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Avatar universal

Hi, I really need some advice...and fast.

I've been in pain management for over 3 years. I've never failed a drug test and have always been compliant with them. And for the last 6 months or so I've been telling them about my symptom changes and my new lifestyle changes and how it has made my pain level increase drastically. Well, last week I was called in for a pill count and unfortunately I failed it, I was short. My question is how do I get in to see another pain management Dr after this has happened? I'm supposed to go tomorrow to my regular Dr to have him send out some referrals to some different pain management Drs. Any and all advice is needed. Thank you for taking the time to read this.
2 Responses
18524847 tn?1465595901
Did your current pain management group drop you?  I know they have the contracts and try to stick with them but they sometimes give you  'chance'.  It was just the one pill count or has there been another you didn't pass?  Just asking because you have more leeway possibly if it was a one time slip up. Remember that the pain management clinics are under a lot of scrutiny and pressure from the feds.  So, it puts them in a position of being very precise with their rules.  I would be honest with the doctor you are seeing today.  What lifestyle changes have caused you to need more pain meds?  Maybe those can be scaled back.  
3 Comments
Yes, they discharged me. I've never failed anything else besides that 1 pill count. I know of people being put on a "probation" period. I honestly do not know what I'm going to do. I've had 3 lower lumbar fusions since 2016. Ive got severe nerve damage, spinal stenosis, osteoarthritis in my lower back, edema in both hips... just to name a few things wrong with my back. The lifestyle change has been due to my mother's health...she is not doing good at all.  I live with my parents..so I've had to start doing everything in and around the house. Things that my body is not used to doing. My mother fell last week and I had to grab hold of her and pull her up to help her back in the house. Just alot of things going on that I'm now responsible for, where I wasn't before. So... where do I go from here? I really don't know what I'm going to do.
I think you need to ask for help with the care for your parents.  If you aren't physically capable due to your own pain level and health, that's it.  You can't have this type of cost to your life.  How far off were you in the count? Are you completely cut off?  I think you explain to your primary exactly what happened. They can write a letter or refer you somewhere else but expect them to be stricter than ever with you, unfortunately.  Are you cold turkey now or do you have some time?
First, my parents cant afford someone else to come in to take care of the things I have to do for my mother. And my father cant do much because he's about to have both knee's replaced. And I tried to explain to them about the things I'm having to do now. For months I tried to explain to them what was going on. I've got about a week and a half to go before I'm completely out of my meds.  I'm terrified, I will not only have horrible withdrawals but I will have no life...when you have to rate your pain from 1 through 10...if I don't have meds to help me function, my pain is off the chart. I  dont know what to do. I tried to explain to them all these things and .. well, I guess they just dont care. I'm going tomorrow to my primary Dr. to see if he will send out some referrals. And I dont know what I'm even going to tell him.
20803600 tn?1546262537
COMMUNITY LEADER
You said you failed the pill count? By how much/how many days? THAT will directly impact the chances of getting into a new PM office.
Despite you informing the current PM of the lifestyle changes and them determining not to change your medication/dosages, doesn’t mean they don’t care.
The issue is two fold, you failed the pill count but you also broke a second rule- no self medicating,meaning you are supposed to take the meds EXACTLY as prescribed UNLESS they give you permission ahead of time to increase your dose.
You said you have about 10 days worth of meds, so until you do locate another PM , your best option is to taper off the meds over the 10 days, which is physically doable, rather than wait until you run out. Even if you do find another PM doctor, odds are that he/she will be unlikely to prescribe opiates at the first few visits. They typically want to review records, imaging, pharmacy records , try other treatment options, then perhaps give pain meds a try.
3 Comments
I'm at a loss here, I live in Canada, and I've been seeing my PM Doctor for over three years now.  And never once has he given me drugs, nor has he questioned the drugs that my regular doctor gives me. I have never been tested for drugs, nor have I ever had to go through a pill count.  I don't understand what they are doing in the States.  I'm on Morphine and Valium, Muscle relaxers, and they have never once questioned it.  Is it normal practice in the States to do that?
I'm in Alaska. My prior pain nurse is jailed, they say she's responsible for 19 deaths. So, everyone started ending valium with pain meds. Insurance won't go thru on meds, dr. Had to be called if you get v elsewhere. It thew me into a. Blood pressure crisis.  You are so lucky.
Yes, it is now and has been for about 7 years. If  there was a reason to be suspicious of misuse of meds,  then you could be subjected randomly to a pill count or urine test. There have been major issues with doctor shopping (obtaining prescriptions for controlled substances from multiple doctors at the same time) , self medicating or running out early/lost prescriptions, Andover the last 5 years or so overdoses of controlled substances by patients.  
We typically are restricted to one pharmacy, fills every 28-30 days, random urine compliance testing and some are called in for pill counts.
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