I took a risk by being honest w/ my pain doc...

[516CAZ]

Firstly, I am not soliciting medical advice. I am just trying to see if anyone has any opinions on my doctor's train of thought...

Sooooooooo... I had an appointment with my pain doctor this past Thursday. I took a huge risk and told him I had taken some of my doses too close together because my pain has been extremely severe, and subsequently, would run out of my prescription early. He chastised me like a child, his voice raising at times. I told him I had hoped for a little understanding since he's known for a while about the extra pain I have been having from multiple untreated dental issues plus extra pain from my low back where I had major spinal surgery last year. Also, I've never had a problem with my prescriptions in all the years I've been going to him. It was immediately clear that this was a mistake.

In a condescending tone, he said he is making an appointment for me for this upcoming Tuesday and that I need to bring my pill bottle for a pill count and would be subjected to a drug screen at that time. He also had me do a drug screen before I left that day.

I wasn't thinking straight enough to ask what it is he is expecting of me at the Tuesday appointment. *I had already told him I would run out early. What is he expecting? Does he just want to see how much in the hole I am? Now, I'm just confused and anxious. Thoughts?


*FOR REFERENCE:
> I am prescribed 5 tablets/day.
> Today, the 10th, I have 6 tablets left.
> I have tried to taper down to 2/day, but the withdrawals are still happening any way. (Any coping tips are much appreciated!!)
> My prescription is scheduled to run out on the 15th.
> If I can continue at the rate of 2/day, by the time of my appointment, I will have just run out of my prescription. Thus, I will be showing up with an empty pill bottle.
> The appointment on the 13th is only 1.5 days before I am supposed to run out on the 15th.

 

[Flynnal]

Honestly, if this is what I have to look forward to when I have a major injury and lifelong pain, I'm not even sure how I'd ever cope, as it seems like it's just insufferable. Constantly having to beg and grovel just to be out of pain...seems too much of an ask, at least to me. I don't know how people cope. You have my utmost sympathy.

 

[LucidSDreamr]

Firstly, I am not soliciting medical advice. I am just trying to see if anyone has any opinions on my doctor's train of thought...

Sooooooooo... I had an appointment with my pain doctor this past Thursday. I took a huge risk and told him I had taken some of my doses too close together because my pain has been extremely severe, and subsequently, would run out of my prescription early. He chastised me like a child, his voice raising at times. I told him I had hoped for a little understanding since he's known for a while about the extra pain I have been having from multiple untreated dental issues plus extra pain from my low back where I had major spinal surgery last year. Also, I've never had a problem with my prescriptions in all the years I've been going to him. It was immediately clear that this was a mistake.

In a condescending tone, he said he is making an appointment for me for this upcoming Tuesday and that I need to bring my pill bottle for a pill count and would be subjected to a drug screen at that time. He also had me do a drug screen before I left that day.

I wasn't thinking straight enough to ask what it is he is expecting of me at the Tuesday appointment. *I had already told him I would run out early. What is he expecting? Does he just want to see how much in the hole I am? Now, I'm just confused and anxious. Thoughts?


*FOR REFERENCE:
> I am prescribed 5 tablets/day.
> Today, the 10th, I have 6 tablets left.
> I have tried to taper down to 2/day, but the withdrawals are still happening any way. (Any coping tips are much appreciated!!)
> My prescription is scheduled to run out on the 15th.
> If I can continue at the rate of 2/day, by the time of my appointment, I will have just run out of my prescription. Thus, I will be showing up with an empty pill bottle.
> The appointment on the 13th is only 1.5 days before I am supposed to run out on the 15th.

Your doctor is a piece of shit. I know this is kind of impossible....but find a good one instead. Man all the shit everybody thinks is mandatory, pill counts, piss tests, pain contracts, monthly visits, dose reductions, prohibiting benzodiazepines/opioid combos - all this bullshit doctor's tell their patients they "have" to do, they don't. My doctor has never done a single one of these degrading things that make patients lives worse.

as far as the pill count - He's going to use this as a concrete reasons to cut you off - you already told him the ammunition he needs to do so, he's just confirming here for the record to cover his ass and justify tossing you.

since you can't stop taking enough, I would: 1) freeze your urine currently that can pass a piss test and bring a heated sample of it in for the pill count with you; 2) switch to a totally illicit source so you can save your pills (kratom, dupe, methadone [addicts sell their take homes], whatever you can get that's safe). Since you will pissing dirty if tested due to 2) you need to do 1) also. You will then have all your pills at the visit and can just say you made a mistake and miss counted them and actually didn’t take them early.

