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Thread: PAP program in NY State

  1. #1

    Exclamation PAP program in NY State

    I diverted from work. Instead of quitting...So,I called to get involved with PAP as I was told I could take my pain medication. The substance abuse counselor and NP both said "no" to my pain medication. So, I tried for a few weeks. I had a horrible painful time due to waking and being unable to sleep due to pain....and I take low dose stuff when I do. The PAP is a 3 yr program and I am in pain now. I know that I can not work with the public in the same capacity as before and do not want to while I need this medication. I disagree with the counselor (I would not let her talk to my patients like she talked to me). They said I can not get counseling without the urine screen and I think the urine screen is a waste of my $$$ . I realize that I will need random urines before my possible re-instatement if I ever want to get my license back. So, why waste my money now. Teach me how to properly take care of my medication control, not take it away!!! A substance use counselor. I just am all confused about this. Maybe I need a lawyer. I do not want to work as a nurse now. Does anyone have suggestions on what they may want me to do or the punishment I will get if I don't go to a Substance Abuse Counselor. I know I will be fined most likely. But, I want to get the counseling for control of my meds.

    I am not afraid of dying.... only living forever in pain.

  2. #2
    Member Extraordinaire hppygr8ful's Avatar
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    Re: PAP program in NY State

    It would help if you could tell us more about what type of pain you are in. Have you had any treatment, detox etc...

    Most state programs require that you have 2 years of documented clean urines before they will let you out of the program - which is why they start testing you right away. All drug treatment programs have random testing that's just a part of the process that you can't get away from. Bottom line if you want to keep your license you do what they tell you. There are lots of ways to treat pain without narcotics! 2.5 years ago I was in so much pain I could not walk - Now I have no pain and no narcotics! But you have to be willing and teachable that's what recovery is all about.

    Ps remember the boards are charged with protecting public safety which means as long as you are using narcs for any reason they are gonna be on you like white on rice. Also remember that PAP is a voluntary 100% abstinance program ( no drugs, no ETOH, No benzo's or sleeping pills not even benedryl.) You could opt for probation but you would have the same restrictions, a DEA investigation into your diversion (which you pay for $5000-$10,000), and you may face criminal charges. It's a lot to think about so really think it through.

    If you were diverting and got caught most lawyers won't touch your case except to tell you to do what they say!

    You can write to me here anytime with your questions and frustrations - I will try to help.

    Peace and Namaste

    Hppy

  3. #3

    Question Re: PAP program in NY State

    I am in counseling now. I have rheumatoid arthritis since age 3 in all my joints. I have tried everything all NSAIDS now Mobic ...was on Vioxx before it was taken off the market. Had 2 surgeries. Now I can not get relief without narcotics at times. I don't take them round the clock, much less than prescribed. But... I guess I will have to pay the fine and get a job that hire people that have to take narcotics since the other things don't work. I take 4 pills a day and still have pain. So, I don't think I can be a nurse unless I want to suffer with pain. We don't let our animals suffer or our patients...why should we or I

    :luck:

    P.S. Have any suggestions for pain since you are doing so well?

  4. #4
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    Re: PAP program in NY State

    I feel for you on this one. Like you I have chronic pain and most dont have a clue what it's like to try to function with such degree of pain. Having a back injury etc is one thing but living with juvenile arthritis is a complete other story people not living with it just wont understand. Like you I also have suffered with this disease since I was 13 and also have stage 3 chrondromalacia in bilateral knees. I was told at age 19 I would need knee joint replacement down the road. Of course I am now 50 and have had 4 surgeries on my knees which gives very temporary relief. My insurance wont cover the knee replacements until I am at least age 60 (havent a clue why this is but it is as it is). I have been on Vioxx, Bextra, Daypro, Cellebrex, Arthrotec, you name it. But with all the hoopla with the side effects and having a cardiac history they took me off all of them. I was then placed on Motrin 800mg, Darvocet-N and Sinemet(bid after 4pm as I developed severe RLS on top of it). Actually with the darvocet I had some control. Fortunately my past action didnt have the stipulation I couldnt take prescribed meds after my probationary status was complete(thank god). My insurance is now doing away with Darvocet on thier formulary which paniced me and using Ultram (Tramadol). So far it has helped and you may want to check to see as it isnt consider a "narcotic". Also I do my best to go 2 weeks using my meds then 3 days off consistently. Every 6 months I do the best I can to not take for almost 30 days just to detox my system. Sometimes I have to give in due to the pain but it keeps me from ending up in an addictive state. During this time I use more Ice then you could probably find in the north pole and meditation I do on a daily basis with yoga. I do swim almost daily also. Since starting the later things I have been able to cut my meds down dramatically that sometimes I only need to take at bedtime or when I have had a great deal of activity. My pain hits me when I'm done working and sit down for the night. I'm usually ok during work as I have had to endure it so long that I just put my concentration elsewhere for that time. As long as I'm moving I'm well. But the end of day and I get in my vehicle to drive home this is when it hits me like a mallet! I found a gym with a heated pool and stop daily on my way home and hit the whirlpool and the swimming pool. This has been the best exercise in the world to help with my mobility and my pain. I have been a CVICU/ICU/Trauma/Burn nurse for over 24 years so beleive me I stay active at work with no time to sit down usually. If you cant get off meds then see if Ultram would be an issue as it has helped me and I havent had any issues with it on pre-employment drug screens. Also when they added the sinemet which I take at 5pm and then before bed was a godsend! I was very skeptical at first but it really made a significant difference in my pain control.

