Pain and medication

[alxvog]

I was wondering, I have a primary care physician and a pain management specialist. Right before I got my visit for my pain management my PCP wrote me a prescription for hydrocodone APAP 10 500 with 5 refills. My pain specialist originally told me to just take what I had left from my PCP but take 2 at time if it helps. So i did so, couple days passed and I realized by me doing that i was going to run out sooner and insurance wont cover an early refill, so I called my pain specialist and he gave me a script for oxycodone 15 mg Q 120. Ok i thought this is fine. Now that means a total of 4 a day and sometimes I have to take a half or 5 a day again making me run out 1-5 days before the new script can be written. I asked the doc to wright me a script early but to put a date on it when it can get refilled because I was leaving town. He put it on the exact day the 30 days were up. And im going to be 4 days short. He was already upset that I was taking half or one extra a day so I said I would compensate by taking only 3 one day which I lied because he seems upset. So would I get in trouble if I went to my regular pharmacist and had them fill my hydrocodone Q 90 and only use what is needed then go to a different pharmacy and give them the oxy script and put away the hydros. What ramifications could this have? Otherwise I am going to have to buy on the black market. I have a disk perfusion and fluid missing between L4 and L5. I’ve been on pain medications for 5 years. So not only would my pain come back full force but I would have withdrawals.

[sandee1818]

Hi and welcome:)
You can not have the Lortab filled as when your PMP prescribed you the oxycodone that was to replace the Lortab. If I am reading your post incorrect please forgive me.
The ramifications of filling both scripts will be very bad for you. it is not only illegal but if either doctor finds out they will cut you off and you will be red flagged.
Once your red flagged you will find it very difficult to find a doctor to treat your pain if at all.
You must try and make the oxycodone last. This medicine is stronger than the Lortab so you should be able to make it last until your next refill.
What your doing could also be considered doctor shopping. You need to cancel the Lortab prescription and let your PCP know that you did receive another narcotic prescription from your PMP.
I hope things work out:)

[sunshine0428]

You are in a catch twenty-two! I have been in the same situation also, so I understand. I would be careful because if one doctor sees that you filled another prescription, they can discharge you. one idea, is to go to a different pharmacy and pay cash-it might work.
sunshine0428

[runitskat]

I'm really confused here. So you have a script for hydro that if too early to refill so you got another script for oxy that you're taking more than the script is written for so you're going to run out early.

How would you be able to get the oxy filled again and the hydro at a different pharmacy. That does not make sense. Your insurance does not care what pharmacy you use. They care that the script is written for x amount of days and they wont pay for it until you've run out. You cannot pay cash for a controlled substance if you are early. It does not matter if you have insurance or not, it's how the script is written by your doctor.

Also if your PM doctor know and told yo to keep taking the hydro than I don't think you would be discharge for taking them both at the same time. He would not have written you a script for oxy or he would have told you to stop taking the hydro.

You need to be more clear with this. You've written it in a very confusing way.

[sandee1818]

It is my understanding that the PMP doctor wrote the oxycodone to replace the Lortab.
I just do not see a doctor jumping from 20mg of hydrocodone to that plus 15mg of Oxycocone too. I believe the PMP doctor meant that the oxycodone was replace the Lortab.
Your riding a very fine line here. Getting narcotics from two different doctor is illegal and as I said if they find out you will be without any help at all.
The oxycodone is stronger than the 20mg Lortab so I think the doctor did mean this was to replace the lortab.
It is never okay to have one narcotic paid for by insurance and then use another pharmacy to get another narcotic with cash. It is illegal an I would strongly advise you not to do this!

[namnam46]

Hi alxvog,

I want to welcome you to the Pain Management Forum and let you know that we are glad that you have found our Forum.  We want you to understand that there are NO Doctors on this Forum only CP (Chronic Pain) Patients that help each other thru their own experiences and expertise from their OWN CP conditions.

I REALLY hope that you will listen to Sandee and runitskat as they are trying to help you stay out of trouble wiht your PMP.  You DON'T want to lose your PMP  as that would be devastating to you with ALL of the pain that you are in!!

Please try to make them last. If you could stay in bed or just around the house for one day and take the THREE that you told your Dr. you would and then take ONLY what's recommended you should be OK.

