Prescribing Narcotics: A Doctor's Point of View

The issue of prescribing medications, I feel, should be up to the Doctor and Patient.  The only exception would be if the relationship between the two were relatively new.  I feel very strongly drugs should come off the streets and stop all these endless killings.

I have an excellent relationship with my doctor, after trying several, and we've been together for over 35 years. 

So, regardless of the opiinion mentioned earlier, drugs have to stay off the streets.

After thought: BEST method I found is massage BUT it's not covered under Insurance therefore we are forced to alternitives.

I have to agree with you there. I have what *I* believe to be fibromyalgia complicated with lupus, however, getting a firm diagnosis is almost impossible where I live.

And honestly, massage therapy could save Medi-Cal thousands in prescription coverage!

Bravo! Very well stated! Thank you for writing a logical, coherent response. I agree with you one-hundred per cent. Good luck!

I was seeing a rhumatologist for several years when the goven't passed this new law.  Suddenly she said I must come in every other month, I couldn't afford it.  When I moved my primary dr to the town I live in I quit the other.  I explained everything to her,transferred all past drs I had seen.  Finally I don't have to go ALL the time.  She keeps a good watch and does the blood tests when needed.  I searched for years before we found out what was wrong, and the right pain meds.  Sometimes you just have to find a really good dr.

Thank you Dr. Borigini, hopefully every dr will come to your conclusion.

After reading many of the posts on here, I have come to realize just how lucky I have been.  I have been sick since late 1996.  The first time I went to the ER, I discovered that the Dr. who had treated me that night had just purchased the practice of the elderly dr I had used for "emergencies".  I had no insurance and he was just starting his pracice but he saw me (sometimes 2-3 days a week) without asking me for any payment.  He also made sure that he gave me samples of my medications.  After a few months, I became eligible for medicaid and since he wasn't an approved provider, he refered me to a dr. who thougt that all of my physical problems were due to my depression!  Long story short, after a couple of years, I was able to return to my oridional dr.  At that time, I was dealing with many different health problems but none of them caused much, if any, pain.  About 3 years ago, the arthritis in my knees became so bad that I could barly walk.  He did prescribe a narcotic until I could be seen by an orthopedic dr for steriod injections in my knees.  Over the next two years, the lower back problems (bulging discs and sever arthritis).  He and I had many discussions about the real need for pain management along with the fear most drs have for helping patients with cronic pain. 

About April, I went for a regular visit.  the office was closed with a note on the door that said they were closed b/c of an emergency and they would call to reschedule appointments.  The next morning, I received a call from my pharmacist letting me know that the DEA had suspended his licence and his DEA number which ment that even non-narcotic prescriptions with refills would not be honored.

At the time, I had roughly 20 monthly prescriptions for every thing from hypertension, athsma, stomach problems, depression, and anxiety - in fact, only 4 of my 20 Rx's were narcotics - AND one of them was my sleeping pill and 1 other was for anxiety! 

As I started looking for a new dr., I quickly learned what you guys have been talking about - one local internist refused to even see me when I told him who my former dr was!  I went to a "pain management" dr. who first told me that the meds on my list were the same "coctail" that killed Heath Ledger, that if you put a 50 mcg/hr on a race horse (I live in Kentucky - horses everywhere!), it would knock the horse out, AND he NEVER prescribed narcotics!!!

I left devistated!  Then, a new neighbor moved into my apartment building.  She suggested I see her dr.  He is WONDERFUL  the first time I saw him, he was in the exam room with me for about 1 1/2 hours!!  We went over my whole list of medicines  and in the last 3 months he has done many tests.  He has raised the dosage of a couple, while cutting out some others.  I am also working with a pain dr He just did a trial of a device that sends electrical impulses to the nerves in my back  it worked well enough for me to get the permanet device - which involves cutting into the bone which then regrows around the device.  Both drs comunicate with each other frequently which is always a plus.  I do have a contract that my pcp is the only one to write rx for any controled substance and that I will only use one drug store - both things that I had been doing on my own for several years. 

I don't think you mentioned which rxs you are one or where you live, but depending on that, your dr may have a legit reason for wanting to see you so often.  I'm in Kentucky and the narcotics I am on (for pain) require a new, handwriten Rx each month and cannot be faxed as they do for anything else I need refills on  -  however, I have been on lower types of narcotics where the doctor could (and DID) put several refills on them.

