Why do dr's freak out & worry about us getting "high"?

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Regular Member

Date Joined Apr 2011
Total Posts : 78
   Posted 4/25/2011 9:51 PM (GMT -6)   
I was recently dx with fm and have had for past10-15 yrs choronic back problems.  I thought I finally found a dr who would work with me and help me.  He prescribes me tramadol to control the pain and we're trying to find something for breakthrough pain (which I get frequently).  Actually, we're trying to reverse this and find something for a more permanent solution to control the pain, and use tramadol for breakthrough pain.  But, today (after taking tramadol for 3 mos) I told him I have to take 4 sometimes when the pain is real bad, and he's like "oh you can't be doing that" and I said why not, my previous dr told me that's ok, as long as I don't exceed 8/day.  But then he's like "you're just getting high."  I was SOOO ticked.  I said, "NOOO, I'm just wanting to be able to function to the fullest capacity with as little pain as possible" (I don't think I've ever been completely w/o pain)  He's like, well, then you'd have to take at least that dose for like the rest of your life!  I'm like well....look, we're trying to find an alternative but until will do could you please not ***** at me for taking something that works!!!  Now, I want to ask him if I can try suboxen but am worried he's gonna be thinking in his mind that I'm looking to get "high."
Does anyone have advice or experience with this??
P.S. He wamts me to try xanax now....I took it tonight...seemed....I don't know, didn't do much. (I do have anxiety....related to pain....I worry constantly about being in pain and unable to function.)
He had me try valium before, but all that did was knock me out!

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Date Joined Jul 2009
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   Posted 4/26/2011 1:14 AM (GMT -6)   
There are many reasons why doctors tend to think many people are simply wanting to get high or worry about it to what seems and sometimes is excess. It could be having run into these types of people before, not being well versed in pain medications, the sensationalistic news coverage of the prescription drug problem, afraid of losing his medical license if some one starts thinking he is prescribing too much pain meds without sufficient documented cause, etc.

If by FM you mean fibromyalgia I suggest talking with your doctor about trying a medication like Lyrica or Cymbalta. While they don't work for everyone they do work for many. I do suggest you read up on each of these medications and become familiar with how they should be dosed because in order to avoid or minimize side effects each of them need to be started at a low dose and slowly increased until a dose level is reached that provides good results. Some doctors are not overly familiar with the dosing schedules and will start you out on a higher dose. In each of these meds it is not uncommon to have to go through 2 or 3 increases before knowing if they will work for you. My wife has fibro and takes Lyrica for it and it helps the day to day "normal" fibro pain a lot and it does also help to shorten the time she goes through her "fibro flares".

Just a note: Odds are slim that Lyrica or Cymbalta will help with your back pain. While it tends to works for fibro and some nueropathy type pain it usually does not do much for other causes.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Regular Member

Date Joined Apr 2011
Total Posts : 78
   Posted 4/26/2011 6:59 AM (GMT -6)   

Thank you, Jim, for your reply, I will read more on Cymbalta, I'm just very very careful not to take antidepressants because they had me on them 10 - 15 years ago for 5 years and they made me totally numb to life and my feelings.  I tried Lyrica, it not only didn't help my pain but also knocked me out cold or made me extremely loopy everytime I tried to take it.  I'm from Illinois and wonder if it's Illinois doctors that predominately shy away from pain killers.