I wish you the best of luck.  Please keep us updated on how you are doing...Sherry

[jamlws]

I wanted to add that if you go to a different place and pay cash for the oxycodone your dr still can find out. They can print a list of all pain meds that you have filled and it will be on there that you filled another script.
So paying cash don't hide anything.
Jamie

[designgyrl]

Please do not get both of the prescriptions filled.  Everything everyone is stating is correct.  You could legally get in trouble for paying cash for one prescription, you also could have your pain doctor drop you as a patient, very quickly, and also you may want to look and see if you've signed a contract with the doctor and they are doing random urine tests.  I'm sure your PMP doctor was not stating to continue to take the hydros all the time with the oxycodone, which means your urine test will come up with extra medication.  It's so difficult to get a great pain doctor, and to get on medication that works for you, please do not take the chance by trying to fill one prescription early.  Please talk to your pain doctor and explain that the oxycodone amount is still not breaking through the pain and see what else he can do for you.  Please feel free to read through peoples posts, this question has came up a few times, and the situation has not turned out good for most of the patients that took too much medication.  

Thanks for posting on the site, hope you'll let us know how you're doing!

Karen

[jayman920]

Listen to al the people on here,if you try to fill it they will fing out, look below



**********************************************************************************************************
As of July 2010, 34 states have operational PDMPs that have the capacity to receive and distribute controlled substance prescription information to authorized users. States with operational programs include:

Alabama, Arizona, California, Colorado, Connecticut, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, and Wyoming.

Seven states (Alaska, Florida, Kansas, New Jersey, Oregon, South Dakota and Wisconsin) and one U.S. territory (Guam) have enacted legislation to establish a PDMP, but are not fully operational.

*Washington State's PDMP was operational but has been suspended due to fiscal constraints.

[alxvog]

Thanks for all your comments, I wanted to clarify. My PMP did originally tell me to take 2 20 mg hydros for my pain if it worked and that I shouldn’t of gotten that prescription filled since i signed the medication contract ( this was a couple weeks ago mind you) and it was from my PCP. So i went about taking 2 at a time and called to see what I should do because I was going to run out. They said they voided my drug contract and to stick with my PCP prescription (PMP nurse said this) so I said ok. Couple days went by and realized my insurance would not cover an early refill and called my PMP back, this was when he gave me the oxy. I didn’t know anything about this drug except that it said take one every 6 hours as needed. So i did but again pain would occur sometimes within 3 hours so I would take a half or full one. Thus creating me to run out early. ( keep in mind: pharmacies will let you refill 5 days early from what the refill says for hydro, which is what i always relied on. So with my pcp i would get 90 pills 4 times a day = 22.5 days - 5 = 17 days ( which I would need 6-7 pills daily and this worked for me with the hydro 90 pills every 17 days) I expected the same with the oxy, when I called to ask for a early script ( not an early refill) i wanted it in hand so I could rely on the 5 day difference from pharmacy but no, they wrote the exact day the prescription should run out on the paper script. So when i mentioned I needed to take a half or full one in addition to what the pmp said the nurse got upset and said he never authorized that. And im not one to argue nore do I have time to schedule an appt just to explain to the doc I need 5 a day. So for those who said not to get both I already picked up the hydro, but haven’t touched it yet nore will i unless i have to. And just to be safe I will go to a different pharmacy to fill the hydro when it I can get it filled. If I get a call or have a problem im hopping I can give him the remaining hydrocodones and explain the situation.. if he drops me then he drops me and I will continue going to my pcp, i really hope it doesn’t come to that but if they weren’t so scary to talk to, and listen more I wouldn’t have to feel like im sinning. Hopefully it won’t get back to him and honestly this happened to me once when I got my shoulder surgery i was getting Percocet and hydrocodone. One from my pcp and one from clinic, this clinic kept giving me Percocet for 6 months and I was getting hrdrocodeone from PCP. I didn’t know I wasn’t suppose too. And Walgreens after 6 months said we need to notify your doc that your getting prescriptions from 2 different places. I said ok. That was it. So im hopping for the best, if you still have suggestions of how I can bring this to my pmp attention without getting him mad please let me know. I do care what he thinks of me and I hate getting in trouble. And I do have 90 hydrocodones sitting there and wont touch till I need to, I still have some oxy but they are running out. Im sorry but no pain medication will block pain for 6 hours. 4 at max even with oxy 15 mg. Im sure if he gave me morphine it wouldn’t last 6 hours.

