Fill Morphine Sulfate Prescription
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My husband has a history of back pain since 1985. He has had 3 back surgeries, epidural injections and 2 spinal column stimulator implants. His last surgery in 2006 was quite successful. He was on 180 mg of Avinza and percocet for breakthrough pain. He has gradually reduced his medication to 30 mg twice daily of morphine sulphate and has maintained this dosage for 2 years. We have been patients of this primary care group for 25 years. The doctor that we both had been patients of retired, so we now see another MD from the same group. I see a different MD from this group than my husband. The reason being that I do not care for this D.O. that my husband sees. He has been seeing him for approx a year. He had always been given a prescription for a 3 months supply. About 6 months ago the D.O. started to write my husbands morphine sulfate for a month at a time and would given him 3 prescriptions with a notation on each script "do not fill until" with a date for each month. When he went the other day for his 3 month visit he was told he had to see him each month and would be written a prescription for his morphine sulfate each month. This wouldn't be a problem but we do no longer have health insurance and have to pay out of pocket for doctor visits and prescriptions. Is this a normal process or should he start seeing a different doctor altogether? We live in Florida.

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Re: CityguyUSA (# 7)

It is not a contract. If it was you could sure the doctor directly. It should not be called a Contract. It is only a document so the doctor's ass is covered. It all needs to be updated to include pot, it's ridiculously ignorant on the government to get involved. It is what it is.

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General comment for this thread. My latest pain management AAPM newsletter says that beginning in 2019, Medicare will no longer pay for opioid doses above 90mg Morphine equivalent per day, without an exception letter from the pharmacy. Above 200mg ME you need documentation from God. These are no longer simply guidelines. This is the apocalypse of pain meds as other insurances will follow. But I digress.

Dr. Tim

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I guess I didn't get my real concern across.

My problem is that I can't afford the copay to go every month to the pain specialist. Especially when he makes an arbitrary decision on what I can afford. When this started I was just on disability and so no medical coverage for 2 years. I was paying retail for morphine and there were artificial shortages back then due to the government putting caps on how much could be manufactured. Some months I had to go to 3 to 4 pharmacies trying to get pills and then the stupid nurse at the pain doctor gives me grief over my "contract" and always using the same pharmacy. I really don't know what they expected me to do I always called and told them.

He turned out to be a terrible doctor. I was having trouble finding something that wouldn't make my knees and legs burn which he should 've known was nerve pain being brought on by the very medications he was giving me so he just kept changing me from one to the next not getting that they were aggravating my condition but he insisted it wasn't the meds. Some of these meds were costing me $400 to $500 out of pocket but I had to take something I hurt so bad usually rating my pain level at a 6 or 7 during the day and often up to a 10 at night. This doctor didn't even use quantifiable assessment techniques just anecdotal type discussions. Finally, Methadone was a wonderful solution except allergic reactions were an issue but he didn't seem to get that either even with hives on my arms it was my family doctor that told me I was having an allergic reaction.

When I finally got on Medicare I had gone through most of the money I had saved up over years of working and then the market crash took a good chunk of the rest.

After a serious malpractice issue with the pain doctor sent me to the ER because he just cut my morphine equivalence in half one time for no apparent reason and he never mentioned word one to me regarding the change. I didn't know what was happening to me. I felt like I was having a heart attack and ultimately I was told I was going through withdrawal as a result of him changing the quantity of my medication. They told me to call him and ask why he did that after I explained what had happened and he said to me, "what are you going to do about it?" Well that was a question that I didn't even know how to respond to. I told my PCP who put me back on the original dose but I knew I wasn't going back to him anymore.

I started looking for a new pain doctor the first one called me a drug seeker and refused to write anything but Naloxone, I think it was but only 10 days which is like a strong Ibuprofen.

The next one diagnosed me over the phone having his secretary tell me that they wouldn't even see me because I told them I felt I needed a dosage increase. These people are taking too many of their own wares.

I found a new pain doctor but there were a lot of red flags regarding his being money hungry and they felt the place was a pill mill. The girls at the front desk doubled as nursed which seemed odd to me. I got swabbed on the first visit which I later saw on my EOB as costing $990. Are you kidding me? He wrote the morphine but he wouldn't write the fast acting saying that many studies say that using the fast acting makes your dosages go up faster so he preferred increasing the long acting strength. I agreed although I was concerned when he did things different than every other doctor.

My PCP was going on maternity leave and then she wasn't going to work full time anymore. I started looking for a new PCP feeling that I didn't like practices where they'd give you to whoever was open. I had a lot of problems and the last thing I wanted was to explain all my health issues to whoever I ended up with. That's fine for a runny nose or a cut but that's as far as I want to take it. I found an older guy that I really liked that said he wanted to figure out why I was having these problems which up till now no one much cared. In the same breath he said although I don't now that I am the right doctor for you. He was writing my morphine with no hassles he was already a plus in my book.

