I wonder if your brother's primary MD is twisting the fact that some neuro pain doesn't respond well to opiods into opiods never work for neuro pain.......which many on here can attest to is obviously false ! Maybe that doc is just anti opiods in general for chronic pain patients. My old primary was like that, which is why he's no longer my primary. Some docs just skipped class on the day they taught "alleviate pain and suffering" in medical school. I understand they can be afraid of drug seekers, etc, but admit him to the hospital so they can see that he's not using the med to get high. It really tee's me off that Rush Limbagh can get all of the oxycodone he wants, but people who really need it and are desperately need it because of real pain can't get help.
Okay.....end rant
Why won't his pain doc write for something ? If his clinic doesn't do maintanance meds, could he refer your brother to a primary care doc who is more familiar with the care of chronic pain patients ?
My best wishes for the both of you