Refuse To Prescribe (Page 2)
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I live in a very small town and the number of doctors here is limited. The number of good doctors is almost nonexistent. I'm finding that calling for an appointment as a new patient the office staff says right away, "We don't prescribe pain meds"! Also have heard "We don't take fibromyalgia patients"! This is said before I ever state what I need to be seen for. Assuming I did have pain, do I no longer have the right to have my pain relieved? I'm so offended by this. If you have chronic pain you are treated like a leper. Apparently it is automatically assumed you have a drug problem. Going to other towns is the same. No wonder people self medicate. Is this happening all over the country?

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50

Your arrogance is astounding. I've seen vets on methadone & because it has a very long half life, they sit in a semi-comatose state. Methadone is very cheap which is why the VA loves it. I've been in chronic pain ten years. I just had 4 more molars pulled due to rotting from inside out thanks to Lyrica. By the time I knew what was happening, I had lost teeth. I've tried many meds for pain. Opiates are the only thing that helped. I haven't had to increase the dose in a year & a half. I pay for it myself. When my doctor retires or can't prescibe, my life will be over. I am not going to spend years in the excruciating pain I was in before. My kids are grown & don't come to visit. I can't go out to eat. We can't travel due to finances. My only pleasure is reading. I'm not over medicated. I have horrible insomnia, in fact. But I'll be damned if someone who doesn't know my medical history, will determine what works best for pain for me. I have spent over $150,000 on medical care &prescriptions in the last 10 years.

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49

I asked my Doctor if he was being bothered by the DEA, Feds about pain meds. He quickly answered yes, they treat us like criminals! What a shame that Doctors are being pressured by the government about the way they practice Medicine! No wonder that the opiate epidemic is so out of control...There are many people who suffer daily and Doctors can no longer help them, because of the addicts who abuse the system! This so-called drug war has been going on for decades and has not even put a dent into the illegal narcotic trafficking!

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48

LAW,

Is Portnoy still there?

I can do my own referral (am a professional nurse and was seeing the famous Dr. Tennant out in California until they busted out on us out of staters.)

I'm an ultra rapid opioid metabolizer and have not had proper care for almost 10 months and am so low on medication that I am now totally a crippled train wreck I've progressed to Central Pain Syndrome.

Thanks,
P450

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47

Yes, many, many patients at Hopkins are from outside Maryland, both on an outpatient basis, and in- hospital. I believe the easiest way is to obtain a referral from your current physician. He or she might also assist in getting an appointment with the appropriate specialist. In the absence of that, call 410-955-5000 and ask for the referral center. The person will assign a physician based upon your conversation. Be sure to have your insurance information.

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46

P450, could you explain a little more in detail the agonist/antagonist aspect specific to Ultram? This is new information for me and I would like to understand it more clearly. Thank you!

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45

Gun, you are correct. Ultram has always been a narcotic but created to offset what they considered in the health care industry drug seekers. It is a mixed agonist antagonist; the second part can (and many physicians do not know this) reverse the potential of your straight agonists or opioids.

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44

IWuz,

Methadone is a dangerous drug and the cheapest LA medication. Created under Hitler when they had a shortage of poppy.

Methadone withdrawal makes opiate withdrawal look like kindergarten. You do have a lot of anger; your emphasis is emotional rather then scientific research supports opioids for less loss of work, divorce rate, the list goes on.

When the FDA and i****s like Odumma start controlling medicine and our scientific community then you have issues. Most physicians do not possess the balls to stand up; in Texas you must be registered as a pain clinic makes a very conservative medical board target physicians faster. The DEA bottom lines a physician a million dollar fine due on accusation not proof of. That million is gone they get to keep that and go out witch hunting more physicians.

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43

Law,

Is Hopkins still treating complex cases from out of state?

I was with Dr. T. (Mr. Famous) in California past 5 years; now California regulations disallow 30 of us rare cases from out of state are without help. I am a professional nurse and published researcher; have progressed to Central Pain Syndrome; and am an ultra rapid opioid metabolizer. I am in Texas.

Your information would be appreciated. I have taken Comp back to court, won, etc. They did not pay mileage for over 16 years of this injury and have a life time medical award.

Thanks!
P450

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42

GunTotingGrandma, Tramadol is now a Schedule IV. But Schedule IV meds don't have the same laws as Schedule II meds. Although a Dr can require you to come in every 30 days and only give you a written prescription. But that is the drs choice and Not required by law.

