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

[516CAZ]

My last drug screen results showed this for oxy:

OXYCODONE CLASS ++POSITIVE++
Oxycodone 1103
Oxymorphone 196
Noroxycodone >6173
Noroxymorphone 75

Are the values listed in ng/mL? Won't they be able to tell my level isn't high enough if I haven't taken enough or any at all for the last week?

AHH LAWD I'm getting nervous! Leaving for the appointment in about 2 hrs...

 

[PharmaD]

UPDATE: I just got an appointment reminder for the pain doc that says my appointment is on THURSDAY, the 15th, which is the day I'm actually due to run out. Sooooooooo, I would have an empty bottle no matter what. I'm confused... Was this a mistake by the scheduler? Should I call them and point it out or keep quiet and show up on THURSDAY instead of TUESDAY??

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.

 

[chippermonk]

My last drug screen results showed this for oxy:

OXYCODONE CLASS ++POSITIVE++
Oxycodone 1103
Oxymorphone 196
Noroxycodone >6173
Noroxymorphone 75

Are the values listed in ng/mL? Won't they be able to tell my level isn't high enough if I haven't taken enough or any at all for the last week?

AHH LAWD I'm getting nervous! Leaving for the appointment in about 2 hrs...

Well, you did tell them you were running low, so hopefully that supports your case

 

[LucidSDreamr]

Won't they be able to tell my level isn't high enough if I haven't taken enough or any at all for the last week?

no they won’t be able to tell…but that doesn’t mean their dumbass won’t think they can tell.

Literally all you have to do is drink a shit load of water and it will further dilute the sample and you’ll have lower values.

There are so many variables and it’s documented in the scientific literature that doses can’t be extrapolated from urine

 

[516CAZ]

I am so FUCKING angry that I drove the opposite way home for 35 minutes after the appointment... He was an even bigger dickface this time- totally unprofessional & unreasonable. We went back & forth for several minutes about why I may or may not be lying. I finally was like, "After all these years with no issues, do you REALLY think I'm abusing my Rx or trying to get high??" (Ok, I know I did a little bit, but it was minor & he can't prove it.) Many things were said/implied, but I'm still discombobulated & unable to recall everything at the moment.

He Rx'd me 2 weeks' worth of 5 mg, 4/day. Soooo, my normal is 75 mg/day, & now he's decreased me to 20 mg/day?? I said, "Consider, for a moment, that I am being truthful; won't that huge decrease cause withdrawals?" Dismissively, he said he'd Rx some meds for withdrawl. He left the room & came back with scripts for the oxy, 9 fucking Zofrans, & 12 fucking dicyclomines. I started to say to him that this was not going to be OK, especially with my co-morbidities, but HE FUCKING WALKED OUT when I was mid-sentence! I cannot believe I didn't fucking lose it.

I went to the MA's station & asked if there was someone in charge of the doctors that I could speak with re: this situation. A very nice supervisor listened to my account of last Thursday & today. They went to speak with the doctor, but apparently he was busy & rather short with her as well. She told me she would speak with him after his last patient, get ahold of his direct supervisor, who wasn't at the office at the time, & then follow up with me by tomorrow morning.

Even though he is kinda right about what happened, there is no way I'll concede or compromise. I will not be handled that way, & it is NOT OK to treat patients that way. He is KNOWINGLY precipitating withdrawals in a pain patient.

FUCK. FUCK YOU!

 

[LucidSDreamr]

I am so FUCKING angry that I drove the opposite way home for 35 minutes after the appointment... He was an even bigger dickface this time- totally unprofessional & unreasonable. We went back & forth for several minutes about why I may or may not be lying. I finally was like, "After all these years with no issues, do you REALLY think I'm abusing my Rx or trying to get high??" (Ok, I know I did a little bit, but it was minor & he can't prove it.) Many things were said/implied, but I'm still discombobulated & unable to recall everything at the moment.

He Rx'd me 2 weeks' worth of 5 mg, 4/day. Soooo, my normal is 75 mg/day, & now he's decreased me to 20 mg/day?? I said, "Consider, for a moment, that I am being truthful; won't that huge decrease cause withdrawals?" Dismissively, he said he'd Rx some meds for withdrawl. He left the room & came back with scripts for the oxy, 9 fucking Zofrans, & 12 fucking dicyclomines. I started to say to him that this was not going to be OK, especially with my co-morbidities, but HE FUCKING WALKED OUT when I was mid-sentence! I cannot believe I didn't fucking lose it.

