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Old 11-16-2009, 04:38 PM   #1
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Too many refills - cut off by doctor

I apologize if this is a duplicate post, but I'm not sure my other post went through. I've been a chronic pain patient going on 7 years now. I've been taking 5mgs of Hydrocodone for the duration of my treatment, mostly prescribed by my PCP. I've been referred to several other doctors and until recently (September) have only taken what my PCP prescribed. My new Ortho doctor started prescribing the same dosage 5mgs of Hydro, but a larger quantity. I still had refills remaining from what my PCP prescribed. So, I take what my Ortho prescribed and also filled (3 different times) the remaining refills from my PCP. I knew it was wrong to do it. Well, today I tried to refill the prescription from my Ortho doctor and it was denied. I was mortified when the nurse explained to me that I signed a contract stating I would not obtain any other narcotic prescriptions from another physician and that my refill was denied and I would have to go back to my PCP for my prescriptions. My questions are; am I in legal trouble? And will my Ortho doctor contact my PCP to tell him what I've done? I realize I'm dependent upon my medication, which caused me to take more than I should. But I do have a legitimate medical condition that causes me pain. As I stated earlier, I've been taking this medication for 7 years and this is the first time I've gotten prescriptions from two physicians. What should I do? I'm afraid if I talk to the doctor, I'm just going to dig myself deeper and deeper into trouble and probably get cut off completely. But I'm also horribly embarassed. My PCP has been my doctor for more than 20 years and is like family to me. I don't want him to think I am a junkie. I was originally prescribed 60 per month, then the Ortho prescribed 120 per month. So, instead of taking 4 per day, I was taking 6 or more. Is that terrible? I've read so many posts on here where people are taking much more than that and at higher doses. I have an appt w/ my PCP in 3 weeks and I am sick to my stomach thinking about facing him. I guess I'm asking if anyone has been in this situation and knows if it's common practice for a physician to contact another physician to explain what I've done. I'm going to come clean w/ my PCP when I see him. I'm just trying to prepare myself before I go. Thanks to all who reply.

 
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Old 11-16-2009, 06:35 PM   #2
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Re: Too many refills - cut off by doctor

Card, oh man...I feel for you. I have to say, I might've tried the same thing, so don't beat yourself up. The only reason I couldn't try it is that my pain med (oxycodone) isn't refillable. But believe me, I ultimately took as many as they gave me.

I don't know if your ortho will contact your PCP. Some others here on the board may know for sure. I doubt you'd be in legal trouble, because I think the police usually go after doctors, not patients who have legal prescriptions...?

So here are a few thoughts: Can you go back to 60/mo. if your PCP will continue to prescribe it? Or, was your PCP trying to transition your pain management to the ortho? You should try to live with the smallest minimum daily dosage. Take my word for it....as someone who went from 5 mg/day to 75 mg/day within a few years. I wouldn't make a big deal of it with the PCP. You can wait to see how he reacts, or perhaps say you had a mix-up with the refills and got confused. He'll probably know the real reason, but no sense raising all kinds of alarms. (Unless you want to.) If he won't write for anymore, ask him to refer you to a pain management specialist. But tell the PM you DON'T want any more than the amount you've been taking on a regular basis (the original amount).

Not advising you to be dishonest, but I choose my words very carefully with my doctors since it's going in my "permanent record". Hope that helps somewhat.

 
Old 11-16-2009, 06:43 PM   #3
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Re: Too many refills - cut off by doctor

Yikes! I've never broke a pain management contract and I follow the rules to a T. Vicodin is a weak pain reliever for a chronic pain patient. I'm sure you built up a tolerance to the pain medications. I would go to your doctor and tell him the truth. Tell him that your pain is not being well controlled. I don't know if the ortho has put you on a list as a drug seeker or not. I do know they can blacklist you and it will be very hard to get into another pain management clinic. I really don't know what will happen. I'm sure there are others on here who can give you more information. Good luck.

 
Old 11-16-2009, 08:33 PM   #4
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Re: Too many refills - cut off by doctor

Sorry to hear about your problem. Believe me, what you did is very easy to do. In fact, most people don't really understand how to approach med refills and etc., especially when it comes from different Docs.

It's probably 50/50 on whether your ortho will tell your PCP. Even if he does, I think all will be fine. As the other poster said, your meds are the weakest pain meds out there, besides maybe Tylenol 3. In fact, that's probably the problem....It's so weak, that you need to take more to get any real pain relief. There is a term used in PM called "Pseudo addiction"....A person's behavior mimics typical addiction, but in reality, it's the result of being under prescribed and inadequate pain control, not real addictive behavior, or the mental side of wanting to take meds. A good Doc will understand this.