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41

Tramadol has changed classification. It IS a schedule drug and requires a triplicate Rx now. That happened last Fall here in Texas. I presume it did the same everywhere else, too.

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40

Nonono, there are no new rules. or laws governing Tramadol. It is your drs choice to make you come in like you would have to if it was a Schedule II. Tramadol is a Schedule IV. It can be called in and you can get refills written on the prescription, no requirements for how often you must see your Dr, no drug panel recommendations.

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39

Prescription for tramadol (4 per day) held up because new rule. Must see doctor every three months. Ok, went in and had take a drug panel and sign pain contract. Have had RX more than halved. Have to over medicate with NSAIDs till gastric symptoms. Hell with that. 65 years old with chronic problem. Still working full time.

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38

Actually new doctors are better educated on pain management. As nurses, in good hospitals we were required to attend 8 hour classes and take a test that had to be passed with a 90% or better. In addition, we had to take shorter courses for continuing education. When I first graduated in 1975 we told the patients, too bad , it's not time yet. Doctors ordered lots of placebos. If patients ask an hour early, they were called "clock watchers". That's why I hate to see us go backward on pain control. I hate to see legitimate chronic pain patients suffer because of the abusers.

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37

Being psychologically addicted to a med and your physical body reacting when the med isn't there is Not the same thing.

I agree about Family Doctors being better than some specialists. But, in recent years the younger Family drs don't seem to have the knowledge that the older ones did and do. Although I think a lot does depend on dedication. I think a lot is a sign of the times and pushing specialists. It also seems to depend on if the Dr received his medical education and training in the U.S. or a foreign country. Those that are educated and trained here don't seem as quick to refer every patient to a specialist if a problem in a speciality field comes up.

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36

I disagree: here at Hopkins the specialists all work together and the software allows the doctors and the patients to view everything! If you are stumped where you are, I repeat: go to a teaching university hospital.

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35

Sharon, with respect your PCP can prescribe pain meds, in fact many, maybe most, patients that come to us were started on pain meds by their PCP, and when the PCP becomes uneasy about the amount of meds they are prescribing a patient they send them to Pain management saying that "they" will continue the meds.
I do not agree with many of the prescriptions being written by PCP's so maybe a better statement would be that PCP's should not prescribe pain meds without a full understanding of a patients condition. Pain Meds MUST not be used to mask pain that should be treated by other means. As an example we saw a patient recently who was on lots of pain pills prescribed by a loca PCP. Yes he hurt like crazy but that was the wrong treatment completely. Looking at his MRI we saw a previous back surgery that had failed over time and he had metal intruding into his spinal canal (using layman a words to describe a very serious condition). He needs revision surgery and had he simply continued on the pain meds the outcome might have been catastrophic.
My view is that a good doctor found this problem and sent him to have it resolved. A good doctor did NOT simply give more medicines (pills) to mask the pain.
Just my 2 cents.

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34

This is what's wrong with today's medical system. There is a specialist for everything but our bodies are integrated. One part affects other parts. I worked as an RN for many years & care became more fragmented. I'd call about a patients problems after surgery & the surgeon didn't want to deal with constipation or various issues related to the surgery. They'd instruct me to call in a GI guy. Sometimes the patient would end up with 4 or 5 specialists & each one only wants to deal with their speciality. It's insane. Goodbye to good old family docs who knew the whole you!

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33

Go to a teaching hospital...a university hospital. You will be treated very differently. Call the hospital and as to be assigned an internist, and that doctor will send you to other specialists with the hospital as needed. Even if you have to drive several hours each way, it is worthwhile to receive competent health care.

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32

Glad you could get that off your chest.

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31

Pain meds work for pain. Pain meds create dependency and/or addiction VERY QUICKLY. Its just a simple fact - opiates are dangerous. I can totally understand why a doc office would state right off the bat "no fibromyalgia..no pain meds" just to waste no ones time. Its not rude - it makes perfect sense considering the huge numbers of people looking for opiate prescriptions for pain that is mostly contrived. Ya.. I SAID IT !! People convince themselves they need opiates for different reasons and so many of them think they are SOOO SMART.. but they aren't (stupid people dont realize they're stupid - thats why stupidity is such an annoyance) and they get angry and frustrated that they are unable to convince doctors that they absolutely must have opiates. People who truly need opiate medication should not even have to ask - their conditions are clear and obvious. If we all could have unlimited access, we'd all be addicts, and many of us would OD and die. If you cant get a prescription but cant live without opiates..get on methadone maintenance.

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