Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V

[downerhead]

I am currently experiencing a problem I hpoe someone can help me with.I recently moved to a new state in a rural area in the southern USA.As many of you know,where there is no street dope around,pharmaceuticals take their place.As a result,doctors are too chicken to write for anything effective.I currently take Xanax for panic disorder and Norco 10/325 for chronic pain.Both are legit prescriptions for legitimate conditions.After my family and I went through the phone book and were told by every doctor's office we called(almost every one in the book)that they won't write for benzos or narcotics(even with medical and surgical records to back me up) we finally found one who would write for both meds.Problem solved,or so we thought.This nurse practitioner does urine screens which are sent to a lab.No problem since I only take my prescribed meds.However,I recieved a certified letter stating that my toxicology screen contained not only alprazolam,as expected,but 2 or 3 other benzos I've never even seen in my life.Also,I was out of my pain meds from my home state doctor so I of course showed negative for opiates.She appearantly forgets me bringing the empty bottle to our first visit when the urine was collected.The lab report also claims the sample was collected the day before I ever set foot in her office.This isn't a drug testing question(I know those aren't allowed)but more of a what can I do kind of question.All the pain management clics here in north western NC want $500-$900 and I can't afford this as I have no insurance and my family is paying my way until I can find employment here,which will be impossible if I'm cut off my pain and anxiety meds.I am in pretty severe pain due to reconstructive surgery on a knee years ago,The condition is degenerative and the pain gets worse,especially as I enter middle-age.I can barely walk on one leg and require round-the-clock pain care.Even though the Norco isn't all that effective,I felt lucky to get even that around here.A phone call to her office resulted in her receptionist telling me they will call me on a random,unspecified day for a re-test and a pill count.Since the Norco doesn't control my pain very well I'm going to be about 6 or 8 pills light on it(though spot on with the Xanax).My question for this long narrative would be is this just a formality to justify cutting me off or am I really getting a second chance?Will the few missing pain pills really damn me for certain?I have no way to explain the additional benzos I never took and my family can back me up since I am with them 24/7.Has anyone else been in a similar situation?Sorry for the long story but I'm really freaking out because if she cuts me off I have no other options.Any advice/experiences/insights would be greatly appreciated.Thanks everyone.

 

[TheLostBoys]

^^^^^^^

Downerhead, when I took a urine test to see if I was taken my norcos & Valium, my doctor called me & said I also had Oxazepam in my urine........I told the doctor that Valium turns in to Oxazepam & then he acted like he knew it did. What a bunch of boneheads doctors sre., they know nothing about drugs .

If I were you, I would ask them what other benzos showed up on the urine test & if they knew that xanax can turn into another benzo, because they can.

I don't know if its s formality of this office to BS you & lying to not want to give you meds.

 

[downerhead]

Thanks Lostboys.They said I had Temazepam(which I've never seen)Oxazepam,and Nordiazapam.I will definitely follow your advice and ask her that on my next visit.Appreciate the timely reply because this is causing me no end of worry.

 

[TheLostBoys]

Thanks Lostboys.They said I had Temazepam(which I've never seen)Oxazepam,and Nordiazapam.I will definitely follow your advice and ask her that on my next visit.Appreciate the timely reply because this is causing me no end of worry.

Valium metabolizes into all 3 benzos that you mentioned xanax metabolized into.......I'm assuming xanax does as well.

Yeah, just tell them they can easily Google it & see that xanax metabolizes into other benzos.

 

[JsinDubya]

Here is my situation, I've been in PM for 17yrs and have been on a lot if different opiate meds during that time, most recently I was switched from MSContin to Methadone which worked okay and was very cheap compared to most other ER medications. My old PMD retired and a very young PMD took over his practice/patients. He noticed I have a very high heart rate and I explained to him that trying to get around is very extraneous due to ungodly pain just getting to the bathroom is like running a marathon, I'm aware that there is a correlation with methadone and an acute heart condition where methadone can extend a pause in your heart beat and cause a fatal arithmea (spelling). So I had an EKG and the results where negative only thing noted was my fast bpm. The dr still took me off the methadone and put me on opana ER (super expensive btw) I also have Crohn's disease and for some reason I'm unable to digest these opanas it's been 3days and I'm now in complete withdrawal on top of insane amounts of pain. I've contacted my PMD and still in the explanation and q&a process over the phone, I've never been threw anything like this, and I'm wondering if anyone else has experienced anything similar with opana ER or with being taking off of methadone bc of a fast bpm even with a clean EKG. Thanks guys