Sorry - didn't start out to write a book but this is one of my pet peeves! 

I agree with all of you , I have been experiencing chroic pain for 2 1/2 years following 4 major spine surgeries and have developed , post laminectomy syndrome( failed back surgery syndrome ) and have excruciating peripheral neuropathy in both legs and feet. I finally get some relief with 2 narcotic meds, but as said I really take care not to up them forr fear of addiction. Also having found a pharmacy that realizes my condition has helped alot with the prejudice I used to get when I first was put on them/

I sympathize with all of you who are in need of meds and are having a difficult time in having them prescribed..I am blessed with the pain specialist I have been with for the last 2 1/2 years.

You and I have almost the same problems.  I recently had to have more neurosurgery and I thought it would FINALLY bring me SOME relief.  Now it's almost worse  because I have developed nerve pain from the surgery which I never had before.  I also have "failed back syndrome" and have been down this road for a long time.  I have a morphine pump and  take oral Dilaudid .  One thing I will tell you, Patrick and I say this from the bottom of my soul please take your meds and don't worry about addiction.  You, as I, are DEPENDENT on your medication.  As time goes by, your body WILL need more of the meds as a natural response.  Studies have shown time and time again that chronic pain patients rarely become addicted to their meds.  Would you refuse a diabetic an increase in his insulin?  Of course not.  Take your meds and at least get some relief.

Matt'smom

If only 1% of patients prescribed narcotics were abusers I think things would be a whole lot different.  Unfortunately statistics indicate that it's more like 17%.  (Opiod Guidelines in the Management of Chronic Non-Cancer Pain, Pain Physician, 2006:9:7, ISSN 1533-3159).  I agree that the medical community should be doing their level best to help relieve suffering, however, I don't believe that obligates them to meet any and every patient's demand for narcotics.  Unfortunately, abuse is rampant and training regarding pain management and addictions is lacking.  I truely hope that you find pain relief methods that help you regain the ability to enjoy life. I know you're frustrated and hurting, but I hope you press on to find relief.

The argument of one per cent or 17 per cent is not the point. The actual problem here, is that doctors, nurse practitioners, etc. are very much responsible for people "self Medicating". If you go to your doctor to seek help, yet he/she is not willing, then you are going to do whatever you can to get out of that pain; ie street drugs, alcohol, etc.

It really isn't very hard to get narcotics, as a nurse, you know. So, why don't physicians understand this fact and "keep control", rather than let the patient go out an self-medicate? One could compare it to abortion; a woman's body is her own business. The same applies to people living with terrible pain and no quality of life. We SHOULD be allowed to be in control of our bodies. A bottle of 100 10 MG Vicodin HP (Generic) costs 30 dollars, a bag of heroin costs about ten dollars. Which should a patient, who is living in severe pain, buy and use? Doctors are doing a disservice (and some of their nurses too, as they act as the "gate-keeper"), by not STABILIZING a patient. That is the number one thing a health care professional is OBLIGATED to do. Get that person out of pain! There is no gray area there.

Yes, people are going to abuse the medicine, but that does not support what these doctors are Not doing; PAIN MANAGEMENT!

I am SO sick of all of the allied health professionals who have a "chip on their shoulder" regarding this subject. I am sure that all of you know what I am talking about. When you call to speak to the doctor, but the "nurse" won't let you. It is a form of POWER and a thought that "they know better". I understand what these (we) people see everyday, however, they only see a very small per cent of a person's life, when they only spend fifteen minutes with them, regarding their pain. If the doctor or nurse spent a day with their patients (customers) and saw what struggles they have, I think the health care community would be much better (I include myself in this statement).

So when the patients are seeing 3 or 4 different doctors and acquiring 300 or 400 percocets, xanax, ms contin etc. a week, and when they're going to several different pharmacies and paying cash to avoid an insurance trail, and when their complaints change  to a new pain source every other visit, when they look at you with a straight face and say, "my pain is 10 out of 10" and we've actually seen people in 10 out of 10 pain, so we KNOW they're lying, and when they refuse to have random drug tests to see if they're using coke or heroin and showing an abuse pattern, and when they call the office every hour to request meds and curse us out on the med line for not giving them "the meds they need to control their pain", and when they get out of prison after selling their meds on the street to the kids at the local high school, we in the medical community are supposed to "stabilize them" and "help them deal with their pain"??? 

