My PM Doc won't change my meds.

It is often local law enforcement (local District Attorneys offices) that either push or don't push prosecuting doctors. The one in the county I live in is notorious for going after pm docs, which is why there is only one left in my coommunity who prescribes narcotics. The others have all turned to the high tech procedures. Often it has to do with the amount of illegal drug activity going on in a community, and it only takes one patient to either sell their pain meds (or have them stolen - remember that also happens) for the D.A. to start looking over a doc's shoulders. And that can begin to make life a living hell for a pm doc who's trying to to right by his/her patients. It takes very little - and it may be totally out of the doc's control - to have this happen. Sad that the doc and patients get punished, but I don't know if it's going to change anytime soon. The best chance may be the newer drug formulations being worked on that can't be crushed for abuse purposes.

Erin - your point about addicts is well-taken. We tend to forget about the genetic predisposition some people have to addiction. If such a person becomes ill, injured and in chronic pain even if they never abused alcohol or drugs in their life, they will far more easily become addicted and tolerant to the medications, and more likely to abuse. The person or the doc may not even know their predisposition until it's too late. So the most complicated pain patients are those with addiction histories or genetic predispositions. Addictionologists (docs who have a specialty in dealing with addictions) have a protocol for managing CPP's who are also addicts, although it's a challenge for many reasons. Still, that is a small percentage of CPP's.

Freya - your post once again was beautifully written and hit the nail on the head.

Just my two cents for now.

PaLady

thank you for the info PAlady & Freya...

wow, this is actually a very delicate matter!  imagine that...oh my dear! my pain management physician is sooooo nice & soooooo small!!!!!!  i can't picture him in jail!  lol...

i had no idea that the liability ultimately fell on the Dr.;  how awful a situation is that?!  a physician that is in the right yet punished due to their patient's wrong doings.

now that i understand a little more about the regulations i can see why THERE IS NOT TOO MANY PM DOCS!

i don't blame em'!  i wouldn't want to take the risk either.

 

if ya think of it it's probably safer to be a neurosurgeon.

 

it's been real folks!

good conversation.

cheers,

erin 

 

Glad to see good stuff going on here while I was having another surgery getting my back screwed back together.....

SangreAzul, listen to CaryF and get to a neurosurgeon, and find the best one you can get.  I found supposedly one of the best in my area, and he failed miserably to help me, but that didn't stop him from operating 3 times over 2 years.  One month at the Texas Back Institute led to a positive, definitive diagnosis and a fusion surgery.  My pain is already much better than before, and I'm nowhere near recovered from the surgery yet.  My new surgeon wasn't exactly complementary of the work done on me previously, and said I should never have been cut on until a discography and CT myelogram had been performed and indicated a surgical case.  I just had an MRI and a positive nerve root block; and I had personally asked my surgeon TWICE before and between surgeries if a discography should be done, and he convinced me otherwise.  If I'd gone to TBI in the first place, it likely would have saved me 3 surgeries, and 2 years of pain that have produced all sorts of other problems, including with my career.  

I'm sorry; I'm not a doctor, but I'd just like to ask both of yours if they're smoking crack!  You have serious, intractable pain, a HERNIATED DISC, and you're NOT A CANDIDATE FOR SURGERY???  WHY??  It's reasonable to try conservative treatment for 3-6 months (P/T, etc.), but past that your best bet is surgery (IMO).  I would highly recommend you get to a neuro doc and request a provocative discography, a fun little test where they inject fluid into your disc in an attempt to reproduce your pain.  However, if they inject the disc and it does "fire up", then you have a definite diagnosis and a clear indication for surgery. 

After my 4 year fight with back/leg pain, I have lost what little faith I previously had in the medical community.  Specialists I was referred to who have excellent reputations turned out to be quacks.  But, there are good ones out there.  You just have to find them, and find them early!  SangreAzul, do you mind telling us where you're located?  Someone here can probably give you some good ideas on clinics or surgeons in your area.  Good luck and God Bless.   

Anon

That's true, Anon. I think the wording in my earlier post was a bit misleading. It's the investigation, paperwork, possible publicity, etc. that makes docs so reluctant. Although I will say in our county the D.A. evidently has a something up his a** specifically for docs who prescribe narcotics. Seems to have pertained to his experience with addiction in his family, although as we know CP treatment does not an addict make in the overwhelming majority of cases. But our District Attorney has prosecuted two excellent pain management docs and won both cases on the basis they were overprescribing or prescribing for "off label" purposes. And of course some of the drugs were finding their way onto the street. The one doc was suspicious even to me, but the other was a general good guy who was trying to help people in pain. Now all the docs in our county - pm specialists or other - are well aware of what happened from all the publicity. Both docs lost their licenses and practices, and one is serving jail time. So now I've got to explore pain management in cities 2-3 hrs away.

PaLady

THat is exactly what the big ta do is about here in Ontario
RX to ppl that have not had history of Pain problems or have a significant Disese /disorder which requires pain meds
I know I have no worries as you very well can SEE my pain and what it stems from and I am not addicted I am definitely neding the painmeds to have a functioning day ........

People with Chronic Pain need to be treated as such not as Drug seekers..........really does Tick me off to no end ........

WE do not nor should not have to live in Pain IMHO

LUVS
LYN