Why so many kids on meds???

[famofsix]

Hang on, Im getting confused. Who should I be getting angry at?

Parents
Teachers/Schools
Doctors
Pharmaceutical companies
The Jones
Myself
Scientologists

OP really doesn't want to know why kids take medications for ADHD/ADD she just wants everyone to know she thinks it is a bad choice in her opinion because it is a simuliant. Nothing is going to change that no matter what families say that are actually experiencing having a child with ADD or ADHD.

OP, I think you would do well to educate yourself on the symptoms of ADHD/ADD and why some parents chose to use a simulant. It is not to get the child ahead in grades over your "normal" children. Also, there are several other choices in medications that are not simulants. It really depends on the child.

While I don't know you or your family situation, I would encourage you to exert some sensitivity on this subject and perhaps compassion...maybe then you will understand why some children need medical intervention for a very real difficulty.

Adults who don't have intervention for their ADHD/ ADD sometimes end up self medicating through the abuse of alcohol/illegal drugs because no one bothered to understand what their struggle was and I don't want my child to go that route because I failed to believe there was something that could help him.

 

[PilotWife]

This is only my second or third post on this board.....but this topic really rubbed me the wrong way..... I have a 7 yr old that is ADD and on meds. It is not that he has extra energy, he does....and it took us and several doctors more that 8 months to diagnose ADD. This is NOT something that Dr's and parents are just throwing meds at these kids. With my child, he could not focus or carry on an intelligent conversation before he was put on these meds, things that 6 or 7 yr old should be able to do, he could not (like dress himself) because of his attention and focus ability was not there. It is not that these kids are hyper and if that was just the poblem then yes - let them release some energy....The main problem without meds is that the children are not learning and socializing. If they cannot learn (and focus) at a young age then they cannot learn to function in society. They do not pick up on social cues from other children during play time therefore they are not "learning" how to behave in a social setting or a family setting OR A LEARNING ENVIRONMENT. They are impulsive, and in young children that is DANGEROUS, without the meds they cannot think through a problem to see the consequenses of their actions. Many of these children are hospitalized for accidents due to there impulsiveness, running in front of cars, jumping bikes dangerously, and in teens they are starting to have sex without fully understanding the consequenses of their actions - these kids REALLY do not see this....and they are behind socially.....then the rest of children their age....so therefore they are easy targets.

I just really do not like being preached to about meds for these children. It is like if your child had diabetes, wouldnt you give them the meds they need to live???? I give mine these meds because he NEEDS them, his chemicals are not normal. So why would you not give your child the best start in life and school that you could possibly give them? Walk a mile in our shoes, do your research and then preach to someone.

AND IT IS NOT because they have extra energy, it is because something is not right in their learning process and brain chemicals.

I need to stop now!! Why would you even post this on a Disney board? Just to see what drama you could stir up???

Jennifer

 

[DragonFox98]

3jsmommy,

We have custody of our nephew, now almost 14. He was diagnosed as ADHD before we got him. He was already on tones of meds - we don't believe in them (just me personally - not that meds don't help some people - keep reading).

Now, we went to the doctor, demanded to know what each and every med was four (he was on five different kinds at different times of the day). Long story short, we took him off everything for awhile - we weaned him down and it was not cold turkey. We soon realized he could not function without some meds - he couldn't concentrate, he became abusive (to DH, myself and our kids), and his weight started to become a factor.

He's now on an anti-anxiety and a med for the ADHD. He is also in therapy and regularly sees his doctor. He's been through a lot of trauma, but the few meds he's on now help tremendously.

But I do agree with you - meds are overprescribed by physicians who just don't want to bother (that was part of my nephew's original problem). I would rather get to the root of the problem than cover up the symptoms with meds.

**I'll get off my soapbox now**

 

[futreWDI]

I do want to stick up for the OP in the sense that the people he may or may not be judging are not the parents on this board. If you are on this board, albeit for Disney research, etc. than you are probably a decent parent. The parents that I believe are overusing meds in certain cases wouldn't have the time to sit on the computer to defend themselves. They are the parents that almost neglect their children and use the meds as a way of shutting the child up. Their children probably never make it to WDW. I still also stand by the fact that there are correct ways to get tested and I believe that some pediatricians may overdiagnose.

