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pain meds and chronic pain
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pain meds and chronic pain

why do doctors not want to write pain meds for people with chronic pain,especially when they have proof? Am I the omly one having this problem? Or are there others?
Tags: pain meds
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Avatar_f_tn
Unfortunately, many doctors are reluctant to write prescriptions for pain medication due to the increasing problem of prescription drug abuse or illegal sales of this type of medication.  it's unfortunate that a some selfish, uncaring people can make things so difficult for those of use who legitimately suffer from chronic pain to be able to get the medications that we need to be able to function even at a limited level.

What type of doctor are you going to?  If you are seeing just a general practitioner/family physician, you may consider going to a pain management doctor.  Many general physicians are very limited in the amount of narcotic prescriptions they are permitted to give and for how long.  However, a pain managmenet doctor not only quite often has many options available for pain control that maybe your family doctor wouldn't have, but they usually also are able to write pain medication scripts for extended periods of time.

However, many pain management doctors require a referral from your regular physician (or other doctor that you have been seeing for the pain), so you may need to get one in order to be able to be seen by the pain mgmt doc.  Most pain mgmt docs also require that when they take you on in their practice that you sign documentation stating that a) you are willing to submit to period and random drug testing to make sure that you are not only taking the medications they have prescribed, but also that you are taking them AS prescribed b) that you will ONLY receive pain medications from this doctor - if you accept pain medication from any other doctor, you can be released from the pain mgmt doc's care.  these forms are quite standard and everyone I know that goes to pain mgmt has signed one.  I believe some of them also state that you will ONLY get your presriptions filled at one pharmacy and you have to provide the doc with the pharmacy name and number.  This is always a good practice to get into anyway, that way the pharmacy can catch any potential interactions between the different medications that you take.

Keep searching, there are many, many good pain mgmt docs out there.  Best of luck with finding help with your pain control.

Gentle hugs,
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356518_tn?1322267242
Hi,
    Geminigirl answered your question well I just want to add that you should not give up. We have all been where you are and have had to find the right doctor for us. There are kind caring compassionate doctors so do not give up:)
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1152183_tn?1273015295
The information about medication contracts is spot on but there is something you need to remember when presented with one.....

Treat it like any other contract.
Don't just sign it, but go through it, point by point, make notes about what certain requirements mean and try to make changes where you feel it necessary. Be sure the doctor initials the changes and signs the contract with you.

You might be able to avoid some problems, like bad results from urine tests, by limiting any testing to blood work, which is what I managed to do. You might avoid repeating treatments and therapies with a new doctor if you can get notes on your contract stating that you already have any exercises a physical therapist might suggest.

.
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1281527_tn?1272915125
This is because of basically three reasons: (a) irresponsibility...people are misusing long-acting pain medications, for recreational purposes, crushing them, and/or mixing them with other CNS  depressants and dying, (b) criminally diverting them for sale on the black market in record numbers, and (c) as a result of this stupidity or greed, causing doctors to have to pay exorbitant insurance premiums, in some cases forcing them out of pain management altogether. In addition, right at this moment, doctors and clinics that deal with pain management are all being audited which either prevents them (temporarily) from even being able to take a new patient and/or prescribe narcotics.
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Avatar_f_tn
SageRave had an excellent point - never sign ANYTHING without reading and understanding it first.  You wouldn't (or shouldn't anyway) sign any other legal document without first reading it and making sure you understand every part of it, and this type of medical contract is definitely a legal document.  By doing what SageRave suggested you are not only protecting yourself, but you are also helping to protect your doctor's rights to continue to practice and prescribe you your medication.

I would also say that this thinking and carefullness goes along also with the medication itself.  Just because a doctor has prescribed a medication for you, doesn't always mean that that medication is necessarily the best one for you.  While doctors and pharmacies are very careful about the medications that are prescribed and dispensed, I feel it is also the duty of us, as the patients, to read the information pamphlet that is now handed out with every prescription that is dispensed.  It's important that you make yourself aware of possible side effects, drug interactions (yes, the pharmacy and doctor should also check for these but they ARE human so they do make mistakes also) and even foods or beverages that should be avoided while taking the medication.  This goes for all types of medication, not just pain meds.