Really, do you think that perpetuating this behavior is helpful to the "patient", to the community, to ANYONE???

The really sad thing is that people feel victimized for having pain because the narc seekers and drug seekers make a mess of all of the medical community's effort to help the people who are actually in pain.  I honestly believe you think you understand what it's like to deal with the junkies and the dealers, but trust me, you don't.  I spend about 2 hours of every day diverted from helping people who actually need help by people who are over using their meds or selling them.  PLEASE don't try to make me feel bad about resenting the 17% that screw it up for the other 83%.   We in the medical community may not be responsible for people abusing their drugs, but we ARE responsible for protecting the rest of our patients, our community and ourselves.

I feel your pain, and don't need pain meds to cure it! The 17% happen to be people I love and care about who became addicts DUE TO PAIN MANAGEMENT ! Nobody starts out addicted, they "become" addicted. Some, just dependant, but almost everyone I know, addicted. Right now as I speak (type) I am ready to scream due to the man I love (who happens to have pain every day) twitching like a freakin crack head in the bed because he had no meds to put in his body today. The delusion to him is that he is in pain and needs them for that. I'm sorry, but the pain he is suffering without his drugs is WAY worse than the pain he deals with normally.

My Mother is the same. Addicted due to an accident with her neck. She is no longer a functional human being due to meds. My step father, same, junkie... His Brother, dead from overdose of phentenol patch, My boyfriends uncle, dead - overdose, his sister, vegetable in hospital due to a motor vehicle accident while she was on MEDS, his other sister, junkie...  Don't know how much more I can endure. I have no way to help these people now that they are out of control.  Any suggestions?

How do you help someone in pain who is also addicted to the meds that are going to help them? Do they hae to live in pain the rest of thier life, or live as a junkie the rest of their life? I don't get it, seems that the lesser of two evils are still two evils to choose from.

Help someone!

How many of YOUR patients are seeing 3 or 4 different doctors? Also, you said that you "KNOW" when you see a drug seeker. As a nurse, I am assuming that you have at least an AA, maybe a BSN, not a PhD. Maybe you are a Sociologist too! I don't really know, except that you are a NURSE. Frankly, it is impossible for you to KNOW how every single person in this world reacts to pain.

Anyone experiencing CHRONIC PAIN, may figure out how to meditate or control thier "outward" appearance to you. Unless you are qualified to CONFIRM that these people are NOT in pain, then it is the Doctor's responsibility to weed out those patients (probably 3-5 per cent of your calls...MAYBE). People should not be treated as second class, just because YOU don't think they need it!

Until you get your NP Psy., or PhD., then I would be a caring nurse, meeting the EXPECTATIONS of those who pay your salary.

One of my Master's thesis was on this subject and I DO KNOW what it is like "out there"! I've studied at more Methadone clinics in San Francisco and New York I have created needle exchange programs in large cities, so yes, I can pretty much understand the problem. As it is said in this forum, the drug war should not be fought in the physician's office, monitored by a nurse, whose only education is 2 or four years of education. If one is an LVN (LPN) it is even less education!

All I would ask of you, is to keep an open mind and do not treat patients as if they are drug seekers. Try to develop a relationship with them. Talk to them about the Suboxone/Subutex option. Don't treat them like animals and be cruel. That is the very last thing an "addicted" individual needs. They need YOUR support and kindness.

I guess until you have to deal with the loved one that is addicted to these "Wonderful" drugs, you will never fully understand. I will post again to let you know when my Mother's funeral occurs because she is inevitable going to die at the hands of her prescriptions that she so swears she needs. She needs them ok, her body needs them because it is so addicted she cannot stop without HORRIBLE withdrawal which makes her hurt worse than she ever hurt prior to the meds. My mother may have been in some pain, but at least she was still my Mother. Now, she can't even talk half the time, can't feed herself, falls down at least 1 X per day (broke her nose last week), can't function as a normal human being anymore. I'm sorry to disagree, but her quality of life was MUCH better when she lived in pain. Now, she is not living at all.

