Oh dear, this does concern me. And I am very shocked! what about spinal patients, and those with other serious chronic long term pain? what the hell do they manage their pain on? crummy codein? I thought they would be more liberal! I am not a cancer patient, and on the outside, apart from a walking stick and minor limp, people cant tell that I have serious neuromuscular issues, arthritis, hip damage, nerve pain and a very bad back with a horrible spine. Another issue is being just under 30, young and 'good looking' to the outside world I look 'healthy' and no one would guess that Im actually living with serious health issues resulting in severe disabling pain and other associated health problems. I hope this does not cause me to be judged poorly and denied medication. Being a long term patient I could not cope being cut down to anything weaker, last resort morphine tablets I suppose but Drs tend to be stupid and dont convert the dosage right they just assume 50 mg of oxy would be 50 mg of slow release morphine when in reality its less than 1.5 - 2 times the strength... so they refuse to double the dose appropriately.
I wonder how much it is as a private unsubsidised script? also I wonder how much Dr visits will cost?? Im from the a British commonwealth country but not the EU... thanks for the reply. Researching is going to be so hard with so much I have to do already Im bogged down in preparations and my pain level is rising with all of the work I have to do to get ready...
*Mods* - I understand the rules on trying to access narcotics from doctors, I'm trying to explain more about the system in England and how the OP should access the services they need, and what to expect. If you think there's anything in my post that is not in alignment with the rules, please feel free to delete any/all parts of the post. Thanks,
Hi, I'm from just outside London and have chronic spinal nerve pain which I take Oxycodone for so hope I can help...
How long are you planning to stay? If it's a short time, just bring your own meds in packaging that clearly displays your name and details. That's fine.
If you're staying for an extended period...
Initially I went to my local doctor (as said, you will need to find your local doctor's surgery and register as one of their patients, either as a temporary patient or a permanent patient. Once you're registered you can make an appt. to see a doctor.) Waiting time will vary on what your problem is, and how the surgery manage their appts. My surgery have 'drop in appts.' Mon-Fri 8AM-9AM where you just pop a long in the morning, ask to be seen by a doctor and then just sit in the waiting lounge and wait for the doctor to call you. It's like a first-come first-served kinda thing. During 9AM-4PM they only see patients with a pre-arranged appointment. At 4PM-5PM they have another drop in surgery, but only for 'emergency patients.' i.e. something so serious it cannot wait until the next morning. Every doctors surgery is different in how they manage their appts. so it's important to ask about this when you are registering.
If you have no prior history of using opiates for such problem, they'll start you off on codeine/dihydrocodeine/tramadol with NSAID's like naproxen/ketoprofen/diclofenac. They may also give you something like baclofen/methocarbamol. It will take a lot to convince a doctor to p/x you oral morphine, or extended-release tablets morphine, you'll have to have tried all the weaker opiates first.
Since you do have a history of medicated opiate use, I urge you to print out literally EVERYTHING you can about your past history. What you've been prescribed, when, by who, what for and for how long etc... Doctors in the UK are very strict about suspected drug abuse, compared to the US and other parts of Europe. If possible, I would contact your current doctor and ask them to write and a 'to whom it may concern letter' that you can give to the UK doctor stating your past history, what you currently take, and what your US doctor would like the UK doctor to prescribe to help manage your case. Obviously an original signed copy, with contact details so that if there is any problem the UK doctor can give the US doctor a quick call/email/fax to talk about your case.
The UK doctor will then decide whether they want to manage you themselves or refer you to a specialist. If they are happy to follow the instructions of the US doctor and just keep on px'ing what you take, they'll do that. If they're not comfortable they'll most likely refer you to a pain clinic. When I was referred, the waiting time was 2 months. For me, that was too long and I couldn't manage my day-to-day life on the weak painkillers the doctors were prescribing me. The pan was abhorrent and intolerable. I asked my doctor to refer me as a private patient to a pain specialist consultant (he's an anaesthetist who also deals with pain management, particularly spinal nerve damage) and I saw him 4 days after asking to be referred, in a private hospital. Also, just a note, the private pain specialist that I paid to see also works at the pain clinic I would've gone to on the NHS. So you don't necessarily pay for a 'better doctor'... you just pay to see a doctor quicker, and in a private hospital. Most private consultants will work in a local NHS hospital/clinic part time, and practice privately part-time.
Again, he doesn't liberally prescribe opiates, no doctor here does. He's asked to taper off my MS Contin, start taking
Dosulepin as a means of long-term management. He did prescribe me 56x10mg Oxycodone immediate release tablets to help with the breakthrough pain, whilst making my transition from MS Contin to Dosulepin. He was INCREDIBLY hesitant to do this. He wanted to give me
Tapentadol instead, but said I could use the Oxy until the Dosulepin had started to work *hopefully* and next time I go, we will stop the Oxy and try Tapentadol instead.
I'm just trying to let you know how conservative the doctors here are with opiate use.
So pretty much:
1) Register with local doctor and make an appointment
2) Provide medical history
Then either:
a) They will treat you.
b) They will refer you to see a specialist on the NHS.
c) You can 'go private' and pay to see a private pain consultant.
Just FYI, my consultant charges £200 for an initial 40 minute consultation and £100 for 20 minute follow up consultations.
By the way, if you can't get a prescription on the NHS, you'll have to pay for it yourself.
I've had Fentanyl and MS Contin in the past on a private prescription. They didn't cost a wild amount, but the extended-release formula's of these meds are more expensive than instant release meds such as Oral Morphine and Oxycodone that I've been prescribed. They're branded, but just a generic formula and cost only a few pounds.
The best thing you can do is prepare as much as possible before you leave and bring over a printed history of your problems and the medications you've taken. Again, I can't stress how conservative the doctors here are, they wont hand out opiates/benzos willy nilly unless you genuinely need them. If you do need them, it's no problem. At the end of the day, they're effective medications used for real conditions to help improve people's day-to-day lives.
If there's anything else you need to know, please post in this thread and I'll try and keep tabs on it. If I forget, do feel free to nudge me via PM as a reminder.
Hope this helps,
Ive been on oxys for 8yrs plus but just come off them. Aaaaagh! Now withdrawing from Fentanyl patches as I want off opiates forever. I cant take the w/d....