Opiates For Pain Mangement

I think that the Internet is a very useful tool to gain information. I also think that this website provides a good forum for discussion of medications.

What troubles me, however, is the huge number of people placing posts asking where they can find a doctor to prescribe large amounts of narcotics, supposedly for pain management. Most allege that their doctors "moved" or "stopped prescribing". I have sincere doubts about these posters. People posting these kinds of questions are rare in reality; doctors don't move without referring patients to other health care providers. Doctors also don't just "stop prescribing" - unless it's for a good reason. One of the good reasons a doctor can stop providing prescriptions is if s/he thinks a patient is taking a dose that's too high or abusing drugs. (Even in these cases, most docs would either taper the patient from the drug or refer the patient to a drug addiction treatment provider.) To all of you doctor shoppers: It's my sincere hope that you get into legal trouble for your actions. You've made pain mangement much more difficult to obtain for legitimate pain sufferers.

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Just by your attitude I can tell you could not have possibly been in so much pain you literally can not see, living alone trying to get to the grocery store just to get a little food and still have to get back home without keeling over in the middle of the street. Me thinks you protest too much. If you have a problem with it don't punish the terminally ill. And yes there are Dr.s handing out prescriptions. They don't even care if they can't find a place to fill them making, us go through withdrawals for a couple of days every month. People don't realize it takes at least a couple of days for the pain meds to saturate the cells enough to help until the next time I get dragged through Hell.

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Excuse me for having an opinion, Rand ... and a diagnosis of Chronic Pain (hips, back, both knees) that require me to be on opiate therapy. You're arrogance is unreal; stating I am unable to understand pain when I HAVE chronic pain and am receiving MEDICALLY-MONITORED treatment for the pain. I went to the Massachusetts General Hospital Pain Management Center (after three years of unsuccessful physical therapy, every NSAID on the market, and short-acting narcotic pain meds like Percocet or Vicodin). There's a difference between me (and likely you) and some other people: I actually have chronic pain, have undergone the necessary imaging studies and diagnostics, had about 1,000 steroid shots, etc. Many of those who allegedly suffer from chronic pain are after the meds. You may not be aware of it, but I certainly can face that reality. I have no shame, guilt, embarrassment, etc. when I pick up my monthly supply of 120 OxyContin tablets monthly. I take as directed; I'm not gobbling 6 at a time or attempting to figure out how I can bypass the time-release mechanism. I don't take more OxyContin than prescribed, I don't take it more often than it's prescribed, I have signed an Opiate Pain Management Contract, I am subject to U-Tox to make sure that I'm not taking other drugs and that I am taking the OxyContin at the right level rather than selling them on the street. Next time you choose to reply to a post, take a few minutes before being judgmental and jumping to inaccurate conclusions.

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@BZD,

I agree that "most" Dr's wouldn't stop prescribing unless it's for a good reason...but from what I've been seeing in many cases not all of them seem to know what they're doing when they do drop patients. Many times it's done without any prior consent to the patient or ability for the patient to come to terms and reason with them on the matter. The patient doesn't even find out that they've been dropped until their next appointment.

The reason I bring this up is because of the increasingly high number of false positives coming up on substandard drug panels that are faulty by nature. Inevitably forcing these patients to find other doctors without having a chance to justify their legitimacy.

So all I'm saying is we can't just point the finger at doctor shoppers alone (as not all of them are in there for the reasons you may think they are). When it comes down to it, the whole pharmaceutical industry is really the one to blame for all the mishap going on with abuse, shortages, doctor shopping, etc... Their entire system and way of going about health care has many flaws in my opinion. Especially with no remorse being given to those who get a false positive by default and suddenly get dropped. It happens a lot, and I see it all over this forum.

Anyone else have thoughts on this?