 

[edgewise1]

I am currently experiencing a problem I hpoe someone can help me with.I recently moved
a new state in a rural area in the southern USA.As many of you know,where there is no street dope around,pharmaceuticals take their place.As a result,doctors are too chicken to write for anything effective.I currently take Xanax for panic disorder and Norco 10/325 for chronic pain.Both are legit prescriptions for legitimate conditions.After my family and I went through the phone book and were told by every doctor's office we called(almost every one in the book)that they won't write for benzos or narcotics(even with medical and surgical records to back me up) we finally found one who would write for both meds.Problem solved,or so we thought.This nurse practitioner does urine screens which are sent to a lab.No problem since I only take my prescribed meds.However,I recieved a certified letter stating that my toxicology screen contained not only alprazolam,as expected,but 2 or 3 other benzos I've never even seen in my life.Also,I was out of my pain meds from my home state doctor so I of course showed negative for opiates.She appearantly forgets me bringing the empty bottle to our first visit when the urine was collected.The lab report also claims the sample was collected the day before I ever set foot in her office.This isn't a drug testing question(I know those aren't allowed)but more of a what can I do kind of question.All the pain management clics here in north western NC want $500-$900 and I can't afford this as I have no insurance and my family is paying my way until I can find employment here,which will be impossible if I'm cut off my pain and anxiety meds.I am in pretty severe pain due to reconstructive surgery on a knee years ago,The condition is degenerative and the pain gets worse,especially as I enter middle-age.I can barely walk on one leg and require round-the-clock pain care.Even though the Norco isn't all that effective,I felt lucky to get even that around here.A phone call to her office resulted in her receptionist telling me they will call me on a random,unspecified day for a re-test and a pill count.Since the Norco doesn't control my pain very well I'm going to be about 6 or 8 pills light on it(though spot on with the Xanax).My question for this long narrative would be is this just a formality to justify cutting me off or am I really getting a second chance?Will the few missing pain pills really damn me for certain?I have no way to explain the additional benzos I never took and my family can back me up since I am with them 24/7.Has anyone else been in a similar situation?Sorry for the long story but I'm really freaking out because if she cuts me off I have no other options.Any advice/experiences/insights would be greatly appreciated.Thanks everyone.

Downerhead, welcome to western NC! I am in the southern part, down towards the SC state line. I go to a local gp who puts his cp patients into a pain clinic associated with the practice. It is actually a np I see monthly who ask about pain levels, gives suggestions, and hands over the prescription. A really nice lady who I enjoy speaking with. I see my doctor every 4th month, unless I have a problem.

Anyway, with a lot of diversion and addiction here in NC, especially western NC, it can be difficult finding a doctor who is willing to take on new patients for the purpose of pain control. Even when they do it appears that non opiate medicine is the first line used and you have to jump through the hoops to get the meds you really need. I wish I could offer you some suggestions or helpful advice. But do want to welcome you to NC, a great place to live, I am a native son. Northwestern NC is a beautiful place, especially in the spring and fall of the year. I do hope you find a good spot that will give you the meds you need. I am sure they are out there.

btw, I don't think 5 or 6 missing pills over the course of a month will get you kicked out, might get a warning? I have been going to my doctor for over 2 years and have never been called in for a pill count, although I was told they could be done. I actually think it is something they tell all of the folks in the practice to keep us honest, and as long as there are no calls for early refills, there will be no calls for pill counts, take that for what it is worth. Glad to have you at BL!

 

[TheLostBoys]

Here is my situation, I've been in PM for 17yrs and have been on a lot if different opiate meds during that time, most recently I was switched from MSContin to Methadone which worked okay and was very cheap compared to most other ER medications. My old PMD retired and a very young PMD took over his practice/patients. He noticed I have a very high heart rate and I explained to him that trying to get around is very extraneous due to ungodly pain just getting to the bathroom is like running a marathon, I'm aware that there is a correlation with methadone and an acute heart condition where methadone can extend a pause in your heart beat and cause a fatal arithmea (spelling). So I had an EKG and the results where negative only thing noted was my fast bpm. The dr still took me off the methadone and put me on opana ER (super expensive btw) I also have Crohn's disease and for some reason I'm unable to digest these opanas it's been 3days and I'm now in complete withdrawal on top of insane amounts of pain. I've contacted my PMD and still in the explanation and q&a process over the phone, I've never been threw anything like this, and I'm wondering if anyone else has experienced anything similar with opana ER or with being taking off of methadone bc of a fast bpm even with a clean EKG. Thanks guys

What brand of Opana ER's are you receiving? I recommend the Global Opana's.......& to get any relief from Opana, you need to crush the pill & snort it.

