I am not trying to be a nay sayer, but I would highly recommend you manage your pain through your regular pain management doctor and NOT the ER. I do not want to speak for others, but I think most long term pain patients would tell you that the fastest way to be rubber stamped as a drug seeker is to use your local ER to manage your chronic pain. In my experience, it is best to be honest with your routine PM doctor, than to go to the ER and tell them you ran out of meds and need either more of the same medication or request something stronger. Unless you have been through the ER scene, you have no idea just how cruel these health professional can be. I wish it were not this way, but ER personnel can be horrifically unprofessional when is comes to dealing with long pain. Be honest with your PM doctor. Use a pain diary to document your need, times when you are experiencing break thru pain, etc. Let your doctor formulate a treatment plan for you. From what you descriibe, you are a rather new patient to this doctor. Give him or her a fair chance to treat your pain. I am not saying never go to the ER, but save that treatment option for emergency situations and not routine drug management.