Some silly questions - Pain Management Message Board

don'tlikecold · 08-01-2006, 02:11 PM

I just found this board but I have posted on the neuropathy board and found lots of info and support there. I have read lots of posts here and found more good info. [removed]

First, let me say that before the neuropathy, I haven't had any major illnesses except CMV twice and appendicitis years ago.

Pill seeking - people seeking pills obviously, but why? Is this people who like to have a lot of pills?

Pill shopping - Is this people who want to try a lot of different kinds of pills?

Also what is the contract that many people mention? My neurologist, in coordination with my GP, is managing my pain. I live in a rural area and we don't have a pain clinic. I don't remember signing a contract so is this only at pain clinics?

Sorry for the ignorance but I would just like to be clear as to what I am reading. Thanks!

Susan

RetiredDirector · 08-01-2006, 03:18 PM

Hi Susan: Welcome to the Pain Management Board. I hope I can answer your questions for you.

Pill Seeking: Means just what it says. Someone looking for pills, usually because they can't stay on schedule for whatever reason with the meds that are prescribed for them. It goes with the next question.

Pill Shopping (usually referred to as Dr. Shopping): Same thing. People that are usually addicted to pain meds and go from doctor to doctor looking for their drug of choice. Most likely will use various pharmacies, so they can not be questioned when they present scripts from several different doctors. In some areas (mine included) the doctors and pharmacies have access to a database, that includes patients names and doctors that prescribed meds and what medications that were written for the patient. That way doctors or pharmacists can look up a patient and find out if they are "Dr. Shopping".

Contract: Is a non-legal contract drawn up by doctors that treat chronic pain patients, usually with narcotic pain medications. They are asked to sign and abide by the contract or the doctor has the right not to treat the patient any further. There are many various things that can be included in the contract, but normally it states the patient will not receive any pain medication prescribed by another physician. They will only use one pharmacy. These are normally used by doctors who are in Pain Management and treat chronic pain patients. In my case, I am treated by my PCP, but he still asks for a contract stating several things, but I have already mentioned the two big items they include. I am treated by my Primary Pain Physician, because like you, we don't have a Pain Clinic in our area. The nearest is about 100 miles away.

I hope I have answered your questions so you can better understand what is being written about. Please ask if you have any other questions you need to have answered.

ARANGER · 08-02-2006, 01:47 AM

Hey Susan,

Director pretty much summed it up. The only things I wanted to add was, another reason a contract is given by many docs is because a PM doc is watched much more closely by the DEA than any other doc. They are subject to audits by the DEA at any time. By you signing this contract, your doc can show an agent that they are doing everything possible to ensure compliance with their patients.

In addition, a contract may state that you are subject to urine or blood testing at anytime or pill counts. Again, this is all done so that a doc can show that patients are following the rules and doing their best to keep the bad patients out.

Like Director mentioned, a contract is a civil agreement and understanding between you and the doctor/office. It would be different then a monetary contract. Basically if you don't follow the rules/contract then you are subject to dismissal from the clinic.

Take Care

don'tlikecold · 08-02-2006, 06:44 AM

Thank you so much for taking the time to reply. I understand those terms now and they make sense. I guess my neurologist doesn't have a contract but that wouldn't be uncommon in this area.

Susan