Be careful tho, Opana is wickedly strong, so start with small lines.

 

[JsinDubya]

The Mfg data on the bottle says "endo". These OpanaER are made of some sort of ballistics proof polymer, the whole pill not just the outer coating. My stomach can't break down lettuce let alone a solid plastic OpanaER, I've been on fentenal patchs before but they cause a rash so I'm stuck taking pills, I'm not too keen on snorting pills but the way I'm feeling now I would try but these have to be next to impossible to.

 

[JsinDubya]

I don't think 5 or 6 missing pills over the course of a month will get you kicked out, might get a warning? I have been going to my doctor for over 2 years and have never been called in for a pill count, although I was told they could be done. I actually think it is something they tell all of the folks in the practice to keep us honest, and as long as there are no calls for early refills, there will be no calls for pill counts, take that for what it is worth. Glad to have you at BL!

At my PMD you sign a contract stating that if for any reason your pill count is off they can (and will) cut you off. They will ween you down with a low opiate like Tramodol for a month. Some PMDs are a lil more lenient than others (I've been to so many different PMDs bc of moving around the states) But at the current Dr they are uber strict-monthly UA's and pill counts. Six pills would be seriously frowned upon but if you call and tell them that you have taken a couple extra pills because your pain is crazy outrageous right now before your next appointment it will look a lot better than just showing up with a low pill count. Just my two cents and experience
J

 

[downerhead]

Thanks to everyone who kindly took time from their schedules(and pain-filled lives)to offer helpful advice.It really means a lot to get such helpful support and advice during this very stressful ordeal,especially being in a new place where I don't know anyone.This place is a world apart from the urban area of south eastern VA where I've lived my whole life.BL and the great folks on this site have really helped me a lot as I have no one around here to talk to about these things.And thank you edgewise1for the warm welcome.I'm further north,near the Asheville/Morganton area,way up in the mountains.To JsinDubya,I would try calling around to different pharmacies and see which brand of generic oxymorphone they stock.If you ask they will tell you.I agree with Lostboys about Opana sucking orally.The only kind I've ever tried were the old kind you could easily crush and iv or sniff and they are much better those 2 ROAs.Like he says,be careful because the difference between those ways and orally is way stronger but they will be a lot more effective for you.Have you thought of asking for something like roxicodone?It would seem if your doctor is willing to give oxymorphone he would be all for giving you the weaker(but more easily crushable)oxycodone.They seem to love switching patients to less potent(in their eyes)meds.With your digestive issues you may tolerate the roxi better by crushing them into powder and dissolving them in a cup of hot tea,cocoa or whatever and drinking it.Oh yeah,took stock of my Norco today and I'm lighter than I thought,more like 12 pills or so.But it's been raining almost everyday since I moved here and with the pins and screws in my knee it drives my pain level way up.I guess the only thing I can do is explain this to my NP and hope she understands.It really sucks that people who only use meds as a source of money ruin it for the rest of us who truly need them.This leaves prescribers overly paranoid about covering their asses against DEA pressure.Anyway,thank you all for your helpful replies,both on the open forums and those who PM me.Wish me luck and I sincerely hope those of you with medication issues get the help we all need.By the way,does anyone know if pain management clinics usually just want to give you shots of some bullshit in the affected area as opposed to the meds you really need?I dread the thought of having a needle jabbed into my knee.Good luck to us all and thanks again everyone,y'all are great.

 

[TheLostBoys]

The Mfg data on the bottle says "endo". These OpanaER are made of some sort of ballistics proof polymer, the whole pill not just the outer coating. My stomach can't break down lettuce let alone a solid plastic OpanaER, I've been on fentenal patchs before but they cause a rash so I'm stuck taking pills, I'm not too keen on snorting pills but the way I'm feeling now I would try but these have to be next to impossible to.