Continue to remind him that you can’t function in life or sleep due to constant severe pain but don’t directly ask for dose increases.


But this is the kind of illegal shit all pain patients have to do that refuse to let the pain overtake their life and take control of their dosing - as they should be in control.

 

[LucidSDreamr]

Honestly, if this is what I have to look forward to when I have a major injury and lifelong pain, I'm not even sure how I'd ever cope, as it seems like it's just insufferable. Constantly having to beg and grovel just to be out of pain...seems too much of an ask, at least to me. I don't know how people cope. You have my utmost sympathy.

It's so fucking tiresome, save yourself the trouble and just fake a heroin addiction and get all the methadone you want to take home with you. addicts are given all the opioids they want and then some with no issues unlike pain patients.

 

[TheUltimateFixx]

... This is messed up.

 

[516CAZ]

Honestly, if this is what I have to look forward to when I have a major injury and lifelong pain, I'm not even sure how I'd ever cope, as it seems like it's just insufferable. Constantly having to beg and grovel just to be out of pain...seems too much of an ask, at least to me. I don't know how people cope. You have my utmost sympathy.

I've had 6 different pain doctors and they've all been awful.

 

[516CAZ]

Your doctor is a piece of shit. I know this is kind of impossible....but find a good one instead. Man all the shit everybody thinks is mandatory, pill counts, piss tests, pain contracts, monthly visits, dose reductions, prohibiting benzodiazepines/opioid combos - all this bullshit doctor's tell their patients they "have" to do, they don't. My doctor has never done a single one of these degrading things that make patients lives worse.

as far as the pill count - He's going to use this as a concrete reasons to cut you off - you already told him the ammunition he needs to do so, he's just confirming here for the record to cover his ass and justify tossing you.

since you can't stop taking enough, I would: 1) freeze your urine currently that can pass a piss test and bring a heated sample of it in for the pill count with you; 2) switch to a totally illicit source so you can save your pills (kratom, dupe, methadone [addicts sell their take homes], whatever you can get that's safe). Since you will pissing dirty if tested due to 2) you need to do 1) also. You will then have all your pills at the visit and can just say you made a mistake and miss counted them and actually didn’t take them early.

Continue to remind him that you can’t function in life or sleep due to constant severe pain but don’t directly ask for dose increases.


But this is the kind of illegal shit all pain patients have to do that refuse to let the pain overtake their life and take control of their dosing - as they should be in control.

Yes, this is the kind of shit that causes people to become heroin addicts.

I'm worried about fucking freaking out at the appointment if what you said about the pill count is what happens.

 

[BourbonMac]

Your doctor is horrible and this is not legal. He wants you to bring the bottle in, for him to check? Yeah, no. That's for pharmacists, not doctors.
You made one mistake and he's doing this? I know you've known him awhile, but shop around for other pain docs, even if it might be hard (for now).

I think you'll probably be fine, he'll just be a huge dick to you even more and you'll have to maintain calm, but you've already done so.

In the meantime, Kratom can actually be very helpful for the withdrawals at least which I'm sure has been mentioned at least once, but idk if I'd exactly recommend that. How's your wds now? If you blaze, something very sleep inducing isn't a bad idea either, nor is magnesium glycinate or black seed oil (especially this one), and don't underestimate a lotta melatonin.

 

[deadhead4lyfe89]

Firstly, I am not soliciting medical advice. I am just trying to see if anyone has any opinions on my doctor's train of thought...

Sooooooooo... I had an appointment with my pain doctor this past Thursday. I took a huge risk and told him I had taken some of my doses too close together because my pain has been extremely severe, and subsequently, would run out of my prescription early. He chastised me like a child, his voice raising at times. I told him I had hoped for a little understanding since he's known for a while about the extra pain I have been having from multiple untreated dental issues plus extra pain from my low back where I had major spinal surgery last year. Also, I've never had a problem with my prescriptions in all the years I've been going to him. It was immediately clear that this was a mistake.