[JadedSweetheart]

Well, MSContin, (morphine ER) lasts longer than 6 hours as it is a long-acting pain med rather than a short-acting pain med like hydro or oxy.  
I don't know what you could say to the doctor about all of this.  I've had the same problem with taking too many roxycodone (throwing them up and having to take another actually) but I just stretched the rest of them out at the end of the month, taking only 3 a day instead of 4.  My doctor does acknowlege that they only last about 3 hours and I am always honest with him about how many I've needed to take at a time, etc.  

The thing is, you called your doctor and he told you to make the oxycodone last.  Then you had a seperate script filled which may have violated your contract.  
I really don't know what to tell you other than try to make the oxycodone last.  I know it's not comfortable and if you feel like you're in agony, you should call the doctor and let them know that the meds aren't working as prescribed.  Some doctors still won't do anything for you about that, though, and then you just have to suffer until the next appt.  
I really don't know what to tell you about it all except that you could get in trouble for getting the lortabs filled and taking them.

[flower12345]

Welcome. There are so many supportive people here!

Does your PCP know that you filled both prescriptions? If not, then unfortunately you could get dropped by both doctors. I think that you will get dropped by your PMP. You violated the contract. You knew what you were doing.

Can you make an appointment with your PCP to tell him what happened?

I don't think that there's any "good way" to tell your PMP. To me, it looks like you doctor shopped. I think you will get dropped if he finds out. Can you make an appointment and tell him that the oxycodone is not helping your pain?

Jaded is right, long acting morphine lasts longer than six hours.

I understand that you feel under-medicated, but the end result of what you did could be not having any doctor willing to treat you with pain medications. I think you should call your PCP and talk to him to see what he says. If you signed a contract, then it is most likely voided.

Once you get red-flagged, you will have trouble getting treated with medications. I tried to be gentle in my post, but I really think that you made a huge mistake by filling the hydrocodone. I understand that you have pain, but the risk that you took (IMO) was not worth the consequences. Wow.

Flower

[alxvog]

They told me weeks ago that they would void my pain contract so I can continue with my PCP pain meds so I did for about a week called, and said im going to run out so they wrote me a script for oxy. Do they have the power to void and re initiate my drug contract.. and I didn’t break the contract. I was about too but I was going to show up at his office and hand him the hydrocodone still in the package stapled and tell him what I was about too do. Why would he drop me for not taking any, giving him the rest, and telling him the issue? Not only do I have pain but I also have generalized anxiety disorder meaning I worry about everything and you guys are freaking me out. lol I know i messed up but I haven’t consumed any of thy hydros.  There has to be a way not to get in trouble here. I was preparing to break the contract but I didn’t yet.

[flower12345]

Sorry that you have anxiety. Yeah, maybe if you take in the unused medication and tell him what happened, he'll understand. I'm sorry that I said that you broke the contract. I really have never been in this situation before. I think that it depends on the doctor, but maybe if you bring in the hydrocodone and talk to him, he'll understand.

[Jaybay]

Count this as a learning experience and hope your PMP will overlook it since you're new to pain management.

You have run out of two prescriptions from two different doctors too early because you ignored the prescribing instructions on the bottles.  Doctors do not take kindly to that kind of behavior as evidenced by your own comment:  "He was already upset that I was taking half or one extra a day..."  Of course you were going to run out early!  When the prescribing instructions state "one to two every 6 hours as needed" that means ONLY every 6 hours.  "As needed" doesn't mean you ALWAYS take two and if you still have pain you get to take more.  It also doesn't mean that you always get to take two in every 6 hour period.  You've already counted the pills and determined that taking them that way will result in running out early.  So don't do that and you won't run out.

The goal of pain management is "management."  That means that your doctor will TRY to get your pain to a manageable level so you can get on with living.  I doubt there is one chronic pain patient who can say that they have zero pain whether opiate therapy is on board or something non-narcotic or even non-pharmaceutical.  There is always a certain amount of background noise and often pain spikes that occur in any given month.  The goal is to avoid those pain spikes as much as possible.

