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Posted By : SoberOne - 7/18/2017 9:50 AM
Can your PCP perscribe opioid pain meds for chronic pain or choirs it have to come from a PM Dr?

Gave your post a heading.

Post Edited By Moderator (straydog) : 7/18/2017 11:28:01 AM (GMT-6)

Posted By : straydog - 7/18/2017 11:32 AM
The days of a PCP rxing opioids in pretty much a thing of the past. They do not want to mess with the red tape, they do not have the knowledge needed to rx such, hence this is why chronic pain patients must be under the care of a PM dr.. There is just too much government involvement & even our PM drs feel like they are under the microscope. Get a referral to one so you don't run into issues.
Moderator in Chronic Pain & Psoriasis Forums

Posted By : Mercy&Grace - 7/18/2017 3:59 PM
A PCP can treat chronic pain patients with opioids long term. But, many are choosing not to. Unfortunately, many doctors tell patients they can't prescribe opioids due to new state or federal laws. There are No State Or Federal Laws that say a PCP cannot prescribe opioids for chronic pain.

Most PCP treat some of their patients for chronic pain. It is up to each PCP, as it is each doctor, to decide what chronic pain patients they want to treat. There are No Laws that state a doctor has to prescribe opioids for chronic pain patients.

Posted By : (Seashell) - 7/18/2017 4:29 PM
A primary care provider - physician or nurse practitioner - can prescribe narcotics/opiates as long as they have a DEA prescribing number.

I think some of the hesitancy of primary care providers depends on individual state differences in how each state is affected by the identified opiate crisis and how state and local enforcing agencies are applying oversight to prescribing providers.

Florida, Kentucky, Ohio, and Texas, as an example, have been deeply affected by the opiate crisis and are employing highly restrictive oversight and monitoring. If you live in Texas, Kentucky, Ohio or Florida, you will likely find it more difficult to find a PCP willing to prescribe narcotics for chronic pain.

I live in Oregon. The federal and state oversight is moderate to high. My PCP provider is a nurse practitioner and she does provide narcotics to patients for long-term needs. The clinic of primary care providers uses narcotic contracts and random urine drug screens, typical of pain management physicians. The primary care clinic also has documented provider-patient discussion and review substantiating the need for narcotics twice a year, at a minimum. This discussion includes review of the goals of narcotic teearment, risks and benefits, and use of alternative therapies (acupuncture, meditation, visual imagery, yoga, swimming and hydrotherapy). All and all, it is an exhaustive process to gain narcotics through the clinic where my primary care is based.

Bottom Line: A primary care provider can prescribe narcotics for chronic pain but must have a DEA prescribing number. Be prepared that not all primary care providers will prescribe narcotics given the increasingly restrictive oversight by the DEA, NIH, and CDC. If your primary care does extend a helping hand in prescribing narcotics, be prepared to have to honor a pain contract and agree to random urine drug screens. Every T must be crossed and every i must be dotted.

I currently receive my prescriptions through a dedicated Palliative Care program and Palliative Care physician. I experience far less "red tape" under the umbrella of Palliative Care.

No one should have to exist under a smothering plume of pain. I hope that you are able to find a PCP or pain management specialist to help you achieve a more comfortable body state,
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Post Edited ((Seashell)) : 7/18/2017 4:33:17 PM (GMT-6)

Posted By : Mercy&Grace - 7/18/2017 4:57 PM
(Seashell), a lot can depend on the doctor patient relationship. If a PCP has treated a patient for 20 yrs and knows them well. THey may be more likely to help manage that patients pain that patients they have not treated as long or know as well. It is also important to note being a PCP's patient for 20 yrs alone isn't enough. It is a combination of length of time and how well the PCP knows the patient. PCPs often treat entire families. They have the opportunity to get to know patients better over many, many years. For example, if a young couple uses a PCP for themselves and their children and stays with the PCP through the years. That PCP has a view of those patients few, if any other doctors have.

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