Oh, and to the OP, I wanted to explain the "not being hungry" because I do face this each day. The way an ADD/ADHD medication works is that it makes you focus on one thing. If you choose it to be hw, teacher, or tv, then your brain is not focused on the other signals your body is sending. It is not that the kids don't need to eat. It is just that they don't feel hungry because the hunger signal essentially gets lost but its there. Eating while on meds is just another adjustment that parents and kids need to get used to.

 

[barkley]

OP really doesn't want to know why kids take medications for ADHD/ADD she just wants everyone to know she thinks it is a bad choice in her opinion because it is a simuliant. Nothing is going to change that no matter what families say that are actually experiencing having a child with ADD or ADHD.

OP, I think you would do well to educate yourself on the symptoms of ADHD/ADD and why some parents chose to use a simulant. It is not to get the child ahead in grades over your "normal" children. Also, there are several other choices in medications that are not simulants. It really depends on the child.

While I don't know you or your family situation, I would encourage you to exert some sensitivity on this subject and perhaps compassion...maybe then you will understand why some children need medical intervention for a very real difficulty.

Adults who don't have intervention for their ADHD/ ADD sometimes end up self medicating through the abuse of alcohol/illegal drugs because no one bothered to understand what their struggle was and I don't want my child to go that route because I failed to believe there was something that could help him.

i think people not knowledgeable/with experience with these drugs assume that since most are classified as stimulents that some kind of stimulant 'high' occurs when someone with adhd takes them. that occurs only when the person does NOT have true adhd and the brain/body chemestry that comes with the condition. people (generaly adults) who steal their kid's ritalin and other adhd drugs do get a high (very similar to speed), but an adhd's chemestry does not react this way. the same can be said of the adhd's reaction to non adhd drugs-meds that tend to make others stimulated or awake make them overly sleepy-while 'drowsy' meds can set them off climbing the walls. my ds for example cannot take benadryl or other simularly formulated meds because they will keep him awake and jittery for hours. a trip to the dentist found that nitrisoxyide has the exact opposite from the desired effect. it was only after we located a pediatric dentist that we learned of how the field of anesthesia is now very aware of the differences in adhd body/brain chemestry and it is of paramount importance that any med provider be aware of ds's diagnosis should he require sedation of any type (he had to have an mri/mra a few months ago, and upon learning of his diagnosis the major med pediatric center we went to would'nt permit an anesthisologist without training and experience in adhd sedation to do the sedation plan and implementation).

i always have to wonder why anyone would CHOOSE to use adhd meds on kids that are not adhd-the reality is it won't sedate them, it will cause them to bounce off the walls. behavioural problems will likely grow worse. you could give a kid a gallon of coffee and and a hefty bag of pixie sticks to the same results

 

[pperfectmom]

To the OP, I agree with you to a certain extent. And it is so hard to have an opinion on this board about some things without people thinking you are judgemental. Lighten up folks, it is an opinion-nothing more, nothing less. My opinion is that lots of pharmaceuticals are way over prescribed. A huge pet peeve of mine is antibiotics. I could start a thread saying they are over prescribed and within minutes I would have people jumping down my throat telling me how they saved their precious child's life. Well...that may be so, but what does that have to do with the FACT that they are over prescribed? The same thing with drugs for ADHD. They are being used more than necessary IMO. In fact, you have schools telling parents they need to get these ADHD drugs for children. Good for you the parents who research before giving their child any medication(I'm one too) but I hate to tell you that a lot of parents do not. I know plenty of them myself who blindly follow what their Dr. tells them about everything from vaccinations to an antibiotic for a common cold.

 

[eeyoregon]

This thread has brought me to tears.

My son is 11 and because of narrow minded opinions from people who have no idea about what they are talking about, I have let him and our family suffer because medicating him scared me so badly and I worried about what other people would think and say if they found out.

We have spent a total of 16 hours in the past 2 weeks talking to a child psychiatrist, completing psychological tests, answering DETAILED questionaires and rating systems for our entire family and reviewing 5 years of IEP's. In addition the MD spent hours observing and interacting with my son.

These weren't just yes/no forms. They are actual psychological tests that are used around the world and sent to a 3rd party for scoring and evaluation.

My son has been diagnosed with ODD, AD, autism (low end of spectrum), anxiety disorder, sensory perception disorder and pervasive devlopmental disorder in addition to the fact that he had a brain injury as a toddler (brain tumor resection) and will never know how much of each piece of the pie is from genetics or his surgery.

