around $12-$15, not $45, although maybe a one or two pill sale might command a lot more.. My Doctor trusts me because I rarely ask for anything exciting, he's known me for years and I'm financially stable to where I'm unlikely to be a seller.

In some ways, we are a nation of gross stupidity. We've locked up MILLIONS of people for consensual behavior, we've used drugs as a way of discarding privacy rights and we've created billionaires through the ever growing punishment industry. Yet we are one of a relatively few countries where you can obtain powerful meds. Most countries have nothing legal other than codeine based. The only people who can't get meds are those who need them - there is no shortage of black market supplies. So, if you are a law abiding citizen, you're screwed. If you don't have enough funding, you're screwed. It is simply RIDICULOUS.

I'm no Obama fan but in this one area, there has been a little progress. Marijuana is headed toward legality - I would have bet this never would have happened. Sentencing is t least getting some review and compassion although it is too late for millions who have had their lives destroyed by the law, nor the drugs.
 
I had a knee-rebuild in mid-2010, but fortunately, my ortho-guy was a huge believer in pain control, as an aid to recovery, starting with the morphine pump for the first 24-48 hours, and Norco 10-525's (or -325's?) for weeks afterward, eventually graduating to Norco 5-325's, then eventually off the things altogether... always telling me: "Get ahead of the pain. Don't wait until it gets out of control before you take a dose, or it'll be 10 times as bad." Doubly-true right before a brutal physical therapy session.

I can second that from personal experience. There are some conditions where rehab is inevitably painfully enough to prevent anyone from reaching the level they need for maximum physical recovery. I started rehab after my triple bypass about 20 hours after surgery and 14 hours after having the chest tubes removed. Like most people who have good outcomes, had rehab been delayed 72 hours or so the rehab would have been much slower and harder. It also helps if they add an anti-nausea medication to the drip. If you don't get vertical within the first 24 hours it's going to be a long and painful recovery.

PS I was down to OTC acetaminophen by day five. People get addicted to pain meds more often when they have inadequate pain relief in the first three days post-op. By day four or five the pain can become chronic and that's when dependency really begins. You are better off if you never get there in the first place.
 
Well.... It has been almost two and a half years since my current bout with the EVIL Mr Pain with no direct help from a plethera of medical types doing everything in their power to avoid doing the one thing that had any chance of relieving some of my discomfort.

So I go into a N. Seattle pain clinic with at best sceptical expectations.

The assistants and doctors seemed interested in my problem but I have been tricked into believing someone cared several times.

The Main Doctor ended the preliminary visit with words tha astounded me.

"After going over your charts and all of the supporting information I would like to try methadone or morphine extended release and see if you show any signs of improvement."

Huh? Just that simple? Just that direct. No excuses about the DEA threatening to pull his ticket.

I'm on day two and I can report that with a modest doseage of the methadone at least half my pain has been abated.

Now REALLY !! Was THAT so damned difficult ???
 
Yay Huggy! Finding a good team is the first but hardest step. Be sure to communicate completely as they can get nervous if they don't feel complete openness. In time, once they know you more, it gets much more comfortable and you'll feel less like some criminal. May it all be roses from here and your pain be eased. Xoxoxo
 
Just legalize marijuana and use it as painkiller instead of oxyocodone and other opioids
 
Just legalize marijuana and use it as painkiller instead of oxyocodone and other opioids

I've smoked pot before in earlier years and frankly it just makes me stupid. I don't like being spaced out. I don't doubt that some people benefit from pot.

For me ... I had an almost identical episode with the opposite leg and hip seven years ago and went through a whole gamit of pain killers with no real help until I was prescribed methadone. It allowed me to sleep and get the rest and stillness neccesary to heal. Since then that side of me has had zero problems. It took me less than a week to ween myself off the methadone with zero after effects.

I'm not recommending methadone or any specific treatment to anyone. It worked for me in the past and seems to be helping as I type this today.
 
Well.... It has been almost two and a half years since my current bout with the EVIL Mr Pain with no direct help from a plethera of medical types doing everything in their power to avoid doing the one thing that had any chance of relieving some of my discomfort.

So I go into a N. Seattle pain clinic with at best sceptical expectations.

The assistants and doctors seemed interested in my problem but I have been tricked into believing someone cared several times.

The Main Doctor ended the preliminary visit with words tha astounded me.

"After going over your charts and all of the supporting information I would like to try methadone or morphine extended release and see if you show any signs of improvement."

Huh? Just that simple? Just that direct. No excuses about the DEA threatening to pull his ticket.

I'm on day two and I can report that with a modest doseage of the methadone at least half my pain has been abated.

Now REALLY !! Was THAT so damned difficult ???

Severe chronic pain has a cascade effect. I hope it works in your favor now. If you have less pain, you can move a bit more, depression improves (if you have chronic pain, you also have some degree of depression), and a virtuous cycle can set in. I hope this is the start of a steady improvement for you!
 
