So the other issue is that when you've taken narcotics for a while, the same dose doesn't give you the same effect. So that's where you get used to the narcotic effect. What then happens is that people start taking more narcotics and then you get into this vicious circle of taking more narcotics and then it not working as well and then maybe sensitizing you to pain so your pain actually feels more.
So you take more narcotics and then the difficulty is are you really needing those narcotics or are you addicted? What is the behavior around getting those? So more and more, we've understood that chronic pain.
So cancer pain tends to come and it gets worse and worse as the cancer spreads. So in reality, it's almost like acute pain that keeps happening over and over as the cancer spreads to a new area. So the goal for pain is that acute pain should be treated with the least amount of drugs that does the job well for someone so that they can get up and move around.
We never can make all the pain go away for someone, we'll say, after surgery. So our goal is to make it tolerable for people to get up and move around because getting up and moving around is really important to make the pain feel less.
So moving is important for most kinds of pain to make you feel better. If our listeners ask, "My painkiller isn't working as well as it used to," then the answer is right, how long have you been taking it and what have you been taking it for? Particularly for things that are chronic like low back pain, or people who have pelvic pain that's chronic, not just like the acute pain that comes with a bad period or with an ovarian cyst that ruptures or something like that.
So people who use pain on an everyday basis, their pain medicines are not going to work as well and they're going to need more and they might become addicted and it doesn't work for chronic pain in the first place. So what are you supposed to do? If your pain pills aren't doing for you what you want, should you get a higher dose? Should you get a stronger narcotic? I think most pain specialists would say this is the time for a reevaluation of your pain and looking at other options for pain management.
So other options at pain management actually include cognitive behavioral therapy. In other words, helping you deal with how you appreciate that pain, how you respond to that pain.
Exercise can be helpful. Physiotherapy can be helpful. Your employer might still be required to hold your job while you take leave for treatment or recovery. If you need leave because of an ADA disability see Questions 6—9 , you should be allowed to use sick and accrued leave like anyone else, unless you are using opioids illegally.
You should also check your employer's leave policy to see whether it provides leave for substance abuse treatment. Even if you have no employer-provided leave available, you still may be able to get unpaid leave.
If you have worked at least 1, hours during the past 12 months and your employer has 50 or more employees, you may be entitled to unpaid leave under the FMLA. More information about this law can be found at www. You might also be entitled to unpaid leave as a reasonable accommodation if you need the time off because of a disability, are not using drugs illegally, and are expected to recover the ability to do your job.
If you are permanently unable to do your regular job, you may ask your employer to reassign you to a job that you can do as a reasonable accommodation, if one is available.
If you decide to file a charge of discrimination with the EEOC, it conducts an investigation. Because you must file an EEOC charge within days of the alleged violation in order to take further legal action or days if the employer is also covered by a state or local employment discrimination law , it is best to begin the process early. It is illegal for your employer to retaliate against you for contacting the EEOC or filing a charge. The various facets of nondiscrimination, reasonable accommodation, and other protections under Title I of the ADA are addressed in different sections of the statute and regulations.
See, e. Department of Labor DOL. Use of Codeine, Oxycodone, and Other Opioids: Information for Employees If you are using opioids, are addicted to opioids, or were addicted to opioids in the past, but are not currently using drugs illegally, you should know that under the Americans with Disabilities Act ADA you may have the right to get reasonable accommodations and other protections that can help you keep your job.
Performance and Safety 4. Could I get a reasonable accommodation because of an addiction to opioids? What should I do if I need a reasonable accommodation? What will happen after I ask for a reasonable accommodation?
Protect Your Rights What should I do if I think my rights have been violated? If you just had surgery or are experiencing a health problem, pain is a natural and expected part of the process.
Pain medicines may help you function better and cope with the amount of pain you are experiencing, but will not eliminate it entirely. Opioids are common pain medicines. They can help if you have bad short-term pain —like pain after surgery for a broken bone. They can also help you manage pain if you have an illness like cancer.
But opioids are strong drugs.
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