We go back next week to discuss our medication plan. In addition to medication he will begin occupational therapy as well as counseling.

"Say no to all drugs"????? WHAT WERE YOU THINKING????? Are you telling me you have NEVER had a headache and taken Tylenol? WOW...good for you!!! Hmmm ...better make sure your city water is not fluorinated as fuoride is also a prescription DRUG.

I plan to treat my son's mental illness and help him to become a better, happier person who can function to his fullest potential in our society. I will also teach him about the ignorance of complete strangers.

 

[PilotWife]

To the OP, I agree with you to a certain extent. And it is so hard to have an opinion on this board about some things without people thinking you are judgemental. Lighten up folks, it is an opinion-nothing more, nothing less. My opinion is that lots of pharmaceuticals are way over prescribed. A huge pet peeve of mine is antibiotics. I could start a thread saying they are over prescribed and within minutes I would have people jumping down my throat telling me how they saved their precious child's life. Well...that may be so, but what does that have to do with the FACT that they are over prescribed? The same thing with drugs for ADHD. They are being used more than necessary IMO. In fact, you have schools telling parents they need to get these ADHD drugs for children. Good for you the parents who research before giving their child any medication(I'm one too) but I hate to tell you that a lot of parents do not. I know plenty of them myself who blindly follow what their Dr. tells them about everything from vaccinations to an antibiotic for a common cold.

I NEVER ONCE had my child's school tell me to put him on meds....and if the case or opinion is ..... Dr's overprescribe, why single out those who have their children on ADHD meds???? And not the other issues with meds such as meds being prescribed for uses that a drug is not tested for. No... the OP started with this for the drama.....and knew that people would be upset, you tell us to lighted up.... but this is a touchy topic and ALL of these parents have had a tough choice in dealing with these issues, and it is their children you are talking about. The children that these parents dreamed of for years and "wanted the dream normal child" ..... these children and parents are given a tough blow, and no one wants to say "hey my child is not the perfect child and something IS REALLY WRONG with them". But you tell us to lighten up....when people judge us as to how we choose to help our children.

Jennifer

 

[pperfectmom]

I NEVER ONCE had my child's school tell me to put him on meds....and if the case or opinion is ..... Dr's overprescribe, why single out those who have their children on ADHD meds???? And not the other issues with meds such as meds being prescribed for uses that a drug is not tested for. No... the OP started with this for the drama.....and knew that people would be upset, you tell us to lighted up.... but this is a touchy topic and ALL of these parents have had a tough choice in dealing with these issues, and it is their children you are talking about. The children that these parents dreamed of for years and "wanted the dream normal child" ..... these children and parents are given a tough blow, and no one wants to say "hey my child is not the perfect child and something IS REALLY WRONG with them". But you tell us to lighten up....when people judge us as to how we choose to help our children.

Jennifer

Wow, you certainly proved your point that this is a touchy subject.

 

[PrincessMom4]

Every circumstance is different. When a child has a real condition then others need to back off. I have done more research into effects (hort and long term) as I am in the health care field and a legal assistant, I like to be informed. I agree with the person who said that the parents who don't research or whatever was would not be on this board defending an all ready different situation.

 

[mm_ja]

To the OP, I agree with you to a certain extent. And it is so hard to have an opinion on this board about some things without people thinking you are judgemental. Lighten up folks, it is an opinion-nothing more, nothing less. My opinion is that lots of pharmaceuticals are way over prescribed. A huge pet peeve of mine is antibiotics. I could start a thread saying they are over prescribed and within minutes I would have people jumping down my throat telling me how they saved their precious child's life. Well...that may be so, but what does that have to do with the FACT that they are over prescribed? The same thing with drugs for ADHD. They are being used more than necessary IMO. In fact, you have schools telling parents they need to get these ADHD drugs for children. Good for you the parents who research before giving their child any medication(I'm one too) but I hate to tell you that a lot of parents do not. I know plenty of them myself who blindly follow what their Dr. tells them about everything from vaccinations to an antibiotic for a common cold.