I can give you a different opinion and I hope to help you...I am a nurse and a pain patient. I have been a pain patient for over 10 yrs, and without the help of a select few doctors, probably would have killed myself long ago.  I have chronic, debilitating pain...but with PROPER pain meds and close following by my dr, I am able to work full time as a Neonatal Intensive Care Nurse and have a pretty normal life. Without proper medication, I was unable to work or function at all...spending every day in bed with no hope.  There is a difference between "addiction" and "tolerance".  I feel you mother may have an addiction as well as tolerance.  Tolerance occurs to anyone who is on a narcotic/opiate med longer than a month or two.  You will get some side effects of withdrawal if you stop them abruptly.  So, no one should be scared to take narcotics...when and if your pain subsides, your doctor can wean you off of your meds slowly so as not to have withdrawal.  If your mother is "falling down" and her quality of life is worse than before her med treatment, then it is NOT the right treatment for her.  From personal experience,  your mother is afraid, or scared to death, to change dr's or meds for fear that her pain she had before will come back. But, you need to get her into an inpatient pain treatment facility....Johns Hopkins in Baltimore, Md. has a great one...if you're not near there, call them and see if they can refer you to one in your area.  She needs care by physician's who won't over treat her, but won't under treat either.  She needs followed also for depression which is VERY common among people with chronic pain.  Hope this helps...work with your mom and remember that you love her...help her as much as you can even if she is resistent...she'll thank you later...

thank you

I live with OA daily  I have had surgeries on my back too.

I am so blessed to have a wonderful family doctor 'who really cares about the patient and NOT the money".. I signed a Pain Mngmt contract and he gives me my PP every 2 months. This is just fine with me.. I take 3 to maybe 4 pills a day depending on my pain.. But mostly 3 daily if needed.  My last visit he wanted a UA test, I said fine but why. He states the DEA  policy on RX pain meds. He has to make sure we are all honest with him.  He just found out one of his patients had 5 different pain pills in her system and HE only precribled ONE to her. Needless to say he dismissed her from his practice. I have no problem with a UA every visit if that is what it takes to help the doctor and yourself. Honesty is the best way to go.  IF you are lying to the doctor on your meds. he will find out.

Typical "Health Professional" attitude. As a PA, you should know, that the very first OBLIGATION you have, according to every law in this country, is to STABILIZE the patient. That means, if a patient sees you, do not immediately assume that they are drug seekers. You must get them out of their pain, immediately. Growing up with a mother who is an MD and a Hospital Administrator, my spouse a pharmacist and I have two graduate degrees in science and public health, I have seen the big picture on this subject. Yes, you don't just hand out narcotics "because people want them", however, it is a Health Care Professional's responsibility to make sure that patient is not in pain. Have you or anyone here studied the people that cannot get quality health care and end up buying drugs on the black market? Or, even worse, start using illegal street drugs. There is a lot of supporting information that Health Care Professionals drive people from their offices to the streets. Something to think about, next time you or anybody else cares for their patients. I feel like I need to bring my CV into a practice, just to calm the damned Doctors down and think I am "less-than", because I might need certain medication. It is SAD!!!

bingo! I dont want to go to the streets! But Im in wa state and cant find a dr wiling to write rx s. Im legitame. I have been on 4-5 methadone a day and my ritlin and my synthroid and premerin and celexa for years! Yes I did sign a pain contract and went byit. I was dissmissed for being lat to an apt. . . .  ? which i doubt was the reason! the dr and I I felt were close and even friends but her moyher runs her new office and it was obvious she has a problem with me. . . so now hwre i am no dr cant find one oh sure theyll see you chg you and say no live with it. . . . what the heck? im a good person dont even smoke or do extr drugs ets. . . how can they just cut you off?  let alone once youve been dissmissed just try to find a new dr. . . its a small town but its like theyre covering their own butts and to heck with yours! its all money they heard people to rehab bet what about the ones in real pain  ? its been almost 2 months of being in bed many phone calls to state and i hear trhere are alot of us out there this is happening to!!! so what do we do? like its been said go to the streets? Im not that way then no one would help me but i feel like that now i cant find anyone to help me !!! my mother lives down the road and shes up in arms too! i tell her everything . . im 50 yrs old and not a kid and i hate the fact u try to look good when going out but he told u dont look sick! Im hurting and need help and hate that im actuly thinking that the street may be my only help at this point or do myself in and im not sure which is worse / / / any sugestions for a dr in wa state   thanks for listening! imahurtin!