I went to the MA's station & asked if there was someone in charge of the doctors that I could speak with re: this situation. A very nice supervisor listened to my account of last Thursday & today. They went to speak with the doctor, but apparently he was busy & rather short with her as well. She told me she would speak with him after his last patient, get ahold of his direct supervisor, who wasn't at the office at the time, & then follow up with me by tomorrow morning.

Even though he is kinda right about what happened, there is no way I'll concede or compromise. I will not be handled that way, & it is NOT OK to treat patients that way. He is KNOWINGLY precipitating withdrawals in a pain patient.

FUCK. FUCK YOU!

I’m sorry to hear how it turned out. cutting a dose by like 60% is not a taper. That’s a wall you’re jumping off.

These fuckers want buprenorphine patients not oxy patients so I wouldn’t take it too personally. He just trying to decrease his liability.

The DEA are the real bastards in all of this, they are the one pressuring him to throw away patients.

In my opinion there needs to be some sort of class action lawsuit. I don’t understand how it’s medically ok to just throw people into severe withdrawal. People kill themselves, have seizures and heart attacks, turn to fentanyl, lose jobs, some people kill their doctors even and then themselves. I cannot understand how this is acceptable practice in medicine. People at the DEA need to go to prison for this.

 

[516CAZ]

Well, you did tell them you were running low, so hopefully that supports your case

They didn't even bother to re-test me today.

 

[chippermonk]

That's fucking awful. I could perhaps see their logic if they were just telling you that they wouldn't increase your dose, but I don't get cutting your dose because of this. It seems purely punitive, and for what reason? How can someone be so shitty to someone? Where is the desire to care for your patient? Horrible

 

[LucidSDreamr]

They didn't even bother to re-test me today.

So what’s your plan moving forward because you’re pretty fucked it seems now? Is your pain bad enough where you need to maintain a higher dose or is it just the issue of withdrawal?

 

[516CAZ]

So what’s your plan moving forward because you’re pretty fucked it seems now? Is your pain bad enough where you need to maintain a higher dose or is it just the issue of withdrawal?

Surprisingly, I feel like the withdrawals are pretty much over. Pain is the issue (not for the pain doctor, apparently). I guess I'm just waiting for their office to call to see what they have to say for themselves... If their answer is favorable, I'll ask to be reassigned a different doctor going forward because it would be ideal for me to stay with this pain clinic as my orthopedic surgeon is part of the same company. If unfavorable, I'll be searching for a new pain doctor.

 

[516CAZ]

cutting a dose by like 60% is not a taper. That’s a wall you’re jumping off.

Exactly. Whether or not I was lying, cutting it down that much does nothing but fuck me because my pain is very real & he fucking knows it. He tried to say he *had to* because (assuming I'm lying, of course) now I'm "opioid naive" & any dose higher than 5 mg might kill me. What a fucking asshole...

 

[4DQSAR]

Find yourself a different doctor and make an official complaint to the AMA detailing what was said.

If this doctor is in the habit of doing such things, you likely won't be the first.

They talk about the 'code of silence' around law enforcement, but doctors can be just as bad.

I would honeslty be looking at what qualifications and specializations that doctor has. In the UK from time to time (only once every few years) it's discovered that someone is practicing without the appropriate qualifications. Being so aversed to providing pain medication to someone with genuine need MAY be a sign that they do not want to appear on the DEA radar.

I had been prescribed fentanyl patches for over a year when a nuse practicioner simply said 'oh, you can just stop using those now' after a major surgery. I asked to see the registrar who maintained my prescription and told me to go see my doctor about slowly reducing the dosage. Funny thing - I was in hospital for another week and she did NOT go onto the ward again. Clearly the registrar recognized that she wasn't 'fit for purpose'. My doctor just told me to keep cutting bits of the patches and to cut of a bit more each time. Took a month but I was fine.

 

[516CAZ]

Find yourself a different doctor and make an official complaint to the AMA detailing what was said.