Above you are talking about antibiotics, you state that it is a fact that antibiotics are over prescribed. In the next sentence you state the same thing is true concerning ADHD medication, and in the next sentence state that that is your opinion. I cant change your opinion, and you cant present me with facts to back up your opinion. I dont know I lost my train of thought and all of this is just upsetting. No one here is going to upset me or make me feel guilty about the decision I made for my child. I know I went through all the necessary due diligence to make the decision that was right for us. I just hope there arent people in your (not specific to any poster) life that are struggling with this type of decision that can be shamed into making a choice that is not in the best interest of the family because of peoples overbearing opinions.

I know none of that probably made much sense it sounds better in my head.

 

[ksumn1]

You know, DH and I were discussing something similar the other night. We were discussing the fact that ADD, ADHD, and also autism were medical conditions that weren't around (or as prevalant) just a few years ago. I don't know if it's due to advances in diagnosing these conditions or the fact that every problem or ailment now has a name.

I know that these ARE all valid medical ailments, because I have a nephew and a 13 year old brother in law who are both ADHD. My BIL is on a very low dose of medication during the school year and only takes enough to help him concentrate in school. He went from making C's and D's and even F's to making all B's and the occasional A in about 3-6 months. Before getting his mediacation levels stabilized he was in remedial classes for English and math. In 3 months he was back in all regualr classes. My little nephew was recently diagnosed (in the last 6 months or so) and he has to take medication all the time. In Pre-K, he was rambunctious and the teachers had a hard time getting him to focus. His teacher is actually the one who suggested my SIl take him and have tested. He started taking medication and so far is doing well, but his activity level and level of concentration vary every day. His pediatrician is trying to get his medications levels adjusted because some days he's a little "spacey" as SIL calls it.

For both my MIL and SIL the decision to medicate was a hard one. My MIl is a big beliver in homeopathic remedies and avoid medical intervention or medication unless it is absolutely necessary. But in both cases, the medication has really helped and in the end...that's all that matters.

I just wonder how many people back in the 50's, 60's and 70's especially males were considered "all boy" or a "behavior problem" when they actually had ADD or ADHD.

One final note, I think most parents and Dr's really try to do what is best for their child or patient. In some cases, it may be some form of behavior therapy, counseling, or medication. But just like everything else, thaere ARE some people who don't want to make the effort to take the "hard" way and try alternatives. They would rather have the DR prescribe medicine and be done with it, and bypass any other route. And there are some Dr's who dispense prescriptions like candy. I live near Carrollton, GA and for anyone who's heard about the Chris Benoit murder/suicide, the dr in question practices in Carrollton. Now, I don't know if legally he has done something wrong. But, he's obvoisly done something questionable if he's being investigated. A family friend works for a local health agency here and she said he was known for giving a prescription a more freely than other dr's in the area.

There are all types of people in this world, unfortunatley and it just takes a couple of them to give alot of caring, concerned parents a bad rap.

 

[momto2inKC]

What I honestly don't understand is why parents who don't have a child with add/adhd feel it's their place to question those who do and our actions To say parents just put their kids on meds is a big assumption. There is rigorous testing our children go through to get a correct diagnosis. It's a very long process which involves multiple doctors. We 'dealt' with my sons issues for a few years before finally giving in and going the med route. We did behavior modification, therapy and such. I always said I would never put my child on meds...boy am I eating my words now! Don't judge if you've not been in our shoes.
And having add/adhd is not just a 'hyper child' who needs to be reminded to do things or sent outside to release energy. There is so much more to the equasion!

 

[DisneyAprilFool]

I wanted to respond to this one, "i have to wonder if a person (adult or child) had severe anxiety disorder or migranes-both of which like adhd are purely neurological in nature-would their use of meds be called into question or attacted? i think not."

You are absolutely right. My DH suffers from horrible migraines, but he's not on medicine for those- he IS on meds for severe anxiety. He is very open with people- if the discussion turns to these areas, he explains the things he has been through and what he's dealt with in life- and I've yet to hear one person say, "Well, medicine is the easy out".

HOWEVER, we have a son who has been diagnosed with anxiety issues and at this point in time, we are dealing with them through therapy versus medication (it may come to that point- he has done some pretty crazy things in the past few years). Someone else posted about a child whose decision making skills seemed much younger then his age- that's the way DS is as well. I honestly think WE have looked more into medicating our son then my husband ever researched before he started taking his own meds- parents are very protective over their kids and most of us are unwilling to take chances just 'because the doctor ordered it'. I think we're pulling more and more away from doing things just because someone with a string of letters behind their name recommended it- but I could be wrong.