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Date Joined Dec 2007
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   Posted 4/26/2011 7:44 AM (GMT -6)   
I say this all of the time but the goal of pain management is "management" of pain, not elimination of it. Most PM's seek to reduce the patients pain levels to about half of what the patient claims they are- so if you are claiming that you have constant pain levels of say 7, then the goal of your PM might be to reduce the pain levels to about a 4- those easily managed with additional tylenol or motrin , along with your base pain medications.
Breakthrough medications are only to be used to manage pain levels that are substantially higher than your highest "normal" pain levels. They should not be used in conjunction with your base medications to treat everyday pain levels.
I know that you said that you aren't taking any breakthrough meds, yet. So while what I said about breakthrough meds doesn't apply to you yet, it is something that you should discuss with your PM doctor when he does prescribe them to find out when and how he wants you to take them. :-)
As far as why he was upset about you taking extra tramadol, first there are the interactions and potential for overdose that can come with taking more than prescribed, no matter what your pain levels are. Secondly, there is the red flag that taking more than prescribed leaves your doctor with. Thirdly, he prescribes meds for a given period of time, usually 30 days worth of meds. If you are taking more than prescribed, then you will run out before that set time frame elapses. In that case, he can not and in most cases will not refill a prescription early and neither will your insurance or the pharmacy. nono
Each prescription is broken down by the insurance company into a number of days that the prescription should last- if you take more than prescribed, the insurance company will reject the early fill, and the dea will flag your prescriptions for an early fill. Ultimately, you will find yourself kicked out of the pain management practice and once that happens, you will find it very difficult to find another doctor willing to treat your pain. If you get flagged by the dea, you won't find one.  shakehead The last thing that you need to know is that tramadol can be very addictive, just as any other opiate. It is a synthetic opiate, works the same as any other opiate pain medication on the same receptors in your brain. Taking more of it can and will induce tolerance issues and withdrawal if you run out. cry The right way to handle increases in pain levels is to call your doctor and ask him what you should do, not just take more because you have pain medications there.
Also, you need to consider other modalities to treat increases in pain levels, heat, ice, stretching, motrin, advil, aleve, tylenol, etc all will help to ease the pain. You can alternate ice or heat every 15-20 minutes on and off to help ease the pain. Swimming excercise and there are many neuropathic medications that may help with the pain of fibro. In fact, that is the standard of care, not so much on the pain medications anymore. Lyrica, neurontin, topamax and the old tri cyclic anti depressant medications do far more for the pain of fibro than any pain medication. Physical excercise and therapy are also great at helping the pain of fibro. :-)
It sounds like you are fairly new to pain management but there are many rules that we all have to follow, including drug/urine or blood testing to confirm that we are taking meds as prescribed, having injections and verifiable proof of our conditions  before most of us have gotten anything close to pain medications that we all have had to submit to. If you don't follow the directions of your doctor, you could loose him and any access to medication ( opiates) to manage your pain . yeah
Most of us have contracts that allow our doctors to call us in for pill counts, unannounced urine or blood testing and failure to have the right amount of meds left or not passing a urine screen can mean that we no longer have the right to any treatment with pain medications. You don't want to find yourself in that position if you are in pain.

Regular Member

Date Joined Apr 2011
Total Posts : 78
   Posted 4/26/2011 8:36 AM (GMT -6)   

Thank you mrsm.

I do appreciate all your wisdom here.  Like you said I am new to pm, not new to pain, just new to pm mad You gave a lot of advice that I will follow and I'm glad to hear it from someone else who suffers too (cuz sometimes when you hear it from doctors who don't seem to care you end up not believing them and I've had so many bad experiences with that - and not so much the doctors, but nurses).  Anyway, I am not allowed to take ibprofin anymore cuz, actually that (and that alone) has been what I've used for my pm for the last 5 years.  So....I've been on nothing but ibprofin, however, I would have to take 1200mg for relief, ending up taking at least 2400mg/day.  My husband made me call and tell the dr this cuz of obvious reasons.  So, entered tramadol (that was 3 mos ago). 

But, regardless, I want off the tramadol, and want to only use it for the really bad "breakthrough" pain since it works so well for me.  My doc has had me try celebrex (didn't work), lyrica (unfunctionable), valium (knocked me out) and just yesterday gave me xanax (don't feel any different when taking).

What do you think about asking him for suboxen?  I've heard that helps people "addicted" to pain meds.  I don't know if I'm addicted or not, but I worry about it and wonder if this will help??

thanks again!