You admit you have anxiety and that alone increases pain.  By obsessing on your pain, on the number of pills you have and the refill dates, your anxiety and pain levels increase.  Distraction is something you need to learn to get away from that reaction.  Your brain gets stimulated (pain); you respond (take more meds than prescribed); and you get rewarded (pain relief).  Uh oh!  Now you're in trouble because you're going to run out.  Do you see how your reaction to pain is getting you into trouble?  Try to distract yourself from that knee-jerk reaction of taking more meds.  Recognize it when it happens and turn to something to keep your mind occupied like reading a book, hanging out here at MH, listening to music - anything to get your mind off your pain and your eyes off the clock.

I am not saying these things to hurt you.  I only want you to recognize that your behavior has to stop or you may find yourself without any pain management at all.  Self-medicating is a pit you cannot let yourself fall into.  Doctors do not adjust meds to suit this kind of behavior.  End of story.  Take your meds as prescribed, and only as prescribed.  If it's not working out, you tell your doctor what is happening and let HIM make any necessary prescribing adjustments.  Ask him to put a daily maximum of pills you can take per day on the bottle.  That will help you more easily keep track of them and ensure you won't run out early.

[JadedSweetheart]

I have GAD as well and I know how the worry just runs over and over again through your mind.  Especially when you're in pain and anxious about being in pain.  It can feel hopeless.  In your situation you are on a medication that is stronger than what you were previously on, so in that case one would expect it to work for you without you needing more than prescribed.  I understand the stress of being in pain and not suffering if there is no need to suffer, however, with PM honesty is the best policy.  I think everyone here appreciates your honesty with us.  
The thing about your post is that you admitted that you lied to the doctor when you told him you would take 3 a day.  Sometimes taking less is just what you have to do if they give you X number of meds to last 30 days. A lot of people here have made errors and had to go without their meds for days, most will never make that error again.  Are you really going out of town or did you tell him that to get the prescription filled earlier?

An important thing to know about PM is that the meds are not to put us completely out of pain, they are to make it bearable.  Maybe even comfortable, so that we can live somewhat normal lives, but not as if we never had an injury or condition.
The thing about filling prescriptions from two doctors is that people do that every day who are not in pain, and only seeking the drugs.  This makes it harder for CP patients like us who are honestly in pain to get the help we need.
Perhaps if you call the doctor on Monday, explain that your medication is not working, and ask for an appt ASAP, they will see you and you can explain everything in person, bringing the medication with you, that's really the only way I can see that you can make it right again.

[flower12345]

GREAT post, Jaybay!

[JadedSweetheart]

Yes, that IS a great post, Jaybay.  I am guilty of obsessing over the pain.  I need to break the cycle.  
We have some great forum members here.  I'm so thankful for all of you.

[alxvog]

I do appreciate all the answers and I do feel your right. I lied about going out of town so I could at least get the paper script, under the assumption I could take advantage of the insurance / pharmacy 5 day grace period. I would have waited till 5 days before to get the refill// I have an appt on the 17 of aug.. 10 days after I will get it refilled by their standards to speak about the cortisone injections.  I’m hoping that the pharmacy doesn’t notify him that I picked up the hydro and if they do I will present them to him and give him the rest because in 5 days I will run out of the oxy ( will try not to but prolly will) and i will open the hydrocodone. Ok guys will check back in, have to get to work :0) . Thanks again.

[JadedSweetheart]

Thanks again for being honest.  So you will be out of oxycodone in 5 days and your appt isn't until Aug 17th?  That IS a stretch.  I don't know what to tell you except make sure when you go to your next appt to tell your doctor that you've had to take more per day and had to take the lortabs because you ran out early.  

You could really get in trouble for getting prescriptions from two different docs, but we have told you that up and down and you know it.