I think the OP had a valid question- and even people with kids using meds probably can think of a case or two where it seemed like using meds was an 'easy out' for someone- but rest assured, most parents do not make the decision of using meds easily.

 

[nuzmom]

First, my children are not ADHD, but I would like to learn a little more about this subject.

My great nephew (10) has been on medication for years for ADHD. He has had what I would call a rough home life. My sister (his grandmother) was raising him for a couple of those years. He's now back with his mom, but they're both going to move back with my sister in a few month (when boyfriend goes to jail). His mom has had issues with drugs and drinking and my sister isn't much better. No surprise, but he is a troubled kid. He is mean talking, self absorbed, has daredevil behavior, physically mean to others, and has to be the center of attention. He does fine in school but started school a year late due to behavior concerns. He plays soccer and is pretty good at it, however, he has no friends AT ALL. He was like this prior to meds and is like this after meds.

Let me also say that he has very very little discipline at home. There is NO consistency. And he gets whatever he wants whenever he wants it. He always has to have better and more than my kids.

He is "active" but is able to sit and watch TV or sit and play video games. He will also read or play with Lego's. He seems to have difficulty sitting when it's something he doesn't want to do. Is this normal ADHD behavior?

I have to admit that there are many times that my DH and I think that the ADHD medication is an excuse for his mom. She admits to giving him extra doses on occasion to get him to "chill out". Yes, for him, he zones out, like a zombie, when given double meds.

They're actually her right now, in our pool, because the mom "didn't want to deal with him today". When they're home alone, he's in his room "playing" ALL DAY LONG. He also has a TV in his bedroom and watch whatever he wants to. To me, he seems to just "go wild" when he's given some freedom.

Here's the thing, when he is at our house BY HIMSELF and UNDER SUPERVISION, he is fine. Still not exactly the most likeable kid, but I chalk that up to his homelife. One thing is for sure, at our house, rules are rules, no matter who you are. He seems to be able to deal with that and obide by that (as long as we're watching). He can even play boardgames with us (but he HATES to lose).

I sincerely don't want to affend anyone with my post and I truly believe that any reasonably good parent would always do what's best for their child. I'm just puzzled over the inconsistent behavior. Is this what ADHD looks like? Is it normal to be able to focus on some things and not others?

I know several other kids on meds for ADHD (through a kids program my DH and I are involved in). They have loving and caring parents that didn't "rush" into any decisions for meds. I'm not questioning that there are many children benefitting from ADHD meds and therapy.

I'm just wondering if my DH and I are WAY off base in questioning my nephew being medicated. Oh, they have adjusted the dosage up and down, so I don't think it's a case of him needing a higher dose. Honestly, I think it's a case of needing some consistent, caring, discipline and ATTENTION (especially for positive behavior).

 

[Tikicampers]

In fact, you have schools telling parents they need to get these ADHD drugs for children.

I don't know about where you live, but here, there is no way a school would tell a parent to medicate their child. I will not even utter the term ADHD unless a child has already been diagnosed by a Dr. If a child with ADD/ADHD can cope without meds, then that's great, but some kids need the meds. to allow them to learn to cope. I agree that there are probably some kids on meds who shouldn't be, but the OP's post didn't say that. There were some pretty broad generalizations. I'm not surprised people got so defensive. I had a mother in my classroom crying as she asked me to fill out some paperwork for her DD when they were testing her for ADHD (the parent started it, not the school). Most parents going through this agonize over what to do, and they should have our sympathy.

 

[6TimeMomma]

I am saying that giving kids stimulants so they can be in a higher reading group in school is nothing like a cancer treatment.

This statment alone shows you have no clue what our children have gone through prior to our decision to put them on meds. And it sure wasn't a light decision where we thought "nothing of it". Walk a mile in my shoes, walk a mile in my shoes. Or, perhaps a mile in my daughter's shoes.

