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Change in meds.. Tad concerned.

ashtonaaashtona Posts: 55
edited 06/11/2012 - 7:44 AM in Pain Medications
I will try and keep this as short as possible. I posted a while go regarding my new Dr and his taking on my PM. He started me on Morphine Sulfate, 15MG's, 4x a day. That did not work and I made another appt. He asked me to try 2 at a time, 30MG's 4x a day. This managed my pain nicely. Not 100% relief but I understand that is not the point...

So this went on, a week supply here, 2 week supply there. Finally my boss started questioning the frequent trips every 1 to 2 weeks for med refills. So I told my Dr that I cannot do this. I need to be given a longer supply.

He suddenly didn't feel comfortable with that level of pain medicine and asked me to come in. I did so and he acted like I was taking WAY too much even though he approved the scripts. So that is question one, he and I seemed to be on the same page then suddenly, he acted like he didn't have any idea what was going on.

The end result, he has me on MS Contin CR, 60MG's, 2x a day with the MS IR for when it gets bad. He wrote me the script and then said he wanted a urine sample. I said fine, I have nothing to hide, no biggie.

Later that day, I was looking at my exit sheet and at the bottom it said "SAP (Substance Abuse Profile), Urine Test."

Does this mean he believes I am a substance abuser for following his orders? Should I question what that means? When I went for the urine test, the nurse said to wait until she gives me the "OK" to leave. She did so and I assume it was to validate I was actually taking my meds.

Ok, so not short. But any insight would be helpful.
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Comments

  • That test unfortunately is just a name for the test that cover most meds PM uses - ignore the name of the test. Many docs require urine samples, sometimes its the insurance company, sometimes its the DEA, sometimes its just that office policy. Never take drug testing as an insult. Where do you live? The docs around here pretty much use a monthly visit for PM refills unless you are in a dose adjustment period.
  • optimist said:
    That test unfortunately is just a name for the test that cover most meds PM uses - ignore the name of the test. Many docs require urine samples, sometimes its the insurance company, sometimes its the DEA, sometimes its just that office policy. Never take drug testing as an insult. Where do you live? The docs around here pretty much use a monthly visit for PM refills unless you are in a dose adjustment period.
    Ok, that is fine. I don't mind the tests. In fact, I applaud them because I hope it gives him peace of mind in treating me. I was just concerned over the name.

    I live in Massachusetts. From past experience, I have only needed Dr's visits once every few months or so. Beyond that, it is when the Dr requests a visit.

    I usually just call, request the refill, they call me when ready and I go pick up the script from his office.
  • No, from my experience a good PM doc had required a visit for every refill. I really wouldn't go to a PM doc who refilled via phone calls.

    The rest is very bizarre :/
  • happyHBmom said:
    The rest is very bizarre :/
    He is not a PM Dr. He is my PCP that is handling my PM.

    As far as bizarre? How so? Please explain.

    P.S. Are you a Dr? I have not posted on this forum in quite a while because you seem to have a thing for posting derogatory statements in my threads.

    Therefore, I am curious about your expertise in such matters. Why would a Dr require a visit for every refill every 30 days if he is just going to refill it anyway? All it does is waste his and my time.
  • Sorry, the bizarre part was the part where he was making you feel insecure. Please don't be defensive. I am trying to help!

    In California, Schedule II controlled substances have specific rules. I am not a doctor, but I can research these things as easily as anyone- the rules are state-by-state. In CA, we can get only 30 days at a time, must have hard copy (triplicate) prescriptions, and an in-person visit. Most doctors require a contract and drug testing as you've seen.

    I would say that if you are expecting a schedule II controlled substance to be dispensed as a heartburn med would, your expectations are too high. The time requirement is going to be greater just because of the legal requirements :(

    If anyone would like to say I'm wrong about this, that's fine. I do live in an area very rife with opiate abuse, so maybe it's different here.

  • happyHBmom said:
    Sorry, the bizarre part was the part where he was making you feel insecure. Please don't be defensive. I am trying to help!

    In California, Schedule II controlled substances have specific rules. I am not a doctor, but I can research these things as easily as anyone- the rules are state-by-state. In CA, we can get only 30 days at a time, must have hard copy (triplicate) prescriptions, and an in-person visit. Most doctors require a contract and drug testing as you've seen.

    I would say that if you are expecting a schedule II controlled substance to be dispensed as a heartburn med would, your expectations are too high. The time requirement is going to be greater just because of the legal requirements :(

    If anyone would like to say I'm wrong about this, that's fine. I do live in an area very rife with opiate abuse, so maybe it's different here.

    I am not defensive in this case but in the past you have singled me out and been extremely negative towards me.

    As it stands, I am here for help and to share my experiences and appreciate any help that I get.

    As for my expectations, I do not expect anyting but proper treatment for an extremely painful condition. Once again, you seemed to have misinterpreted my post. I signed a contract and I agree 100% with drug testing.

    What I was concerned about was the "Substance Abuse Profile" that was written on my exit sheet which detailed my meds. If they are testing for Substance Abuse? Fine. If they are indicating suspicion of SA, I would be concerned.

    Perhaps that is the difference, location. I live in Massachusetts. I get a script and I go to the pharmacy and fill it. He has my MRI's, he has seen my severe limp and inability to lift my legs. I see no reason for a visit every 30 days.

    Just to be clear, I have several heniated discs in my lower back. Most are moderate to severe. I am not talking about a sprained ankle here.

    P.S. Thanks for bringing up heartburn, though. I do have another question. I have been on MS Contin now for 3 days. Since starting it, I have had severe heartburn and I am not sure if this is just coincidence. Does anyone else get heartbrun from this medication?
  • Although where I live doesn't require any urine or blood drug testing I was glad to get a prescription for my Oxycontin with 2 repeats on it. My Dr. is across town and takes more than an hour to get to her. Since having my back injury for over 2 years and on the same medication since January my Dr. thinks I'm stable so don't need to see her for 3 months. I am going to see her though to pick up my pension forms she made out for me so I will be seeing her twice anyway during the 3 months.

    Ashton I was on MS Contin the same amount and didn't get heartburn with it. I usually took it with a small meal each time and stayed sitting up for at least an hour afterwards so I wouldn't get heartburn. Best wishes and hope you're having tolerable pain levels. TC. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
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