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Long term use of narcotics?

manaleriemmanalerie Posts: 550
edited 06/11/2012 - 7:23 AM in Pain Medications
Ok, so today was a total wreck. I couldn't even walk. Probably the worst pain in my spine to date. I posted the whole story already, under pain medications titled y'all were right. I have a question that I think would be better asked in its own thread.

After calling my PCP today, the office called me back, and said the doctor would like to know what exactly I would like him to do for me. I told her "I don't even know what he can do for me, but I can't get a hold of my neuro, and I am in severe pain" She asked if I have tried taking tylenol. I told her that yes I have, and I have been taking max doses of tylenol, Ibu, and/or naproxen for the last year. She says, ok, so don't take anymore of that. Let me talk to the doctor again, and call you back. She calls back and says:

"Dr. says that narcotics are not for long term use. There is nothing he can do for you" Then she scheduled an appointment for next week.

I am going to PT
Getting epidural next week
I cannot have surgery

I've been to my PCP, a PM, a Neuro, a NS... are there any other doctors that I should be consulting?

Is that really all there is for me? Is there no other non-narcotic pain reliever? We've tried everything, so now you just have to deal with it? I'm certain there are meds specifically designed for long term use, am I wrong?


  • I have been on vicadin es for over 6 years,and i am not a surgical canidate,i dont think what the doctor is telling you is true,you could find another doctor.

  • I would find another doctor, my friends wife has been on opiates for 10 yrs and just talked to her today for the first time about what she's been through.OMG, the dosages and mix of meds scares me to death.Now she has a great PM and has been slowly built to this stage, is in full capacity mentally and can function physically at very low level due to injuries.

    Now just meds and no further tactics would be bad IMHO, I feel my best when doing what I can physically with the meds as an adjunct.I have read what your going through and it seems your doctors are not doing their best to help and so it may fall in your hands to remedy that sadly.Its terrible to be medicated for life, but a new medical find/procedure may come around and free you too.
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  • I agree wholeheartedly with frustrated!
    You gotta do what you gotta do in order to have as
    as close to a normal life as possible. I have been able to function quite well on opiates and when I asked my doc about the long term effects on the organs he said that the body hardly knows that they are there and are much safer than ibu, tylenol, etc which can do lots of damage to your organs. opiates are the only way to go long term. You might want to find a new PM because as the title says that is their job, to manage your pain. Good luck and please keep us posted.
  • I really can only blame myself in this situation. My PCP has ignored me for years. Any of you here that have read my posts know that I have done nothing but complain about him, and I keep saying I'm finding a new one.

    You just get used to someone you know? You want to have faith in this person that you have spent so many years trusting your life with. I keep on telling myself I'm gonna give him another shot.

    I have only seen my PM once, and I will be seeing him for the second time next Tuesday for my injection. I did not discuss pain medication with him, since I was getting Ultram from my Neurologist. I did however explain the side affects I was having, but we didn't go into detail. Should I express my concerns with him? He did state that other than the epidural, there is no need to continue seeing him.

    I have an appointment with PM on Tues, PT on Wed, and PCP on Thursday. I think I am going to cancel the appointment with him on thursday, and find another PCP. How does one even go about getting a new PCP? When I moved here, I went to him on recommendation from my in-laws. I don't know a whole lot of people here, to ask for opinions. I guess I should just ask for a list from BCBS, and take my pick?
  • with painintheback. Find a new PM. This type of situation is what they are trained for and there for. I don't know what happened with other PM, have not read that post apparently. But we just have to keep trying and working our way through these uneducated, fearful, and sometimes just pure asshole docs. Not gonna change their narrow-minded perspective. Keep searching and good luck.
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  • Possibly is there confusion?

    Here's why I ask. The purpose of a PCP is supposed to be so that one doc is "all knowing" about what is going on with a person. Sort of a hub and the other docs are specialists that only treat what you are referred to them for. So your PM doc won't take over from your Neurologist, unless it is the Neurologist that consulted on your treatment and then, depending on your treatment requested, it may be an in and out and then back to the Neurologist for continual care.

    For instance;

    The doc who is controlling my meds and care is the Neurologist. I do have 2 neurosurgeons and 2 PM docs. The neurologist referred me to the NS for a consult on one part of my condition. The NS refered me to PM for treatment via intervention. But the neurologist is the one controlling the meds and monitoring the overall condition.