Endo is the worst brand name......their Opanas are like plastic skittles. Forget about getting any relief from them, won't happen.

If you can get the Global Opanas, they are exactly like the old octagon Opanas & crumble very easy......if you have an opiate tolerance that's substantial, then snorting is the only good way to do Opanas & I hate snorting pills.

If you can't get the Globals, time to ask the doctor for a different pain med & make sure you tell him you are not getting g any relief from the plastic Opanas.

 

[Solardarkness5]

I have a prescription for norco 10's and usually I get one refill with each script. I can usually refill my 60count every 15 days but for some reason the CVS (worst pharmacy) app says that I can't refill until 21 days. The bottle even says "15 day supply" and this is a legitimate problem because I take them every day to be able to get through the day. I do not abuse them or ask for early refill but a whole extra week without? Has anyone else run into this? Thank you in advance.

 

[edgewise1]

Downerhead, you are not all that far away. Morganton/Hickory, and Asheville are within 30-60 miles respectively. You are correct about it being rural, but that is part of it's beauty.

I had the knee shot thing a few years ago and though I dreaded it, it didn't turn out to be that bad, more importantly it helped the pain for a few weeks. Do you have a pill count date? Or are you asking about it because the letter you received said it could happen? You may have to find a way to try and take a pill less each day, or even two pills a day less until you catch up. Does heat help, or ice/cold help? If so then maybe at night try using this as a means to catch up.

 

[Claireclump]

Hi all I suffer from Chronic pain and the doctors have me taking 7 different drugs right now!! That's 32 god damn tablets a day!!
Just thought I would say hi and now I'm gonna take a look through other stories!! Thanks xx

 

[JsinDubya]

Have them call your Dr to authorize the refill or have them forward to a different pharm. Also this maybe an issue with your insurance not allowing for a 15 day supply, That being said why did your doc only write 15day supply with a refill? My PMD would never do that.

 

[TheLostBoys]

I have a prescription for norco 10's and usually I get one refill with each script. I can usually refill my 60count every 15 days but for some reason the CVS (worst pharmacy) app says that I can't refill until 21 days. The bottle even says "15 day supply" and this is a legitimate problem because I take them every day to be able to get through the day. I do not abuse them or ask for early refill but a whole extra week without? Has anyone else run into this? Thank you in advance.

Most likely its your insurance company.......they are a pain to work with sometimes.

I would look to refill it at another pharmacy......have you tried walmart or a mom & pop pharmacy?

 

[Cliffy78]

Hi all I suffer from Chronic pain and the doctors have me taking 7 different drugs right now!! That's 32 god damn tablets a day!!
Just thought I would say hi and now I'm gonna take a look through other stories!! Thanks xx

Hi Claire, welcome!!! Lots of great stories here, have fun 32 pills! Lol

 

[Tripman]

Does anyone have experience with degenerative discs/pinched nerves and related nerve pain? My left hand/forearm has issues with the little finger and half of the ring finger being in a constant state of numb/tingly/pins and needles sensations. I get a lot of shoulder and neck pain and have multiple degenerative discs, C4-5 and 6. I have tried taking an old school tricyclic amitryptyline which has not had much success.

I generally take 1200mg SR paracetamol 2x daily and a mixture of anti-iflammatories for the pain in my neck, which doesn't really do a great deal but I struggle to work on stronger pain medication and have in the past been through rehab for opioid addiction.

What my real question is, does anyone have experience with related numbness/tingling/pins and needles from an issue with their neck? If you do have experience, how did you resolve the issue? Is it still ongoing?

I've been having problems with my left hand/forearm numbness for around 6 months now and it's driving me to distraction. I want it to end, the doctors seem to view nerve damage as something alien and complicated... I have heard of success with lyrica (pregabalin) or neurontin (gabapentin) and am curious what anyone who has tried this thinks. Will these substances make it difficult to work? I have taken lyrica recreationally before so can see how that might have an impact on being able to function properly at my office.

Sigh, the pain game.

 

[Whosajiggawaaa]

Yeah man, Lyrica should sort you out. ^

Doing a lot of home physio exercises has helped my shoulder quite a bit since surger 2/3 months ago.

 

[JsinDubya]

Yeah man, Lyrica should sort you out. ^

Doing a lot of home physio exercises has helped my shoulder quite a bit since surger 2/3 months ago.

^+1