OMG!!! This should be on a plaque in EVERY Pain Management Office in the US. Yes, of course there are patients who get narcotics and abuse/sell them but there are ways of seeding them out. For the rest of us (like me) we need to be treated properly and consistently. I've been out of work for over 3 years, lost my car and house and live on what my wife works. If I had ONE doctor that would not be such a freakin wimp and look at my situation; MAYBE i could get my life back and return to work! There should be a Network for people like us so we don't sit back in pain as some dude outside of our house sells and pops narcotics like candy. IT'S RIDICULOUS!! Anyway.... thanks for what you wrote!

 I have yet been to a doctors office that required a lie detector test when giving your medical history although I have been present while a multitude of test results have been studied along with the available history.

 If the doctor is prescribing too high of a dose a simple phone call should correct the situation although as your mothers condition worsens well you do the math.

 One other thing to consider one day you my be in the position of needing heavy duty pain meds and then you will find out first hand the damage that over reaction by snitchs and abuse by addicts has caused!

1stRed, your response was cruel and callous. Shame on you!

The vast majority of chronic in patients who have been prescribed opiates to control severe pain use their medications appropriately. They do not use their medications recreationally. They appropriately store their medications. Their doctors provide an appropriate level of supervision.

The problem with is not with our community. It's with people outside of our community. Since writing the original post, I have spoken to my pain management doctor about the situation. He believes that my mother's oncologist recklessly prescribed the opiate. He says that this happens all the time. He thinks that providers who prescribe opiates should be doing continuing medical education activities on this. My mother IS NOT a chronic pain patient. My mother does have a history of using bad judgement while traveling--that is not going to the ER when she has a medical emergency while traveling, driving home and then going to the ER. Her oncologist is aware of this. My mother tried to get her doctor to prescribe barbituates. He would not do it. According to my pain management doctor, there are enough warning signs (the irresponsible traveling) that say that she should be kept on a much shorter leash. He said that the vast number of people who get in trouble with opiates got them from doctors who are not up-to-date with how to prescribe them.

My pain management doctor advised me to WRITE, not phone the doctor. He told me that, under HIPAA, the oncologist will not be able to give me information. The oncologist should be able to independently verify my story--how much he prescribed and the concentration. He should be able to determine if I saw all the opiate he prescribed. What I want is for the oncologist to force my mother to get a neuropsychiatric evaluation. I have evidence that her reality testing is not what it should be. I think my mother needs to live in a supervised environment, such as a Senior Independent Living apartment complex. I think my mother needs to give-up the RV and travel with a tour group instead. I also think my mother needs psychiatric care. The only way for this to happen is for my mother to get in trouble.

My point, 1stRed, is this: I WOULD NOT BE IN THIS AWFUL SITUATION HAD MY MOTHER'S ONCOLOGIST PROPERLY SUPERVISED MY MOTHER. I know I'm not alone. I know other people who find themselves in similar situations because THERE ARE SOME DOCTORS WHO PRESCRIBE OPIATES WHO ARE NOT PROPERLY SUPERVISING THEIR PATIENTS--AND THE PROBLEM IS NOT WITH PAIN MANAGEMENT DOCTORS, BUT OTHER SPECIALISTS WHO, AS A PART OF THEIR PRACTICE, HAVE TO PRESCRIBE OPIATES. 

Just for me to understand this more clearly... why is your mother seeing an oncologist???

My mother is seeing an oncologist.

re: re: re: re: lol

WOW! I see "CONTROLLING" personality all over this post! I hope you are not a Pharmacist, who thinks that they can unilaterally decide what do dispense, or not. I love my mother more than anyone else in this whole world, however, that does not give me the license to get involved or try to control her or her activities. I can encourage her, support her, educate her, but I cannot control another human being. Nobody has the right to control another person's life, regardless of your relationship to them.