    The PM doc here consulted with my NS and PM docs in the US and got my SCS implant, however since that is only a pain control measure, the neurologist is still the primary doc in charge.

    So maybe you feel like you are getting the run around when you really aren't. Possibly sitting down with the doc and asking "who's responsible for what?" might help square this away.

    I hope I didn't confuse you.

  • Hello Amanda.I was thinking that if you got the Ultram from your Neurologist,and the injections from your PM...the PM may be thinking that the Neurologist is treating you with all of the medications that you need.

    I signed a contract with my PM and I cannot get scripts (for pain)from another Dr. I can get other meds,for instance my PCP does treat my thyroid with synthroid medication,and if I would get a cold I could get meds for that.I cannot take OTC cold medication so I do get prescriptions when I have a cold & cough meds have codiene in them and I get scripts for that as well from my PCP.

    You may not have signed a contract (I read some of your posts,but not all I'm sure),and some Drs are not as open about sharing information with their patients as others.Maybe I missed it somewhere,but it seems as if your PM and your PCP are not on the same page with your care.

    I've been taking lortab since Nov.07.We are talking long term because I was on meds in the past.Mine has 500mg tylenol and I take it 4 times a day.I am beginning to get concerned because of the effects on the liver,and I do get a liver func.test every 6 months.
    There are pain meds with no tylenol in them and plenty of people are treated long term with narcotics.

    To change PCP's~Do you know of anyone that has a good reputation?If so you simply call their office,ask if they take your ins.,and are accepting new patients,tell them that you wish to switch PCP's,and schedule an appt.
    They should take it from there,and get your records.Most Drs don't take it personal when you switch,but if you think yours might,you could call there first and tell them that you plan to change Drs so that they aren't so surprised when they get the call/fax for your records.
    When I changed PCP's it was because I moved out of state,but if I were going to change this is what I would do..I think I would explain my reasons to my Dr before I left,but that's just me.

    Good Luck,I hope that you get the treatment that you deserve.
  • "C"

    I was being treated by my primary for my back. After about 6 months of "muscle spasm" diagnoses, and PT I asked him for an MRI. He sent me in for an X-Ray. After the X-Ray, I asked him to please call me ASAP with results as I was concerned that there was something seriously wrong. At my 3rd ER trip (for the same issue) an ER Dr. mentioned the very minor possibility of a tumor, which of course frightened me. After my x-ray showed "muscle spasms" I called my primary, and insisted on an MRI.

    After the MRI, my primary said I would need surgery. He told me to see a neurologist, and a neurosurgeon.

    I went to the neurologist, who said I didn't need surgery, and put me on Kadian (extended release morphine)

    I went back to my primary to get a script for nicotine gum. He asked me about what meds I was on and surgery. I told him that the kadian was making me very sick. I told him that I hadn't seen the neurosurgeon yet, as I needed a referral. I also said that I wasn't ready to go that route, and that the neurologist said I didn't need surgery. He became angry and said that the only way I would get better is if I have the surgery. He asked "what, do you want to be on pain meds for the rest of your life?" He said that he would no longer be treating me for my back. I would have to go to a PM.

    I made an appointment with the PM, and Neurosurgeon. I told my neurologist that the morphine was making me way to ill. (nausea vomiting, I couldn't function) I also told him what my primary said about not treating me for my back. He switched me to Ultram and Skelaxin.

    I went to the PM, and he said I would need more PT, and that he could give me an epidural. Other than that there is no need to see him any further.

    I went to the neurosurgeon, and he said there is no way he would do surgery on me at this time. I am too young, and the injury is not severe enough to do the surgery at my age. He would not cause me another 50 years of pain. I then asked the NS what I should do from there. Who should be responsible for treating my pain. He said my primary doctor should handle that. My husband explained to him what my primary said, and the NS said that he would send a letter to my primary telling him that surgery is not an option for me at this time. He asked me what pain medications I was taking, and I told him Ultram and Skelaxin. He asked if I was sleeping, and my husband told him no. So he wrote me a script for Valium.

    From there I went to my Neuro. (same building) and told him the issues I was having with the med. We both thought it was the skelaxin, so he changed it to norflex. I also told him that the NS had given me Valium to help me sleep.

