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Responsible drug use - pressure from doctor

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Chronic Pain
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countrydad
Regular Member
Joined : Jul 2012
Posts : 194
Posted 12/14/2017 9:15 AM (GMT -7)
I'm 41 and I've been dealing with chronic pain for over 10 years. about 3 or 4 years ago I finally was referred to a physical medicine doctor. We have tried a lot of things with varying success; physical therapy, home traction device, muscle relaxers, anti-inflammatories, and most recently nerve ablation. The nerve ablation gives me decent relief, but I still get flares of pain once every week or two.

My conditions all seem to be related to auto-immune issues; crohn's, arthritis, neck pain, headaches. Everything that comes up, I do research and find auto-immune at the core. I also have a genetic fusion of C3-C4. The nerve ablations are on both sides, C3-C4-C5. I first had it done in November of 15 and just recently had it done again (so 2 years of some level of relief.)

I also see a psychiatrist for numerous anxiety/stress/depression issues. So I am on a few scripts from him. Back to what brought me back here to post. My doctor has been giving me 5/325 Percocet for the last 2 or 3 years. For at least the last year it has been 30 pills at a time and I request refills every 30-40 days. To me this does not seem excessive at all. Reading other posts here, it seems like a very mild script. Earlier this year he started drug testing me when I picked up the refills. I understand this, given the "epidemic", but it made me feel uncomfortable none-the-less. Yesterday I called for a refill. I have 2 pills left from a 11/08/17 refill; ~35-40 days on 30 pills. Today they left me a voicemail telling me my script was ready, but he won't refill it for 60 days now.

I once again feel like a criminal for asking for relief from pain. I do everything I can before I take a pill; ice, s-hook massager on my shoulders, traction if possible, sleep if possible. Still I get days where I need to keep going at work or with my 4 kids and if I am in pain, I have to take 2-3 pills in a day just to keep the pain at bay. Am I wrong to feel ... insulted? I certainly don't feel addicted nor as though I'm abusing it.

Just looking for support/advice. Thanks.
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18323
Posted 12/14/2017 11:38 AM (GMT -7)
Hi countrydad & welcome back. I thought I remembered you from before when I read your post. I remembered you having crohns & the genetic fusion. I have crohns & the crohns arthritis gives a whole new meaning to arthritis.

Things have truly changed for drs & patients that are being treated for chronic pain. Saying it is restrictive is putting it mildly. about the UA's, the DEA & CDC are now the one telling drs here is what we think you drs need to do if you are going to treat a chronic pain patient. UA's can be done monthly or randomly, monthly pill counts depending on the dr, sign a Contract with lots of stipulations including the patient will not obtain pain medication from any other dr & all sorts of things. If a dr does not go by these guidelines they will hear from them. Every time a narcotic is filled by a patient the information goes into a database with info such as the name of the dr & patient. This way the government can keep track of drs & patients.

Since the dr is now cutting you back on medication ask to be referred to a PM dr.. Depending on what the PM dr decides at least you have the potential of not having to spread 30 pills out for 2 months. As long as a patient does what they are suppose to do there are no problems. In all my years of being in PM, I have not ever had any problems.

There is a possibility your dr received a letter from the DEA or CDC stating these are the guidelines we request you to go by when treating a chronic pain patient. I learned quite some time ago to not get insulted by what the drs are doing. These drs are truly in fear of losing their license so they follow those guidelines or risk having problems.

Take care.
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skeye
Veteran Member
Joined : Mar 2008
Posts : 3089
Posted 12/14/2017 12:26 PM (GMT -7)
Countrydad,

Like Susie said, these days most of us being treated for chronic pain get drug tested by our prescribing doctor. It bothered me at first, too, as I also felt like I was being suspected of abusing my meds/treated as if I had done something wrong, which I absolutely do not do. But then I realized why the doctors were doing this, and that it was just something that every patient had to go through (no one is singled out -- I've even been randomly drug tested at times when I've not been on opioids, because ALL my doctors patients are subjected to the same rules), and now it doesn't bother me. As I said, I'm doing everything right and have nothing to hide, and so if that is what I have to do to keep my doctor and my meds, then that is what I have to do. It is sad that there have to be so many rules like that in place, but some people do abuse their meds, and the government is making things just as hard on the doctors as they are on the patients because of it. Don't take it personally.

As for the 60 day thing, you can always call your doctor and ask to speak to him/her in order to clarify why your meds have been changed. Or making an appointment to discuss your medications may be an even better approach. If your doctor is not a PM it may just be that he/she is being pressured to prescribe less opioids, so like Susie said, it may be time for a PM doc. Although many of them have not cut back on meds, too/for the same reasons... It's a tough time to be a chronic pain patient.

Skeye
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n2braves
Regular Member
Joined : Jun 2013
Posts : 29
Posted 12/14/2017 10:14 PM (GMT -7)
The way things are today, the only doctors that really want to treat chronic pain are the Pain Management Doctors. And I guess it makes sense that they are the most qualified to do so. Most of us of a certain age are used to the fact that your MD or family physician wrote all your scripts no matter what they were and that was very convenient for us. That just isn't happening anymore. In some states they have passed laws that a doctor can only script 5-7 days worth of pain meds to a patient presenting with acute pain and if more meds are needed the doctor has to justify the need for them. I will admit that in years past some doctors may have been a bit liberal with the script pad, but boy has it gone too far the other way now. I am so hoping that things come back to the middle and soon. There are lots of chronic pain patients really suffering right now. Anyway, I do think if I were you, I would get in with a good Pain Management Doctor and once you earn his or her trust you will have no problem getting your meds. Take care.

Cindy
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Mercy&Grace
Veteran Member
Joined : Jun 2013
Posts : 1874
Posted 12/14/2017 10:51 PM (GMT -7)
Pain patients can no longer push themselves because they have pain meds to help with their pain. If you see a Pain Management Doctor you will have to go in and see the doctor every 30 days. You will have to sign a pain contract. And also agree to routine drug screens. Some doctors also do pill counts.
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