Additionally, if it comes up, I would just be honest with your PCP and tell him that you really didn't understand things....You were given refills, so you assumed they were able to be used. After all, everything was above board and each Doc knew about each other. Furthermore, you'll need to tell him that you're really in pain and lay it on the line as to how you feel....Tell him how bad it can get and how you suffer. One of the biggest mistakes patients make is not telling Docs exactly how they feel. Many will down play their pain in fear of getting cut off. If need be, plead with the Doc to not cut you off....Let him know exactly how bad you feel. Conversely, if you just accept it, it may be perceived that you really aren't in that much pain.

I would be shocked if you are in any type of legal trouble. As stated, this med is very weak, and you really didn't do anything wrong per se. Additionally, the authorities go after people who don't have any legit issues and / or those who Dr shop....Going Doc to Doc for unrelated issues and the other Docs aren't aware of the other Docs. Neither apply to you. Law enforcement doesn't make the habit of going after legitimate pain patients....Even those who really screw up. However, if someone was purely taking the med recreationally, that's a very different story. Especially if the med was obtained via false pretenses (i.e forged scripts and etc).

Just curious....How did your ortho find out about the refills? I would write him a letter and tell him that you were aware of only being able to get meds through him, but since the meds you were prescribed before seeing him (i.e a Rx with refills), you thought it was fine. Additionally, I would apologize and tell him that besides your PCP and him, you've not visited any other Docs and you weren't trying to pull anything. I would also stress to him how much pain you are in and how it effects your life. Not that you are trying to get any sympathy, but rather to ensure he knows exactly how it adversely effects you. It may go a long way to smoothing things out a bit and if by chance your PCP and the ortho talk, you've covered your bases. It may also prevent him from saying anything.

What you really need moving forward is to either have your PCP treat your pain more aggressively, or be referred to a PM Doc. Not only are you on a very weak med, but it's got lots of Tylenol in it. Ok for short term use, but not really appropriate for LT use. Chances are one would be fine, but the point is that there are so many other options (meds) out there for PM, that one just doesn't need to take all that Tylenol.

Hope this helps and I'd be glad to help answer any questions you have. Take care and try to relax....I really think all will be fine.

Regards,

Ex

 
Old 11-16-2009, 08:46 PM   #5
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Re: Too many refills - cut off by doctor

Find another pain guy and give the new doc all your history and get your meds again. These docs dont uderstand the pain we go through and how much meds we do need.Your not in any type of legal trouble so dont worry. Your ortho probably wont call anyone. But find a new pain specialist and be honest with him and tell him how many pills you are taking and you need more or something stronger. You should be on a fast acting pill and a long acting pill.aka norco then a ms contin or oxy

 
Old 11-17-2009, 11:34 AM   #6
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Re: Too many refills - cut off by doctor

Yeah, don't beat yourself up about it. Like the other have said, go back to your pcp and explain what happened. You're not the first, or the last to do this. I know that I was so happy to find a pain doctor that I didn't really read the contract until much later. Now I call my pain doctor to give him updates all the time, just in case. I had a muscle spasm and my pcp gave me a script for valium (small dose), I called the pain dr. to tell them, "just in case".

Dave

 
Old 11-17-2009, 10:44 PM   #7
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Re: Too many refills - cut off by doctor

Another thing is you really need to pay attention to the quantity you take each day. Those pills have tylenol in them and you definitely want to be careful not to exceed the recommended daily amount of tylenol. For a chronic pain patient my PM doc likes to have patients stay under 3500 mg tylenol a day. I think the straight tylenol amount per day is around 4000mg.