If this doctor is in the habit of doing such things, you likely won't be the first.

They talk about the 'code of silence' around law enforcement, but doctors can be just as bad.

I would honeslty be looking at what qualifications and specializations that doctor has. In the UK from time to time (only once every few years) it's discovered that someone is practicing without the appropriate qualifications. Being so aversed to providing pain medication to someone with genuine need MAY be a sign that they do not want to appear on the DEA radar.

I had been prescribed fentanyl patches for over a year when a nuse practicioner simply said 'oh, you can just stop using those now' after a major surgery. I asked to see the registrar who maintained my prescription and told me to go see my doctor about slowly reducing the dosage. Funny thing - I was in hospital for another week and she did NOT go onto the ward again. Clearly the registrar recognized that she wasn't 'fit for purpose'. My doctor just told me to keep cutting bits of the patches and to cut of a bit more each time. Took a month but I was fine.

I will check that out. Good thinking

 

[4DQSAR]

Well - I think it better to find solutions that provide the best outcomes for YOU. US medicine still seems insane to me but I WOULD check. The USA is an extremely litigeous nation and I'm told doctors actually pay insurance against legal actions. But I put it to you that if a doctor ISN'T qualified, they are likely risk adverse for fear of detection.

Patient are the canary in the coal mine. WE have to be the ones who ensure the appropriate institutions are aware of bad actors.

Of course, if this doctor lacks the appropriate qualifications, the insurance company won't pay. So that's them bankrupted on the spot.

 

[chippermonk]

Hopefully talking to someone else in the clinic can get things straightened out. But yeah, that particular doctor is not someone you want to have to deal with anymore if at all possible. Just have to make sure that whoever you deal provides you with the meds you need. Even if you get stuck with the same doctor. But no way I can see someone with your pain condition only getting 5 mg. Some doctor has to recognize the need.

 

[516CAZ]

Hopefully talking to someone else in the clinic can get things straightened out. But yeah, that particular doctor is not someone you want to have to deal with anymore if at all possible. Just have to make sure that whoever you deal provides you with the meds you need. Even if you get stuck with the same doctor. But no way I can see someone with your pain condition only getting 5 mg. Some doctor has to recognize the need.

They had said someone would be in contact with me by this morning. By noon, I had still not been contacted, so I called them. The admin. or whoever tried to reach the supervisor, but there was no response. She said that she sees the issue is "in her bucket," so I should expect a call by around 3 pm. I told her this is a time-sensitive situation, but I knew there wasn't really anything more she could do. I will be calling back every hour or two until someone addresses this. As I've warned my boyfriend, the longer you put off talking to me & resolving this, the angrier & more murderous I become. Choose your own adventure.

 

[Nicocastillo7]

I understand how you feel, something similar happened to me, until last month they give me 50 pills of 10mg of methadone to take home, my doctor has a patient who was hospitalized that month and the guy mentioned that from time to time he took methadone, when I went to see my doctor she told me that and told me that "as a precaution" I had to take my medications every day in the hospital and I could not take them home anymore, I got very angry and I told her, why would I have anything to do with what happened to her other patient? ... but I still accepted, it sucks but at least I am not abusing my methadone anymore

 

[516CAZ]

Update: The supervisor for the pain dept. called me in the afternoon. They sounded resigned to agree w/ the Dr. right from the start of the conversation. We re-hashed the situation. B/c I came to the 2nd appt. w/ 1/2 pill in my pill bottle, they're saying I violated the "pain agreement" anyways by not taking my Rx exactly as Rx'd, as evidenced by the 1/2 pill still in the bottle. I'm in violation b/c I didn't fucking take the last 1/2 PILL?? REALLY?? I said you KNOW that is ridiculous. Consider, for a moment, that I AM telling the truth & this really IS drastically affecting my health, does anybody feel bad about that?? I am normally Rx'd oxy. 15 mg, 5/day. The Dr. cut me down to 5 mg, 4/day. Even on my very 1st appt. w/ them, they Rx'd 10 fucking mg. So, my question is- are the Dr.'s actions purely punitive? Nobody seems to be concerned about my actual well-being. The Dr. is KNOWINGLY precipitating withdrawal in an est. pain pt. who has never had an issue w/ meds since going there. In the end, they told me that it’s their medical licenses & there’s nothing they could do about their decisions. I said, THEN WHY AM I TALKING TO YOU??”