  5. #5
    Member Extraordinaire hppygr8ful's Avatar
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    Re: PAP program in NY State

    Quote Originally Posted by PutOutnPO'D View Post
    I feel for you on this one. Like you I have chronic pain and most dont have a clue what it's like to try to function with such degree of pain. Having a back injury etc is one thing but living with juvenile arthritis is a complete other story people not living with it just wont understand. Like you I also have suffered with this disease since I was 13 and also have stage 3 chrondromalacia in bilateral knees. I was told at age 19 I would need knee joint replacement down the road. Of course I am now 50 and have had 4 surgeries on my knees which gives very temporary relief. My insurance wont cover the knee replacements until I am at least age 60 (havent a clue why this is but it is as it is). I have been on Vioxx, Bextra, Daypro, Cellebrex, Arthrotec, you name it. But with all the hoopla with the side effects and having a cardiac history they took me off all of them. I was then placed on Motrin 800mg, Darvocet-N and Sinemet(bid after 4pm as I developed severe RLS on top of it). Actually with the darvocet I had some control. Fortunately my past action didnt have the stipulation I couldnt take prescribed meds after my probationary status was complete(thank god). My insurance is now doing away with Darvocet on thier formulary which paniced me and using Ultram (Tramadol). So far it has helped and you may want to check to see as it isnt consider a "narcotic". Also I do my best to go 2 weeks using my meds then 3 days off consistently. Every 6 months I do the best I can to not take for almost 30 days just to detox my system. Sometimes I have to give in due to the pain but it keeps me from ending up in an addictive state. During this time I use more Ice then you could probably find in the north pole and meditation I do on a daily basis with yoga. I do swim almost daily also. Since starting the later things I have been able to cut my meds down dramatically that sometimes I only need to take at bedtime or when I have had a great deal of activity. My pain hits me when I'm done working and sit down for the night. I'm usually ok during work as I have had to endure it so long that I just put my concentration elsewhere for that time. As long as I'm moving I'm well. But the end of day and I get in my vehicle to drive home this is when it hits me like a mallet! I found a gym with a heated pool and stop daily on my way home and hit the whirlpool and the swimming pool. This has been the best exercise in the world to help with my mobility and my pain. I have been a CVICU/ICU/Trauma/Burn nurse for over 24 years so beleive me I stay active at work with no time to sit down usually. If you cant get off meds then see if Ultram would be an issue as it has helped me and I havent had any issues with it on pre-employment drug screens. Also when they added the sinemet which I take at 5pm and then before bed was a godsend! I was very skeptical at first but it really made a significant difference in my pain control.
    You have given some very good advice here. I can't say I know what Juvenile arthritis feels like - my chronic pain was due to a series of injuries I in
    curred over years of working with horses, cattle and other animals. PLus for a while the Dr thought I had fribromyalgia. Once I detoxed - and my liver which was 50% gone from the Tylenol in the vicodin and all the booze I drank
    I was sent to real pain management specialist - not one that prescribes narcs only. I had physical Therapy, acupuncture, and I was started on a medication called Ketoprophen which is a very long acting NSAID that you take BID when the pain flares up.

    However, if you have a documented medical condition that requires some Narcotic Pain relief. Then you should have you physician report this to board along with a complete treatment history. The board may make an exception for you. It's not the fact that you need these medications that got where you are - It's the fact that you diverted from work and there's no excuse for that. The fact is that everyone of us in probation, diversion ,peer assistance or whatever they call it in your state are here because our actions made us unsafe to practice.

    I would get all your l medical records together, labs, prescripton history etc and petition the Board - It's worth a try.

    Peace and Namaste

    hppy

  6. #6

    Re: PAP program in NY State

    Thank you for all your help with this subject. I just don't want to tick anyone off within the State. I don't know what they can do to me. Cement shoes perhaps
    I have been on medication since 3 yrs old and tried all the NSAIDS. I am not afraid of drugs for sure as you see. My liver works great still and I am on level 3 treatment now for my disease. But i have not tried ketoprofen. I will look it up for sure! Thanks again:luck:

  7. #7

    Smile Re: PAP program in NY State

    Well, I am in the program. I was in detox on my days off of work actually. 12 hr shifts give you long weekends. Actually, I never took much of my PRESCRIBED medication. Not even the max daily dose. But, after I was out of work for the diversion I stopped with my home baby dose vicodin too. For almost a month. One of the counselors said.. I wonder what your baseline tolerance for pain is. Heck, the tolerance is high it is just some times you need relief. 4am when it wakes you up for instance. I have different modalities to treat my pain. I have had it since age 3. I actually had alot of active flares in my childhood. It is true that when you have autoimmune problems an injury or surgery can cause disease activity or flares. I was not sure I believed it at first. Maybe I just hoped it wouldn't happen... lol I'm feeling better though!
    :luck:
    Someday you will need to be rescued, whether you realize it or not. Every night be grateful; just in case today was that day.....every day is my day...:39:

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