Two years ago, I left my pain management doctor of 10 years for a variety of reasons, including his no longer taking insurance. I also just wanted to see if a different doctor had any new ideas.
Because my pain has gotten worse, and it no longer seemed effective, my new doctor transitioned me from Tramadol ER to Butrans Patch last year. It made me too sleepy, so after a failed one-month back to Tramadol ER, we went to Xtampza (Oxycodone). It was definitely helpful, but 9mg 2x daily was too low so, she raised me to 13.5 2x daily. However, she told me she never prescribes oxycontin or Xtampza to patients except with cancer, palliative care, and a few special cases. If 13.5 wasn't enough, she won't go higher.
Well, after a short "honeymoon" period, it is not enough.
All through these changes, she's prescribed 7.5mg x3 oxycodone. But she has an issue with its time-release counterparts.
In addition, she's absolutely inconsistent regarding her Cannabis policy. She will write recommendations for it. She will let people use CBD with trace THC. She doesn't urine test for THC. But she randomly sends one urine test out to a lab for a full panel once a year and while she won't disclose when that is, she tells patients just "to not get caught."
Obviously, that makes little sense. I chalk it up to her believing in Cannabis, but being paranoid of the DEA.
Personally, I don't like its psychoactivity, but have found it valuable at night when I'm in pain and my regular oxycodone wasn't enough.
Ok, here's the question I need help with.
I mentioned all this to a close friend who also is in pain management. He actually has his GP as his prescriber and suggested his GP might be willing to take me on too. He takes a higher dose of oxycontin, same oxycodone, and consumes high THC cannabis daily (he's had 7 spine surgeries). He asked his GP (who he is friends with) and the GP is happy to add me as a patient.
Should I switch?
I worry about
going to a non-specialist. I also worry that this doctor may be a bit too freewheeling. I assume he has a small number of other pain patients, but his approach is to give patients as much freedom as the law allows (e.g. we only need to see him every 4 months and he electronically sends refills in-between; I also think he doesn't even urine test as the law doesn't require it).
This doctor would make life simpler and make me feel more at ease about
using a bit of cannabis. With my current doctor, I will barely use any and never within 10 days of my appointment.
My biggest concern: going to a non-specialist for prescribing. I'm sure there are other viable pain specialists around, but finding one that will give me the freedom I want will take some digging. Few allow cannabis at all and I just hate the idea, in principle, of losing my liberty. Also, I gravely worry about
the increased danger of Alzheimers from opioids and feel like my memory is not what it was 5 years ago. Cannabis prevents neuro-inflamation and studies suggest it relevantly lowers the risk of Alzheimers.
What should I do? I've had to scale back with work a huge amount over the past couple years because of pain. I need much much better relief.
Post Edited (cogito) : 5/16/2020 8:59:26 PM (GMT-6)