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Can they just cut you off?
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Can they just cut you off?

I am currently on 75mcg of Fentanyl patches.  I have been on them for about 8 months and prior to that I was on Oxycontin for about 1 year.  I am wanting off these patches but am so scared of the pain.  I have been in the early stages of withdrawal in the past and am scared of what getting worse is like.  I have another issue though.  I have been self medicating my emotional pain with marijuana.  I have been put on several depression meds in the past all either made my depression worse or made me gain a lot of weight which makes my pain worse.  I am seeing a doctor who drug tests every visit. I have to tell him this Monday what I have been doing and he already knows I want to be tapered off the medication.  I am so scared that he will just say "see ya, you are no longer my patient".  Does anyone know our rights as patients?  Can they just do that?  I have told this doctor since I started seeing him 4 months ago that I wanted to lower the dose and he hasn't lowered it yet for various reasons concerning withdrawal.  I am so scared to go to the doctor on Monday I feel like I am going to have a coronary.  My drug test last time was suspicious so I know there are going to be questions this time.  Any help and no judgement would be appreciated.
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hi there...i m not really sure in your case...i was cut off for having hydros in my system when i was prescribed oxycodone...but i was cut off with 165 pills....the main thing is to be honest with the doctor....if you are honest i m sure he will help you...good luck..maria
hopefully he understands your history of use and is familiar with the strength of the opioids you have been on. its not going to do any good to worry about it. I know when I have been in the ER a few times I had a multitude of drugs(including pot,methadone, and various other opioids) in my system, and they acted like they knew it, but did not rat me out to the cops.  the surgeon must have seen it before, because he did tell me "you need to stop eating those pills like candy" it was the first of a few wake up calls, that finally woke me up

why you were prescribed fentanyl patches is a good question, but regardless you need to do something to get off them, thats all there is to it. we know what its like around here thats for sure!
How often do you change out your patches every 2 or 3 days hopefully 3.  If you can  I would ask to lower your dose on the patch to 50 then have him give you 25's as well, try and taper that way if you can get down to the 50 then eventually 25 that may help you jump off.  I would wait unitl the 4th day on 75 and go to 50 it will be tough but you can do this!! Then eventually jump to 25  then eventually kiss them goodbye. I don't think he will cut you off but be honest like everyone says.  
I want to say first off that it is never a good idea to use any kind of illegal drug. I am not judging you only saying that it is obviously not good for you and it will only bring you more problems not only with your doctor but the law also.
That aside, you will be dropped as a Pt. Did you sign a contract with your PM doctor?
Anytime an illegal substance is found the doctor will/can drop you as a Pt right awy with no recourse availble on your part.
This medication is very difficult to come off of but you can do it with the right support and help. When you see the doctor inform him right away about your illegal drug use before he tells you about the drug test and explain why you were using it and ask him to help you detox from the medication. He may help you but I will tell you it is very doubtful.
People get dropped for much less with no medications and no help to detox.
You can look in your area for detox programs that will help you and I would suggest you do this right away so that you will have some help if the doctor does drop you with no help to detox.
I do not use this medication so I am not familiar with the detox procedure. The members in the SA community will be able to assit you in your detox efforts.
I wish you the best and hope that you suceed and also stop using the illegal drugs as well.

Welcome to the Pain Management Forum. You will get no judgement from me.

Unfortunately I have seen many ppl post that their Drug Screen came back positive for THC and they PMP dropped them immediately. I am not trying to scare you any more than you are now.

You do have some patient rights. I beleive they have to treat you for 30 days in most states. I assume that you signed a contract that in effect said if your drug screens are not what think they should be you are subject to immediate dismissal. They cover themselves with that contract. They may allow you one more months of meds. Some do and some don't. Much depends on the clinic and their policies.

As was said earlier, be honest and upfront. Request help with withdrawals and they should honor that regardless of the results of your drug screen. Good luck and please let us know how you are doing.

Take Care,
I have had two PM physicians tell me that the only "recreational" drug they allow is pot.  I don't smoke it, I never have, but the fact remains that some doctors realize the pain relieving qualities that marijuana possesses and they do allow it.  My GP at one point before I ever started going to pain management even told me that "all I can tell you is that I can't prescribe it, but if you can find it, smoke it".  If you are honest with him, it may save you.  What may work against you, however, is that you didn't discuss it with him FIRST, even if he does allow his patients to smoke it.

do they have an in-house lab? if you take a drug test monday-- will they have the results immediately, or do they send to a outside lab which takes days/weeks to get the results back? If they wont know the same day, I would suggest you get yourself a medicine to taper off the Fent with and do it yourself before they get the results in because its very very likely they will drop you. the pain clinic i used to go to would drop you if you so much as had an aspirin in your system that they didnt RX you.  good luck to you and let us know how it goes
Thanks to you all.  To answer some questions asked; I suffer from multi-level degenerative disc disease in my back w/ the majority of pain in the lower back. I also have arthritis in my hands and feet, carpul tunnel, tendenitis (sp?) in my hands and elbow and one Dr. said I may have Fibromyalsia (fibromyalgia). As far as being honest w/the Dr. I have to some degree as I told him the first time he was going to test me.  He post-poned the test for 30 days.  I am not a thin person and fairly sedentary.  It takes longer than that to get out of my system.  I also have realized now that I have to stop that I don't know how to deal w/the emotional pain w/out it.  I don't like that realization but it is what it is. I hope to plea for assistance w/both of my "pain" issues.  Thanks again.
If I were you, I'd have a back up plan.  Go to your PCP and work something out with them.  I was dropped by PMP just by getting a second opinion.  I followed his rules to a T and never refused any treatments or injections.  He dropped me 2 days before my refill.  I was more then furious.  I went to a PCP and he is taking over my care.  If the PMP does discontinue his care with you, he is suppose to wean you off the medications.  Good luck.
He absolutely can discharge you.  Did you know he test's you every visit?
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