Would a medic who takes a low dose of opiates daily be considered an impaired provider?

SGT(P) Private RallyPoint Member — Sat, 11 Mar 2017 01:05:52 -0500

As a medic suffering from chronic pain I have taken a low dose of opiates daily for the last 3 years. Me and my PCM have explored several other pain managment options, and the only thing that works is the low dosage that I am on. The medication does not effect me mentally or physically, and my PCM agrees with this, but ultimately does this make me an impaired provider by Reg?

Response by PO3 Christopher Jonah Nelson made Mar 11 at 2017 1:10 AM

PO3 Christopher Jonah Nelson — Sat, 11 Mar 2017 01:10:13 -0500

By regs, I can't say, but it definitely impairs your judgment. The question is the degree to which it impairs your judgment. Even just imbibing things like caffeine are judgment-impairing, but it's at such a low level that it's considered to be within a single standard deviation. If your physician has tested you and determined that you're able to perform your duties adequately, I would take the word of your provider. The worst thing you could possibly do is start self-diagnosing yourself; that way lies hypocondria.

Response by PVT Private RallyPoint Member made Mar 11 at 2017 1:11 AM

PVT Private RallyPoint Member — Sat, 11 Mar 2017 01:11:54 -0500

Not sure about the regs, but have you discussed with your PCM the possibility of low dose naltrexone? It'll upregulate your opiod receptors which leads to decreased pain. Treats the pain in a more natural, sustainable way. Hope this helps

Response by SFC Joseph Weber made Mar 11 at 2017 5:57 AM

SFC Joseph Weber — Sat, 11 Mar 2017 05:57:22 -0500

If your chain of command thinks you are a good medic then I would go with that. You are promotable so you must be doing something right. I'd come see you.

Response by PVT Mark Brown made Mar 11 at 2017 2:28 PM

PVT Mark Brown — Sat, 11 Mar 2017 14:28:18 -0500

Good question. Due to back injury suffered while on duty in South Korea I take 40 mg of Oxycodone daily, sometimes less. I do not feel impaired in the least. What made feel impaired were are the psychotropic drugs the VA mental health doctor (and actual MD, PhD) to treat my sleeplessness, night tremor, other PTSD symptoms. These drugs, all added together, made a total zombie out of me. They screw me up big time. I am now drug free as to MH drugs. I took myself off all of them and feel 10000% better. The VA wants to just dope us up and get us to tell them how wonderful the treatment is that we received. BUll$..t. Thank God for helping me get off all this junk. I just can't express how much better that I feel now. Did they want me to get any sort of psychological help? - NO! Just take the pills and shut up and see you again in 90 days. Another problem was that every 90 days when it was time to see my doctor, he or she was no longer with the VA and I got to meet yet another pill pushed. I have a great Primary Care doc now (just got away from my prior PCM doc) who is willing to take time with me a talk to , explain things in a way I can understand, she will go along with my concern about taking too many meds. She is great. I am afraid she will get hired away from the VA. She is Filipino and a very caring provider. (I just don't know how to write a short answer!!)

Response by COL Charles Williams made Mar 13 at 2017 12:41 AM

COL Charles Williams — Mon, 13 Mar 2017 00:41:15 -0400

Yes

Response by SGT Private RallyPoint Member made Mar 13 at 2017 12:36 PM

SGT Private RallyPoint Member — Mon, 13 Mar 2017 12:36:51 -0400

This isn't a black and white area it really varies based off several things. If its a concern than you can see about a fit for duty possibly. In the end if the PCM states that while taking the drug your are good to perform all duties than your fine. Now I do believe that you would no longer be deployable.

Response by SPC Neil Hood made Mar 13 at 2017 12:55 PM

SPC Neil Hood — Mon, 13 Mar 2017 12:55:11 -0400

Pretty subjective, prescribing physicians will tell you to avoid driving but many patients are immune to low dose opiates. Life goes on as well as a need to do your job.

