pain management with previous substance abuse issue

[pennylane3]

My pain management MD will not prescribe opiates for me b/c of my past substance abuse problem. I have been clean x 2 years, have attended treatment x 1 yr, follow 12 steps, have sponsor, get random urine tests q month (as I'm a nurse) - Can't take NSAIDs b/c of 2 past GI bleeds. Have had 4 epidurals with some relief - have tried chiro, PT, yoga, exercise, meditation.  I thought the Patient's Bill of Rights gave you the right to relief from pain. I've offered to sign pain contract.  He's referred me to an addictionologist to be evaluated (of which I will mention has not returned any of my phone calls).   Feeling very frustrated.  I admit to the wrong of the diversion of narcotics from work but they were for the chronic pain b/c no doctor would believe that I had chronic pain - turns out to be fibromyalgia and 3 herniated cervical discs.   Any suggestions would be appreciated!

[neekamichelle]

I ruptured a lumbar disc in 1997 putting a watermelon in my fridge. 2 weeks after the incident my left leg was paralyzed from the waist down. Then almost overnite, my mind shutdown as if I were inhaling sleeping pills. All I wanted to do was sleep. It was impossible to focus, consentrate or function, period! My dr. diagnosed me w/CFS andFibromyalgia. She prescribed dexadrine to help with brainfog. It was not covered by my plan. The script wasnt affordable at that time. I had 1 yr old autistic daughter and was single parent. Responsibility smacked me in the face everywhere I turned! My dr. relocated out of area, drug seeking was coined and amphetamine abuse was skyrocketing in the news I knew I had a snowballs chance in hell of ever getting help w/CFS andbrainfog! At the ripe old age of 31 I began using methamphetamine (never used anything before). Terrified of back surgery I tried to seek out the most noninvasive procedure (my father wasnt able to sit the last 40 yrs of his life /failed surgical back syndrome). I ended up w/harrington rod fusion/sciatic nerve damage but regained use of leg and tossed the forearms. Never did the pain go away! In 2003 I began opioid trtmt for chronic severe pain (the meth use was snuffed out by severe overmedication on fentanyl patch. I lost 80 lbs. My legs atrophied and twice I was told I smelled like death. A friend who was burned in 2 seperate house fires told me I could avoid withdrawals(i hated the stress of chemical dependancy) if I used meth and ceased the opiods. She was so right! My skin crawled twice on my arm and that was it! From that pt on I use opioids inconsistantly for pain and meth to avoid zombie land. My current dr. surprised me w/UA. I was honest explaining from beginning to end my ordeal w/meth that began 14 yrs ago pointing out my excess weight, my beautiful teeth and all the appts I had been "high" on meth. I explained how I use the least amount possible, can sleep on a full sack and how nonfunctioning and horrible life is w/out it. I also explained that ive never been to jail or arrested for anything.
My dr. took myvulnerable honesty and ran straight to judgement day with it! Instead of hearing me, she slapped me into the category of criminal junkie/ crackwhore and insisted I pursue the same treatmt facility used by corrections clients! The following appt she asked how id done w/use. I told her I had used twice but had reservations about trtmt program and OMG! Id never seen such behavior from a professional! She began ranting/raving about how she wasnt going to lose her license over me and that I was full of ******** and a liar, she then informed me shewas cutting me off opioids, and didnt even bother to check the results of the clean UA I had peed for her! I havnt seen her since. The 2 appts since have been with a different PA who continues to reduce dosage. I have degenerative disk disease  (genetic) and am once again having bouts of paralysis w/l.leg. The flip rightout PA no longer works at that office and the one I now see tells me how much better I"ll feel off the meds. She also has compared her former use of alcohol with my pain trtmt and assures me she feels better sober as will I. NO WONDER WHY THERES SO MANY SELF MEDICATORS!! The ones who CAN help you dont LISTEN!!! Any advice??

[nick30]

you need to get that appt with the addictionologist ASAP. don't give up, keep trying until you get in. he won't chase you, you'll have to chase him.

[sandee1818]

There are pain management doctor who specialize in pain management and addictionology. My previous doctor was well educated in both fields and many are. This also helps weed out the bad apples as these doctors are qualified to see through Pt's who are out to decieve them most of the time. try and find one in your area that specializes in both areas.

[nurseaudrea]

There is such a thing called pseudo-addiction because someone can be in pain but not prescribed the right dose or the right meds to take and then take on addiction type behavior to obtain the meds just for relief. You don't need a 12 step program for that, you need the right kind of doctor who will listen to you. If you are honest with yourself and you know you were doing that because your pain was undertreated, then why do have to tell them you had abuse problems? I know sometimes people can create pain in their mind because they think they need the meds, their body is craving it so it hurts worse, but many times you may have true physical problems and you truly do need the meds. You just need to know the distinction between the two and find a doctor who understands this and will help you accordingly. They are out there. You just have to do some searching. If they think you might still have addiction problems maybe you can go on something like Methadone to help with your pain. I would never take it unless it was the last thing on Earth available, but if you don't have any other choice, many doctors are more comfortable with that. You are in a tough spot. You do have the right for your pain to be treated, and treated properly. Too many times these doctors are not in your situation so they don't really understand what it's like to be in CP. They can sympathize, but they have no problem sending you on your way. They don't want problem patients.
You say he's sending you to an addictionologist. Do you think this is to make sure you are legit before he will treat you. Will he see you again and treat you for your pain once you have had an evaluation? If that's all you need to do then it is worth a try. Keep trying.
I wish you luck            Audrea

[badback8798]

I was caught going t several different doctors to get enough pain-killers to allow me to function. I finally found a doctor who understood my situation and listened to me. If you are in the Boston area I may be able to refer you to this doctor. This doctor is NOT a quack or a pain-pill distribution type doctor! He is a real caring, compassiontedoctorthat understans pain all to well.

[jb1567us]

Have you tried Tramadol?

[bamamom02]

The only suggestion I have is to seek another pain specialist, if possible.  You are right about the Patient's Bill of Rights-a patient has the right to have their pain relieved (I'm a nurse as well).

Have you shown the pain mngment. doc proof of attending treatment and following the 12 steps, etc?