 
Old 11-18-2009, 05:49 PM   #8
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Re: Too many refills - cut off by doctor

I am going to be a bit direct with you, not to hurt your feelings but because what you did is dishonest and it did break the rules of pain management.
You said that you were taking more than you are supposed to, 6 a day instead of 4, and you knowingly filled another script from another doctor that doubled the amount that you were getting a month.
What happened to the refills from the PCP script? Were those all gone and that was why you were filling the orth's script? Or were those original refills still left and then you tried filling the ortho's script?
The problem, is when your pain is not managed by a dosage of medication that you are prescribed, it is NOT okay to just take more. NO MATTER WHAT. You should have called either the ortho or the PCP, whichever doctor you were going to have manage your scripts/medications and cancelled out the other script. If the dosage a day was not enough to cover your pain levels, then you should have contacted that prescribing doctor to let him know and ask them what you should do. That is how it is supposed to be done in PM.
Will the ortho call the PCP? He very well may. I know that my PM's office does just that. They call each and every doctor that the person who is getting multiple scripts from and tells them. They also alert each pharmacy in our area. If you go to a new pharmacy around me, there is a little waiver that you sign when you fill in your medical history/allergy information that gives them permission to contact your prescribers- same as you sign in medical offices .
You may get a letter in the mail from your PCP telling you that any upcoming appts are cancelled and that they will no longer provide pain meds for you. You may also get one from the ortho's office since they are the ones that caught what you were doing.
I wish you the best but what you did was wrong and as a result, you may not get into another Pain Management practice. I'm sorry that this is what you are dealing with, but we all have rules that we have agreed to live with and now you have to deal with the consequences.
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Old 11-18-2009, 06:47 PM   #9
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Re: Too many refills - cut off by doctor

My PCP prescribed 60 per month with several refills. I told my Ortho that I was taking 4 per day which is why he wrote the script for 120 per month. But honestly, 4 per day wasn't helping with my pain. I didn't say that to him because I was afraid I would look like I was just seeking more drugs. Mistake #1 I guess. I just should have been honest w/ him. When I visited the Ortho, I still had refills left from my PCP. So, when my 120 ran low, I filled the remaining refills. Yes, I broke the rules and yes, I know I have to live with the consequences. But if either doctor looked at my records, they will see that in 7 years I have NEVER obtained a prescription from any other doctor. I was even going to a PM doctor for a while for injections and never once asked for a prescription. I also saw another Ortho doctor and a bone/joint specialist. Again, never asking for pain medication. I have been treated like a drug addict by my pharmacy and been embarrassed infront of other customers on more than one occassion when filling my prescriptions in the past. I've also read so much about the problems with drug seekers and was so paranoid that I would be labeled the same. This led me to believe that if I told my new Ortho doctor that this amount wasn't enough, I would be looked at as someone who was just looking for drugs. And guess what, I ended up looking like one anyway. I also suffer from recurring migraines which are unbearable. Again, rather than being honest w/ my doctor, I kept silent thinking I was going to be labeled an addict. So, I used my pain medication to help w/ those as well. And I didn't even mention the fact that someone close to me had been taking some of my medication w/out my knowledge. Now, if I had gone to my physician and say "oh, by the way, someone's stealing my medication", do you not think they haven't heard that a thousand times before? I let my timid personality get me in this predicament. And now I have to deal with the consequences. So here I am trying to figure out how to ration out my remaining pills until my next appointment and praying I can make it. Seven years is a long time to be taking this medication. And my tolerance level is high. And 4 pills per day of only 5mgs of Hydro isn't enough. Why I didn't just have this discussion w/ my doctor is just stupid, plain and simple. And irresponsible. You're probably right. My Ortho probably contacted my PCP, which is what I've feared. But I'll just have to come clean and hope he understands. Believe me, I'd rather be well and not have to look at these pills ever again. My Ortho didn't dismiss me. I have more injections scheduled and appointments w/ him coming up. They just told me that since I broke my contract, I would have to continue getting my medication from my PCP as before. I'm hoping with them telling me that, it means they didn't contact my PCP. Otherwise, wouldn't they have said I'm completely cut off? In the mean time, I'm hiding my medication and have asked that the pharmacy require a photo ID when I pick them up. I'm not even going to tell my doctor that someone has been taking them from me. He probably wouldn't believe me anyway. Besides, it doesn't change the fact that I have been taking more than prescribed and have been filling scripts from both doctors. Thank you all for your replies. Hopefully this will all work out for me.

 
Old 11-18-2009, 09:33 PM   #10
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Re: Too many refills - cut off by doctor

I'm sure it will work out for you. You have done far more right than wrong and this board is full of people who have made mistakes.....Far greater than you in fact. Some have even been addicts.

I would suggest doing what I wrote in my first post and talk things over with your PCP. You have a legitimate condition and deserve quality PM care.

Best of luck to you.