Response by SFC Private RallyPoint Member made Mar 14 at 2017 8:50 AM

SFC Private RallyPoint Member — Tue, 14 Mar 2017 08:50:12 -0400

Yes. When le I sympathize with your plight of having to take this medication in the first place - a functional capacity should be determined by your chain of command. Research can not completely determine the effects this medication will have on you. Ask yourself this question from a patients point of view- would you want an opiate impaired person rendering your care, or better yet taking care of your children (if you have any)?
Your posting this question tells me that you are not 100% ok with this.
I wish the best of luck to you in this situation.

Response by Lt Col Jim Coe made Mar 14 at 2017 3:19 PM

Lt Col Jim Coe — Tue, 14 Mar 2017 15:19:40 -0400

Don't know what the regulations say. I wouldn't consider you impaired if the drugs are legally prescribed and have no measurable effect on your performance of duty. If the "PCM" is an MD/DO, I think you have a strong case with regard to impairment.

Response by SPC Private RallyPoint Member made Apr 11 at 2017 1:25 PM

SPC Private RallyPoint Member — Tue, 11 Apr 2017 13:25:25 -0400

Definitely sucks but as mentioned before, if you make a mistake the first thing thought of would be impaired judgment due to medication. You may function 100% but the off chance because everyone makes mistakes.

Response by SGT Private RallyPoint Member made Apr 11 at 2017 9:33 PM

SGT Private RallyPoint Member — Tue, 11 Apr 2017 21:33:45 -0400

If they are prescribed to you & you are taking them as such, then no. If your meds say not to drive or operate machinery & you make a mistake, that's when you could be in trouble. I would find a different med. As a medic you need to be 100% all the time. No matter what effects you have or don't think you have, it effects you somehow, or else they wouldn't work.

Response by Lt Col Paul Maxwell made Apr 16 at 2017 6:59 PM

Lt Col Paul Maxwell — Sun, 16 Apr 2017 18:59:02 -0400

Reasonable question to be considered, and evaluated. But impossible for me, or Anyone here on a FB page, to adequately assess. That is the realm of someone who knows your entire complex medical story, and evaluates you in person. Best of luck to you, both in your career and health.

Response by SGT Jeffrey Dennis made Apr 21 at 2017 2:15 PM

SGT Jeffrey Dennis — Fri, 21 Apr 2017 14:15:30 -0400

I was in a bad motorcycle wreck and was on Dilaudid for a while and then switched to 7.5 Mg Hydrocodone tablets (Norco). I can say, that none of it really had a change on my Level of Consciousness. However, it could have impaired my judgement without me knowing. I was off work for a while anyways, but its definitely something to consider.

Response by MSG David Johnson made Apr 21 at 2017 4:29 PM

MSG David Johnson — Fri, 21 Apr 2017 16:29:53 -0400

SGT(P) Private RallyPoint Member You might ask about Tramadol as an alternative med. you didn't specify med or dose so there may be differences of opinion.

Response by Cpl Joseph Roberts made Oct 3 at 2019 4:05 PM

Cpl Joseph Roberts — Thu, 03 Oct 2019 16:05:32 -0400

Without looking away any other responses yet, the opinions of those unfamiliar with long term opiate usage should be taken with a grain of salt. I've been on opiates for 7 years for chronic pain resulting from spinal cord injury. I've been on a pretty high dose and am currently low dose. I can say that regardless of the dose, if i regularly took it and did not get high, my mental clarity was the same. It's only with opiate nieve patients and those seeking a high where your mental function may suffer.

Response by SSG Private RallyPoint Member made Jul 13 at 2021 11:19 AM

SSG Private RallyPoint Member — Tue, 13 Jul 2021 11:19:23 -0400

As a fellow medic I understand you have pain management issues. But the rest of the comments on here are correct. You, your provider need to discuss it further in relation to daily duties, MOS physical requirements, deployments etc. But most certainly your provider and you need to discuss that.

Response by Sgt Dale Briggs made Jul 13 at 2021 2:30 PM

Sgt Dale Briggs — Tue, 13 Jul 2021 14:30:00 -0400

That’s a question for the medical providers, you defer to experts in their field, you can be treated and tested I suppose. But personally I wouldn’t think it an automatic disqualification, given what little I know, but who am I.