hi, my dr cut my pain meds last month and now i am just about out. i called them and they chastised me for taking more than prescribed and will not help. i went from 30 mg morhpine 2xdaily with 30 mg oxycodone 3xdaily to 15mg oxy 5x daily. i need 30 mg oxy to cover my pain, about 4 times a day. i thought i would be able to get seen early and get refilled but they say no. i dont know what to do, my pain is real, and my body is also acclimated after taking this since sept 2010. what can i do? can i get the oxy from urgent care, or can i get suboxone? if i got up to 10 hours without the oxy i am in terrible pain in my arm and all over and my legs are very restless and i feel like i'd rather die than go thru this

Hi Clarkstar,

I'm trying to understand the sequence of events, and I'm not sure if I have them correct or not. The way I read it:

You were taking 30 mg MS 2/day and 30 mg oxycodone 3/day.

Then for some reason, your doctor changed your prescription to 15 mg oxycodone 5/day(?)

This was insufficient to adequately control your pain, so you took 30 mg oxycodone 4/day, and now you have run out before the end of the month, and someone (the doctor or who?) refuses to prescribe any more.

Have I got it right?

Did the doctor give any reason for changing the dosage?

If I have it right, I doubt you'll be able to get anything from urgent care. Depending on local policies, you may (or may not) be able to get up to a 5 day emergency supply from your doctor or pharmacy (provided this has not happened too frequently, which in some cases can be more than once).

AFAIK, Suboxone is usually only prescribed as part of a drug treatment program. This may involve your not being able to get any opioid analgesics in the future, as in effect, you would be admitting to being an addict (I am NOT saying that you are an addict; I'm just relating what I understand the situation to be). I understand Suboxone may be being used for pain control, but it may carry a stigma with it (like methadone sometimes does).

There's a lot I don't understand here, which is why I think I may be misunderstanding what you're saying.

Doc

I'm wondering too, why the change was made & if there was any discussion or explanation at the time of the changed Rx.??

It wasn't a typo?? or some kind of mistake by the dr?

Is is a pain management dr or primary or ??

i was in pain and very tired when he wrote it so i didnt even check it. he wants another mri but the last one showed nothing and they are damn expensive.

you had it right. the doc said he thought i was taking too much since it had risen to basically double in 4 months time. i started taking 15 mg last december or so though. plus i gained about 70 lbs since february. my pain levels keep going up, and noone has given me anything definitive about why my arm is hurting so bad. i had talked to the pa about getting on suboxone ealrier this year to wean off the oxy but i was afraid it wouldnt help me with the pain enough. otherwise i fear i will be eating 30 oxys a day for pain relief and i read online that everybody has their lives ruined by painkillers

In part, you've answered your own question. People have had their lives ruined by substance abuse, whether painkillers, alcohol, tobacco, or prescription or street drugs. The operative word is abuse.

Unfortunately, what should be a medical issue has become a political one.
Google: politics of pain

The risk of addiction is actually very small among chronic pain patients without a previous history or propensity for abuse, or psychological problem (which is what addiction is).
http://www.health.com/health/conditi...9482_1,00.html
http://www.chronicpainrevolutions.co...ic-pain/75.htm

This is not to say that prescription painkillers are without inherent risks.
http://www.stoppain.org/pcd/content/...tablishing.asp

I can commiserate with the weight gain. I found some help with the diet in the back of this free book/download:
http://intractablepaindisease.com/
I'm also getting some good results with pain levels from the hormone replacement (depleted by chronic pain) mentioned in the same book.
http://neurotalk.psychcentral.com/thread156416.html

Doc

It was interesting to hear you say the incidence of addiction is low for real cronic pain issues. My Pain specialist is not very worried about me being addicted to a low dose of Morphine. He has given me infusions also for my cerivical spine. However I am terrified of the stuff. I do not abuse anything, but I worry about my future. I have degenerative disk disease, in many areas of my spine. I didn't really have a choice with taking this drug, or my quality of life would be caputs. Should I be worried about the future with this medication? I have dropped from a huge dose before my last spinal fussion to 30 x 2 day. I am one year post op, and I want to go down to 45mgs. this coming Jan. Pain is tolerable right now. It is the long term I am worried about. I want to be able to have some good parts to my life, as this is only one of several degenerative, and autoimmune disease I have. ginnie

Worried? I don't think so. Worry is rarely constructive or therapeutic.

Prudently concerned and vigilant? Definitely.

The keys are to follow the directions/rules conscientiously, jump through the proverbial hoops, and keep a frank, honest and open dialog/relationship with your doctors - everything above board. Keeping a pain journal may help. Then if (<-- BIG "if" ) you get into trouble down the road, they'll be there for you and help you through it. It's doctors who feel they've been deceived/betrayed who wind up bailing on a patient or cutting them off.

There are always new developments and hope, but realistically, you may be on some sort of narcotic pain medication for the rest of your life. You're on a journey - it's a process. Keep reading, learning, communicating - about your conditions, your meds, chronic/intractable pain, and the politics that are increasingly governing its treatment. Become aware, pro-active, and your own advocate. All of these can help you keep on the path, and....

Reduce the Sense of Suffering, and
Improve the Quality of Life

IMO, your attitude and goals are excellent (but again, realistically, your dosage will probably go up over the long term; every patient/medication is different).

Doc

I don't know if you can get the help at the emergency room. If I felt bad enough I would go. I know about the withdrawl symptoms. It is horrible. Truely if it is not something you can tolerate, I would rather admit to that in the hospital, than go through it without any help. Make an appt. with your doctor, and talk to him face to face. Do you go to a pain specialist? I truely hope you can find some relief soon. ginnie

sorry for taking so long to reply. the doctor actually wrote me another script after i called my pcp and explained to them what happened. i think the doctor menat to prescribe 30mg, either that or he's sadistic. if i have to go thru withdrawls again i will kill myself. but i cant since i have to care for my parents. i am being careful to follow the new script instructions but it calls for 1/2 of a 30mg pill every 4 hours. this old doc cant get it right and my normal doc/pa is ****** at me. i have an appt with a pain clinic this friday so i hope to transfer my pain mgmt care to them.

i dont know why they dont just give the meds out to people that need them, they are all scared. this is ridiculous, i mean pain meds should be available to people in pain!

in the meantime my mom is very sick and my dad just had half his face scraped out due to melanoma so he cant do much. i took a break yesterday, played some cards then some pinball, and felt really guilty when i came home and my dad was worried since i hadnt called and my mom was sicker. i had a caregiver with her all day and thats costing us 21/hr and i had the hospice nurse out in the a.m. before i took off. now tonite i couldnt sleep a wink and had plans i dont know if i can make or even if i should.

augh!~