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Discharged from pain management! Need help.

Hey guys, i'm new to the forum here and just thought i'd say hello and let you guys with experience in on what is going on with me.

I am 30 years old and live in Kentucky and was referred to pain management by my pcp back in March. I have rheumatoid arthritis, chronic lyme disease, bulging discs in back and neck and honestly the lyme is a very painful disease. I was diagnosed way to late for the antibiotics to work and now I just have to live with it.

My pain mgmt Dr started me out on 2 norco 10mg twice a day. They did seem to help a little but they wore off in between the doses so i asked for a thrid one and he agreed. So for the last 2 months I have been taking 3 per day. This last visit I had tan out of medication a couple days prior to my new visit because my pain has been worse lately. I got dental surgery back in the fall of last year and had some percocet 7.5mg left over in my cabinet. I took 3 out of the bottle to get me through till I seen the Dr again. 

Now the first time I ever went to this clinic he never urine sampled me and after the first month he ended up writting me two prescriptions per month and I only had to go every 2 months for a visit. Not once in 5 months did he ever drug test me or pill count me, even during the initial first visit. Well my last visit they asked for a urine sample. I gave it and did not think nothing about the percocet being in my system. 30 minutes later they called me back to see the Doctor and he ended up adding another Norco to my RX for a total of 4 per day as needed, handed me two prescriptions and went on his way. Went the next day and got them filled. Well it has been two and a half weeks since then and I got a letter in the mail today saying he could no longer treat my pain dude to misusing the doctor patient agreement and to seek further pain management promptly. 

Now here is my concern... Should I call and try to explain what had happened with the percocet? Or do you think it is too late now that I am discharged? Will I have a hard time getting into a new pain management Dr to treat me? I went by my pcp today and told them what had happened, they took a copy of my letter from the pain doc and said they would ask my pcp to help me get referred to another one. On the letter it did not specify why they dropped me either.

Something else I am wondering about is the prescription he gave me 2 and a half weeks ago for next month. Will I be able to fill it since he has discharged me? It is a hand written rx and I have it here with me. I go to a small mom and pop family owned pharmacy and am hoping I can still get it filled because that would hopefully cover my pain for another month until I can find and get an appointment with a new pain management Dr. 

I always here they usually give second and sometimes even third chances but not this one. Hopefully I dont have a problem getting a new one to treat me. It worries me severely because before going to pain management I have tried evsrythibg you can possibly think of for my pain with no avail.

Thanks guys for taking the time to read this!



  • @kybluegrass It seems people are taking the pain management agreements lightly these days. You cannot self medicate, even if you have an escalation in pain. You should have notified your doctors office, and asked them for advice. It does not give you permission to take your meds out of context. Also, you absolutely cannot take other scripts when you have a pain contract. Even if it was prescribed to you in the past. This is going to be on your medical record now. You can try to call your doctors office, but expecting them to just give you a second chance really isn't the way to handle the situation. You knowingly disobeyed the rules. Also, im not sure if your script will be filled. Your doctor could have called and cancelled it. All you can do is call and talk to your doctors office. Sorry to sound so harsh, but trust between you and your doctor is the most important thing. You should never take advantage or take that lightly. It doesn't matter your diagnosis, your doctor does not HAVE to prescribe you pain meds. I wish you luck. Keep us updated! 

    Retrolisthesis C4 of C5 and C5 of C6
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    Disc protrusions with Annular Tears C3/C4, C4/C5, and C5/C6
    Disc Material Compressing Spinal Cord C3/C4
    Severe Forminal Stenosis C5/C6
    Ankylosing Spondylitis 
    Annular Tears L3/L4 and L5/S1
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    PLIF with Rods, Cage, and Pedicle Screws-L4/L5
  • memerainboltmemerainbolt IndianaPosts: 6,475

    Read over other post on this form regarding pain management. This will give you an idea of what is going on with other's in PM and what the replies were.
    But most of the replies you were as Jilly stated, you can't take more than prescribed.

    Hang in there and keep us posted.
    Veritas-Health Forum Moderator
    Please read my  Medical History
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  • dilaurodilauro ConnecticutPosts: 13,579


    The agreements between a patient and the pain management clinic is a very serious and solid pact.   Breaking any  of the groundrules is subject to immediate dismissal.

    I would contact the doctor to explain what  you did.  They may have zero tolerance for this.   After all, if you were in   more pain, what you should have done is contact your doctor and explain this .  They could have either written a new prescription or said ok to you using those few  percocet.     But that is past and you need to see what the doctor will do if you plead your case.

    You did NEED TO FIX this.  Once this is on your record, it is permanent, so any new pain management clinic you visit or pharmacy, they will more than likely have all the information about your discharge.   That will make it next to impossible to be accepted.

