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PM and Meds

My PM has a new rule - only one controlled substance can be written per person. As of now, I take Oxycontin 20 MG x 3 times a day. I asked about breakthrough pain and was told the doctor will no longer write for breakthrough pain. As I type this, my back smarts pretty good and have nothing to take.

I was told that if they need to, next month they will bump me up to Opana ER. I'd rather stay with the Oxycontin with something for breakthrough. I hate the idea of being on something stronger when something less strong usually works. It's just on days where I've over done it, I tend to hurt more.

Anyone else out there have this type of issue? I think all the bad press about narcotics is starting to scare him about writing the prescriptions. His new motto is "Less is Better". Sorry, but as someone who hurt's like crap, the right amount is the amount that provides relief!

Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2


  • Did you happen to ask him what his reasoning was? It's certainly not any law in any state of which I know.....

    I do know that most PMs will prescribe a breakthrough medication, a short acting med, to be taken "as needed" and many people do not take it this way which only causes issues...They take it every day, and the maximum dosage which then it becomes a part of their maintenance medication so when they actually have true breakthrough pain, they don't have anything to take...So I do know this frustrates a lot of PMs...

    And yes, the goal is to try to get the long acting medication to a place where it is helping with the majority of your daily pain (obviously with other modalities as pain meds is meant to reduce things by 50% only)....to where you really don't need any type of other pain med except in rare cases a few times a month.

    I would assume they also want you doing other things like ice, heat, even using other meds like nerve pain or muscle relaxers to help as well.

    I would talk to him more about what he wants you to do when you run into a situation where you have breakthrough pain...How often does this happen for you?
  • Actually, I spoke with the ARNP about it and she was frustrated as well. She can only write what he will allow. In fact, for patients who she knows requires breakthrough medication, she has been sending them to a different doctor who will write the two scripts. She is trying to raise my maintenance drug to see if that will head off the amount of breakthrough that I have. If that doesn't wok, she said she would refer me out as well.

    I think where the breakdown in thinking occurs is when someone who is sedentary takes a bunch of breakthrough meds versus someone who tries to stay active. My pain level stays elevated because I do not just sit around and accept pain. I go out and play ball with my kids, go golfing with them, attend scout campouts, etc. It hurts me to do these things, but if I don't stay active it drives me nuts.

    I will hate to change PM's, but if that's what I have to do in order to get relief then I guess that's what I'll have to do.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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