Just legalize marijuana and use it as painkiller instead of oxyocodone and other opioids

Pot is not a wonder drug and does not help pain nearly as effectively as opiates. The side effects are certainly better and if it works then you should certainly use it over almost any other pain meds that almost all have worse side effects. It is not as simple as just legalizing pot though. Pot does not solve all or even most pain problems.

Huggy also stated N. Seattle. I assume that he is talking about Seattle WA where pot IE legal. And not simply medical pot either – pot is legal here period.
 
Well.... It has been almost two and a half years since my current bout with the EVIL Mr Pain with no direct help from a plethera of medical types doing everything in their power to avoid doing the one thing that had any chance of relieving some of my discomfort.

So I go into a N. Seattle pain clinic with at best sceptical expectations.

The assistants and doctors seemed interested in my problem but I have been tricked into believing someone cared several times.

The Main Doctor ended the preliminary visit with words tha astounded me.

"After going over your charts and all of the supporting information I would like to try methadone or morphine extended release and see if you show any signs of improvement."

Huh? Just that simple? Just that direct. No excuses about the DEA threatening to pull his ticket.

I'm on day two and I can report that with a modest doseage of the methadone at least half my pain has been abated.

Now REALLY !! Was THAT so damned difficult ???

Severe chronic pain has a cascade effect. I hope it works in your favor now. If you have less pain, you can move a bit more, depression improves (if you have chronic pain, you also have some degree of depression), and a virtuous cycle can set in. I hope this is the start of a steady improvement for you!

I feel less pain already and can walk better..climb stairs better ... I'll control my weight better now that I can move better which will help my battle with type II diabetes. I'll deal with the addictive component of the methadone as my body heals now that I can get the drastically needed rest when I sleep. I am confident that as with the previous bout with injury and pain back in 2007 that I can now heal and get to a point where I won't need the pain medication. It may even take surgery to correct my crushed discs and artheritus but I'll cross those bridges when I get to them. This is a MOST welcome start to some recovery. AND yes chronic grinding pain IS depressing. This is a MOST welcome change for the better
 
I'm rooting for you! Once you are able to heal then move more, the weight will get easier. That's a cascade affect you can look forward to. If you can make it through that plateau, I swear the metabolism changes and it gets MUCH easier. While I can't relate to the chronic pain personally, I can speak to the weight. I lost 90 lbs and have kept it off. I promise it isn't a lifetime struggle. You will find you move because you have pent up energy rather than having to force yourself to move. Small changes in diet are enough, one at a time, and much less daunting. If you ever want some simple satisfying suggestions to replace a vice, shoot me a message. I'd be happy to share the ones that worked for me and brainstorm ones that fit you.
 
I'm rooting for you! Once you are able to heal then move more, the weight will get easier. That's a cascade affect you can look forward to. If you can make it through that plateau, I swear the metabolism changes and it gets MUCH easier. While I can't relate to the chronic pain personally, I can speak to the weight. I lost 90 lbs and have kept it off. I promise it isn't a lifetime struggle. You will find you move because you have pent up energy rather than having to force yourself to move. Small changes in diet are enough, one at a time, and much less daunting. If you ever want some simple satisfying suggestions to replace a vice, shoot me a message. I'd be happy to share the ones that worked for me and brainstorm ones that fit you.

I've been dealing with the weight(I'm only thirty pounds above an ideal number) for a long time. My doctors and I have designed an intelligent diet that works very well. That lack of mobility was the key ingredient missing from making progress toward my ideal weight.

I don't mean to be mean but you live in Louisiana. I ain't tryin to shovel no stinkin gumbo down my pie hole.. :lol:

I eat roasted chicken breast ..whole grain breads ..mixed assortment of veggies.. basically as lean and balanced a diet as I can stand. I have long ago cut out the "ice cream" and other snacks like commercial chips and the like already.

I am very certain that being able to use both legs will eat up calories. I'm not going to participate in any marathons any time soon but just being able to go up the two flights of stairs to my rooms one step in front of the other rather than limping dragging my left leg along will be a HUGE improvement.
 
HA! Gumbo wasn't on the list. I was going to tell you how to cook a rabbit! Working legs will do it too, though ... and sleep, which I am off to do. Sleep well, hopefully (are you able to get hours now, REM yet?)
 
HA! Gumbo wasn't on the list. I was going to tell you how to cook a rabbit! Working legs will do it too, though ... and sleep, which I am off to do. Sleep well, hopefully (are you able to get hours now, REM yet?)

Got REM.... Mon Chere'

[ame=http://www.youtube.com/watch?v=5HplYOYFWK8]What' the frequency Kenneth lyrics - YouTube[/ame]
 
"None of your gods or fairies will help this condition"

I'm not here to challenge your categorization of religion. It was my mistake for only listing classic texts. There is another side that is equally important: it's not the belief system but the activity of spiritual practice that enlivens one. Yoga, Tai Chi, martial arts etc. are vital to one's health and improving condition, including outlook that can truly dissolve aspects of pain. Having never tried it myself, I resisted like most people do. But being honest and actually giving it a shot reveals effects previously thought impossible.