I had been to him about 3 times and there was his death notice in the paper. Apparently he had been diagnosed with terminal cancer and so that was that.

The next doctor I thought to myself really needs to be younger. I don't want to invest a lot of energy only to get 6 months down the road and be doctor shopping again.

He ended up being in his late twenties which was a bit younger than I had wanted. He too jumped on my morphine like look at me I'm young and writing morphine. It struck me as odd since at this point I was going to pain mgmt and I wasn't required to come back for refills just call in. But if he wanted to write them I really didn't care. I figured I would get them through whoever was easier.

The pain doc would occasionally try something new or retry something that hadn't gone that well the first time. Since my pain wasn't under control it was really hard to tell if I was flaring or having a bad reaction but I tended to think most of them were bad reactions. Then every once in a while he would try something that was recently released. Those tend to scare me because pharma isn't well known for quality diagnostics these days however they were usually too expensive and not covered by the formulary so they didn't work out. Then one day he told me he was going to try me on Ketamine. I hadn't felt that good in years and NO side effects. He told me to call in when I needed refills. It's not an Opioid so it doesn't have the restrictions but it is classified with Xanax and other benzos. One day out of the blue he asks me how much I am paying for the Ketamine. I told him around $80 a month. He liked to talk politics with me and we had been talking about the War on Drugs and I told him I'd like to see it end and he agreed. Anyways his next remark came out of the blue. He says to me well then you can afford to come in every month. I said I'm on disability I really don't have an extra $40 a month. He said well if it comes down to my kids eating or you it's going to be my kids. What? Effectively he wasn't going to refill the Ketamine and when I made an appointment to increase my morphine he tells me to get my PCP to do it. I called my PCP and he said absolutely no way he will increase it that I'd have to go to pain mgmt for that. So I called them back and told them that my PCP won't titration at which point I am told that I'll have to schedule another appointment. I said I was just there 2 days ago. But you were not here for an increase in your morphine. Yes, I was that was the only reason I was there. You'll have to schedule another appointment. Are you freaking kidding me? They weren't going to back down. This was what people were talking about the office being a pill mill.

So now I want my PCP to talk to them and find out what was going on. They hadn't treated me like this before. I specifically wanted him to ask why the sudden change on the Ketamine but my PCP doesn't ask or even have a conversation about my inability to pay. So he accomplished nothing on any front. We have no answer on the Ketamine and why the sudden change nor my ability to come in every month nor the titration of the morphine.

My PCP'a solution to go to another pain mgmt doctor who wouldn't even get involved with either because I had no official discharge. Another $40 up in smoke with no result. His answer was to work it out with the other pain doctor who has now closed the office and gone to a new city without so much as a screw you. No discharge, no letter to my PCP or me saying he was leaving town and his patients are to see Dr X who will continue treatment.

Now that a few more years have gone by and my symptoms are forcing me to go to other specialists. I can't even afford the Ketamine anymore and since it is a bulk powder it will not be covered under Medicare. I had attempted to get an appeal but no such luck. Even the non-profit that used to reimburse me for my morphine wouldn't cover it and now it looks like that fund us defunct which is now forcing more money out of my pocket.

I used to not believe the stories about people who would end up eating cat food but I can see how it would happen.

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Re: CityguyUSA (# 21)

Well you proved you dont know what you are talking about ... typical .... automatic weapons are alrready banned for gemeral public ..... all govt abuses whether its overstepping their authority in your medical care or trying to supress the liberties in the bill of rights ... they need to be addressed this country is supposed to be a constitutional republic problem is in a constitutional republic the people have a responsibilty to do their part and educate themselves and vote responsibly ...... problem is tge people get the govt they deserve even the responsiple people get punished because of those that do not take their responsibilties seriously ...... enjoy

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Re: Becky (# 2)

There's a good reason why they won't fill them did u figure out why is it early is he abusing why do u so desperately need to fill them u should always have enough

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Re: Roro (# 20)

I don't think this is the place to take on the 2nd Amendment but I will say this. If you think that your automatic weapon is going to prevent or stop the government that spends 54% of the discretionary budget on the military think again. One missile into CA and it's all over for the entire state.

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Re: CityguyUSA (# 19)

Yep & it wont just be medical mandates a congressman from ca is trying to itroduce a bill to strike down the 2nd amendment you think the govt is out of control now wait till that happens ..... govt will ride rough shod over every aspect of your lifewhen that happen

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Re: DR TIM (# 16)

I'm angry at the doctors for allowing the government to run rough shot over them. It seems that we're becoming a society of weaklings that are running scared from a government we're supposed to control and unless people stops this it will get worse and it won't just be opioids.

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Re: DR TIM (# 16)

Everything you say is on the money your very educated the only issue I have is a lot of Drs downplay the severity and how ridiculously hard it is to get of benzodiazepines the only luck I've had at all is a long slow taper at a drop of 2.5%-5.0% a week of the starting dose anything faster had me heading for the psych ward,and I believe seizures can occur and in some cases cause death. No disrespect, you are one of the more honest and open Drs I've heard or spoke with. Thank u for your enlightenment.

