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648944 tn?1241469694

Back-up Pain Med Sources

Hi, everybody, and especially those of us needing controlled substances to deal with our chronic pain of whatever sort.  

I would be grateful for your thoughts about back up sources for meds.  Here are some situations that could affect any of us...

SITUATION:  I typically make prescription renewal appointments with my pain management doctor four weeks ahead of time (i.e. generally at the same time that I pick up the previous prescriptions).   On one occasion recently, I went to the appointment, only to be told that the doctor wasn't there, and wouldn't be there for almost a week.  He apparently went on vacation, and either his staff inadvertently scheduled the appointment during the vacation period, or they neglected to inform me of a change.  Regardless, there was the risk that I would run out of meds before he could return and have an appointment time available.

This was a real situation, and the doctor and his staff were appropriately apologetic.  Nevertheless, the experience made me think: what could I do if I were to run out?  I posed this question to the doc, and his answer was just that I'd have to go to the emergency room.  Not a comforting answer...

SITUATION:  I go to a regularly scheduled prescription renewal appointment, and am informed that the doctor is indefinitely or permanently unavailable...maybe something has happened to him or her...injury/death/whatever.  Finding a replacement in the (presumably) limited time the meds will last poses definite challenges.

This situation has not happened to me, but it's not hard to imagine that it could happen---to me or to anybody with chronic pain being treated with controlled substances.

I'd like to see a discussion of alternative courses of action in the event of situations like these.  One (the emergency room) has already been suggested, and I don't know anybody happy with that.

I'll suggest another: accumulate "cushion" supplies of the meds.  This is loaded with issues: how do you do it without engaging in a tissue of lies to the doctor, the phamacist, etc., putting both them and you at risk if they are uncovered? or manipulating your consumption of the meds in unhealthy ways...etc., etc., etc...Not good, anyway you look at it.

Ideas, anybody?  All of us face these situations, at least hypothetically...

Thanks!  Frank Paine

5 Responses
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Avatar universal
I used to have to drive 22 hrs for mine(11 hrs each way). luckily this only went on for 6 months. PHEW glad that's over. and yeah i 2nd your opinion, it is very sad(and unnacceptable) that what should be simple issues can cause so much angst and pain among us.
nick
Helpful - 0
356518 tn?1322263642
I get my appointments sometimes say 25 days apart or even 20 sometimes depending on the doctors schedule and I will keep the extra days safely put away in case of emergencies like this. I know this is not the right solution but there really are not many available. I really do not like having to feel like I need to have a safe supply if something happened but I see no other alternative.
When I first was seen by a pain management doctor , I seen him for about 6 months regularly and all the sudden he had to go to India where he was from for a family crisis and I was left hi and dry! I said then I would always have a back up plan or some way to help myself if that happened again.
I keep in touch with others that suffer chronic pain in my area and so I know of several doctors who treat chronic pain so I feel pretty safe that I could get help if I really needed it at any point.
I would suggest you talk to others who suffer from CP and how they like their doctors and keep that in mind that way you have an idea of someone you can go to if you needed to.
It is really really sad that we have to stress over having the medications we need to survive! I was speaking to a gentleman today that has to drive 6 hours one way to get the help he needs because no doctors in his state will treat chronic pain at all! It is ridiculous that he has to go 6 hours one way to get the help he needs and deserves.
I wish I had a solution as we all do but we will have to keep looking and searching and maybe we will come up with one:)
Helpful - 0
Avatar universal
If my doctor was suddenly unreachable due to illness or accident and it was time for an appt. I would be so out of luck. My PM doc works by himself so there would be nowhere else I could turn.There would be no use in going to the er because they do not write triplicate scripts. They would also assume you were a drug seeker going to the er when out of pain meds so they would most likely not give you anything unless you were in acute distress, and then they may give you something like ultram. This happened to me one time and it was useless. The way they looked at me was like I was a drug seeker. I would never do that again. They can't see that you are really in that much pain even if your blood pressure and pulse are high. They worry too much about giving out narcs than if you are really in pain because so many other people go in just to get narcs when they really just want to abuse them. It's sad that is has come down to this.
I do know that my doc will call his patients to tell us when he is going on vacation and they will give me an earlier appt time or just write the script out early before he leaves for me to pick it up at the regular time.
Like Nick said, I don't think stock piling it is a good idea because that could lead to something bad, for instance we may think one day our pain is really bad and be tempted to take more than prescribed, just because it is there, knowing we won't  run out early. That is a bad thought to even think of.
I would be totally scared to death if something happened to my doc because I would not have anyone else to write them for me. I would have to go through wd's and wait for him to come back.
Helpful - 0
Avatar universal
I've thought about all this before (and my my haven't you been busy today tuck). The stash idea is atrociously bad. Abuse potential, temptation even for those of us not into that sort of thing.
I'm not sure how different the situations are between us coz i'm in Oz, not US. I have seen both PMP's and PCP's(or GP in Oz - general practitioner) for pain management. Whilst at the PMP I could get meds from other Dr's if those Dr's could contact my PM doc(and sometimes even if they couldn't), but only if they had my files, otherwise no luck. Now that i'm with only my GP I think he'd freak totally if I got drugs elsewhere. I'm not sure what i'd do. I suppose i'd 1st try another doc at the same practice coz they have my records and would know that my doc is unavailable. after that i'd be begging on te streets(not literally). probably in bed crying/screaming.
ER's don't help at all in the merry land of Oz. I suppose I could fly interstate and see my old Doc but that's pretty extreme. Not sure I've really answered anything yet. no ideas .

Tuck, have you thought about going to florida early in search of a new dr rather than waiting till u move here(and potentially have to find a dr whie in horrible pain). just a thought.

Nick.
Helpful - 0
547368 tn?1440541785
Hi Frank,

You have brought up a good question. I cannot speak to the PMP patients because in my state it is the PCP that prescribes pain medications for their CP patients. It is a fearful proposition that there would be only one PMP that could prescribe for me in all circumstances. In my state you cannot hop from one doctor to another and I do not advocate doctor hopping but certainly everyone should have a backup in the situations that you describe.

I have developed a relationship with my PCP. I am well know (and liked I hope) at the clinic where she practices. In her absence I have seen another physician that has ordered my pain medications, based on my medical records. Indeed he said I was not receiving enough pain control and increased the dose of my narcotic pain medication. My PCP was ok with this upon her return. She even called him "astute."

I also know other physicians fairly well that I believe would prescribe a short term supply in case of the situation(s) that you describe. At least until I was able to either see my PCP or find a new one. I think we all need a backup plan. I am fearful of my relocation to FL. I know no physicians in that state and will need to build new relationships. If need be I will travel back to WI. I will be very concerned when I relocate this fall.

So I think it is important to build relationships in the medical community. I have the advantage (sometimes disadvantage) that I have been a nurse in several area communities. The other factor is the years of caring for my parents and working with their physicians in their medical care. So that would be my recommendation become familiar with your area medical communities and the physicians. How this would work in Pain Management Clinics I would imagine would be similar. Ask your PMP who would be his/her back-up. It is hard for me to imagine that one would have to be totally dependant on one physician though I guess in other states this may be true.
Just thinking out loud.....  
Tuck  
Helpful - 0
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