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Opioids Pain management issue

P

psychopath

Bluelighter
Joined
Apr 1, 2011
Messages
531
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First and foremost, spare me the foolish responses. Secondly, the person I am talking about (seriously not me) is prescribed opiates for a debilitating and eventually terminal illness (multiple sclerosis).

A month ago this person was prescribed Nucynta 100 mg 6x daily from their pain management doctor after about 3 years of taking Norco 10mg 4x daily. This person had a follow up appointment yesterday to request going back to Norco because the Nucynta is borderline worthless in managing their pain. Urine screens are common for pain management and the individual had 5-6 screens since going to that doctor.

ALL of which would have contained THC. He expressed no issues with this in the past and even said screens "looked good". This person was dismissed because yesterday's screen had THC in it.

In every medical marijuana state, multiple sclerosis is one of primary diagnoses for medical marijuana.

This person is physically dependent (not called addicted if taken as prescribed) and has been for years. What the hell is this person supposed to do? Don't tell me to purchase illegally diverted meds. I need advice for a long term situation.

What the hell?
 
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All we can tell you is to have "this person" find another doctor... I'm not sure what you're looking for. Whether its a medical marijuana state or not, physicians are not legally required to recognize its use. Medical marijuana patients are still being denied organ transplants despite their use being 100% on the up-and-up.

You can't force the doctor to keep prescribing medication and it was probably in the pain management contract the person signed. All you can do is look for another doctor. I don't think this will generate a diversity of discussion but because I'm sympathetic to what "this person" is going through, we can see what develops from this.
 
My hold up is that ALL of the previous tests had THC in them and why is the doc just now taking issue with it?

Is this person "blackballed" from other pain management doctors?
 
It depends on the doctor and the responses are going to vary, but I know that I had to sign a contract allowing them to test me, and violation of the contract such as in your friend's case may be a reason for them to stop prescribing his medication. I would suggest following Cane's advice and talk to another doctor if the pain management doc won't prescribe the meds he needs.
 
I do not believe the person would be 'blackballed'. I had a debilitating illness as well (stage 4 lymphoma) and my doctors knew I had been a heroin addict, and was on methadone/other narcotics the whole time during my treatment.

I have in my past though come across a few doctors who were not sympathetic towards drug use and had no interest in prescribing me anything, and even cut me off of klonopin cold turkey. Needless to say i found a new doctor..

Just because one doctor doesn't want to see you anymore doens't prevent the patient from seeking treatment elsewhere. I highly recommend trying, what's the worst that's going to happen?
 
This person does not want to develop a reputation as a "drug seeker" in the local Dr. circles because they never have been....

I suppose trying to find another one is only option..
 
I am sure that if your friend explains to another doctor that he tried the marijuana to help relieve the symptoms of his condition he will not be labeled a drug seeker as quickly as he would if he had tested positive for cocaine or whatnot
 
Yes. If the patient has legitimate issues, then they won't be labled a drug seeker. "Drug seeking" is more like going to your doctor with a headache and saying "I need OXYZZZz yo, I am allergic to codeine and aspirin" . Shit like that. When i was going thru treatment I had legitimate pain concerns and had no problem getting dilaudid/fentanyl. I was in so much pain I needed it though, not justlooking to get high.

I also smoked weed during these times and since I had cancer, it b asically helped with a lot of things. Nausea, pain, insomnia, appetite, etc. The doctors didn't mind, as long as I didn't go back to shooting dope and shit.
 
one could have all their records from the PMC, including all UA's + for THC and all their notes should be included - briniging this forth would look good, showing there is nothing to hide.

though, not being in a mmj state, one is left to go to illegal sources and from there all behavior is questionable[if not to the doctor-then maybe their supervisor-dig?]

is Marinol/Dranibinol available(best bet) should be at the least for any MS patient...


Edit:
THC isnt always looked for mind you, i have blood-work and UA's for my medical conditions, but THC is not hardly ever checked for.
they may of decided to look eventually, and establish a base-line, then see what happened with use from there, after so many tests...
 
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This person seriously is not me. They don't need the schedule II opiates as schedule III adequately controls pain. They are also more opiate naive than I am. And like Brokedown said, it is necessary and likely will be for the remainder of their life.

Panic, my buddy has been strongly considering asking for Marinol for a while. I think I am going to tell them to speak with their neurologist about the next step and express interest in Marinol.
 
i have mmj, and marinol.

the marinol is null for myself, but is what some would rather hear people say, no matter what the law says.
... ones reputation can trump all law and pain, ive learned some think.
 
if they are inclined enough it is also an easy way to watch a base-line...
it should be very consistent and predictable with such controlled doses - that does take extra time, money, data, and effort to view and record though .
 
The drug test that was the cause of dismissal was a standard 7 panel test. It was NOT sent to a lab. I did not think those tests were that detailed.

EDIT:

The other tests were sent to labs because I saw they billed insurance $700 and some dollars for it.

About a year ago, the nurse who comes and gives my friend monthly infusions said that she did not believe the pain was being treated correctly. SHE suggested I ask pain doc to change to something stronger. I did this my next appointment. The smug, rich, and occasionally paranoid (probably due to a DEA investigation several years) screened me within 10 minutes of me relaying the nurse's suggestion.

My neurologist has also called the pain doctor on 3 occasions to discuss a change in medication. Each time he believed that "it was not right in this situation".

^Thought it might help describe the situation.

Another EDIT:
I assume from his paranoia that he might not put ALL aspects of treatment on paper.

Third EDIT:
My buddy saw him every 3 months, so the levels would need to only be consistent for a month or so.
 
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psychopath said:
The other tests were sent to labs because I saw they billed insurance $700 and some dollars for it.

About a year ago, the nurse who comes and gives my friend monthly infusions said that she did not believe the pain was being treated correctly. SHE suggested I ask pain doc to change to something stronger. I did this my next appointment. The smug, rich, and occasionally paranoid (probably due to a DEA investigation several years) screened me within 10 minutes of me relaying the nurse's suggestion.

My neurologist has also called the pain doctor on 3 occasions to discuss a change in medication. Each time he believed that "it was not right in this situation".
Click to expand...

Your "friend", eh? ;)

86 all the drug test talk folks - you should know that isn't allowed in here.
 
I swear on mother's life it is not me. My nickname was not chosen for any reason. I would probably only lie to you if there was some advantage in me doing so. The individual is not exactly computer savvy and when they told me, I told them about the site, then they asked if I would make my original post.

I realize there are some Is and Mes in there, but it seriously is not. I have ZERO shame. I would tell you if it was me. Continue to watch what I post now and in the future. You will realize I am blunt, probably to a fault. I use quality words and do not have many posts, but IT IS NOT ME.
 
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Congrats on BLer status! I really couldn't care less if its you or not, I'm just busting your balls, man.
 
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