Hi all,
Haven't been here in awhile. I suffer from pn in legs and feet. I'm unable to wear anything but flip flops and short pants or I go crazy with pain. I sit on ice packs at work and am limited to about 4 hours a day of work. That's my brief background. Oh, and I have no clue what happened to me. I'm 60 y.o.

I have been taking Lyrica (75x2) for about 2 years, as well as Tramadol (50x3).
These are pretty low doses and I have never increased the dosage or asked for them to be increased. I'm well aware about the opioid problem and take my meds as directed. I've never run out early, etc.

The other day, I went into my pharmacy (big chain) ans handed them the rx and told them I'd pick them up tomorrow. I do this every month. There was a new woman on the computer nearby that stopped what she was doing and came over. She said she wouldn't be able to get the Tramadol til ' next week'. This would have been about 5 days away. I told her my rx was due now, but I'd pick it up tomorrow and that I know it doesn't take 5 days to get the Tramadol, because I do it every month! She asked how long I'd been on Tramadol and I told her a few years. She said she would need to talk to my rxing dr (pain dr) because she doesn't think I should be on it. Like I said, I understand the opioid problem and I also know that some reports say pain meds shouldn't be used for,chronic pain. I don't care. It helps me and its none of her business, as far as I'm concerned.

We had a little heated 'back and forth' on the subject. I finally told her I felt she was crossing the line and she should really not be providing me with unwanted 'medical advice.' She said that she had a doctorate, so in fact she was a dr. I told her having a doctorate did not make her an m.d. and I would like her to just do as the rx directed her to do. I told her to call my dr and I'd be back the next morning to pick up my rx.

I came back and she was sweet as pie and had my rx's ready to go. She said she spoke to my pain dr and he would be going over options with me on my next visit. I said 'fine', I'll do whatever my dr tells me to.

I think I know why she changed her tune. At the pain dr, its usually crowded, but they call me right in. The nurse once told me they do it because I'm never a problem and only take a minute. Like I said, I never beg for higher dosages or cause the dr any problems. I've heard many patients crying and begging the dr for meds when I'm there. I can live a semi decent life on my two meds and am happy to continue on this path.

Oh, also, the pharmacist said if I come back with a Tramadol rx next month, she won't fill it.

Is this the way things are going to be now? Everyone will be treated as drug addicts?

I’d talk with the manager of that store..maybe that Pharmacist can do/say that, or maybe they are overstepping their role..
can a pharmacist refuse to fill a RX - Google Search

I had a pharmacist tell me she would not continue to fill a pain medication because she felt I needed to be on long-acting pain medication, vs short-acting. I asked her to fill it as the doctor ordered, but she said she would only do that one more month, then she would refuse. I had the back/forth, just as you did about her not being my doctor and not having the right to intervene in my medical care. I ended up moving my prescription services to another pharmacy. I did tell the manager why (who has known me for years) and she was upset at my decision...but understood. It was not the first time the pharmacist tried to change a medication...the other was a heart medication that she felt needed to be something different.

Insurance companies constantly think they are your doctor...mandating what you can and cannot take, regardless of what your doctor orders. Now it's the pharmacists. Thankfully, they are not all like this...actually it is a rare occurrence. Move to another pharmacy or talk to the manager...or both.

Alas, the 'topic' of pain medications and how or if they are prescribed is ongoing on every forum.

Doctors, pharmacists and drug insurers are all very carefully monitored by the DEA. Having the DEA on 'your back' is truly frightening. Each part of the prescription process is on high alert, as a result.

The current 'accepted wisdom' about most prescription pain medication is this:

1. Opioids are only effective for short term pain.
2. Opioids lose their effectiveness beyond this short term period, requiring either greater amounts or a switch to something stronger.
3. The black market for opioids is a major problem in our country, part of the current opioid crisis.
4. The leading cause of death for Americans under 50 is opioid overdose.
https://www.cbsnews.com/news/overdos...cans-under-50/
5. Manufacturers of prescription opioids carried out an intense campaign to encourage doctors to prescribe opioids, starting about 25 years ago. Now the effects have created a major crisis.

So what those of us who rely on pain medications must deal with is the 'blow back' from the attempts to curb the epidemic.

The way to deal with this is to have ongoing and frank discussions with your doctor(s). The sense of persecution that those who rely on pain medications are often experiencing can be intense. I have found that anger doesn't serve me well when dealing with any part of the prescription process, or any medical service.

By the way, the reason that opioids became so popular in the US (they are completely banned in some western European countries) is:

1. Doctors were encouraged to prescribe them.
2. Doctors prescribed them because their patients found relief from pain.
3. Pharmacists filled the prescriptions.
4. Drug insurers liked opioids because they are much cheaper than most other medications for pain.

However those who become addicted often finally resorted to Heroin, since Heroin in even cheaper than black market opioids.

And finally, the reason some people become addicted is that they are lacking a neural connection that most people have. The addictive substance closes that connection, and the person lacking that connection suddenly feels great.

The drugs to fight opioid addiction (Methadone, Suboxone, and others) bridge that gap in the neural connection, reducing the craving and 'bouncing out' the opioid or heroin if taken. Patients must have urine tests at each visit to the prescribing psychiatrist to insure compliance.

