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Mom, now over 95, after a few strokes, every now and then gets a pain in her side, shoulder or leg (arthritis) that is so bad she grimaces, and she has always been a person who had exceptionally high tolerance to pain, so I know it must be really really bad if she’s showing it.


Several times, I’ve taken her to the hospital because of her pain, usually occurring late, off-hours, etc. Tests were administered, and each time, gladly, she was given an aok and some kind of recommendation or pain med. Because she is very receptive/sensitive to medicines and because she has balance issues, and I can’t really lift her, about a year ago during an episode where she was given and additionally prescribed a "mild" pain medication, as it was described. I asked if we could start by giving her only half-a-pill; it may be enough. The emergency room doctor was on board with that, I was always staying with her throughout those times and with a half-a-pill, she’d relax and within an hour the pain cycle would be broken, and she’d not be out-of-it, just relaxed deeply enough to fall asleep usually. When she’d wake up, she’d be rosy again.


There is one pill left from that prescription. It’s been sitting in the medicine cabinet on the verge of expiration. Last fall, before Covid, we went to her Primary Dr.’s Nurse Practitioner, a wonderful professional and caring person, for her bi-yearly check-up and med review. I reminded her all about the repeated experiences at the hospital emergency room for pain and while there were a few pills still, how well this worked for Mom, and asked if we could have it on her med list, if needed after the last few are gone (usually over months between episodes) She was reluctant, describing it as a narcotic, but did so when she understood it was either a pain med or an entire week of pain, not kidding. Because we went through that the first time she started having pain a few years ago. Taking her to the ER the first time they found nothing of concern in the tests and sent us home, giving Tylenol Extra-Strength, recommending hot compresses, etc. The pain cycle got so ingrained it wouldn’t stop, after a painful exhausting week peppered with calls to medical professionals, we went back. She was given something for pain there (Tramadol), and sent home, where she relaxed, fell asleep and woke up pain free.


Back to the 1 pill. A few months ago, I called her PCDr. to check on it and request, she’d just had an episode and I noticed there were 1 1/2 left. Her doctor, not the NP, called me and argued against it saying things like “I wasn’t the Dr. who originally prescribed that for her” and “She might fall” and ultimately refused to write it and over-rode the NP, telling me she shouldn't have done that. What this means, is that when the last pill is gone, the next time if she has another episode, I will have to take her to the hospital in order to get the pain medication and, being the one who’s with her all the time, I know she needs. As did the NP who "got" it and then was over-ridden. I just hope the pandemic is over before I have to do that. Just saying. Whew. Thanks for listening:)

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What a shame that she can’t get relief.

My mom is the same way. Never takes pain meds. But my gosh, it’s horrible to remain in pain and can’t relax enough to get rest.

I am so sorry that she goes through this pain.
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Yes, I explained the whole story to her Primary Care Doctor. The main point I made is that Mom is not, nor has ever been, a person who takes medications when not ordered by a doctor. She has never liked to take any kind of numbing medications, she would rather power through it, she's always been that way. One bottle of Tramadol that had probably 12 pills has been on the shelf for nearly 2 years, and there's still one left- that wouldn't be the case if she had an addictive personality. She most definitely is the kind of patient who benefits from the medicine and has no use for it when not in pain.
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I agree with Margaret and Glad. Addiction is hardly the question here, though unfortunately, addiction in our country has made ALL DOCTORS afraid to prescribe opioids. Margaret is absolutely correct in saying that many problems/side effects of these pain killers is what they are combined with. Motrin (my drug of choice which unfortunately I can not longer take due to its bad effect on gastric mucosa) causes bleeds, et al.
Falls are a concern, but when there is pain opioids don't have the same effect as when there is none. If you question this, see a patient with a dose of MS as a pre op sedative go high as kite while a patient in pain is all uneffected mentally. Falls are a concern for any 95 years old, and pain medications or no there WILL be falls.
There may need to be a visit to a doctor specializing in pain control to get the proper medications. Good luck.
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She is 95 for crying out loud! Addiction at this point in her life shouldn't be of concern or play into a decision to prescribe or not.

FIL passed from prostate cancer when he was in his 60's. He did not want to take the opioids for fear of addiction. He was terminal. Doc told him ha needed to take them if he did not want the constant pain he was experiencing.

Perhaps have her evaluated for hospice which no longer means she will pass within six months, it seems. Hospice will provide the meds she needs. Some are on hospice for several years.
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This sounds ridiculous. Change doctors. Don't just accept this.

There are some pain killers that are seriously addictive – eg fentanyl and oxycodone. Codeine can be addictive, but was developed a century ago as the least addictive and ‘high’ producing of all morphine derivatives. It has become a big bogey for no good reason. I quote my own very experienced GP. Tramadol is a bit more of an issue, but not much more (and it has very variable doses).

I have a lot of back pain, and have been registered to get 6 tablets a day of 30mg codeine. I am NOT addicted and take no tablets if I have no pain. I suffer no withdrawal symptoms. This has been happening for years -I have had serious scoliosis for 60 years, although deterioration has made it worse than when I was younger, and made the pain more likely to flare up. Today I have had only half a tablet as a preventer with breakfast, and it's now 4.30pm.

Doctors and drug companies should have been sued and struck off over Fentanyl. There are now legal suits against drug companies, but doctors got off scot-free. Now many of them are over-reacting like crazy to the bad press they got. Some of them quote codeine hospital admissions and deaths, without acknowledging that the cause is almost always the paracetamol (acetaminophen) or ibuprofen with which they are combined but whose lethal dose is lower. Very few of them have any experience of personal pain. It's b**l s***t.
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I certainly feel for your mom when she is in pain. I also feel for you as her caregiver.

I see both sides of this issue. It doesn’t take very long at all to become addicted to pain meds.

Did you explain to the doctor that answered the phone that you only give your mom half of the pill?

Does half of the dosage make a big difference in becoming addictive? I would check on that.

I am so sorry that your mom stays in pain.
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