"Imaging finds different forms of meditation may affect brain structure"

So meditation is like a pain med, it changes your brain.

Furthermore, “There is a true biological effect" just like with pain meds.

Indeed, the more we hold onto our ways, our ego, the more pain we perceive to experience. The more we let go of our individuation, the more we become unified with that which cannot be damaged. The more we tap into this limitless essence of the universe, the more we can do previously impossible tasks. Take the example of drying a completely wet towel on your back while naked sitting in 25 degree weather. This sounds absurd. You know what? It is done all the time.Harvard Gazette: Meditation changes temperatures

My conclusion in my few months of honestly pursuing alternative measures to manage pain and mental stress, I have found no better option then what I have mentioned. It's no easy task but anything worth doing isn't. It's awfully easy to pop a pill and can be costly. I am in no way condemning the use of pain meds for managing pain, but don't think the happy pill is the only solution for you in your condition. I know we always want to resist doing things that require effort but it is proven that if you stick to spiritual practice, you will improve mentally, physically and spiritually. Healthy nutritious food is plenty of water can't hurt either. I understand your condition is quite physical but drinking sufficient water each day can possibly alleviate some of the tension in all sincerity. This is the main solution for many people who have back pain but don't nourish their bodies. It's just a matter of how much do you care. Pain meds remove this care for alternatives--I know this all too well as it became my whole existence--but combining them could prove monumental in your life.

Are there problems with drug distribution and policy in the US? HELL YES! And in order to combat that, we must join together and fight it. I am totally with you. But what you can do today can take you one step closer to living a less painful existence. I am well aware of back pain, my dad has been on pain meds since 97 and taking it helps him tremendously but opiates tend to make you passive. Your approach to challenging DEA is a great step and you could benefit by taking this pro-active effort to other areas of your life for even more improvement.

Fascinating stuff for sure.. With no pain medication I cannot reach to put on socks on my left foot. With 30 mg of morphine sulfate in my system I can just barely reach and put on socks.

Yoga and other similar exercises prescribed in the myriad of physical therapy assisted and un assisted is a futile "excercise" in torture for me. I don't know how many times I must say that my condition IS NOT GOING TO HEAL. Crushed and bulging discs do not miraculously repair themselves. Arthritically degenerated spinal sections do not magically regenerate bone tissue. Openings in the pelvic bone closing with calcium deposit do not etherically open wide for nerve passage.

Please stop attempting to insult my intelligence and make light of mine and others pain. Maybe a harsh criticism but after having gone through the whole gambit and having been a student and private practicioneer of meditation ..student of several martial arts schools including Kung Foo..Tai Chi ..Karate .. by some of the best sensais available since I was 17 I REALLY don't believe your suggestion has been overlooked. I am expert in beathing technique using color visualization to aid in decending to sleep. I could and have taught the subject.

You do not know how much time and discomfort I have invested in the above sort of prescription by some of the so called best physicians working in one of the best university medical staffs in the world.

I cannot function without EXTREME discomfort without the aid of pain killer. I can BARELY function with pain killer but the difference is HUGE in my life as it affects my sense of well being and mood. With grinding pain 24/7 I am not a happy camper. I am very angry all of the time and hate living that way. When I can aquire enough pain medication to "take the edge off" of the hell I normally endure my mood brightens up significantly and just the ability to put on a pair of socks is an uplifting experience.

Describing pain medication as "happy pills" is condecending and frankly highly insulting to the words I am putting out here about mine and others conditions.

Many of my friends are dealing with similar problems involving chronic pain.

As for your prescription..been there done that..please pass the pain medication ...thank you.

"I don't know how many times I must say that my condition IS NOT GOING TO HEAL."

I wrote something in the above post that is clearly in error. In 2007 I experienced much the same problem as I am having now and the right leg nerves are not bothering me at all. Obviously SOMETHING healed.
 
pain management is just hard to do....regulations have made a lot of doctors scared to manage pain to the full extent they can

i have a weird situation....i cannot take Vicodin or loritabs...never helps the pain and both give me a skin crawl reaction.....great feeling the narcotic skin crawl and pain...nice combo.....so i have to be moved up the pain killer scale to percodan's....that is an instant problem...

i am a zero pain person.....i pick that option and i do not back down from it...which resulted in being given morphine while in the hospital....that was a bit much and should not have been the first option...as i explained to my doctor the next day....i was given x number of strong pain killers for home...i have not taken any of them...i tend to like them a lot....and i have not been in pain....

i will save them for an ingrown toe nail...

the craziness of the fda kills me..you got the script records.....just figure out who is writing a 100 scripts a day for oxis.....we had that here for a while..doctor went off the deep end and decided to be a legal drug pusher..you would go by his office and there would be 50 or 60 cars.....his office as on a main road...it was flat obvious what was going on and it went on for years...but my oral surgeon has to file paperwork explaining why i get the percadons instead of the vicodins...
 

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