Pain management denied by gp

[frankiepaul11]

Hi , I have recently fractured 2 ribs and after a few days I went to a&e because of the pain. They confirmed my symptoms were infact cracked ribs. They gave me codeine to last a week which has completely transformed the experience I am now able to manage simple things that I couldn't before. But the medication is almost finished now I have to contact my gp about continuing the pain medication for the near future. However my particular gp surgery has a general policy against prescribing pain killers such as codeine. The reason they do this is because this surgery is largely for homeless people and although I have not been homeless for 2 years and never have taken heroin they deal with so much addiction they have developed these policys. My question is do I have a right to access this medicine in my situation and if not how can I make the dr see that by not having access to this drug I'm going to be debilitated for the next few weeks. Thanks

[happytulip]

Yes you have a right to appropriate analgesia.

One complication of fractured ribs is pneumonia. Pneumonia develops because people 'shallow breathe' because they can't expand their lungs properly because of the pain. Gunk develops in the bases of the lobes and hey-presto, a pneumonia is formed.

Basically it is vital that you are able to take a good few deep breaths every 20-30mins to open up the lungs.

I have seen many people present with pneumonia following fractured ribs due to mis-managed pain.

Paracetamol taken regularly is an extremely effective painkiller and ibuprofen is a very effective anti-inflammatory. If your GP has concerns about codeine then I would discuss other options with them. Explain your concerns.

You can also buy co-codamol over the counter at a pharmacy. It contains paracetamol AND codiene, but at a lower dose than prescribed by your GP. But be warned, you can still get hooked on the codiene.

A very sensible discussion with your GP about pain relief for very painful fractured ribs sounds necessary. It will take them about 6-8 weeks to heal so take it easy.

I'm not sure if you've had addiction issues before but it might be worth pointing out to your GP that just because someone is or was homeless doesn't mean that they have addiction issues.

We are all different.

Good luck and deep breaths.

[frankiepaul11 in reply to happytulip]

Thanks for the informative reply. I have never had problems with addiction in my past or present. I will try my best to communicate my pain and the concerns I have regarding the impact that pain will have on my life. Unfortunately I know it's going to be an issue with these guys and they are very unlikely to actually listen to me. Thank you so much for your time.

[happytulip in reply to frankiepaul11]

No problem.

Just say exactly what you have said to me. No previous problems with addiction and you require appropriate analgesia for a significant injury.

Another method is to turn the tables. Ask your GP "what makes you reluctant to prescribe me this pain relief if it is effective and other pain relief doesn't work?" They need to justify and explain their practice to you. You are the patient. Policy or no policy, you can't treat every patient as the same. Medicine doesn't work like that.

Just on a side note. If you do get prescribed further codiene studies and patient experience has found that paracetamol and codiene compliment each other and work well together. That's why IV paracetamol is often given with IV morphine in acute injury in hospital.

Codiene is an opioid derivative as I am sure you know so taking codiene and paracetamol together sort of improves the efficacy. Less pain = better sleep= better mobility = faster healing. All good!

[frankiepaul11 in reply to happytulip]

You have been very helpful. Thanks again.

[Cazza2612]

It sounds to me like the practice is treating all patients as addicts and not as individual cases.

If you are not homeless now and don’t require there help in that way my advice to you would be to change your practice to a practice that is more medical focused on patients as individuals and treat each issue as it is. If you require pain relief medication then you should be able to receive it until you don’t need it anymore. It’s not like you’re asking for something that you’re not entitled to.

I have been on pain medication for years and I don’t class myself as an addict and neither does my GP It’s just what I require at the moment to help with my pain condition and if I could I would stop taking it all in a minute.

Regardless to Your situation no Dr should judge every patient as being in the same situation you are all individual and just because some are addicts doesn’t mean you all are.

Honestly my total advice would be to move to a much more care, understanding and non judgemental practice that will treat you as an individual.

Good luck. I hope you get some pain relief soon. I don’t even know you but I would give you pain relief if I could.

Carole

[Konagirl60 in reply to Cazza2612]

That’s not always as easy to do as you think but it’s something to try.

[cyberbarn]

To be fare to the GP surgery, it isn't just your surgery, it is all of primary care. Codeine should only be given for short periods of time. So I don't know what the prescription they gave you was for, but after a week you should be stepping down a level and over the country co-codamol should be used now which you can buy yourself.

As others have said, paracetamol and codeine together work better than separately. And you can take ibuprofen at the same time too. Ideally you should aim for maybe another week at most with a codeine product at a lower level, and then carry on with paracetamol and ibuprofen for a week, then see how you are.

[Ventorist11 in reply to cyberbarn]

That is not true that Codeine should only be given for short periods of time. This statement is a sweeping generalisation that is affecting people, like myself, with long term pain issues treated by Codeine daily. Yes, your right, in the instance of someone not needing it for long term use or where an alternative is effective. I am getting angry with these statements about analgesia and how they are being used to tar opioid analgesia with the same brush. Meaning, patients on them long term are dependent or addicts. There is a thin line and it needs to be looked at closely before general sweeping hysteria is amassed. And this is what's occurring more and more. It all originates from the MHRA and other medical Government agencies. It was also terribly represented in a scaremongering one sided BBC documentary recently which, as we all know, is a Government mouthpiece information centre anyway.

[stampede187]

Hi, I agree with the points made already. In addition, maybe think of swapping GP? Its quick enough, and you just need your H&C number, ID and address confirmation. I have moved from place to place, and never a hassle.... some GP's will even see you as soon as you register if they can access your records

All the best.

[nodmeister]

I would write to the practice manager saying exactly what you have told us. Good luck.

[Izzybelle22]

Dear frankiepaul11, The bottom line is hard to comprehend but believe it or not, broken/cracked/fractured ribs have always been known as having no cure, no quick fix and thus the well-know saying when it comes to fractured ribs, "and there is nothing you can do about it." This is a waiting game because most people fully recover in due time. Hang in there for it is only takes 'time to heal' and for you, poor thing, it may seem as if it is forever.

[auntieb]

It may also be worth pointing out to your GP, that you do not need to be prescribed drugs to form an addiction. There are thousands of people who are addicted to OTC medicines and therefore don't always get the help and support needed to come off them.

Many years ago I developed an addiction to Solpadeine, which is n OTC painkiller with codeine and paracetamol together. It is soluble and I guess I got addicted to the taste of it as a drink. (I know, yuk, right?) I never took more than the recommended 8 per day, although there were many days I wanted to. Whenever I tried to cut down I was in so much pain, it just didn't happen. I would make it up and swig it while driving, have one before I went out for a drink, even drink it as a refreshment while in meetings t work. It wasn't cheap, even then, I felt enslaved to it. I even started going to various chemists to buy it so no one would guess. I only ever mentioned it to my GP once and he asked me how many I took in a day. I told him 8, and he simply shrugged and said that was ok, and I shouldn't worry. In the end, I just stopped them cold turkey. It was the only way I could do it, but it was hard.

Good luck, I have had a fractured rib and they are extremely painful. I hope you feel better soon.

[Rabs550]

Omg yes of course you have go back to the hospital or they must have given you a leter telling you what's wrong and one must of gone to your go contact ur gp again if he still don't help you keep going hospital if the pain is unbearable or even try the 8.plus co codomal that you can get from ur local chemist and also tell ur doctor if you can't help me refer you to pain clinic xx and take care