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How to request different pain medicine without being accused of being a drug addict

earth2robineearth2robin Posts: 51
edited 06/11/2012 - 9:02 AM in Pain Medications
Hi everybody,

You know that look/feeling almost every doctor gives you the moment you request stronger pain medicine, even just a refill? I would like to avoid that situation with my doctor but am unsure how to go about it. Here's the situation:

I had an ACDF and Corpectomy/Vertebrectomy at the C6/C7 level on 3/21/12 for cervical myelopathy. Other levels are bulging and show signs of DDD, but none as significant as that level. My pain in my right arm, shoulder, and neck area is greater now after surgery than before surgery; however, the goal of my surgery was to relieve the severe compression of my spinal cord, not to relieve my pain and other symptoms (as my surgeon said). My orthopedic surgeon said he was surprised I was still walking before surgery after seeing my bulging discs and osteophytes during surgery. After the usual pain pump and stuff in the hospital, I was discharged with oxycodone 5 mg, 2-3 every 4 hrs as needed. I have only needed the original prescription I was discharged with plus a refill for mid-April and now May. The first 2 weeks I was taking the pills around the clock, but after that I tapered off to taking 2-3 pills only 2-3 times a day. For my May refill though, instead of oxycodone, I was prescribed Norco 10-325, every 4 hours. I had no problem with downgrading at first, I hate the cycle you get stuck in with feeling nauseous then sleepy with oxycodone but the Norco has not touched my pain. How do I approach my doctor about a different or stronger medicine? Should I wait until this prescription of Norco is gone so it looks like I at least tried it for longer than a week? I am afraid to wait too long because then the doctor might say that if I could survive one month, then I can survive more months. Before I decided to go to Seattle for my current doctor (I live in a fairly rural area of SE Washington), I went to a neurologist where I live but he would not prescribe anything because there is a huge local addiction problem. In fact, most doctors in my area require pain contracts. Right now, my surgeon from Seattle is still prescribing my medicine. I don't know if that means he does not require a pain contract or if it is because I still require follow-up care with him. Seattle is radically liberal compared to where I live. I have actually seen multiple people lighting up a certain illegal substance (hint: it's green and its grows naturally, when not eradicated) in broad daylight in very public places without people blinking an eye on each trip to Seattle that I have taken.

Has anyone been in this situation before? How did you handle it? Any ideas?

Thanks for reading!



  • Why not explain to your doctor what you just posted here. If your pain isn't properly managed, your recovery will be hindered.

    I'm curious what your problem is with a pain contract. They're meant to protect us and the doctor.

  • A few questions...

    Does your surgeon have it set up for you to do any Physical therapy coming up?

    Were you on any long term medications before the surgery?

    A surgeon is only meant to handle your surgery and the post op pain. He is doing the normal thing by slowly weaning you down on your opiates....The hard part is that we can get used to having little to no pain with stronger narcotics but finding that happy medium of learning how to deal with the residual pain.

    You can certainly try to speak with him about your pain and ask what he would like to do...Do not request a narcotic...

    You also need to try non narcotic modalities to help with your pain as well. An opiate is not meant to be our sole means of lowering our pain.

    There is PT, yoga/stretching, ice, heat, massage, acupuncture, TENS unit, injections, steroids, a muscle relaxer, a nerve pain medication, counseling...etc...

    Just to name a few ways to help one's pain..

    I have had 3 cervical fusion surgeries (two levels each time)...The last one being both anterior AND posterior....

    After my first surery....I weaned down from the Percocet after a few weeks to nothing. And only needing an Advil from time to time or a muscle relaxer like Flexeril, Robaxin, or Skelaxin once in awhile...This lasted for a good 3 and a half years...

    But unfortunately with disc issues and fusion surgeries....It's a hit or miss on continuing pain...Some people, like my mom who had surgery back in 1984....hasn't had any issues since then. As well as there are thousands upon thousands of people who are like this...

    So...the key is trying to move towards non narcotic meds and other treatments to see if they will lower your pain enough...

    The expected level is about a 5 on the pain scale with using various modalities...I live with a 5-7 on the scale depending on activities..

    Keep in mind that you are VERY early in the recovery process...It's very normal to have good days and bad ones....

    Make sure that you are following the Dr's orders to a T....No bending, lifting, twisting....and not lifting more than x amount of pounds..

    So it's too early to know if your surgery is a success where you can be off of all medication...

    Again...I would speak first with the surgeon..adding a muscle relaxer can make a huge difference...

    Once he is done treating you and you still have pain...You can make an appt. with a pain mgmt. Dr. to work with you for the rest of the recovery practice...The main thing is to not go to this type of Dr. at the same time...regardless of a contract...seeking prescriptions from two different places will look bad..

    Keep us posted...

  • Just tell them the reason(s) you think it would be prudent to switch. It isn't a big deal really, or it shouldn't be. Good Luck
  • I'm not surprised that the change to Norco isn't working as well for you since most people find that oxycodone works better for them as a pain reliever than Norco, which is hydrocodone ( vicoden as it's also known). If you were consistantly taking 2-3 5 mg tablets of oxycodone and now are taking one 10/325 mg of hydrocodone instead, then the surgeon is slowly tapering you off a higher dose medication onto a lower opiate dose as you get further away from your surgery date. This is typical. Most surgeons will handle pain medication for a period of about 3 months, but if you are still in need of pain medication after that, he will most likely refer you to pain management once he releases you from his care.
    It may take a bit of time for your body to adjust to the change in medication at the lower dose and different medication than the oxycodone, but as you slowly get better and the acute pain subsides, you may find that the Norco works . The goal of pain management is management, not elimination. Try using ice, heat, stretching, physical therapy , TENS, and other modalities to help ease the pain as well. Using a combination of those things may help you get a reduction in the pain levels as your level of function and use of other methods to treat the pain start improving.
    Good luck
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