Regular Member

Date Joined Jan 2011
Total Posts : 230
   Posted 4/26/2011 10:50 AM (GMT -6)   
I'm so sorry you're having to deal with this, and an insensitive doctor to boot. Unfortunately narcotic abuse has been a big thing for a long while now no matter where you live.
Like MrsM said, it's not about making the pain go away; it's chronic pain for a reason. But it is about quality of life. The pain will never go away, but you need to find a way to get it to a manageable level where you can function.
Aside from medication there are also oodles of ways to combat your pain. Everything from meditation to biofeed back, wraps, compresses, sprays and creams, etc. I recently sent someone a link to Solutions for a full back herbal pack that you could throw in the freezer, or into the microwave; between the herbs and the semi-moist heat, and the fact that you could drape it down the length of your back, I thought it might help.
For over 3 years now I've lived on narcotics. I've taken Vicoden, Loritab, and now Oxycodone. Alot of the times we switched my perscription because my doctor felt I was getting to high a dose, as one's body can build up a tolerance if you take it all the time. So he would switch me to something else at a lower dose and I would take that till the pain became to great. I use a variety of things to help combat my pain though aside from my drugs. I use BioFreeze on my arm, which is great in the summer given how cooling it is. I use absorbine gel linement that I had originally bought for my horse. I also have a TENs unit, extra-strength TigerBalm, and a few IceyHot sleeves that cover half my hand and all of my forearm.
Being proactive about your pain is also a biggie. If you're on a maintenance dose, make sure you take it on time regularly, using break through only when you positively need it. I have done the whole "but I had a bad day!" and taken extra meds. As a result, I ran out. I had a new perscription in hand, but it didn't matter, the pharmacy couldn't/wouldn't fill my script. And so I went three days without pain meds. I was a wreck! Between pain at full strength and withdrawls... you can imagine what an ugly thing that was. Also between doctors that have you on contracts, and insurance companies, over using your meds is a bad thing and can get you booted from your treating doctor's office.
My pain doctor, while not a fan of perscribing narcotics, always tells me the same thing every month; if you can skip a dose, do so.
Just be aware of what you're taking. Tell your doctor you're concerned about your quality of life, find alternative methods to help deal with your pain. Remember, be your own advocate, and be proactive. *hugs*

Originally injured 10/26/2007 - Initial diagnosis; Tendonitis
Have seen several specialists; Bone, Muscle, Hand, Neurologist, Chriopractor, Physical Therapist...
Went through a battery of tests, multiple MRI's
11/16/09 finally diagnosed CRPS - Stage 2
Permanently disabled, on Oxycodone and Celexa.
February 2011 successful SCSU trial
May 2011 SCSU implant surgery

Regular Member

Date Joined Apr 2011
Total Posts : 78
   Posted 4/26/2011 12:12 PM (GMT -6)   
Thank you Rhaevin! I sense your compassion and appreciate it. I do use alternative things such as heating pads, I use BioFreeze too, I exercise, that helps a LOT, I stretch at least 3 times a day. I actually WORK FOR A CHIROPRACTOR who gives me adjustments specific to my major pain areas 3 times a week!! My chiropractor is very "natural" oriented and has supplements that are VERY good quality, I take several different ones.

To be honest, I think I just am SO busy, and hardly EVER sitting down so that's what level of functionality I wish to maintain, which is probably irrational considering my pain, but....if possible, I'm gonna persue it cuz I love being busy-that's the quality of life I enjoy: doing things for others, working, cleaning, exercising, playing with and walking my dogs, visiting friends and family, etc.

because of what mrsm said, I am sincerely making an effort today to take the absolute minimal amount of tramadol as possible.....so, we'll see...
Blondie37_Fibromyalgia_terrible back of neck/shoulder area pain_degenerative discs_chronic pain for 15 years_new to pain management_can't take ibuprofin due to taking too many_have taken and tried everything from antidepressants to morphine to lyrica to muscle relaxers to xanax to valium to celebrex, etc.

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Date Joined Feb 2003
Total Posts : 15835
   Posted 4/26/2011 1:16 PM (GMT -6)   
Hi Blondie, I too would like to welcome you to Healing Well's chronic pain forum. While I am glad that you found us, I am sorry that you have to be here.

I think you have received some great responses from the other members here at the forum. There is a war on drugs out there alright, it included our prescription drugs as well. There has been so much hype on the tv about the abuse of script drugs, and they are making it more difficult for us people that need this medication. Yes, the drs are running scared, because they don't want the dreaded visit from the DEA taking an inventory of their office. I live in Tx and my PM dr write more narcotic scripts than any dr in this state and she has regular visits from the DEA. However, she is not afraid of them, they have even given her some good tips that she is now using in her office. But, not all drs feel his way I can assure you.

One thing a good PM dr will tell you is, you will never be pain free, you will always experience pain, however, the goal is to allow you to have quality life and you cannot expect medications to take all of your pain away, not unless you were made a zombie with too much medication.

Are you seeing a PM dr or a PCP or even a rheumy? I do know rheumy's treat Fibro so thought I would ask. You do appear to have a very busy lifw and there is nothing wrong with that. However, pain does take a toll on the body and in many ways this could be your body's way of telling you to slow down and give it a little rest too. I am not saying stop your activities because that is the best thing anyone can do is stay as active as possible, but you can overdo.