 

[SnowWhite12]

Just had to vent, and I am guess I am just as entitled to my personal opinion as everyone else. I am a Licensed School Social Worker, and the one that does the evals for ADHD where I work. I do not prescribe meds---a medical doctor must do that. If they meet the criteria (and it is a very lengthy process---we do NOT take it lightly in the school system), they are sent to the doctor who does further evals, and always sends child to a neurologist to make sure nothing else more severe is going on as well. If my DD is ever diagnosed with ADHD, I will not hesitate to put her on meds. If she had high blood pressure, would I not put her on medication? Duh. ADHD is a medical condition just like diabetes, high blood pressure or anything else. Depending on severity, the child definitely benefits from meds. And for those of you wondering, if a child "were accidentally" put on ADHD meds, and not really ADHD (which I think would be extremely rare), the meds would not affect the child, which is why a lot of parents give up on the meds during the first week. They don't realize that depending on what kind of medication, it could take up to 6-8 weeks to see any results (for example Straterra). Leave the poor parents alone who decide to use meds. Their kids will think them for it someday, when they are given the chance to succeed to their utmost ability.

 

[eeyoregon]

He is "active" but is able to sit and watch TV or sit and play video games. He will also read or play with Lego's. He seems to have difficulty sitting when it's something he doesn't want to do. Is this normal ADHD behavior?

Great question!! And the answer is very complex. YES it sounds as if he has a form of ADD BUT it is not acting alone. This is exactly what our dillema was/is with our son. Then we found an amazing child psychiatrist who was willing to take the time to look deeper.

Your nephew sounds like a complex pie with many different slices attributing to the situation, as does our son. We now have a whopping total of 7 diagnosis of which only one piece of the pie is ADD. But when all of those little pieces are out of whack and compounding one another, it makes life very difficult for the child and family.

It is great that you care!! It very much sounds like there are some other factors in your nephews situation...maybe you will be the link in helping the pieces of the pie work more effeciently with one another.

gina

 

[Order66]

I can't believe the amount of ignorance regarding ADHD and medications I've read in some of the posts. You think we medicate kids to calm them down? As my doctor put it, if we wanted to calm them we'd prescribe valium, not stimulants. ADHD kids have 1 of 2 miscommunications going on in their brains. Either they don't produce enough neurotransmitters to fire the messages along or for some reason the neurons are blocking them. The medications either stimulate neurotransmitter production or they "unblock" the neurons so the chemicals can be received, depending on what the problem is different meds are prescribed. It has nothing to do with calming them down, it's making their brain function normally so they can actually process thoughts like everyone else.

I have twin sons. One has ADHD and one does not. They are both rough, tough, active boys and until you live it you can't understand I guess that there is a world of difference between a normal active rough boy and one suffering a medical issue. I knew my son had a problem when he was about a year old, but didn't (couldn't) do anything about it until school age. He went through kindergarten diagnosed but unmedicated. He struggled with simple things, often wandered and was quick to hit anyone who angered him. BTW, most ADHD kids are highly intellegent. We sure didn't have to medicate him to achieve better grades or test scores. He already did (and still does) outscore his non-ADHD twin brother. Meds don't make the kids smarter. They are already smart. I don't medicate my son so he's "better" than anyone elses child. I medicate my son so he can function like everyone elses child.

Without medication my son can't focus on anything. He cannot look at you when you speak. He cannot follow 1 step instructions let alone 2 or 3 sucessive tasks. He couldn't write legibily. He has difficulty playing with other boys because his brain was everywhere else but where he was. He was extremely impulsive and did many things that could have resulted in serious injury. While a normal child might think "I wonder what soap tastes like" they leave it at wondering......my son would actually EAT the soap. It took us the better part of a year to get the right medications at the right levels. Under medicated he was emotional and subject to crying meltdowns. These have ZERO do to with tantrums. Finally he is on the right meds at the right levels and now is no different in his "hyperness" or "inattentiveness" than your average 7 year old boy.

To the person who's family is double dosing....they are not calming the child down, they are making him hyperfocused. So focused in fact he cannot STOP the single activity he's doing. Overmedicating is abuse plain and simple. And yes, to be able to focus on somethings but not others is exactly how my son is. He could sit and watch a movie, build legos or play a video game for hours. That is because that is the only stimulation around. But provide 2 or 3 other stimuli like other people or something going on outside and he'd be right back into his mode of all over the place. In ADHD it's not that the child can't pay attention, it's that they pay attention to EVERYTHING at the same time and cannot focus on the task at hand.

I would no more withhold my sons Focalin than I would withhold antibiotics for an infection or Motrin for pain. A medical need is a medical need no matter the diagnosis.