Discussions that mention vicodin

Pain Management board


Hey Jen, You mentioned you had a "little situation", if nobodty tells you what you have done wrong, you will keep making the same mistake. First there is no such thing as a little situation in PM when it comes to your pain meds. If you have been seeing this doc for 2 years, does he not prescribe 30 day supplies at one time, 60 pills , 90 pills 120 etc. Regardless of How the order was written, take 1r every 4 hours or 1 every 12 hours, That prescription was most likely a 30 day supply, I've never recieved anything othe than a 30 day supply.

The prescribing orders allow you to take a pill every 4 hours if you have too during a flair or BT pain. I'll bet he gave you a number divisable by 30 and somewhere on the prescription you picked up, a days supply was calcualted. If it's been 2 years and pharmacist knows your doc prescribes 30 day supplies, that's what it is, regardless of how it's ordered. To say you didn't know this script was a 30 day supply is pretty rediculous 2 years into pain management with opiates.

The idea of BT meds is to give you something to deal with pain when the LA med isn't working, and to prevent you from having to make an emergency call mid month, after hours or go to the ER when your Base meds aren't working. Not to take them every day as much as you can based on the way they are written. If you know it's a 30 day supply, and I can't imagine not knowing, than at some point when the flair ended you should have stopped taking meds every 4 hours and resumed your normal schedule and use the BT meds as needed.

If you take the max amount of BT meds every day they simply become part of your dalily routine. They aren't BT meds, they are just a second opiate your supposed to take with your LA med. Did the doc tell you this is how to take them? When you actally do have a flair those BT Meds are no more effective than they were every other day you took the max amount because you felt the way the scrpt was written permitted this.

Many docs don't even use BT meds because many patients will take the max amount every day anyway. When they do have a flair, the BT meds aren't BT meds anymore, they were just what you take daily with your LA meds. It leaves you in the same position of not having the means to manage BT pain for which the meds were prescribed.

As far as a your GP prescribing opiates for life to a 21 year old that has never had back surgery, I would think it would make them very uneasy after a few years. GP's aren't PM docs, but their licence is on the line just like anyone elses. A patient that says I didn't do anything wrong when they know their BT meds were a one month supply isn't being realistic and can be seen as a problem patient.

If your ever not clear about how long the meds are supposed to last or how your supposed to use BT meds, ask the doc and avoid having to try and explain you ran out early because the doc wrote the script that way. Placing the blame for running out early on the doc won't make you one of there favorite patients.

I know people have bad flairs and there are days you may take an extra BT pill. That means sometime during that 30 day period you lhave to make up for the extra ones you took and do without. BT meds aren't meant to be part of your daily routine, and if you use them that way and then request refills before 30 days is up, that is non compliance, regardless of how the script was written.

Is the doc suposed to see you once a month to prescribe LA meds and then squeeze you in whatever day you happen to run out of BT meds? Where should the doc draw a the line. 2 years into the process is kinda late to say I didn't know better and only took them the way they were prescribed. IR meds last 4 hours, that's why he would allow you to redose every 4 hours if you need to on the particluar day your having BT pain, otherwise they really aren't BT meds.

Deciding that script was somehow different from every other 30 day supply you have been written and blaming the doc for running out early, isn't a "little situation," it's a major problem that will cause a doc to reavaluate his comfort in prescribing these meds for you.

At least you got 30 days to taper off or find a new PM doc. There is no gaurentee that a PM doc that sees you haven't tried every other method he can offer will prescribe the meds and dose you want. There are dozens of non opiate modalities PM docs can try but if you start with Oxycontin it's kinda hard to teach someone bio feedback or self hypnosis or any other method and expect a patient to be equally satisfied.

If a PM doc is ever audited or questioned about his prescribing practices, he better have a comprehensive list of other method to manage your pain that has been tried and failed or he won't have a DEA # long. You had a GP presribing that could offer no other inteventional methods to manage your pain. Have you ever seen a PM psychologist, had nerve blocks, tried hypnosis, acupuncture, Tens, TINS, chiro, PT, myofacial release,or massage. How many PM clinics have you been to and what did they offer aside from medication management that they themself were not willing to prescribe.

If the one PM specialist that he refered you to says you don't need opiates and need to learn other methods, The GP has nothing to fall back on and justify the need to pescribe these meds. The DEA isn't going to question a doc when the meds he uses are the last and only resort to restore quality of life, but if you don't have a healthy list of other methods tried and failed, the DEA doesn't think OxyContin should be the first thing to try when someone complains of chronic pain or when Vicodin no longer works.
Good luck, Dave