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Re: Painsurvior (# 14)

Here is a link to the cdc guidelines for opioid prescribing:

cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

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Re: CityguyUSA (# 7)

Everything that you described is normal practice. The times they are a changin'.

Dr. Tim

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You're lucky, he's still filling them. He did not have to fill them every three months, for three months, and the way things are they are cutting people off. Count your blessings. Because u don't have insurance, a doctor's not going to say well come see me once a yr I'll give u 12 refills. Doctors' credibility are on the line. You just have to jump through hoops, trying to weed out the jerks that are making a good living at going to the doctor without need and selling those pills to people that are really desperate for a ridiculous cost. Again, feel blessed. I got off morphine and methadone after years of back pain and I got better physically and mentally. After some time I believe they make it worse screwing up your receptors.

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Re: Roro (# 11)

In Arkansas we can go every two months . Not every state is the same. I asked my pain management dr and I believe they would know the laws better than anyone. She runs a tight ship! So I don't think she'd do anything to trigger an audit. She does all her pain management patients in Arkansas that way. Now she wont do it for her Oklahoma patients. Because the requirements are different. So its state specific.

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Re: DR TIM (# 12)

In texas you will not get psyc and opiods the state has made it illegal to recieve both ...... according to my pain management group .... only way i found out was they asked if i was recieving any meds from a psychiatrist .... i said no why ....& got prementioned answer

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Re: CityguyUSA (# 5)

These are generic comments for this thread. Standard of Care guidelines now say that pts must be seen monthly to get their opioid refills. Your doctor does not want to see you monthly any more than you want to be seen monthly. Follow ups do not pay his bills. Pain physicians in general don't like being told how to prescribe any more than you like being told how much you can have. We now know that the risk of accidental overdose increases by 400% with both opioids and benzo's being given. Big Brother has decided to reduce your risk. What is the worst withdrawal depends in part on what doses we are talking about, but virtually nobody ever died from a benzo withdrawal. Hydroxyzine will not cover completely withdrawal from a benzo; apples and oranges. Steroids historically are the worst withdrawal by far when chronically taken. The new reality is that doctors are being forced to act when you are non-compliant with opioids, whether you are taking too much or too little and all pain doctors should be doing random drug panels on all pts being given opioids especially. Remember, the only currency you have with your pain doc is your credibility; usually if you burn that you don't get it back. RE: CBD and THC, whether they are legal or not in your state, doctors can't know or control the dose you are receiving and they know that most pts who use THC/CBD for pain relief don't stop taking other pain meds. Finally, I see pt after pt on this website wanting a pain doc who will prescribe opioids and some version of a psych med - benzo, stimulant, etc. Don't do that, just say no. If you want opioids, go to a pain doc; if you want psych meds, go to your PCP or psychiatrist.

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Re: Painsurvior (# 10)

Do search for cdc guidelines for opiod perscribing ...... most follow them if i remember correctly they require monthly face to face .... not doing so could lead to a dea audit

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Re: Verwon (# 1)


It's not against the law to be given the next script or the month after! I get mine 2 months at a time with a time stamp on it.

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If you do a search for .... cdc opiod perscription guigelines ..... you will find that you are actually fortunate to not be transferred to a centralized pain management organization ..... but anyway b4 making 2many waves i would recomend reading the cdc guidlines as that is what most use to aviod scrutany by dea ...... but hey ? do i no

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Having just read through dome of Verwon's link to Wikipedia on Morphine I found it very interesting that Benzodiazapenes are considered the worst withdrawal to go through. . i was pretty sure that they had withdrawal problems yet I asked my doctor twice and he said I wouldn't have any issues because they were replacing my Lorazepam with Hydroxine, a medication he said help me sleep. Now, I am really concerned as this removal of Benzodiazapines is one of the goals in Pennsylvania for anyone taking Opioid medications is this even safe? There's no talk of weaning just that they don't won't a person taking both.

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Re: Thomas (# 3)


I used to go every 4 months. But that is all changing. We are not even allowed to talk about a splinter in our finger when we go for our 3 month pain appointments. I wonder what's going to happen when I try it.

They seem to think they need separate appointments for some legal reason, he was very insistent about the separate appointments but I'm wondering if they are having financial problems or maybe just bad legal advice or are they're using some other *****s do it yourself document off the internet a boilerplate doc? It's a nine-page document which I have serious problems signing so if there are any legal types here I'm wondering about the enforceability of a document where they are holding your medications hostage - that would seem to me to be duress and should I cross out things that I can't agree with or wait till push comes to shove and sue them in magisterial court and then claim duress although magistrates aren't very bright they may not know how to resolve the situation.

Is it even a contract since the doctor isn't really giving up anything but just doing their job? I have to tell you this is the first time I have been made to feel like a junky. Anyone?

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