Only once in my experience with opioids did I stumble across a medication that 'made me high'. I was astounded, and finally 'got' why addicts like opioids, but the second dose sent me into anaphylactic shock (what happens when I take an opioid). It had a piece of torn meniscus stuck in my knee joint and was in agony.

When I finally had the arthroscopic surgery to remove the piece, I was sent home with Tylenol for pain. I have learned to deal with many many kinds of pain, relying only on Tylenol, Gabapentin (not an opioid) and Cymbalta (an antidepressant on label for pain, which I now have to give up due to disabling side effects).

I recently fractured my lumbar spine in a hard fall backwards. I am waiting out the healing (no surgery required) and become somewhat discouraged. Pain is a terrible thing.

We need better medications for pain, and we need to insure that those in pain can have the currently available medications that they need.

Regards, ElaineD

Thanks for the responses. I came here knowing you folks would understand the situation.

I'm quite sure I'm addicted to both my medicines (Tramadol and lyrica). I have driven to the office in the morning (20 minute drive) only to start feeling that woozy feeling you get when you forgot to take your meds. I have to then drive home and take them and then drive back. That's part of my concern with the pharmacy. The pharmacist was basically telling me I'd be out of meds for the weekend. Why? Why would you do that to a patient that always fills the rx's on the same day for years? Is this when people hit the streets for drugs?

Okay, let's assume I'm addicted to them. I take them as prescribed and if I don't take them, my pain goes through the roof. I'll be addicted to them, thank you. I'm under a drs care and haven't had a pain free hour in many years. It also irks me to be told the Tramadol wouldn't be in til 'next week' only to come in the next day and have it waiting for me. Lying is a pet peeve of mine.

Also, I don't appreciate being put in a situation where the more I stand up for my care, the more I'm treated like a junky. Arguing with them merely fuels their defensive stance on the situation. They have chosen the easy way to deal with the crisis - treat everyone as a junky.

Ok, I've vented. I have my pain dr appt. this afternoon and am curious to see what comes of it.

Cheers

Regardless of the outcome I'd take my business elsewhere. These people work for you. You are the customer and it makes my blood boil that you were treated this way. Obviously this "doctor" is not familiar with pain and how life changing it is to find something that allows you to have a somewhat decent life.

Okay, I went to my pain dr appt yesterday. He asked me if I had a good time at the pharmacy recently. I laughed and told him briefly what happened. He has spoken to the 'dr' at the pharmacy and told her I was not one to worry about.

He said its the DEA that's on everyone's case and held up a sheet full of names (his patients) that the DEA wants explanations for. If someone has been on pain meds for a while, their name was on the list. He said he has a stage 4 cancer patient on the list who shouldn't be walking because his spine is about to crumble.

I explained that the more I stood up for myself at the pharmacy, the more I sounded like a junky.
He said that was happening to everyone and was a sad side effect to the new policy. He said we can't fight it, so we'll adapt to it.

My old meds were Tramadol 50x3 and Lyrica 75x2.
My new ones are Lyrica 75x2, half rx of Tramadol 25x3 and Butrans patch. Can't read the rx if its 7.5 or 75.

Basically I'm going to wean off Tramadol and go to the patch which is a 'long term' pain reliever. Long term is the key, I guess. I was rx'd the patch a couple of years ago and was denied. The dr said that will no longer be a problem.

I guess everyone on pain meds here can expect to go thru yhe same crappola I did.

There is a HUGE difference between being addicted and being dependent on a medication!! There are many medications that cause patients to become dependent...not just pain medications. Heart medications often cause dependency, and steroids are the worst offender in my opinion. Steroids not only require extremely long tapers to get off them (sometimes years), but this class of medication causes extensive damage to many aspects of the body.

If you are constantly thinking of your next dose of pain medication and looking forward to it because of the side effects, then you are likely 'addicted'. But if you take you medication exactly as directed, but cannot stop it without withdrawal symptoms, then you may just be dependent on the medication....Big difference.

Opioids are NOT just for short term pain. There are many opioid medications for long term use that do not lose their effectiveness after short term use. If used correctly, opioids are effective means of pain control. Sure, there are some opioids that are best for only short term use...and it is best that patients use the LEAST amount necessary for the shortest term possible to avoid addiction or dependency issues. But many people have chronic pain and opioids can be used for chronic pain under proper direction of a doctor. Other classes of medication should be tried first for chronic pain, but if all else fails, opioids can be used safely. Patients also have to be honest about side-effects and any increase in desires for the medication.

Let me add: Please don't think my reply implies that there is no opioid crisis...there is! But giving opioids a bad name due to some that abuse it, leaves many chronic pain patients out in the cold. It just requires proper management, honesty, and open discussion between doctor and patient to avoid dangerous behavior before it gets out of hand. Maybe one day they will come up with a pain medication/treatment that has no benefit to the abuser.

I am not sure how relevant this is but here there are moves afoot which will let a pharmacist check on-line how many different pharmacies a customer has vistited before completing a prescription for an opioid medication.

This is intended to prevent "doctor-shopping"; people who are addicted to (not dependent on) an opioid medication sometimes visit many different doctors, collecting many prescriptions for the same medication.

Yes, I used 'addicted' when I should have said 'dependent'. I certainly don't crave my meds and usually have a few left over from when I've forgotten to take them.