When dealing with medications, a little knowledge can definitely go a long way.
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1187071_tn?1279373298
I am the same way I have been in so much pain and crying a dr has looked at me and said "sorry nothing I can do for you, you need to go to your family dr and see if they can help" Then he hugged me and got up and left the room. I was not happy at all and in alot of pain. There are people out there that like to sale their meds or take to many or give them away which makes people like us that have pain 24/7 and have real pain that needs to be treated can't get treated, it isn't fair at all.
I am going to be going to a pain dr, but I have to go to a shrink first to get cleared by him before the dr will start giving me pain meds and I have signed the contract but I read every word of it. If I break the rules somehow it is my own fault and don't need treatment and should deal with the pain all the time. If someone breaks the rules the doctor can lose everything cause of that one person that is why they are scared to give anything. If people would follow the rules it would make it easier for the rest of us that needs treatment.
Jamie
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Avatar_f_tn
I have dealt with chronic pain for over 26 years now.  One doctor told me about 24 years ago that I was going to have to "learn to live with it".  A couple of years later, I was still suffering, and close to suicide when a friend approached me about a pain clinic physician she had read about.  I called, and they felt they could help me.  I had to BEG for a referral (finally, without my knowing it, my supervisor called and said the doctor would have to deal with the guilt of my suicide if they did not help me...what a blessing!).  
The FIRST thing they did at the pain clinic was to get rid of any medication with any degree of narcotic.  I was taking Synalgos DC, which was a mild codeine-derivative.  None of my doctors nor the pharmacist thoght I took at high enough levels to be "addicted", but I had to go thru their withdrawal program.  Since then, I have adopted the philosophy that taking any narcotic was not a long-term option.  Today, 1 or 2 is enough, but tomorrow it will take 3 or 4.  Pretty soon, you find yourself relying upon the medication in order to "function".
Finding a good doctor for daling with chronic pain is difficult....it is a difficult condition to deal with from the standpoint of the patient and/or the treating physician.  It iIS possible to "learn to live with it".  Lots of prayer, experimenting with different medication options, learning to "pace yourself", and discovering that life IS worth living....even with the pain.  
Good luck to you (and everyone dealing with chronic pain) on finding the right physician to take care of you!
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1152183_tn?1273015295
Weigh the benefits and risks of narcotic medications for yourself.

Chronic pain renders us dependent on ANYTHING that will ease our pain. My personal philosophy is that my worrying about addiction is  ranked third, behind pain relief and the quality of life that wish for myself. Others feel differently.

Read as much information as you can on ALL medications before disregarding their benefits related to your specific situation.
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547368_tn?1332173665
Hello Esor,

Welcome to the Pain Mangement Forum. I am sorry that you have untreated and uncontrolled chronic pain. You are where many of us have been in the chronic pain journey. All above responses have been very informational.

I noted that you reside in KY where the opiate misuse or abuse rate is one of the nations highest. Several years ago the movement to decrease the statistics in your state was instituted. I beleive the specific opiate named was/is OxyContin but this problem is nation wide and your state is not alone.

However residents in KY are prescribed opiates for pain. It's just requires looking for the right physician. As was suggested you may have to request a referral to a Pain Mangement Physician (PMP).

When entering a PM Program you will most likely be required to sign a contract. These contracts are designed to protect the clinic/physician, not the patient. As Sage so wisely suggested, go through the contract point by point. If you want to make changes or additions do so and have the PMP initial his or her approval, if they are agreeable. Protect yourself.

I too was told I would have to learn to live with my pain. Well that over used cliche' goes just so far. After a number of years of "learning to live" with my chronic pain (CP) I was near the point of ending my life also. I had a plan and a date. I was not living, I was barely existing. Fortunately and shortly before that date I stumbled across a PCP that recognized I was in pain and diagnosed my condition and now treats my CP. I had long ago given up and stopped searching and she literally saved my life.

I encourage you to keep searching for a compassionate physician, one that will either treat your pain or refer you to a PMP. No one should have to learn to live with severe CP, no one. There are many ppl on opiates in your state, there are physicians that prescribe so please don't give up.

I wish you the very best and hope that you will keep in touch with us and let us know how you are doing.

Take Care,
~Tuck
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Avatar_f_tn
Thanks for all of the good answers.I am well aware of how the docs.in ky especially do not want to write pain meds even to those of us with chronic pain,24/7. They all want to pass you off to another dr.Ive seen so many drs over the last 15 yrs,that its shameful. Also it is so true that there are a lot of people getting pain meds that really dont need them and,end up selling them on the side.Too many people like to take narcotics to get high or whatever,but in all honesty,I dont remember ever being high from a narcotic! It just eases the pain so I can function like a (normal)person.Thank God I finally found a dr.who is working with me to get me feeling better.There was a 7 year gap in between losing my last dr.who had me feeling good again after several yrs of ultram and garbage full of chemicals.He just up and left the state and,all of his patients in the dirt.So here I am 7 yrs later,and Im feeling pretty good again.Not exactly where I want to be but,Im patient and hopeful that my new dr.will get me back to (my old self) again. Again thanks for all the great advice,it was all helpful.   esor15
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Avatar_f_tn
does anyone with cp have IC with ulcers in thier bladder? I just had a hydro distention done wed.morning and ive gained 8 lbs in a week and a half ! for no apparant reason,I am so confused. I have No appetite at all I lost it a long time ago,I dont eat enough,i cant force myself to eat when I have no appetite,so i cant understand why im gaining so much weight so fast! any advice or answers are welcome. Please if anyone has or is going thru,the same thing or knows of some one else who is,please help? any advice is welcome. esor15
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547368_tn?1332173665
Hi Again Escor,

It's good to hear from you. IC, I assume you mean Interstitial cystitis. It's a painful chronic inflammatory condition of the bladder wall. I am sorry that you have IC.

Are you on Elmiron? I thought maybe your weight gain could be due to medication but that is not listed as a side effect. Are you taking prednisone? Sometimes a temporary weight occurs with a steroid?

If you haven't changed your eating habits due to stress that I am at a loss as to why you may be gaining weight.

You might want to post your question in our women's health or urology forum. You are always welcome here but you may obtain more information in one of those sites. But please let us know how you are doing. Possibly one of our members may have more information that I do.

I am happy to hear that once again you have a good PMP. It's a shame that it too you seven years to find it. CP can be so challenging!

Best of Luck to You,
~Tuck
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