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Advice on my Pain Management Clinic

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Posted 11/4/2015 6:13 AM (GMT 0)
Hello Everyone, I am new to this site, so please be patient, and please all advice is valuable.

about a week after I had filled my script for my meds, I am taking 70.5 mg of Methadone per day for chronic pain, various problems, about half of my script was missing. Thinking there was not a whole lot I could do about it I tried to make them last as best I could. Of course I ran out, thinking I could just tough it out, I tried. Oh holy hell, I had no idea how bad it was going to get. Well I lasted a few days and decided to call my Pain Clinic to let them know what had happened, and to see if I could be seen. Well NO, I would have to wait to my next scheduled appointment, but I needed to I could go to the ER to seek help. I tried to just do it for a couple of more days until I could not stand the withdraws anymore and went to the ER. Ugh after waiting forever I got into a room and was told that there was really nothing they could do for me, gave me scripts to help with the symptoms, and told to contact my Clinic they should help me. I tried to hang with them meds, but they were not helping, and I was just getting worse. I called my Pain Clinic after a day or so, and was told NO I could not get in that day, but they would send a message back and someone would call me. I waited for an hour and asked if I had been forgotten, was told no, they were busy and when they had time they would call me. This never happened! Of course the ninny that I am, I could not stand the withdraws, I tried Urgent Care, they referred me to the ER, I tried the local Drug Addiction agency, was told to go to he ER, so off I went to another ER only to be told that they could not do much for me, gave me a script for the nausea and home I went. I have 2 days to go to my scheduled appointment, I am still fighting withdraws, hell not quite so much anymore, but I am very bitter. I am not too sure how I am going to act when I get to my appointment, I won't blow it, I will be nice, but I want to know why I was allowed to go through this damit!!?? I know I signed a contract and it was my responsibility to safeguard my Medication, but I am not perfect, and I let my guard down. I have never had any problems with this Clinic and I have been going there for over 3 years.

I guess what I am asking is opinions of how I should handle the situation when I go to my appointment.
Sorry this became a mini novel, but Thank you for reading and a big Thanks if you respond.
Calamityjay
Posted 11/4/2015 7:06 AM (GMT 0)
You need to be prepared for them to dismiss you. When you get your prescriptions filled the pharmacy gives you info on your meds and tells you what can happen if you don't take. Pain contracts also tell you that if you stop taking these meds suddenly that you can go into withdrawals. You were aware of the what would happen if you didn't have the meds before you started taking them and you agreed to it. Your pain contract may or may not also tell you what happens if you lose your meds. If it does, you also agreed to what it said when you signed the contract. We have to be responsible with these meds.

Frankly, you have no reason to be upset with your dr. Your dr is not the reason that you didn't have enough meds. You put yourself in the position you were in. You don't have to be perfect to safe guard your meds. You need to be honest at your appointment about what happened to your meds. You also need to be prepared for your dr to tell you he will no longer treat you. And for you not to be able to find another dr to manage your pain. Drs don't want patients that aren't responsible with their meds and that don't accept responsibiility for the things they have agreed to. By the way, all ER's and Urgent Care will do is treat the withdrawals. They will not give you any opiates.
Posted 11/4/2015 8:17 AM (GMT 0)
Mercy & Grace,

Thanks for your input. I almost agree with everything you have stated, know it to be true. I was NOT looking for Opiates from ER or anywhere else, I was looking for better control with withdraws.

As for being upset with the Dr. like I said, no one can have total control and things can and will happen. I expect a tad of compassion and understanding when something happens for the First and only time. I never said that I blamed my Dr. for not having enough meds, my Contact states "may" not "will", I have been honest with the Clinic, and was told that going to the ER would not count against me.

BTW, a little back story on the good 'ol Doc :) in a very small nut shell,

A doctor's medical license will be suspended after the Medical Board found he diverted opiates from patients for his own use( Not once but twice - that's 2 different years ) , and administered drugs to a female employee in a "special cup of tea" without her consent.

There is always reasonable room for a first, or second chance....like I said NO one is perfect, or are only certain people allowed this luxury?
Posted 11/4/2015 10:41 AM (GMT 0)
Welcome to the forum and yea some ppl don't count and its not the Dr's if you get what I mean.

First off I was on methadone over 13 yrs and thank the powers that be I am not now. I can assure you there's absolutely nothing short of giving you methadone that ER or anyone could have done to make those withdrawals any better and by the way ERs are not allowed to dispense methadone. Clonidine helps a tad, immodium a tad, but even subutex or suboxone would not have lighten the w/ds from 70mgs a day. Even had you been given another opiate your w/ds would have been stiff for there's no unlethal amount of hydro or oxy to adequately cover the 70mgs of methadone and prevent w/ds.

It's a bone of contention with me when ppl are put on the darn med and titrated to far reaching amounts without having adequately been prepared for what the future holds.

If you want to talk to your Dr about something he can do something about try getting him to prescribe something different while your this far out clearing your system and by the way your no way near the end of the horror of symptoms related to sudden withdrawal of methadone. It's been known to take months to completely get back to normal.

