Fed up/Tired PCP refusing meds

See, this is what makes me upset. I told him repeatedly how much I was taking and what was needed to alleviate my pain. I was constantly in his office at this time and he even took a urine sample one time to make sure I wasn't taking large doses. Never did he mention that my dosage was an issue until it came time for a refill and it was relayed through his nurses.

Never once has he talked to me about substance abuse or any concerns, all of this information has been filtered through his nurses. Should I bring it up to him next time I see him? Or will I look like I'm drug-seeking and being pushy?

I feel in a way that I might have to be pushy bc I'm in serious pain that affects my daily life and I have NO one else to advocate for me.

I am curious about something.

Exactly how was the script written for the vicodin. This really will determine what your next course of action should be.

Thank you everyone.

Jim1969, to answer your question, I was prescribed for like 6 pills a day, every four hrs I believe. Usually when I would get a refill, it was past the day according to his written instructions but not according to his expectations, I guess. For example, he would write the script for 6 a day and then say he expected that to last me twice as long (like 3 a day). Also, he knew that during this time I was working 12 hr workdays, 6 days a week, 8hrs on Sundays on a job that was on my feet. My pain was exacerbated and my days were longer than most. I was (and still am, due to insomnia from my pain) sleeping an average of 5 hrs, if that. My insurance never had a problem refilling my medication and he never changed the directive on the bottle. I hope I explained that ok.

Just a little observation.

Most people who frequent these types of message boards are not going to understand medical abbreviations/shorthand. This is why instructions on pill bottle are not written that way.

Oh also, requiem, you keep mentioning that he probably wont prescribe me any narcotics/opoids but he wrote me a script for tramadol. Tramadol is an opoid, isn't it? Or does it fall in another class than vicodin?

I know I'm joining this conversation late but just wanted to add a few things. First Tramadol is a narcotic-like drug, what that means is its a opiate agonist which is a synthetic created drug to do like opiate drugs would do but just enough to help relieve pain. Basically just enough to help with the pain and not go overboard like opiates can. Less likelihood towards addiction problems as well.

Second you mentioned your having problems with your PCP prescribing for you, a lot of PCP's do not like to have to prescribe opiates and higher meds because of the way regulations are getting tighter on them. Most would rather like to pass you off on PM docs because they don't want to deal with it. You as another mentioned did hurt yourself by being honest to your doctor. When prescribed pain meds you never ever ever tell your doctor that your taking more then recommended because you are basically giving yourself the "Drug Seeker" label which then hurts your chances of getting anything. Especially if you try switching PCP's then because it simply looks like your trying to find a doctor that will give you drugs. This is the hard issue that doctors are dealing with in today's world because they have to try to separate and figure out who the drug seekers are from the true patients that are suffering and needing them.

Sadly to many doctors will just label all to often even the suffers drug seekers. What would have been help would have been to take what you were prescribed and then because of it not helping talk with your doctor about it. If he then continued to refuse to help you you could more on to another doctor but after telling him you used more then recommend you hurt your chances of getting him to help you and instead he simply begins to shut down in terms of wanting to help your further and would rather then the PM doctor help you. Which it seems you found a bad PM doctor is he does not believe in pain meds at other then for cancer patients. In my life so far in the medical field I've been on higher doses then most cancer patients ever get, so labeling it to the fact that only cancer patients need pain meds is severely unprofessional.

I just hope that you are able to get the attention of either a PCP or a PM doctor that you can tell your story to and that will actually realize your not a drug seeker and that all you need so help. All your asking for is a dosage of pain medication that will help you so that then you can function and won't have to take more. A drug seeker would constantly keep wanting more and more but it can clearly be seen this is not you. You are just pleading to be able to manage your pain until hopefully something can be found to fix your back problems. I wish you the best luck!! Trust me I know the medical field is screwed up and its understandable in some ways why because of all the druggies that have ruined it for those of use that really need the help.

My doctor prescribes Tramadol for me to use PRN. If I followed the label instructions but took it everyday instead of as needed it would last 10 days. My doctor informed me she expects it to last two months.
My doctor's office will not prescibe more than that-she would however contact my rhuemy or send me to a pain management doctor if I needed more than that.

Unfortunately the posters on this thread that pointed out that simply taking more than prescribed may have gotten you labled as a substance abuser are right. Even though the dose you took may not have been unreasonable once you start in on narcotics it's all about exactly following instructions.

I hope you have luck finding someone else to handle your pain management.

Leah, I think it is totally understandable why you took the dosage you did, because you knew that would relieve your pain. However, I have to begrudgingly agree with the others here in that this is pretty much a "No No" when it comes to CONTROLLED substances. I can't tell you how many times I have been tempted to do the same thing, when my pain was intense. And to be quite honest, I have done it...but not on a regular basis....and BY NO MEANS am I condoning this behavior. I always had to make up for the extra I took, then had to suffer because I didn't have enough meds to take. It became a vicious cycle of constantly counting pills and "stretching" them out so I wouldn't be without at the end of the refill month.

This is the reason narcotics are controlled substances. We may feel like since we paid for the pills and they are OURS, we can take them as we see fit. But unfortunately, that's not how it goes. You simply MUST follow the doctor's instructions or face the consequences that you now are facing. I do, however, think that the doctor is somewhat to blame for this situation. He should have, in the very least, made it clear to you how he wanted your script to be taken. I agree that by writing "as needed", it becomes a bit ambiguous and can cause misunderstandings or abuse. My pain med isn't written that way. My hydrocodone script states "Take 3 times per day for 30 days". My doc told me to space them out as I felt I needed to each day, but only 3 per day. I think if she had written "3 times per day as needed for pain" (as most pain meds are written, I believe...just from my experience as a nurse) she would probably question my refilling at same time each month.

As far as where to go from here....I think if you really like and trust your PCP, then you should keep him. But I feel you definitely need to start from scratch with a new PM doc. I don't know how big your city is or how many PMs are in your area, but look around. And I think it is your right to not let the new doc see your old records if you don't want to...you do have to sign a release for him to get those records. But then again, the new PM also has the right to not take you as a new patient if you don't submit your records. But DO give him your xrays, MRIs etc.

As far as having no insurance, that is a big problem, unless you can prove you are indigent and on public assistance. If there is a local teaching hospital, you can discuss this with their business/financial office and they can determine if you can receive care at their facility without insurance and at a drastically reduced rate plan. Most have medical clinics in house with pretty much all specialties of medicine and you could get a doctor there. I would check into that.

I'm sorry for all your going through. I totally understand your predicament, but when it comes to controlled substances, we simply CANNOT be in control.