What if I was your brother and I think all you are doing is completely crazy? Do I have the right to make you go into a locked, psychiatric hospital? NO! We are all responsible for our own bodies. Medications are created and manufactured for a reason. I don't know your mother's specific diagnosis or other problems, but SHE is responsible for HER acts, NOT YOU! I don't want to come across as being harsh, but it is just reality. Stick to your own life and be there for your mother. Show her love and support, rather than hostility and control. I am confident if you continue on this road, it will end very BAD!

I hope your mom's cancer goes into remission and never comes back, but meanwhile, you are not in her skin, so you cannot make her decisions.

Hi Brenda,

I've had the exact same treatment up here in Canada. My local pharmacist actually

phoned my Dr to lecture HER on the pain meds she's prescribed to me.  I was blown away and came to the defense of my Dr. saying until she had a phd in medicine and knew my physical history to withhold her judgement. Every time I would get my r/x filled there I would get "the look", once having to defend myself in front of a line up of customers. So now I go to a big box retailer pharmacy instead and have no problems.  I've got to say I feel so bad for you patients in the U.S. who have to pay sometimes hundreds of dolloars for a Dr's appt.  Up here each and every Dr. appt. is covered by our provincial healthcare, we don't pay a penny.  And since I see my Dr every 30 to 60 days I can see how that could add up.  I really hope you guys get the changes you need to your health care system,

your supportive Canadian friend

The same thing happened to me, with my Walgreen's Pharmacist and my physician. "HE" (Pharmacist) thought that my doctor was prescribing too much of a particular medication. Keep in mind, I have been on this regiment for over FIVE years! I guess he was just bored and thought that he needed to set my Doctor straight!

I visited my physician after that phone call and all she did was laugh hysterically! In fact, she did not bring it up to me, I asked her about the phone call. She basically rolled her eyes and said that this particular pharmacist "was a little off". That made me feel really good, because I HATE going to the pharmacy and treated like a street, drug user! If my doctor, after five years, decides I need certain medications, then all the Pharmacist has to do, is count the pills. Don't throw attitude or make me feel "less than". It is ridiculous!

I hate my once-a-month visit to the pharmacy! It isn't just the Pharmacist either, it is "Pharmacy Techs" too! Power is a very bad thing, in the hands of the wrong people. They give you that evil eye and make you feel weak, just because you need these medications. I no longer tolerate that behavior. If an EMPLOYEE treats me inappropriately, I go straight to the Corporate Offices and tell them about my experience. They need to know.

Hi! This is my first time writing. I read everybodies email and I feel for everyone of you. I'm in chronic pain all the time. I got e-coili 3years ago and liver diease. They gave me 6mos or less to live. They put in an old folks home and on hospice, to let me die. I was in that home for 5mos and the doctor they had for me did not touch me once. He would come once a month and would say, see you next month. I laid in bed all that time. My kness frozen up on me,(my legs were straight out). My boyfriend of 6mos took me out of the home to live with him. He lived in another state, 4 hours away from my family. I was bedridden for 2yrs. Alot of theraphy and doctors, I'm walking today. I went from bed, wheelchair, claw cane, now regular cane. I have neuoraphy, arthris and osteoporoisis. I take morphine, vicodin, neurontin and plenty of other medicines. My family doctor referred me to a pain management doctor to see if he could help me better with my pain. Well he said he would first take me off the morphine and vicodin. That was the last visit with him. My family doctor knows from my records that if he did that I would be bedridden again. I want to say their is doctors out there that will help you, just got to find them. Thanks for letting me get this off my chest. I think of all the people who I read on this website. God Bless you all.

I have cronic back pain from a herniated disk and leg pain that began with a car accident. I Became determined to over come this pain naturally (after some extensive study and what seemed to be good advice. After phys. theripy and one year of narcs. to control pain, I commited to one year of no narcs. I did not even call the g.p. or the sergeon, who seem to be knife happy, for that year. The sergeon retired, the g.p. moved out of state and now no doctors in my area will accept me because of my condition.

Hi there,

just curious, what is the Canadian Consensus Document?  I live in Ontario, Canada with chronic pain on a daily basis, being treated effectively by a wonderful Dr., I'm one of the lucky ones.  However, I'd really like to know about this document you mentioned it and where you found it,

thanks,

Andrea

http://sacfs.asn.au/download/consensus_overview_fms.pdf

Thanks so much for that document on Fibromyalgia, The Canadian Consensus, excellent reference study for anyone suffering with this (as I am).