If you choose to remain on it be prepared to guard every last pill like its a gold mine because the withdrawal from methadone nvr gets easier no matter how many times you do it.
Posted 11/4/2015 1:11 PM (GMT 0)
What are you planning on doing about 1/2 of your pills going 'missing'?

When my son in law was around, I started leaving just a few pills in my bottle and keeping the rest in an old bottle (same prescription, same label) hidden away. I wasn't 'sure' it was him, but it seemed that whenever he 'visited' my pill count wasn't what it should be. It hasn't happened since he disappeared! Coincidence? I think not!

I've also been known to ask the pharmacy to count them out in front of me as some of the shops around here have been known to short the count depending on what med is prescribed and how many are prescribed. I actually switched pharmacies over this.

Anything stronger than Tramadol means that I have to have someone set out what I am to take in a given day and 'store' the rest as I tend to 'forget' when or if I took a dose! Learned the hard way!

Have a plan to protect your meds!
Posted 11/4/2015 1:36 PM (GMT 0)
M&G is right on. Be prepared to be dismissed. It doesn't matter how the pills went missing, you are responsible for them. Short of filing a police report you are SOL in that category.

Sorry you had to learn this lesson the hard way.
Posted 11/4/2015 2:44 PM (GMT 0)
No offense intended, however, anyone who is in pain management absolutely needs to understand that if they run short, loose or have their meds stolen, no matter what specific wording is chosen in the contract, meds /scripts will not be replaced.
If you had any idea how many times a week, someone calls their Dr's office, looking for more meds, replacement of "stolen" meds, claims of "lost"prescriptions, you would understand why they can not, do not , and will not make exceptions.
Even filing a police report means nothing other than the person made a report claiming their meds were stolen. It is not proof .
I noticed you didn't answer the question about how the meds came up missing. I am sure your doctor is going to expect an answer. Methadone is dangerous in someone's hands it is not prescribed to.
As far as the ER treatment or urgent care goes, all they are going to do is give you something to ease some of the symptoms and send you on your way.
Withdrawal is not a medical emergency.
Posted 11/4/2015 2:58 PM (GMT 0)
Welcome to HW calamityjay.I hate that you're going through that.I'm sure you felt like you were dying.

Each one of us would be in the same boat if our Meds were lost or stolen.

Pain Management Doctors won't replace stolen Meds.It's a Blanket Policy so they won't do it for anyone.

I'm not sure what will happen at your appointment.If you want to stay there you may have to do some smooth talking.The fact that you didn't get any pain meds from another Doctor may be the thing that saves you.

Honestly,I couldn't live without my PMD.I plan on being her patient til one of us retires.

I wish you the best of luck.

Take care.

Rick
Posted 11/5/2015 5:32 AM (GMT 0)
Hello Everyone,

I want to thank all of you that posted back, I value the input. My regularly scheduled Pain Appointment is tomorrow, and well I will let you know how it goes :)

Calamityjay
Posted 11/5/2015 12:25 PM (GMT 0)
I can agree to all that is stated above.

Opiate withdrawal is not considered an emergency, but will make you feel incredibly awful.

As others have said we would all be in the same boat.

Many ERs and urgent care centers will alert pain management if a patient requests pain meds.

I know this is a tough situation. Good luck at your appointment.
Posted 11/5/2015 7:59 PM (GMT 0)
Hello Everyone,

Back from my appt. and wanted to let you know that all is well. I was just asked what happend?, told to trust no one, and given my scripts, and sent on my way. Extremely grateful that I did get a 6 day early fill, without any incident, and now just waiting to feel better.

Calamityjay
Posted 11/5/2015 9:11 PM (GMT 0)
You were extremely lucky. Guard your meds from this point on.
Posted 11/6/2015 4:13 AM (GMT 0)
Thank goodness you got your meds. Listen to straydog and do whatever you have to do to keep those meds safe. I don't think one can be too careful anymore. That was extremely nice of your Doctor to go ahead and refill. I know mine won't no matter what. Hope you are feeling better! Take care.

Cindy
Posted 11/6/2015 5:43 AM (GMT 0)
"A doctor's medical license will be suspended after the Medical Board found he diverted opiates from patients for his own use( Not once but twice - that's 2 different years ) , and administered drugs to a female employee in a "special cup of tea" without her consent. "

When a dr has their medical license suspended and they do what the state medical board tells them they must do in order to get it back, they are often stricter than those that haven't have problems. I don't know if Calamityjay means that her dr did these things or if it is another dr. But when a dr has a substance abuse problem they are monitored very closely, even if their medical license has been fully reinstated. As far as givng someone a drug without their knowledge, that is a crime that involves local law enforcement and not just the medical board.

Frankly, I find it very hard to believe that a dr that has the history like the one stated above is still allowed to prescribe Schedule II meds. Dont misunderstand me, drs have problems just like everyone else. But because of their profession they have more rules to go by than others and more restrictions if they have problems.
Posted 11/6/2015 6:10 AM (GMT 0)
If that does refer to your Dr you need to run, not walk, to another practice.
When the current one is shut down, it will be hard to find another Dr to take you on, since you came from the previous clinic.

If this info is known, the practice should be closed. Like M&G said, it's bigger than the medical board, it's a crime resulting in jail time.

