let me give you an example. i have very bad displaysia of the hip. june 08 i had a massive surgery – they cut my hip off, rotated it, and screwed it back on.
the next morning at 9 am [less the 24 hours after the surgery was done] i called and asked for pain meds.
called again at 10.
around 11:30 the nurse came in to give me the shot in the stomach of Heparin. i asked him *again* for my pains meds THAT HAD BEEN DUE AT 8am. he said “yes, yes, getting them.”
i was supposed to get them EVERY 4 HOURS.
at noon, i called *again* for my meds.
my dad came to visit me at 2pm.
i STILL had not gotten my 8am meds.
because the nurse “didn’t want me to get addicted.” because “i was so young (31) and so smart, too smart to need painkillers less than 24 hours after my hip was cut off and re-attached.” because “he hates drug addicts, and didn’t want to think I was one”.

(this *is* the same nurse who refused to believe that i had an infection in the incision, refused to record that my temp was 100.9, and when i was re-admitted because it turns out i had MRSA, tried to convince all the doctors that i was *FAKING* having MRSA. i had to have TWO MORE BLOODY SURGERIES to get rid of the MRSA – but iwas “faking”. my EMGs show that my nerves are freaking *dying* and that i have over 30% nerve damage in my right leg, mostly in the sciatic nerve at the point where it crosses the joint – but this nurse told every doctor on the floor that i “faked” THOSE tests, too. how do you FAKE MRSA? how do you FAKE an EMG? how do you FAKE a fever with a nurse who stares at you the whole time and takes your temp THREE TIMES? how do you FAKE huge swelling and MRSA bacteria in the incision site? you don’t.]

i was born with a disease that leaves me in constant chronic pain. i’ve been on vicodin since i was 10. but until the hip surgery, i RARELY took pain meds – generally, i’d be given 30 vicodin and end up throwing away 20 a year later. my doctors hated me, because i wouldn’t take the pain meds, unless the pain was over a 9 and was making me ill.
i’ve been in a wheelchair for over a year. my pain level is almost always over an 8. i never, ever, ever get a pain level lower than a 7. my nerves mis-fire often, and even non-medically-trained people can SEE the muscle spasms.

and then i go to the pharmacy to drop off my Rx, tell the pharmasist “this cannot be filled for 2 days” because of the 30-day rule – and am accused, often, of being a “crack-head-drug-addict”. i’m sitting there in my wheelchair with my leg screaming and i’m polite and nice [without fawning] and i tell the pharmasist that i know it can’t be filled, i’m dropping it off on my way home…

but A) i’m not an “old person” [people won't believe that i'm over 25, let alone that i am now 33] and B) i don’t have a “broken bone” – so OBVIOUSLY, in the opinion of most medical people who don’t know me, don’t know my med history, and don’t bother to ask, I’m “just an addict” and i don’t deserve to not hurt. or rather, they think i deserve *to* hurt, because according to *them*, i DON’T. dear gods, how i wish they were right! i would gladly never ever take even asprin if only this pain would go away…

most people with chronic pain are treated poorly by most medical people. or, at least, every person i have ever communicated with who has chronic pain are treated poorly by most of the medical people they have contact with. my friends nephew with MS, my mother [a nurse practicioner] who’s had 7 surgeries on her back, about to have the 8th, my friend who lost a foot and has terrible neurathopy, the people i know with fibromalgia, the people i know with Lupus, the people i know with nerve damage, bone spurs, herniated discs – all of them have to fight all the time, because everyone just ASSUMES that they’re “faking”.

*THAT’S* why your “of course this doesn’t apply to “legit” pain patients” isn’t useful. it isn’t true.

I’ll borrow a nice car from a friend, get something that looks like an iPhone, and get some designer knock off stuff to wear. I’ll pull up to the pharmacy drive thru, chatting on the fake iPhone about how I have a fabulous European vacation planned. When I leave I’ll have the satisfaction of knowing that your panties will be so unbelievably twisted and that you’ll obsess and stew about me the rest of the day. It’ll ruin your day to imagine me as some mythical welfare queen who’s living the high life on food stamps.

Good luck with wasting your time and energy obsessing over medicaid patients. It’s no wonder so many of you are miserable in your careers.