As far as getting high from medication, I have been on opioids since 2004, and I have never been high or gort a high feeling on any of my medications. If a person was getting a high feeling, then I would think they were on a dose too strong for them. It is not unusual to have to try several different meds to find the one that works for you. But, one thing you will find is pain medication does not work all that well for neuropathic pain. Medications like Neurotin, Cymbalta and such are meds used for that particular type of pain.

I would give the Xanax a chance to work, one pill is not going to do the trick. Many times you have to let the medication build up and let your body become use to it. Judging one pill is not really making a fair call on if it will help or not. You mentioned Suboxen, I believe drs have to have a special license in order to dispense this particular medication. I may be getting it mixed up with another drug, however, you can go on Drugs.com and look it up, it will say if a dr has to have a special license to dispense the drug. Another thing that will send a red flag up on a patient is if the patient asks for medications by name. Drs do not like this and I know of patients being fired by the dr for doing this very thing. Once you get fired by a dr it is very hard finding another dr that is willing to take you on as a patient.

Anyway, I wanted to pop on and tell you welcome aboard. Take care.
Moderator Chronic Pain Forum

Veteran Member

Date Joined Dec 2007
Total Posts : 1230
   Posted 4/27/2011 6:52 AM (GMT -6)   
Hi Blondie,
I'm glad that I could help. I understand using the motrin and tylenol thing and far too much of it to manage pain. I did it for many years before my first back surgery. Just before my first back surgery, I was taking 2000mg of motrin every 4 hours to manage the back and leg pain that I was having. My poor physiatrist about dropped when I told him.... shocked
As far as suboxone goes, it has had mixed reviews as far as management of pain goes, but I wouldn't go there yet for you, for a few reasons.....first, not all pain management doctors are able to prescribe suboxone. It is used primarily in the treatment of withdrawal symptoms from abuse of opiates. I don't know how it is right now, but I do know that in order to prescribe it some months ago, there had to be notation in your medical records that it was being used for the management of opiate withdrawal/abuse. You do NOT want that in your medical records, because it will follow you where ever you go from then on. Secondly, you are still very new to the world of pain management and there are far too many other types of pain medications available for you to try before going down the road to these type of super  heavy hitters. Suboxone, not inducted correctly can have seriously negative effects and can be much harder to taper off of than many other pain medications, because of the long half life, especially after being on it for an extended period of time. It is similar to methadone in that aspect.
I doubt that at this point you have abuse concerns, unless you are constantly taking more pain medication than you are prescribed and doing it to get high, rather than to treat your pain .
The one thing that I read that did concern me is that you said that you like the feeling (energy boost) that it gives you. I would be very , very careful about being diligent in making sure that you are taking the medication to treat pain, not for the boost in energy. I have been in pain management since 1995 , on and off, and despite having been on many different medications, not once have I ever gotten a feeling of an energy boost or felt anything other than some pain relief for a while.
As far as the Lyrica and the Cymbalta not working, as with all medications, the dosages need to be titrated up and down for effect- this simply means going up or down in a medications doses until the maximum benefit is met, while keeping any negative side effects at a manageable level.
When you go on a new medication, be it a pain medication or one of the neuropathic ones, you are going to be started on the lowest dose- this is because they want to watch for negative side effects- most of which will go away given a week or so to give your body time to adjust to the new medication and to see what dose you will need going forward. My rule of thumb when giving a new medication a try is to give it at least two weeks and at least one increase in dose if needed before deciding that it is or isn't working. In most cases I will even wait at least a month before making the call. This is because most of the side effects we experience will go away or lessen over a few days to a week.....
You also are on a low dose of neurontin, so there is a lot of room to go up in dosage to see how well you do and how much it will help with the fibro pain. I would expect that there is going to a be a lot of trial and error in finding the right medications and combinations of them before you finally find the right one for you, so have lots of patience and give each medication try a fair chance to see how the side effects reduce over the course of a week or two before dismissing them. You  might be surprised at the relief that you will get by giving each medication a fair chance.

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 4/27/2011 7:19 AM (GMT -6)   
     Good morning Blondie!
          It looks like you have recieved excellant responces here, so I won't add to them, but I wanted to "Welcome" you to the CP forum as well.
           We look forward to more visits with you.
          Take care,
       SE wink
Moderator Chronic Pain Forum

"The clock is running. Make the most of today. Time waits for no man. Yesterday is history. Tomorrow is a mystery. Today is a gift. That's why it is called the present."
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