In a condescending tone, he said he is making an appointment for me for this upcoming Tuesday and that I need to bring my pill bottle for a pill count and would be subjected to a drug screen at that time. He also had me do a drug screen before I left that day.

I wasn't thinking straight enough to ask what it is he is expecting of me at the Tuesday appointment. *I had already told him I would run out early. What is he expecting? Does he just want to see how much in the hole I am? Now, I'm just confused and anxious. Thoughts?


*FOR REFERENCE:
> I am prescribed 5 tablets/day.
> Today, the 10th, I have 6 tablets left.
> I have tried to taper down to 2/day, but the withdrawals are still happening any way. (Any coping tips are much appreciated!!)
> My prescription is scheduled to run out on the 15th.
> If I can continue at the rate of 2/day, by the time of my appointment, I will have just run out of my prescription. Thus, I will be showing up with an empty pill bottle.
> The appointment on the 13th is only 1.5 days before I am supposed to run out on the 15th.

It really sucks when a doctor judges you hardcore and treats you differently

 

[BourbonMac]

I'm lucky because I've fucked up so many times yet he keeps prescribing me shit lmao. I wish he wouldn't, I was almost fully detoxed of diazepam.
I think he might've done that intentionally... it's hard to say. He's pretty lax as far as prescriptions usually. He did leave me hanging a couple times, but not that much. I was fuckin dying

 

[thurston]

A warning about kratom. The last pain doctor I went to tested for it on the drug screen.

 

[TheUltimateFixx]

I've had 6 different pain doctors and they've all been awful.

The majority of the blame lies with excessively restrictive governmental stipulations. Even sympathetic docs have their hands tied because of the collective anti-opiate hysteria.

They are required to log and JUSTIFY the prescription of every single dose of any opiate-containing medication against ludicrous standards of what the government now deems 'acceptable' or 'necessary'.
You wanna help your patients that are suffering; but are you willing to risk your entire career because one 'excessive' prescription gets flagged up in the system and you're suddenly accused of aiding and abetting the habits of some junkie -?

.. Yes there are plenty of judgemental, morally superior arsehole docs who want to prove a point with addicts, and are using the current regulations to do so. But plenty of decent ones who still hesitate to prescribe appropriate therapeutic amounts to ANYONE despite their own better judgement, for fear of losing their jobs.

 

[LucidSDreamr]

I'm worried about fucking freaking out at the appointment if what you said about the pill count is what happens.

Hopefully it doesn’t happen to you…let us know.

I don’t know what state you are in but check the state opioid prescribing guidlines. Also the cdc revised guidlines. In CA and the CDC revisions there are explicit instructions to doctors no to cut patients off cold turkey as it can result in suicide or fentanyl use.

If he cuts you off cold turkey, I wouldn’t try to argue because nothing will change his mind
.

Highlight this exact portion of the guidelines
, show it to him letting him know what it is, and ask him to write into your chart that we discussed a taper per the opioid guidlines but he went against against the guidlines and did not do it.

 

[516CAZ]

Your doctor is horrible and this is not legal. He wants you to bring the bottle in, for him to check? Yeah, no. That's for pharmacists, not doctors.
You made one mistake and he's doing this? I know you've known him awhile, but shop around for other pain docs, even if it might be hard (for now).

I think you'll probably be fine, he'll just be a huge dick to you even more and you'll have to maintain calm, but you've already done so.

In the meantime, Kratom can actually be very helpful for the withdrawals at least which I'm sure has been mentioned at least once, but idk if I'd exactly recommend that. How's your wds now? If you blaze, something very sleep inducing isn't a bad idea either, nor is magnesium glycinate or black seed oil (especially this one), and don't underestimate a lotta melatonin.

I took 2 yesterday and 2 today, so withdrawals are coming & going. I only have 1/day left until the appointment. However, my prescription isn't due until the 15th, so it will hit me for sure. So far, runny nose, body aches, tummy trubs, loss of appetite, nausea, irritability... I'll have to check out magnesium glycinate and black seed oil.

 

[516CAZ]

A warning about kratom. The last pain doctor I went to tested for it on the drug screen.

Thanks for the warning!

 

[SuperPsych]

I'd get some kratom if you can. It should be good enough that you can at least have a pill left. I didn't know that some places tested for it. I'd personally risk it myself. If he asks about it just say that you had to use it to bridge the gap and you never used it until you ran out.