You need to get out of that situation now.
Posted 11/6/2015 6:18 AM (GMT 0)
Mercy&Grace,

So what's your point? I asked for advice, got it, saw Doc, all is good, Problem solved :) I don't understand the timing of your recent post.

Calamityjay
Posted 11/6/2015 6:31 AM (GMT 0)
I think the point is if your drs guilty of the things you said he is being carefully and closely watched and although he wrote your meds early and you got them filled this is something those watching could step in and shut him down for. Drs with a troubled past are expected to be above reproach and you could one day find yourself in the very same situation you were in last week if that were to happen. In theory patients of Dr's and clinics who have been left hanging by actions such as a sanction against them are not readily accepted by other practices and the same ERs and Utcs will respond the exact same way they did to you this time, they will not care why your seeking help for withdrawals.

Just trying to advise you to be aware of the facts.
Posted 11/6/2015 7:12 AM (GMT 0)
rocckyd,

Yep the practice I am currently in. Was about 8 years ago. NO jail time. Lots of mandates from the Board. Cases have been settled and he is still on Probation, and being praised for how well he is doing. I suppose the wrong doing is being looked at as a shame but he still does continue to practice. There aren't a whole lot of Pain Management Clinics where I live. My Primary Care Phys. felt I would do well in this Clinic, was assigned there when she was no longer allowed to write scripts for Schedule II drugs. Long story short the local Pharmacy turned her in for excessive amounts/scripts of these drugs. I have not had the best of luck when it comes to my Chronic Pain.
Calamityjay
Posted 11/6/2015 1:56 PM (GMT 0)
Hey Calamityjay.

I'm glad it worked out.We have to protect our Meds like our lives depend on it because as you found out it feels pretty bad without them.

Take care and hope you're feeling better.

Rick
Posted 11/6/2015 3:13 PM (GMT 0)
There was just last month a doctor here who apparently lost his license for over-prescribing, early fills, diversion in NJ. He apparently was disciplined prior in NJ as well.
His clinic in a nearby town in NY where he was also licensed was raided and shut down just last month.
No one will take any of the people who were going there into their pm practices.
Posted 11/7/2015 3:40 AM (GMT 0)
That's what happened here in Florida and when they got done hundreds of real patients ended up in the methadone clinic with the addicts. They had no choice really because none of the other Drs here wanted any of the patients there.
Posted 11/7/2015 4:07 PM (GMT 0)
It's a real problem. If a patient is seeing or hearing of shady dealings going on at their doctors office, the smart thing to do is get out quickly and find a new doctor, instead of waiting hoping nothing is going to happen.
It may not be today, or tomorrow, but you can be sure, if a doctor is known for not following the rules ,sooner or later, he is going to get caught.
Posted 11/8/2015 3:26 AM (GMT 0)
He obviously has a substance abuse problem. That means that when he takes drugs again and/or doesn't adhere to his probation rules you won't have a dr. Finding another dr to manage you pain may be very difficult if you can find a dr that will even see you. Dr want copies of your previous drs medical records and when they see this on your record they may not accept you as a patient.
Posted 11/9/2015 7:10 AM (GMT 0)
Again a Big Thank you to everyone for their input. It is a difficult position to be in, as far as the Pain Clinic goes. There aren't that many available, the Drs. are being shut out trying to treat their patients for Chronic Pain, anyone who has pain issues pretty much ends up in a Pain Clinic. When I had gone to the ER I was asked if I was a patient of Dr. xxx?, I said no why? Yet another Dr. under investigation for their script writing. Of course he was suspended for writing for now, and his patients scrambling to find someone to fill their meds, and like I had found myself before being in the same situation before, looking for help for something I had no control over.

I am guarding my meds, I cannot or will not go through that again, boy oh boy have I learned a lesson, or two.
And seeing that is is inevitable, everyone in the Clinic must go down on the Methadone to no more than 40mg per day. I had been without it for over two weeks, so when I filled my script, I have not taken my full dose yet, it just might make it even easier to reach the 40mg limit. I sure hope so, a tad scary at first.
Finally making some headway to a much cleaner house, and even clean laundry!!
Posted 11/9/2015 10:40 AM (GMT 0)
Try not to go back to the original dose if you know what lies ahead. Two weeks was plenty of time even with methadone to lower your need. The chemical design with this drug tops out and after therapeutic dosing the benefits do not rise. Thus the reason overdose occurs. They take one more and one more chasing the ultimate high and its not going to happen before they cease to breath or ever. Works for pm the same way, your not going to get anymore pain relief at 80mgs then your getting at 40mgs your need has just risen due to the tolerance your body builds tricking you into thinking you need that much.

It's so very difficult to drop down on this med because of the grip it has on those receptors. Coming down 5 mgs a week is the suggested taper off for comfort and unfortunately the Dea, the laws and even the Dr's don't give a hoot about your comfort and are not going to give you that much time to drop that 40mgs.

Do yourself a favor and working with the clean slate stay down on that dose. Your currently on about the highest dose I have seen written for pain management and I can assure you if the Obama administration has its way you won't be on it at all.
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