Regards,

Ex

 
Old 11-19-2009, 03:06 AM   #11
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Re: Too many refills - cut off by doctor

I hope you don't mind, but I will say a prayer that you find the proper care you need. I know what it's like for your pain to not be treated fairly or properly. For the last year and a half, I've put up with doctors under treating my pain. I have spinal cord nerve damage, 2 herniated discs in my neck and have been in severe pain this entire time with minimal pain medicine. It's awful. I just recently found a pain clinic that is willing to help me. I too, hope it works out for you. Good luck.

 
Old 11-19-2009, 07:27 PM   #12
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Re: Too many refills - cut off by doctor

If you're Ortho is keeping you on and said to go back to your PCP for meds, it sounds like he didn't contact your PCP. It really doesn't matter unless your PCP kicks you out since you are planning to come clean anyway. I would encourage you to do that regardless because your ortho may have contaced your PCP and he may wait and see if you say anything. So by coming clean and no longer hiding anything you may win points from your PCP. Just say what you have here and I'm betting things will work out.

Good luck!
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Old 11-20-2009, 03:50 AM   #13
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Re: Too many refills - cut off by doctor

I'm really sorry this happened to you. It's an unfortunate learning experience. I have been on pain management formally and informally for so long due to my spine issues that I became pretty aware dos and don'ts to receiving pain medication. I'm sure you're already aware of this, so I hate to state it again, but you never want to receive multiple narcotic prescriptions form different doctors. One reason of course is to monitor your acetaminophen intake - that is a huge concern. And now insurance companies will send monthly reports to your prescribing Doctors if it appear that there are more than one Doctor prescribing narcotics.

At this point I would just speak to your PCP Doctor honestly (it is likely he received a notification well). Or you could just approach, that your Ortho would like him to start handling the your prescriptions and let him know how many you feel you need to be taking on a daily basis ot manage the pain. Since, you're taking 5/500, I'm guessing the concern might be the amount of acetaminophen that you're taking. Your best bet would be to talk to your PCP about changing to Norco with is 10/325. You will receive the double the Hydrocodone - so you'd be taking less pills daily - possibly 3 daily as opposed to 6 and getting the same pain relief. And your intake of acetaminophen will be much lower to protect your liver.

Another thing to consider (which helped me immensely) is getting a referral to a pain management Doctor. It may take a while to get in to see one, so you will need your PCP to handle your pain management needs. Currently my pain management Doctor handles ALL my pain management needs and that works perfect for me - currently she has me on a long acting patch and Norco for breakthru pain. It is so nice to have my pain effectively managed. It's like having my life back. Also, the first thing I tell ALL other Doctors that I see that I will not be accepting any narcotic pain medication prescriptions from them for any reason and any discussion regarding making changes to my current regiment must go through my current pain management Doctor. I like the protection it gives me in knowing my pain needs are being monitored so closely. It's the closest thing to personalized care I have- silly I know, but I really value it.

I hope you get answers soon and your pain managed effectively. Keep us posted on how you're doing.
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Old 11-20-2009, 06:20 AM   #14
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Re: Too many refills - cut off by doctor

I agree 100% with what Fiona_Jo has said. Go back to your PCP, tell him the truth, and by that I mean filling the scripts BECAUSE you weren't getting enough relief, and that it was an honest mistake. I know that some here will argue that this isn't an HONEST mistake but I believe in giving someone the benefit of a doubt. Tell him you'll agree to what ever level of monitoring tests that he thinks is necessary. That's all you can do, and get him to recommend or refer you to a PM doctor.

Last edited by Administrator; 03-26-2014 at 01:19 AM.

 
Old 11-20-2009, 08:48 PM   #15
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Re: Too many refills - cut off by doctor

Card,
I feel for you, honestly. You are absolutely right, you do need to have a talk with your primary about what happened and why . You also need to have another discussion with that person you suspect is taking some of your medication. Being timid with anyone is not going to help you solve both of the current issues. The person that is taking your meds, be it family member or friend, needs to be told in no uncertain terms that you will not put up with it again. If it does happen again, your next step is to report it to the police and they will take it from there.
Your conversation with your doctor needs to start like this, while I appreciate everything that you have done to help me manage the pain that I am in, I am still in pain every day that is not being effectively managed. I made a mistake in getting a prescription from the ortho filled because ______________ and believed that because it was the same medication that it was okay to do so. I now understand that it wasn't. What can we do to better manage the pain that I am in , and make it so that you feel secure in prescribing to me?
Hopefully, that will be enough to both let him know that you feel undermedicated and that you also made an error in doing something that you believed was okay.
I wish you the best,
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