I echo what others say. Try to find a new doctor if you can. Keep going to this asshole until you secure a more understanding doctor. This guy sounds like a piece of shit. Doctors should not be chastising their patients, especially if they get mad to the point of raising their voice. That's not cool. I'm sorry that you are going through this. No one should have to lie to their doctor. There are good doctors out there so try not to let this asshole lead you to losing hope

 

[BourbonMac]

I took 2 yesterday and 2 today, so withdrawals are coming & going. I only have 1/day left until the appointment. However, my prescription isn't due until the 15th, so it will hit me for sure. So far, runny nose, body aches, tummy trubs, loss of appetite, nausea, irritability... I'll have to check out magnesium glycinate and black seed oil.

Heard about that drug test. Doubt that but knowing that's possible... yeah I guess avoid. You can grab black seed oil at Walmart. Warning: it tastes like butthole, and you should have food in your stomach. I remember the first time taking it feeling really clear headed and nice, but my stomach hurt until I ate later. Some people use it on their salads and shit casually. Thymoquinone is the main component in the oil.

It lowered my kratom tolerance a crazy amount. Basically, it hits that mu opioid receptor, or rather tickles it a bit, so it can help you, no guarantees though. I think at least 10% minimum it'd help, but that ain't nothing. I'd say up to 25%... But that's only my experience with kratom withdrawls. Pain pills are territory I don't know there, but I had some major diazepam wds in January.

 

[DeathIndustrial88]

What opioid do you take?

There may be ways to extend it's metabolism or potentiate it, to help your pain better.

I see some people saying it's illegal to ask for a pill count, but not always. It could be if you're just a pain patient, but as an addict, you have to sign an agreement that you're subject to pill counts, piss tests, etc.. whenever they want. This may not be the case though for pain patients, unless you've entered any kind of contracts or agreements with him.

Your doctor is a piece of shit & probably a brainwashed idiot who unfortunately rakes in them checks from happily sticking people on a thousand other toxic drugs, worse than opioids. I would try calling around for a new doctor immediately if you can.

Loperamide is an option, but I'm almost afraid to even suggest or tell anyone about it who doesn't already know. It does help with a lot of the physical symptoms of withdrawal. But it is toxic to the heart in high doses. It could help you function enough for a few days to get stuff done though. It is an antidiarrheal medicine, that is technically an opioid. It just doesn't stay across the blood brain barrier, so it doesn't activate the receptors in your brain, but it will give effects peripherally.

I use to abuse the fuck out of loperamide & try to get it to cross the blood brain barrier & stay there. I now have a heart arrythmmia. No clue if they're related, but who knows. Wasn't worth it. But loperamide kept me from unaliving myself some times in between getting heroin or pain pills.

It's the main ingredient in Immodium. People have died from this stuff though & that's why they don't sell loperamide in bulk anymore like they use to. But it's still easily over the counter. Do your research, only try small doses & do NOT use for a long period of time. You may be able to combat withdrawals safely with this to stretch your pills out.

I am sorry OP. People should not be going through this BS. Thanks prohibition!

PS : Some people recommended just getting into an addiction clinic. Which isn't always a bad idea. But be warned, to be on Methadone in the US, you must go to the clinic EVERY DAY, some times for months/years at a time before they'll even start to give you take home meds. And they will dose you to the point where you won't even feel your meds anymore. With Suboxone (buprenorphine), you can get a take home script right away. Buprenorphine is incredibly potent & strong, but it's only a partial agonist & the pain relief from it is mild. It's so potent that it's going to wreck your tolerance to other opioids, plus it will also block other opioids from working if your dose is high enough. Although I've known people with chronic pain who actually prefer bupe. But by getting into a clinic, you're gonna be subject to piss tests & pill counts, so...

 

[516CAZ]

I'd get some kratom if you can. It should be good enough that you can at least have a pill left. I didn't know that some places tested for it. I'd personally risk it myself. If he asks about it just say that you had to use it to bridge the gap and you never used it until you ran out.

