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  • Pain Contract Violation Info?

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    Old 02-13-2017, 02:45 PM   #1
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    Pain Contract Violation Info?

    Hi there. I previously was on a pain medication contract for the treatment of degenerative back disease in my low-back, and have had back problems and pain for a long time. I was prescribed 7.5 mg Percocet to take 3 times a day.
    Due to pain tolerance, I took more than prescribed before my next doctor appointment in which I was given a drug test (which I wasn't aware of, it might have been in the contract.) So, I ended up violating the contract.

    Anyways, I was wondering if anyone knows more information about pain contract violations? It was only recently that I was informed by a dr. that I was no longer allowed to be given pain medication, after trying out lots of dr.'s within that hospital & provider.

    My insurance only covers the listed clinic on the insurance card and the specified hospital, so I recently switched the hospital and made an appointment with a doctor there. I was told they were not affiliated with the other hospital they went to. To be sure I would have a fresh start, I called the new hospital and asked if I would need to transfer medical records from the old one, and they said I didn't need to, and I'd have to sign a release form.

    So, I went into the walk-in clinic today at the new hospital to try and get pain medication for my back pain, and right off the back the dr. said 'the clinic at the other hospital said you're not allowed to get pain medication' and I wasn't given anything and left promptly.

    Is this because I called and asked if they transfer records from the old hospital? Did they possibly call the other clinic and ask about me since I asked if they transfer records? Or does my health insurance somehow show a pain contract violation? It's also a smaller town (20,000 population) so do they contact all local hospitals to let them know of people who violate contracts?

    I would like to move forward with a fresh start and a new doctor without the pain contract violation somehow coming up, and being able to get onto a new pain medication plan or at least be able to go into a walk-in clinic occasionally when the back pain is severe and get pain medication.

    Last edited by ads1052; 02-13-2017 at 02:47 PM.

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    Old 02-13-2017, 05:22 PM   #2
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    Re: Pain Contract Violation Info?

    Unfortunately, your violation will likely follow you, as it is NOW part of your medical records. Most states have a database which shows what meds you have had filled, dates, and by how many doctors.
    Typically, when a patient is cut off, the pharmacist is notified, and it may be listed in the database as well, and your insurance may also be notified. Many states require a check of the database before a physician prescribes any scheduled meds, even a ongoing patient. In my state, both the dr and the pharmacist must check before filling a scheduled drug prescription.
    Urine tests are common and usually required as part of the contract, and random, as well as random pill counts are typical. Failing either one is automatic grounds for dismissal, and notifying your other medical providers. Did you not read the contract before you signed it? It's not a good idea to sign any document without reading it completely and understanding it.
    Going to multiple Drs., urgent cares, ERs , or clinics will only add to the problems. That is considered dr. shopping, and is another red flag behavior that alerts doctors to potential problems.
    There are many other ways to treat back pain beside opiates and it might be worth investigating those options.
    Anti inflammatory meds can ease pain caused by inflammation of DDD, physical therapy, swimming, regular excercise , TENS , stretching, and even topical pain relief creams and ointments can all be very helpful as well.
    Just so you know, taking more than you are prescribed, without your Drs consent before, will result in dismissal too. If you do find another doctor willing to take on your case, they recommend injections, physical therapy and other modalities, since the current trend is to use non opiate treatment options, rather than continuing long term opiates.
    Best of luck, hope you can get another doctor to work with you.

    Last edited by backhurtz; 02-13-2017 at 09:35 PM.

    Old 02-13-2017, 07:06 PM   #3
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    Re: Pain Contract Violation Info?

    Welcome! Sorry you are going through this. Unfortunately you aren't alone; too many people don't thoroughly read their pain contracts and their treatment suffers when they end up breaking the rules. Often doctors don't explain to people that one slip up can jeopardize their treatment forever.

    They may have requested your records (that is definitely standard - one big reason is to check for red flagged patients), or there may be some sort of online records system, or a state opioid database that you are red flagged in. Besides clearing up things with the old doctor (your only chance with that is if something wasn't in the contract, but it likely was), you could keep searching for a doctor who will give you a fresh start. Going to multiple doctors can also hurt you though, as mentioned. Some treatment is better than no treatment, so even if you can't find a doctor willing to prescribe opioids (although the climate is moving away from that direction anyways), you may be able to find one willing to work with you and find a combination of other therapies.

    I think finding a doctor willing to start over and try various therapies (often in combination) is your best bet. Even if you have tried things before, often a different dose of a medication, starting multiple things at once, or even time having passed can lead to a different result. Opioids aren't the only effective pain treatment, and should be a last resort. Some recent studies are pretty against them, citing hyperalgesia and more, saying they aren't effective long term, only short term. Who knows, this may end up being a blessing in disguise. Things are moving away from opioids so it was very likely you would eventually have been cut off or your doctor wouldn't have raised your dose with your tolerance, so you'd be in this situation anyways. Hang in there! Best wishes.
    constant headache since 2006

    Old 02-14-2017, 05:59 AM   #4
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    Re: Pain Contract Violation Info?

    Thanks guys! That is helpful info and makes sense that other dr.'s/hospitals would have access to that information. I guess I didn't realize how strict things were with the pain medication. It's too bad they don't give 2nd chances :P oh well. Thanks for writing ~

    Old 06-22-2017, 04:05 PM   #5
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    Re: Pain Contract Violation Info?

    1/2015. Samething happened to me at a spine and wellness center in nystate. The dr increased my dosed to 1-2 tablets a day. I went accordling but didn't realize that equaled to max of 6 a day. Called me for a suprised pill count. So I ended up 16 short a week before I was due for a refill. So thats why they "discontinued" my oxycodone 5/325 and then dropped me.
    That stupid dr should of never started me such a strong drug anyways.

    Old 07-07-2017, 01:12 PM   #6
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    Re: Pain Contract Violation Info?

    When you sign a Pain Contract, first off you should read it. It states in that Contract that you can be given an Urine Drug Test at any time, they can call you into the office just to test you. They do this to keep CP Patients from abusing their meds. When you took more of your pain med than allowed you violated your Contract and generally the Dr. will put a note in your file, commonly referred to as a "red flag" and they will dismiss you from their care.

    The red flag stays in your file and goes to every Dr. or Hospital that you transfer your records to. The only thing you can do is try and find a Dr. that you can try to explain why you did this, and see if they'll give you another chance. If they do it may be a less-strong pain med, but they are going to watch you carefully. Every UA shows 1 of 4 things....

    1. Is the amount of narcotic in your blood the right amount and kind for your RX

    2. Is the amount of narcotic not enough. Meaning could you be selling your meds?

    3. Is the amount of narcotic too much? Meaning your abusing your meds and taking too much.

    4. Are their other Narcotic drugs in your system? Meaning your taking things you shouldn't be.

    Once you get a Red Flag in your file for a Pain Contract violation it is not easy to get back on someones treatment, esp. in today's histrionic drug atmosphere.

    If you do get back on someones service and get meds again, you need to stick to exactly what your RX says....because they will frequently randomly drug test you, they can also randomly require you to bring your pill bottles in for pill counts. Make sure you read the Contract.

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