Worry about spouse's 'secret' oxycodone use

[rubytuesday55]

My spouse has chronic, debilitating pain and sees a pain specialist who prescribes him a 30 day supply (120 tabs) of 10/325 oxycodone/month for the past few years. Six of my spouse's sibblings and his father all suffered (died) directly and/or indirectly from chemical addictions. I accidentally discovered that my spouse is also getting another 120 tabs (2 week supply) of 5/325 from his PCP. He has been filling these each every two weeks and takes them himself (I am certain he does not perceive himself as having any 'problem' addiction-wise, but then I do not understand why go to 2 different doctors for the Rxs). I was worried about the potential for addiction considering the genetics, and his telling me that he only takes 1 tab 'once in a while'. I was also concerned that using these over the years, about his liver and kidneys. His doctor has been having difficulty controlling his high blood pressure. My spouse is an 'old' 59. When I made the discovery, I discussed my concerns with his PCP who tells me that my spouse should not be getting all that med and from 2 different doctors, and that they usually check a national database (but for whatever reason, had failed to do so). His PCP says that when his Rx is due to be refilled (by him), he will explain to my spouse that he will need to get his pain meds from his pain doctor. (He also takes Topamax, Cymbalta, Skelaxin, Lidocaine patch, Lipitor). My other worries, now are if I did the right thing, because what I read is that 240 pills/month to treat true pain is not harmful. I do not want my husband to suffer but taking that many pills and still being in pain, to me, signifies that even that isn't enough, so how many would be 'enough'. I think he will always have pain and needs to find ways to cope. I now feel guilty that I perhaps should not have called this to his PCP's attention (still, not being a doctor, I think if his PCP felt this treatment was safe and warranted, he would have continued with whatever treatment was medically necessary). Was I wrong to worry? My spouse does not know what I did. Also can I expect him to go through some kind of withdrawal? Thank you for your response.

[rubytuesday55]

Thank you for your response. I do think that there are other meds the PM doc might want to try. Believe me, I have offered and requested to accompany my spouse to his appointments but he always declines. I do try to put myself in his shoes and I live with pain every minute of every day of my life since I was struck (as a pedestrian) by a speeding car, twice, doing extensive orthopedic, soft tissue and muscle/tendon/ligament/bone damage in addition to my arthritis and fibromyalgia. My husband can be very obstinate in his denial which makes his blood pressure escalate. Rather than call him out on his 'behavior', I decided on a resolution that would not create more conflict, rather, leave it to the medical professionals do whatever in his best interest without fear of losing respect from me. I know he has pain. I did not mean to sound as if I was not sensitive to that. Before my husband ever sought treatment from PM, he was one who would take Motrin--but not the recommended dose--if 2 tablets were suggested, then he'd take 4 at a time--ergo, he could be takng massive amounts with n more pain relief than as with the recommended dose. He is hard to rationalize (with me) with dosing issues (and I am a RN). Our pharmacy does have links to the national and statewide database so I was surprised that they had been lax in checking as well. I suppose we cannot leave things of such importance to assumptions. I am feeling better now about the way I chose to handle things. (I should also mention that with 2 of his sibblings who were drug addicts, the family did hold interventions that included accompanying them to the doctor's appointments). Both succumbed young indirectly from the consequences of their addictions and are no longer with us. My spouse does not relate his drug usage at all in the same way as his sibblings.

[JadedSweetheart]

When I posted my response, I hadn't seen peek's response and I just wanted to say that she said it all better than I did and I completely agree.

[JadedSweetheart]

Given the other meds your spouse is on, I would say he does most likely have a painful condition and needs to take something for pain.  That being said, it is called "doctor shopping" when someone goes to more than one doctor to get prescriptions for pain meds.  I'm surprised the pharmacy hasn't said something to your spouse, but then he has been doing this for a while so they may not have caught it for whatever reason or he may have explained it away.  
Not all states are connected to the national database or use a statewide database, but most are/do, so depending on what state you live in, this may be another reason it has not been caught.
The doctor shopping that your spouse has been engaging in IS wrong and he needs to stop that, but I personally would have spoken to your spouse about it and encouraged HIM to do the right thing, not gone behind his back to his PCP.  I understand your concern and the family history is definetly something to be concerned about, but at the same time many people overcome a pre-disposition to addiction.  240 pills a month is not a lot in comparison, but the total daily intake of acetomenophen should be taken into consideration.  He should talk to his pain management doc if the meds are not working well enough.
You say you feel that if he's taking all of that and it's still not "enough" that you don't know what would be enough and that he needs to cope.  I don't know what his pain is caused by but I do think you should try to put yourself in his shoes and imagine if you were in pain every day all day what you would do for relief.  The pain may also be contributing to his high blood pressure and generally pain meds bring down high blood pressure, so it seems to me that if he were taking too much, he wouldn't have a high-BP problem at all, but that is just me guessing.
Lastly, if the PCP felt his treatment was warranted, he still would not be able to prescribe pain meds to a patient already seeing pain management and recieving a prescription for pain meds from them.  The PCP does not want to have any liability as states really come down on doctors who over-prescribe pain meds.
It's unlikely that he would experience withdrawls from not having the one script and he could just taper down off them if he has some left until the PCP appt, but you should tell him ASAP so that he can prepare for it, rather than get blindsided by the PCP when he sees him.
Honesty is always the best policy and if you want him to be honest with you, you need to be honest with him.  I hope it all works out for you both.  Maybe ask if you can go to his pain management doctor with him and have the doctor explain your spouse's condition to you and why he needs pain meds.  You can also ask questions such as what the other meds are for and how you can help your spouse with the pain.