    Definitely talk to this doctor if they will let you.  Plead your case, but dont be surprised if it all goes on a deaf ear.   Today's situation with opioids make it so very difficult.

    Remember, as others have said here, no doctor is obliged to prescribe opioids for their patients.  They will write prescriptions only for those patients who need them and have followed all the rules.

    Good luck, but do everything you can to fix this and clear  your record.   You dont want this black mark against you forever.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • Hi kybluegrass

    I say the following not to come down on you but to give you some advice from a someone who cares and has been talking pain medication for over 20 years. We who have been taking and need pain medication to be able to get up and have at least a half decent day make sure we follow instructions given us by our doctor. Of course we all make mistakes I have, but we cannot afford to do that especially in this day now where we including doctor's are being monitored for any time medications are not used right. I have spent hours over the past months fighting to try to wake up the world that pain medication is needed but with that I know I have a responsibility to take my meds right. 

    You say he never tested you neither does mine but I know it is a possibility just like you did and if I use anything else I put myself not him in a position of being cut off. 

    You say you have tried everything else so were you getting help other than the pain meds like a plan of any kind to treat or find out some of your pain is coming from and what can be done. If not maybe you should look for a second opinion once this is all taken care of, it's just a suggestion and I am learning things everyday at the age of 69 about all my health issues by reading as much as I can about each problem. It can be surprising there can be things out there if we do our work to find them. Have you tried pain cream you might want to ask the doctor about that when you get a new one. I have arthritis and disc issues swimming and massage plus eating the right foods too can help. Ron put together that "Blend" if you type in the upper right hand corner it is there just check it out you never know. A huge thing too is being so young and dealing with all you are has to be so hard so whatever you can do now will help you later on in life.

    I would call like suggested and ask if that prescription was meant to hold you over until you can find a new doctor. Don't just let it go like Ron and others suggested do what you can to clear it up that is critical for your future.

    Those who have responded to your post care and want to help like I do so hang in there and keep us all up to date with what you find out. 

    tI hope I helped you even a little bit take care of yourself and I will be hoping you find some help. Sherri

  • Thanks guys for all the great advice! This forum is amazing and i'm glad I found it!

    On a rush to get to work for now, but do you think I will be able to get my next prescription filled that the doc gave me for next week? I really need it to help me get by and control my pain until I get into a new PM Dr. 

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  • I'd suggest you talk with your PCP about what happened to see if they are willing to assist.  I live in KY as well and pain management clinics are under attack politically from every angle.  The doctors are going to cover their butts on everything because of how much the KY Board of Medical Licensure has cracked down on doctors prescribing pain meds.  My PMP moved to southern Indiana (which is where I go now) so that he could practice medicine the way he wants to, not the way politician's want him to.
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • To answer your question about being able to fill the prescription, I think it is probably pretty unlikely. It was likely cancelled at the same time as the letter was sent.

    Typically, when a patient is dismissed, any prescriptions are also immediately cancelled and the pharmacy notified.

    The ONLY way to find out is to call the office and ask if they cancelled the prescription.

  • dilauro 

    That's incorrect about every doctor or pharmacy having information about his discharge.  There is not a central database that any doctor can access in the USA.  

    Your rights under HIPPA...

    "Only you or your personal representative has the right to access your records.

    A health care provider or health plan may send copies of your records
    to another provider or health plan only as needed for treatment or
    payment or with your permission. 

    The Privacy Rule does not require the health care provider or health plan to share information with other providers or plans."

  •  I think part of the problem is that the general public is unaware of how pain clinics operate until they find themselves there for chronic pain. I was also a little naive regarding the implications of signing a pain contract. I had a general idea of what not to do after reading my copy. If you are in doubt, always ask first. Mistakes are costly even if made innocently at a time when opioid abuse is rampant.

    There is a slim chance you might be accepted at another clinic, but with no pain meds prescribed. If so, then a multi disciplinary pain clinic will offer you non narcotic medication, spine injections, physical therapy, etc. Are you being treated by internal medicine and rheumatolgy for the chronic lyme disease and RA? Hopefully your family doctor can refer you elsewhere for the treatments I mentioned above. Take care.
    Ol' Spiney..Micro-D L4-L5, TLIF L4-S1 -post op central HNP L4-S1,stenosis, retrolisthesis, EF, facet arthropathy, lumbar& cervical DDD. FBSS- Medtronic pain pump & SCS
  • dilaurodilauro ConnecticutPosts: 13,579


    I sent you a message describing with Electronic Medical Records are and how they are not a violation of any HIPPA rule.

    And that the central data base is being created as we speak.   Its far from complete, but it will be there 

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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