Finally, you'll be told that your pain management physician may stop prescribing medications if you:
• Don't show any improvement.
• Develop a rapid tolerance for the treatment.
• Develop significant side effects from the medication.
• Fail to abide by the terms of the agreement.
That final point – failing to abide by the terms of the agreement – is also likely to result in the doctor refusing to provide any more care for you at all.
Harsh But Necessary
I know some of these things seem harsh and unfair to honest people who are in severe pain and simply looking for some relief so they can function and live a decent life. They are unfair. But as my Mother always told me, “Life's not fair.” Because there are so many people out there who do abuse drugs and who have become experts at cheating the system, those of us who need stronger medications to control our very real pain, are forced to abide by these highly regulated restrictions in order to receive the treatment we need.
We tend to get angry and blame the doctors for making it so difficult to get our medications and for making us feel like we're suspected of being drug abusers; but the fact is, doctors are mandated by their states and the Federal government to play by these rules. If any question should arise about a physician prescribing controlled substances for a particular patient, that doctor has to be able to provide proof that every care was taken to ensure the patient was taking the drugs properly.
Also, it's virtually impossible for a doctor to be absolutely sure whether a patient is genuinely in pain or just seeking drugs. Studies have shown that most physicians are not able to discern true pain patients from drug seekers with any reliable degree of consistency. Unfortunately, abusers are often very good at faking it, and there are no lab test that can accurately identify pain levels, so doctors are forced to do the best they can, utilizing tools like treatment agreements and random drug testing to make sure they're not contributing to someone's addiction problem.
I wish I had an easier solution for you, but until someone comes up with a better way, our best option is to make sure we understand the treatment agreement before we sign it, then do our best to strictly abide by the agreement.
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© Karen Lee Richards 2009
Last Updated 6/3/09