I echo what others say. Try to find a new doctor if you can. Keep going to this asshole until you secure a more understanding doctor. This guy sounds like a piece of shit. Doctors should not be chastising their patients, especially if they get mad to the point of raising their voice. That's not cool. I'm sorry that you are going through this. No one should have to lie to their doctor. There are good doctors out there so try not to let this asshole lead you to losing hope

I pulled up my last drug screen record. It does not list kratom as a tested drug. I've had kratom before, but can't remember where I got them? Was it a smoke shop? I guess I need to make a decision quickly as I just took my second to last oxycodone...

I will definitely be looking for a different provider! Like you said, I'll only keep going to this doc until I find another. The majority of reviews for pain places around me (Phoenix, Arizona) are not good.

I said to him, "I definitely regret being honest with you." I'm usually a very strong advocate for myself, but I think I was just shocked at his reaction. As a woman, I know I have to advocate harder. It just caught me off guard, I guess... WHAT A DICK.

 

[516CAZ]

What opioid do you take?

There may be ways to extend it's metabolism or potentiate it, to help your pain better.

I see some people saying it's illegal to ask for a pill count, but not always. It could be if you're just a pain patient, but as an addict, you have to sign an agreement that you're subject to pill counts, piss tests, etc.. whenever they want. This may not be the case though for pain patients, unless you've entered any kind of contracts or agreements with him.

Your doctor is a piece of shit & probably a brainwashed idiot who unfortunately rakes in them checks from happily sticking people on a thousand other toxic drugs, worse than opioids. I would try calling around for a new doctor immediately if you can.

Loperamide is an option, but I'm almost afraid to even suggest or tell anyone about it who doesn't already know. It does help with a lot of the physical symptoms of withdrawal. But it is toxic to the heart in high doses. It could help you function enough for a few days to get stuff done though. It is an antidiarrheal medicine, that is technically an opioid. It just doesn't stay across the blood brain barrier, so it doesn't activate the receptors in your brain, but it will give effects peripherally.

I use to abuse the fuck out of loperamide & try to get it to cross the blood brain barrier & stay there. I now have a heart arrythmmia. No clue if they're related, but who knows. Wasn't worth it. But loperamide kept me from unaliving myself some times in between getting heroin or pain pills.

It's the main ingredient in Immodium. People have died from this stuff though & that's why they don't sell loperamide in bulk anymore like they use to. But it's still easily over the counter. Do your research, only try small doses & do NOT use for a long period of time. You may be able to combat withdrawals safely with this to stretch your pills out.

I am sorry OP. People should not be going through this BS. Thanks prohibition!

PS : Some people recommended just getting into an addiction clinic. Which isn't always a bad idea. But be warned, to be on Methadone in the US, you must go to the clinic EVERY DAY, some times for months/years at a time before they'll even start to give you take home meds. And they will dose you to the point where you won't even feel your meds anymore. With Suboxone (buprenorphine), you can get a take home script right away. Buprenorphine is incredibly potent & strong, but it's only a partial agonist & the pain relief from it is mild. It's so potent that it's going to wreck your tolerance to other opioids, plus it will also block other opioids from working if your dose is high enough. Although I've known people with chronic pain who actually prefer bupe. But by getting into a clinic, you're gonna be subject to piss tests & pill counts, so...

I'm prescribed oxycodone IR, 15 mg, 5/day. I am just a pain patient, not an addict (not officially anyways). Yes, I had to sign a stupid "pain agreement" thingy at the beginning. I've never been subjected to a pill count before, but they do random urine drug screens. I don't think the addiction clinic route is a good idea for me. I'm in severe pain all day, every day, so I definitely need the opioids for pain relief.

That's so funny that you mentioned loperamide! I just bought some yesterday because I remembered someone recommending it on here years ago! I need to search for that post to see if it included dosing recommendations. I've just been taking 2 tablets of 2 mg every 4 hrs. I don't think it's enough. If you or anyone has any suggestions on this or any other potentiators, I'd be very appreciative!

I am prescribed several meds that I think MAY help with withdrawals. I also have a bunch of old dicyclomine that helps. OTC, I take biotin and NAC (N-acetyl cysteine).

Here are ALL of my (oral) Rx's:
atorvastatin
bupropion SR
fish oil
gabapentin
hydroxychloroquine
lisdexamfetamine
omeprazole
oxycodone IR
propranolol ER
sumatriptan
tizanidine
trazodone.

Thank you for your insight, DeathIndustrial88!