I am so sorry! Anybody in stage 4 lung cancer should have access to anything they want! Anything! What do these doctors think is going to happen to you? Get addicted? That is the LAST thing they should think about. I know people are limited to activities, due to their finances, but if you can travel out of your area and find a doctor you can trust, it would be well worth it.

I am staying in a "psychotic" city in a "psychotic" state, so I have to travel almost three hours to find a tolerable (not great) physician. Many Doctors, Nurse Practitioners, Physician Assistants have the GOD complex. They hold all of the control (so they think) over your body and that is wrong. It should be a relationship, in which both parties are satisfied with the treatments and medications.

I have started "Interviewing" my doctors, prior to committing seeing them. If I don't like them, I move to another, until I find a doctor that remembers WHY he/she is a doctor; to keep their patients comfortable and functional. If they cannot do that, FIRE them! Even though it is your health at stake, to the doctors, it is a business, so you should treat it as a business. Ask them questions; what Med School, are they Board Certified, what training, what is their philosophy, etc.? If they are annoyed, or think that you are over-stepping, then MOVE ON!

These ***** Doctors need to learn that THEY do NOT have all of the power in your relationship. You have 50 per cent input and they should respect that!

I guarantee you, if that doctor were suffering from the same sort of pain you are in, he/she would make damned sure they have all of the medications that they need/want. I KNOW this from personal experience!

Seriously, I hope you find your heroic doctor, that treats you correctly and makes certain that you are comfortable and living the best quality of life possible. I will do my best to see that you are given a personal "Angel" to get you through this (and I am not even religious, much less a Christian).

Our thoughts are with you and stay strong!

i have suffered from chronic pain since 2003. i had a laminectomy with fusion (back surgery with rod and screws and bone graft) in 2003. i suffer from degen.disk disease. i have bad disk from C-3 thru C-7 in my neck. i suffer from fibromyalgia. i have had a stroke and have had atrial fibrilation so i am on coumadin...and have other health issues and i am only 56 yrs old. i was a substance abuse counselor and had to go on disability in 2003. i did try pain management and was on ms contin for about a year but i took myself off of it. i am now taking percocets and they help some and i refuse to take the ms contin again...i too feel like the second class citizen when i go to the pharmacy and we all should not have to feel this way.  i am not in pain management anymore and my family doctor has now retired so i am getting my pain medication from  a new doctor and it is such a struggle. when i got my last prescription he had written on the prescription " patient should have filled this on such and such date...do not fill until time"....i was furious when i saw this....i felt like a druggie...and i am taking this prescription back to him next week for him to rewrite it because i am not taking this to my pharmacy to be embarrassed...how dare him to do that?...that made me feel like a second class citizen AGAIN !!!!....thanks for letting me vent.....

Just wanted to let you know we do have a portion of an article here that explains pseudo-addiction.  You can read the article here:  Opioids:  Addiction vs Dependence

You make some very good points.  Thanks for sharing.

Well, that is why CONTINUING EDUCATION UNITS are needed. There are always (daily) new drugs coming to the market. There are also new ways of treating pain, with certain combinations.

If you see a physician or nurse, who graduated in 1973, they will absolutely know less than a physician graduating in 2007. Any licensced professional needs to keep up on the latest drugs, therapies, etc. That is the physician's obligation and that is why all of us MUST have a certain number of CEUs a year, to renew our licenses.

I don't think those "fun" advertisements on the television will actually teach medical professionals pharmacology! Health care professionals have to be hungry to learn and keep UPDATED on new diseases and how to treat them.

When I read about people suffering needlessly,it makes me sick.A friend of mine has RA and is in constant pain.She is 58 years old and though she is clearly unable to work,Social Security has denied her 3 times so she has no insurance thus she can't even go to a Dr.It's really sad but becoming more common everday.I am a breast cancer survivor and I've been on Oxycontin,Oxycodone and Dilaudid for 3 years now.I was blessed to find a pain management Dr that understands pain.I signed a pain contract,which I was glad to do.I have to go to her every month,take all my meds for pill counts and have random drug tests.I take my meds as directed and everything works out fine.