They gave me a “pt. advocate’s” #... I called right away. We discussed the situation. They actually sounded like they cared a bit. They said they would speak w/ the Dr. & (unnecessary) supervisor, then call me back. Yesterday being a Fri., the situation was obviously time-sensitive. No one called.

This morning, I called the "pt. advocate" again. The call immediately went to vm. I left a msg.

So, w/ severe anxiety & in immense pain, I called the main # & reached a 3rd-party answering service. They took my info & said they would page the Dr. The “on-call” Dr. returned my call. The call was short. They said that they had read the Dr.'s notes, & that there was nothing they could do except tell me to go to the emergency rm. if experiencing w/d symptoms.

This is what gets me- "the cruelty is the point." Though these ppl. have the day off, it does not mean a day off for me. My pain does not stop when business hrs. are over. They must know this. They choose to do nothing. "Do no harm" is something they swear to, but sometimes to do nothing IS to do harm. I didn't do anything wrong. I am genuinely experiencing desperation & severe pain. This, nobody is willing to even take into consideration. That's really fucked up. Also not taken into consideration- my mental health.

Gutted. Angry. Helpless.

 

[hhum4n]

I'm leaning towards showing up on Thursday like I don't know anything is the matter. Liiiiiiiike I didn't pick my appointment date as I would normally schedule a follow-up (every fucking month ); he was the one like, "I'm making you an appointment on Tuesday and you can be there or not blah blah blah bring your pill bottle and be ready for a urine test blah blah blah." LOL... I'm saving my last pill to take either the day before or the day of, so it will show normal levels on a drug screen.

I'm totally in on the malpractice idea. ️

What country are you in, and are you commercially insured?

If you are in the U.S. and commercially insured through yourself, a spouse, or partner, then you have plenty of options here. You need to call the insurance company directly (phone number should be on back of card) and let them know you want to formally file a complaint AND a grievance (these are not the same thing). Providers (including individual practitioners) take this very seriously as does the state you live in/ Surgeon General's office. After/ or during that conversation they will ask you about the details (stay high level on the verbal), explain you want to send them a formal email. The insurance company advocate should inquire/ communicate with practitioners and providers to assist in switching providers. You have rights, you just don't realize it. Insurance companies manage a network of providers, and within that network the providers have a profile, rating, and CNG marks. You will get things in the mail after this, and that paperwork has STRICT time deadlines, so don't blow it off if you take this route...

 

[Babygirl25]

I'm prescribed 160 mgs of slow release oxycontin, twice a day and 20 10 mg instant release oxynorm for breakthrough pain. I'm also on 300 mg of pregabalin twice a day. And I'm having stomach troubles at the moment so I've thrown up a few doses recently. And although my Dr is aware of it he won't do anything to help. I dislike most medical professionals intensely and it sounds like we both have uncaring drs. The only suggestion I can make for the future is what I had to do, but it did come at a price.

My meds are delivered as my pain keeps me housebound but I went from a monthly script which left too long a time to run out of meds. I now have them delivered twice weekly, so although sometimes my 6.00am morning dose doesn't get here until 11.00 am, it's usually earlier, I know that by that lunchtime I won't be without meds. I also found them easier to space out of I were running short as you're talking about 3 days supply and then 4 days in a week.

At the moment I have a dose and a half to get me through until Tuesday morning. That's manageable. When I had a whole moth to use as I needed it was so much more difficult as whenever I needed more I'd tell myself I'll work it out but never did. So maybe asking this fuckwit who laughingly calls himself a "pain" Dr, yeah right, to just give you a week's supply at a time might be an option.

Or get a new pain Dr, just remember you interview them, if they're interested in helping instead of judging you which stresses you out and that makes the pain worse, right. You need someone who is more in touch with his sense of compassion than his fuckin' ego. Apologies for the language, but pain patients have enough to deal with without being made to feel like it's their own fault. I hope you feel better soon sweetheart.i really do feel your pain, not just a figure of speech.

Baby girl. X