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Opioids Weird conversation with my pain doc today..

I live in the uk and my pain doc just switched me from 200mg methadone to 150mcg/hr fentanyl patch. He wont give me bt meds and just wants to keeps raising my fent until it covers me. I find this frustrating as I have usually been prescribed some king of long acting opiate along with ir oxy or morphine for bt pain. Last time I saw him I mentioned this and he said" well im the one with the prescription pad".... What an arrogant prick!!!!. Im still titrating the fent. He started me low at 75mcg and moved up in 25much increments every 2weeks. He's sold on fentanyl being the be alla and end all of pain management but imo its not all that.
 
englandgz74 said:
I live in the uk and my pain doc just switched me from 200mg methadone to 150mcg/hr fentanyl patch. He wont give me bt meds and just wants to keeps raising my fent until it covers me. I find this frustrating as I have usually been prescribed some king of long acting opiate along with ir oxy or morphine for bt pain. Last time I saw him I mentioned this and he said" well im the one with the prescription pad".... What an arrogant prick!!!!. Im still titrating the fent. He started me low at 75mcg and moved up in 25much increments every 2weeks. He's sold on fentanyl being the be alla and end all of pain management but imo its not all that.
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Sorry for dragging a thread up but that's the current thinking with UK pain medication now, no breakthrough painkillers and all on the main painkiller, i'm not convinced it's the best thing to be doing as you risk the patient (ab)using more to manage their pain.
 
Yeah thats pretty much what he.said. He said the practice of prescribing bt meds was andbi quote "old fasioned". I havejt been to see a pain doctor in over 10years asbi was happy on methadone from my gp so this change in policybsuprised me. I awlays thought the point of bt meds was that it allowed a lower dose of the main med and alower dose of total opiate. I think that with the fent patches being much harder to abuse the patient will just use as directed and not over use anything (although if they think that then they dont know.addicts very well lol)
 
a little of both. he is right, if you are genuinely in severe chronic pain then the bupe wont do much. he also wants to keep you as a patient but when you think about it there is no shortage of potential patients. try what he says before you try bupe.
 
I couldnt imagine not taking pain meds. I had such a bad injury. So now Im quite dependent on the stuff. I couldnt really type of write before pain management and now Im habituated to opiates. So that is two things that keep me stuck to pain medicine. I used to enjoy the stuff, now I just worry about running out.
 
I know that feeling (worried about running out early) you them have the pain of the original injury plus the pain of the wds. I come to the conclusion last week that enough is enough and after 17 years of being prescribed every kind of opiate I want free. I know have to attempt to taper of 150mcg/hour fentanyl patch and then find a way of dealing with the subsequent underlying pain issues another way..........wish me luck!!!!
 
England I get exactly what your saying. It is a bitch. I suppose if you have acess you could get some D to cover a lapse in medicine. I usually hit up family and the friendly neighborhood spiderman.

Fentynal is a good drug. Most long term therapies include BT and ER meds. Im on oxy and morphine. My docs would much rather give me more morphine than oxy for some reason. This may change when the new generics oxycotins come out, but Im at the mercy of the system to some degree being on gov aid. I would rather be on Fent than morphine for my ER.
 
at my old pain management clinic, if you tested positive for any illicit opiate or benzodiazepene that wasn't prescribed, instead of kick you out they just plopped you on suboxone. in fact i had one of the PA's give me a thirty minute lecture about just how powerful buprenorphine was at managing pain.......heh.
 
When I first tried to get clean from opiates for chronic pain I thought I'd do the responsible thing and ask for suboxone instead of anything else. What a mistake that was. Within a few weeks it did literally nothing for me. I asked to switch and the doc just basically told me I admitted to him that I can't be responsible with other opiates. Eventually - after about a year of suboxone and terrible pain - he put me on fentanyl patches. They def work, but they do absolutely nothing for BT pains which happen a lot for me. So, it wouldn't be a bad idea to let your doc (a professional opiates dealer, for all intents and purposes) handle everything, take what he gives you how he says and then report back. I think once you ask to go down and you're on bupe, it is very hard to convince a doc that said plan didn't work, and you need to go back on traditional opiates.
 
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