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I also went to Mass General's Pain Management Center for treatment of my VERY real and chronic pain. For me, the pain centers in the hips, with the right hip being more affected than the left. MGH was great - there as a lot of trial and error, lots of repeat diagnostic testing, and the entire process requrired patience. I was sent there on the advice and referral of my PCP, who had been treating my pain after countless steroid shots, 2 years of consecutive phys therapy, 2 failed surgeries, 2 more surgeries to repair the failed surgeries, Cognitive Behavioral Therapy, blah blah blah. Because pain is a subjective rather than objective experience, it often is undertreated or untreated. Yes, doctors need to use discretion in selecting patients that are going to be treated with opiates/opioids. But some people seem to be of the opinion that people dealing with chronic pain are fabricating it to get drugs. Undoubtedly some are. But those few shouldn't compromise effective pain managmenent for those who are legitimately experiencing chronic pain. When I get my montly Rx for pain medication, I don't go in with my head down in shame and pass my prescription to the pharmacist like I am in the middle of a drug deal. Why? Because I don't act that way when i get my medication for high blood pressure; there's no difference. In both cases, I am treating medical conditions under the supervision of a knowledgeable physician.

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While you make some valid points, David, you are overlooking one fact about using tests. When a result comes back and it's not what the expected result is, the sample is re-tested using LGCM (liquid gas chromography method) - and if you're doc isn't doing this, s/he isn't getting proper results. This practice of re-testing is fairly universal; doesn't cost the doc anything - the insurance pays. And unlike the "dip stick" tests, it is as accurate as possible - we have no better test. Is it always right? No, but it is right 99.999% of the time. It's expensive, so it's not routinely used - but is used by the vast majority of doctors who see a test result (i.e positive for some substance or negative for a prescribed substance) that isn't expected. One could make a pretty penny in court if a doctor fails to do this type of test. The first statement of the Hipporatic Oath is :First, do no harm..." Shutting off patients without providing referrals is grounds for loss of license - unless, of course,the pain patient has been bs-ing the doc the entire time.

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I am going through the same thing. I had knee surgery in August, getting cadaver ligament making a new groove for knee cap to ride. Within 30 days my body rejected it and I got an infection all the way in the joint and bone and had 2 more surgeries to removed ligament and clean infection and another clean out. I can not have another surgery for a min of 6 months due to trauma. My surgeon did relocate and he was very concerned leaving me in this situation and I was greatly concerned because of my primary care physician continuing my scripts. I also called my insurance and noted in my file that my dr would not get on board.
( I also had L knee surgery in April the same year. 2016 )
I want to point out a couple of things!
Both Dr work for the same practice.
I predicted it
My surgeon sent note regarding my meds and what needs to continue.
I have detailed emails to primary stating everything about meds and getting new surgeon (which I got but won't be seen for 3 months.
So no ligament no therapy my knee cap goes wherever if not taped or wrapped and I can only walk or take 150-200 steps without brace and walker.
BAM NAILED IT!!!!!
Primary care never acknowledged anything and as of my 2nd visit he has still not read my chart.
1 st visit he completely stopped 2 mg of Xanax without telling me and when I called to discuss this with him to get something so I don't go thru withdrawal and his response was go to REHAB and they will take care of me. He also took 30 pain pills away without discussing it.

GUESS WHAT HE DIDNT CARE ANDI ITS NOT BEEN. EASY MENTALLY AND PHYSICALLY. I was/am left to suffer

2nd visit went even worse, not going into that

As of now I am another 3 weeks out to see surgeon who will not discuss anything (meds) until I see him. What has happened is being addressed and I had scripts left that hopefully I can fill this next week. It was written 100 days ago and ready for refills. As of now his DEA is good until 2017 in CA..

Any advice to fix or help me in all of this. My quality of life has diminished to nothing and has taken a toll on my family and everything else!

one thing my surgeon mentioned was that the pain I'm having and going to have won't be relieved until I'm fixed so we have to continue my meds to try and just manage to live for a minimum of 6 months. If my pain was so bad and/or my primary won't help go to the ER and bring records and notes of what to continuedue to what happened.

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You can always file for any legal remedies due to patient neglect. Sound like you are in with a bad group?

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