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Discharged from pain management! Need help.



  • The user and all related content has been deleted.
  • I also agree with Sandi. I think you'd do better with a time release pain med that will stay in your system consistently. Norco and Percocets work better for break through pain. I'm thinking that farming might be too hard of a job with your back problems, but understand that you need to make a living. Maybe it's time to consider another line of work that won't make your spine problems worse. I know how frustrating it is to deal with chronic pain 24/7, but we must adhere to our pain contracts. I hope you see all this advice is to help you so you don't end up without access to pain management. 

    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
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  • Well according to my contract, maybe I am abusing my medication or taking "more than prescribed". Obviously if the Norco was working at the prescribed dose I would continue taking it at the prescribed dose, however, it is not. Before I started taking one tablet and a half I was taking the prescribed dose and developed the tolerance that way. Same dose for so long, obviously will create tolerance. Even if she did increase it to one pill per day, the effects for me wear off within 4 hours. So in reality, I am not abusing or over using my pain medication. 

    For example, why would someone take a half dose of Tylenol if they could only get rid of their symptoms with two Tylenol's? I understand that Tylenol is Acetaminophen and is a completely different chemical structure than opioid pain medications. But just stating that no matter who you are, your tolerance will catch up with you quicker than your Doctor is willing to work with you.

    I seem to react better to Thebaine derivatives more so than derivatives of morphine. Oxycodone even at a much lower dose seems to help me manage my pain three times more than Hydrocodone with a much longer duration. Everyone is chemically created different and our receptors react differently than everyone else's.

    What makes you so determined that I am going to get kicked out of pain management? I'm not gonna over dose because I don't abuse my med's, I take what my tolerance needs. Just because Jack can take 5 mg of an opioid pain medication and feel relief does not mean Jill can achieve this also. Jill may need 10 mg or (15 mg in my case) to get relief from pain. I am not going to fail a drug screening because I am taking the correct medication.

    I came here for help, not a lecture that I am already aware of already. As long as you follow your pain contract, you will be fine. If I happen to screw it up then shame on me, I should have never developed a tolerance to a tolerance inducing/creating medication. 

    Anyway, back to the whole purpose and point of my thread and my recent post... How should I go about getting prescribed oxycodone, the medication that works best for me?

  • Keep in mind, we are not the only ones that are making mistakes and having to work the system to get the pain relief we need. Most pain management Doctors are well aware that they are creating lots of problems themselves and doing things they themselves should not be committing under their own contracts.

  • I did not up my dose to 15 mg purposely fyi. My tolerance crawled to 15 mg. Why would I want to take 15 mg for no reason? You say that this is why my tolerance has risen? Well then whatever mg of medication you are now taking, how about you cut that in half yourself and see how that works for you? Obviously what you are taking is working well for you, what I am taking is not, not at prescribed dose.

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  • According to your posts, you started Norco in March. 2 months later, were increased to three per day, and in July, were already running out before you were supposed to., taking old meds, and later getting Percocet from a relative. You wouldn't run out of your meds if you were taking them as prescribed. As I said, you are creating what you are calling 'tolerance ', and making excuses.

    There is NO amount of pain meds that will erase chronic pain. Pain meds are meant to reduce, not eliminate chronic pain. Manage, not eliminate. 

    You seem to be full of justifications and 'reasons' why you keep taking more than you are supposed to, but if you really believe that disregarding what the Dr told you regarding following exact dosing instructions and contacting her first is wrong,  and justified, you wouldn't hide it from her. Instead, you would tell her exactly what you are doing, taking more than you are supposed to.

    You are lucky you haven't been tested yet. There are two types of testing- one is a simple positive or negative, but the other is quantitative, meaning it will show how much Norco you are taking and that type of testing is usually done by being sent to a lab. It is done in most pm offices these days. It is also done after the positive/negative in office screen.

    You are setting yourself up for big problems, and using the tolerance excuse EVERY few months just isn't going to work in the long run. 

    You appear to be making a huge mistake that too often leads to chronic abuse/misuse of pain meds. You have the bottle, it's not eliminating your pain the way you want it to, so you take another half or another pill, soon that additional half/1 won't be enough, and you will take more..thats a slippery slope you don't want to be on. 'CREATED tolerance'.

    Ask the other members how many people just like you we see get dismissed on a daily or weekly basis. 

    You might be angry at me at the moment, but believe it or not, I AM trying to help you avoid a second discharge, and guide you in helping yourself for the long term, and not put yourself or your doctor in a position that no one wants to see you in.

  • RLMS56RRLMS56 Posts: 1
    edited 01/12/2018 - 3:17 PM

     Most states (I’m in CT) have laws in place when a patient is discharged from pain management. The provider must state in writing within 30 days of dismissal. Also they are required to give 30 days of current meds. Remember patients have rights and they usually favor the patient. You can also file a complaint with your insurance carrier. 

    Edited by Liz, Spine-health Moderator

  • RLM,

    Most states do not require pm doctors to provide 30 days of meds. That is a rumor, and not a fact.

    As far as the dismissal letter go, the doctor can simply state that the patient/doctor relationship is terminated/violated. They don't need to give a specific reason. They usually say they will provide emergency care for 30 days, but needing pain meds is not an emergency.

    Patients have rights YES, but it is the right to have their pain taken seriously, but that doesn't mean it must be by opiates/ pain meds. There are many ways to treat pain, not all of them require treatment by medication.

  • This thread needs to be toned down in heat.

    Advice is being offered in good faith, there is no need to be adversarial in answering.

    Please respect the kindness of others and this thread will remain open.



    William Garza
    Spine-Health Mod

    Welcome to Spine-Health

  • The user and all related content has been deleted.
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