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Question about BT meds

I've only been in Pain Management for about 4 months now and have a question.

If you don't use all your BT meds for the month, do you inform your Doctor or is it OK to keep them in case you need them at a later date?

I am still getting used to how things work in PM and thank you for any help you can give.



  • I have no experience with "Pain Management" though I have certainly needed pain meds with healing. I think communicating with your doctor exactly how many you used and have left really establishes a "trust" relationship. That's what I would do. Then let the Dr. decide to either decrease the number of your next script or to see how you do over the next few months. I seriously would be very honest though at my next appointment.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • N2Braves
    I also have to agree with Allmetal regarding being honest with your doctor. He may allow you to keep a small stockpile of BT meds on hand in the event of an emergency or he may not , at this point, but you will build tons of trust by being honest with him/her. It will show him two things, that you aren't self medicating , aren't upping your baseline med dosage by taking all of the allotted Bt meds each day, and will show him that you are trying to use other modalities in addition to the medications to manage the pain. ALL of those things will go a long way in building your credibility with your doctor.
  • Thank you to both posters for their replies.

    Very good advice and that is exactly what I will do.

    Just wondered because I don't get very many.

    Know some people here get so many allotted per day and I only get 30 per month.

    Anyway, will share each month with my doctor how many I end up with.

    Thanks again.
  • I may be the only one with this opinion that is willing to say it out loud, but I feel that the BT meds are yours..so keep them if you don't use them all. Why would you really want to give them back? I understand that some of us here with Chronic Pain that go to PM feel the need to tell the Dr. everything... and feel like they are "keeping" things from the Dr. by not telling them that they have more pain meds left. As long as you are honest about your pain level and don't take other pain meds or more of your pain meds then you are supposed to then keeping what you don't use is okay as far as I am concerned. Some months are worse than others so what if you give them back at one appt. then you need them the next month? You are kinda screwed... I have a LOVE/HATE relationship with my pain meds... I hate that I need them to function as a NORMAL person does daily... and I love how I feel when I take them (pain reduction, out of the "fog", and the ability to do more)...

    I mean, do u really feel "Guilty" about hanging on to them? Why? I'm sure that I will get some pretty diverse responses about my reply... and that's okay.. That's why we have this forum...not to just say what others want to hear, but to say what we really think without repercussions...

    I have found that some people here are really "by the book" a little too much. They sometimes make ME feel like I'm not a good person because I take pain meds and actually like taking them. I feel better all the way around when I do, and when I don't take them I actually feel so bad that everything in my life is affected. I have, unfortunately, been in Pain Management and a Chronic Pain Patient for over 20 years... I have been through it all. And I will be taking pain meds for the rest of my life. Until the day that a true breakthrough is made as far as "Back Problems" are concerned... This is my life... for better or worse.

    As of right now in my Pain Management I am only on Short Acting pain meds... but in my many years in PM I have been on many meds... long acting with BT meds as well as Short acting... So, I do know a few things... my Dr. is adding a LA med when Summer is coming to an end.. and then I will hopefully be in a better situation as far as pain goes...

    I am in NO WAY condoning a person to "Stockpile" their pain meds... that is totally different then keeping what you don't use. When people Stockpile it is usually for the wrong reasons.. Maybe they sell them, or take way too many when they have extra... I don't know. But when things like that happen they are just setting themselves up for disaster with the Dr. which in turn makes things bad for all of us.

    Patients in Pain Management do have to walk a fine line... and it is very easy to step to the left or the right... But we are also just people... and people make mistakes. So, I guess I have said all that I wanted to say...maybe more. LOL So, let the responses begin.........
  • Will see my Doctor on Thursday morning so I will talk to him about it then.

    Guessing he will say just keep them for the bad days because at my first appt, he gave me my scripts and I let him know that I still had two days worth left from my former doc and asked if they wanted them.

    He told me no, I paid for them, they are mine so just keep them in case of emergency.

    I had brought them because I know from reading this site that some places do pill counts.

    This clinic doesn't do pill counts and is pretty laid back as clinics go.