[alxvog]

Question for everyone// i took a shot in the dark asking this question expecting no response from anyone but how on earth do you guys find time to respond so quickly and find time to make it back to my post to add more.. It boggles my mind cause I was just sitting at work and took 5 min to post something really quick and during the weekend around midnight took a look. And there was like 10 responses HOW. do you guys find time. I would love to be able to assist people when they have questions. I just got married in May, im 26 with no children, and 4 dogs. It’s awesome you people are hear to help, I needed this information but too bad you guys cant get paid for your responses. You took time out of your day to respond to a stranger’s question. I could be a drug addict trying to find ways to cheat the system but you guys actually see me and understand me. Don’t get me wrong after 4 years of being on pain medication there is an addiction and would need to be slowly taken off my medication once the pain is controlled. But thank you for the professional responses and respecting me. I have another question. I did have low testosterone and never wanted to be sexually active.. I do just hardly ever. My PCP gave me cream to put on shoulder and it did in fact raise my testosterone levels to normal but don’t want to be romantic or sexually active hardly ever. Its very frustrating and not fair to my wife. Any suggestions?? She does everything to try and make me interested, she is beautiful. I don’t look at any other woman in a sexual manner. I just don’t ever want it.

[namnam46]

Thank you from EVERYONE on the Forum for the compliments!! All of us are CP (Chronic Pain) Patients. There are SEVERAL of us that Disabled from our different Pain issues. Many others that aren't as of yet and are still able to keep working, but they will eventually wind up being on Disability.  ALL of us would MUCH rather be Healthy and NOT have to take the Pain meds that we have to take. Someone is ALWAYS on line and we do our VERY best to Respond and at least WELCOME the individuals even if we don't know anything about their problems and reassure them that SOMEONE that DOES understand will be along at a later time.

We do our BEST to not judge as we know that ALL of us are pretty much DEPENDENT upon our medications just to be able to get up in the mornings and in my case I need it to be able to use a cane to walk and NOT my Walker!! We are ALL at different places in our pain and we are able to HELP each other thru the different stages that our pain will be going thru.  

Don't automatically think that you are addicted as it may be that you are DEPENDENT on your meds. I'm going to give you a SIMPLIFIED version of the meaning, I hope that I'm saying this the correct way!! If you HAVE to have your pills because of your pain that
then that is Dependency BUT if it is because you are CRAVING them and it has NOTHING to do with your pain then that is Addiction. In other words a Physical Dependency IS NOT AN ADDICTION!!!  I hope that you understood that. I'm POSITIVE that someone else will be along and be able to gie you a BETTER and more in depth answer!!  :)

We're VERY happy that you are here and hope that as time allows you will be able to help some people (and I DO mean as time allows you).  

As far as your LAST question is concerned I want you to know that there is a FORUM for your problem also.  If you would go to the SEXUAL HEALTH Forum and ask that question there I think you will get the help that you need. I don't have any expertise as far as what  medication may do as far as the Sexual Drive is concerned in men.

Some others may be along that CAN answer your last question but it probably will heop you to post on the other Forum as well. YOu are welcome to post on as MANY Forums as you like!!  :)

I wish you the very best and we are VERY glad that you are here!!!.....Sherry

PS CONGRATULATIONS on your Marriage!!  I wish you and your Bride a HAPPY life together!!

[jayman920]

very well said, one thing i found out is tell no one you are on pain meds. I feel people judge you. That is my experience and will just tell my wife,

This is a great group, i found it by typing a question into google, they have GREAT PEOPLE with great answers. Some people will cheat and get info for there next appt to find ways to get meds and i think people know what i am saying, but overall its great.

God Bless

Jay ;)

[namnam46]

That's a VERY good choice to ONLY tell your wife!! Even other members of your family have NO business to know what meds you are taking!!!

By the way, I feel the same way about MH. I, TOO, found it by Googling about the Fentanyl Patches that I use.  SOOOO happy that I GOOGLED that day!!

Best of Luck and God Bless you...Sherry

[melissaky]

Hi and I would also like to welcome you ! We do have some wonderful ,knowledgeable members here as you have already seen .The people here are also very ,caring as well .I thank God that I found this forum (thanks to google) as well .It is so hard to suffer with pain and the support I get from here makes it so-o much easier to cope . I can't give you any better advice than you have already gotten here but I just wanted to add my welcome .Congratulations on your marriage .I wish you and your bride a happy, long life together . Take care Melissa