    I was still having troubles with a racing heart, not sleeping etc. I stopped the Norflex, and still had issues. Last Thursday I called and left a message about the racing heart, and not being able to sleep, even with valium. A few hours later I fainted. I went to my Neuro right away. He said that I had been taking this med for 2 months, why trouble now? I explained that I had only been taking it for a month, reminded him that at first we thought it was the skelaxin etc. He says you started this July 31, August September, that's two months. (Not really but I don't wish to argue) He says that while he doesn't know what caused me to faint, he thinks my racing heart is anxiety. He asked what I take for panic attacks. I told him I usually take klonapin, but since the NS had given me valium, I didn't want to take them together. He said I should start taking the klonapin everyday, and If I happen to faint again, we will do a work up.

    I ended up fainting again, in the middle of the store later that night. The next day, I called my primary and he sent me to the ER. My concern was that I know the trouble is the ultram, and I am not comfortable taking my klonapin for other than it is prescribed which is to take only a few times a month. This is why I called my primary, for his opinion.

    I still had troubles over the weekend, and ended up in urgent care. The doctor there said that yes, ultram can cause all of these symptoms. Since I typically have low blood pressure, the changes in my heart rate will make it more likely for me to feel faint. I had already started weaning off of ultram, and stopped it that day (Sunday)

    My neuro is not in the office on Monday, so I called him today to tell him what had happened over the weekend. I was in severe pain, and could not move. I had left a message with the nurse, and he didn't return my call. I also called my Primary, to get some sort of opinion, or idea or SOMETHING.

    My PCP sent me to these doctors. My neurologist is managing my medication. I feel that he is not giving me safe advice. All of them know what meds I have been prescribed and by who. I called my PCP looking for help. I wanted pain relief, advice, something. I feel like something is wrong with the neuro's advice.

    All I got was "Narcotic pain meds are not for long term use" is there not something else they can do for me? Is there any other non-narcotic meds? Maybe something topical I could try? I try to address my concerns with my PCP, and he wont give me the time of day. He wants nothing to do with my back. period. I have to say, I am hurt by how he can just kick me to the curb so to speak, as soon as my MRI shows there is a real problem. I mean, he had no trouble treating me before the MRI

  • Robin,

    I have only seen my PM once. Next tuesday will be the second time. And yes, I had no need for him to give me medication, because I was being treated by my neuro for that. Maybe, if this medication thing is not straightened out by next Tuesday, I will discuss it with him. Ask him if he can take over? Would that be appropriate?

    I think I am going to write a letter to my current PCP, explaining that I feel he has not been attentive to my concerns, and I think it is time to find a new PCP. The problem out here is, that a lot of the doctors run under the same "clinic" which is also a type of insurance out here.

    So I have XX insurance, I go to a XX doctor at XX clinic. Most of the doctors here belong to XX, and changing doctors withing the XX group has issues of its own.

    My PCP, PM, PT, eye doctor, OB and even the ER are all a part of XX. My neurologist is not. (For some reason that bothers my XX doctors) Maybe because they are all linked into one computer system, and can't see what exactly is going on with the neuro?

    My insurance changed a long time ago, but I still go to this clinic. I would like to find a doctor around here who is not a part of that clinic at all.

    My husbands grandmother has the same doctor as I do. She tried to switch over to a new doctor, from the same group, and he wouldn't take her. She felt he didn't want to take a patient from a colleague.
  • Amanda that's pretty wild. So your first real road block was the neurosurgeon refusing to take care of you due to your age. Then your neurologist seems to be confused about your meds (that's the one that scares me the most) and your PCP is mad and won't help you any longer because he feels you need surgery end of story.

    That is definitely a pickle. There are so many more pain treatment options available and these docs of yours need to wake up and smell the roses and send you to someone that can help you.

    If nothing else, I would think that a second opinion from a new Neurosurgeon might be worth looking into.

    If I were in your shoes, knowing what I know about treatment and surgery, I would not stop looking for a doc who will help if by nothing else but researching alternatives for you. In the meantime make sure you have a doc who is willing to treat your pain with meds until you can get some sort of resolution.

    If nothing else, possibly a spinal cord stimulator or pain pump until you are "old enough" to have surgery. Sorry didn't mean to put it that way, but if that's what your current doc is saying...

    hang in there,

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