    If it is OK with him, I will just keep them and put them away cuz we all know that an emergency is always possible.

    Of course I am trying to adhere to their rules as much as I can right now.

    Thanks for your perspective, I really appreciate it.

  • scinmyheartsscinmyheart Posts: 76
    edited 06/18/2013 - 1:44 PM
    I've probably got 125-150 BT pills in my safe...built up over the last five years or so...am I going to turn them over to my pain management doctor? Don't think so
  • sandisandi Posts: 6,343
    edited 06/18/2013 - 6:50 PM
    I also have a small amount of my breakthrough meds that I have accumulated from having days that I haven't taken the total amount allotted. I did tell my PM doctor that I had them, and he told me to keep them on hand, so I have. That was the only reason for my suggestion to tell the doctor if that is what the OP wanted to do. It does help to build credibility with the doctor, and it also provides the reason if a urine test or blood test should be ordered if the amount shown is not at the "proper" level..
    I also don't see a reason why a patient shouldn't be able to keep a few days worth of their meds on hand in the event of an emergency, but given the PM environment, and all of the rules in place, I tend to think that being honest is the best policy in the event that something comes up, at least the doctor can look back at your history with them and make a decision based on his previous experiences with the patient......
  • Unless you have something stated in a Contract with your PM, you don't "give back" unused medications. If you no longer need them or they've expired, you may turn them into most pharmacies that sponsor a drug take back program. Some police departments and EMS services sponsor the same program. I've even taken pills before that I didn't need any longer and put them in a ziplock bag of vinager and thrown them away. The vinager dissolves the pills so you have a bag of fluids.

    It is better to tell your PM if you are taking the medication or not. If they do a drug test on you and you either don't have any or just a small trace of it in your system, they will cut you off. One way of thinking about it is this; they gave you the meds to take, use them if you need to. If not, don't but let the doctor know how frequently you do take it. They may adjust how much you get, but it's better to be honest with your PM.

    I think most people do have a few emergency pills available, but remember that if you keep a med that a doctor no longer prescribes you and it turns up down the road in a drug test, they will most likely dismiss you as a patient. There is another poster on this site that is in that exact situation now. She had Hydro left over from a while back. She had a flare up and took it. She got popped on a drug test and the PM dismissed her.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Went to my appt this morning and the Doctor told me to just keep any extras for an emergency.

    He said they have no problem with me having some extras on hand.

    Like I said before I don't get that many per month anyway.

    Plus in the summer months, I tend to have more problems due to the heat and thunderstorms and such just kill me pain wise.

    Thanks Keith for bringing up some very valid points.

    If we change meds down the road, and I know we will because when I hit a tolerance issue, that is how we handle it.

    At that point, I will destroy them. (Thanks for the suggestion on how to do that!)

    You all that suggested telling the Doc to build up that trust are so right.

    I had that with my former Doc and it is so very important.

    Thank you all for your help, it is invaluable to me.

  • I'm glad you had such a great appointment (or it sounds like it). I'm not here to judge anyone. I think as long as your doctor does know more or less how much you are taking, I can understand the need to "stock up" (in realistic quantities which I'm sure are different from patient to patient). I have much more problems in the winter. Currently my pain levels are thankfully not to the point I require pain medication, but I'm realistic and know as I age, Pain Management will probably become part of my over all journey. I always read the Pain Management columns and often comment on them. Sometimes I feel like I shouldn't because I don't have experience with that (I mean, clearly I have tons of experience with taking narcotics after surgeries, but thankfully just in the healing process).... I'm glad most people seem ok with me commenting anyways. I know at least when my time comes I'll be well informed.
    Glad your journey appears to be going some what smoothly!
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • And if you do need to dispose of narcotics you can always call the Sherif's Office or the Health Department. I know I'm involved with grants/coalitions that fund "Take Back Day" in our county in Florida, USA. There are rules, like there has to be an office on duty to guard the box, etc... so you might live somewhere you can take them any day, but I know here we can only afford to fund it I believe twice a year.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
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