Can’t find a doctor to prescribe pain meds?

Don’t feel alone.  This doctor is worn down and just saying no.  Opioid poisoning as a cause of death more than tripled in the US between 1999 and 2006.   Death from prescription opiates is now more common than death from heroin and cocaine combined.  (USA Today)

Today a new patient came to the office looking for a physician to prescribe the opiates she wanted to take for her fibromyalgia, interstitial cystitis, and chronic low back pain.  She proceeded to say she just wished the good doctors who had previously been prescribing her massive doses of opiates were still around.  She thinks one of them must have done something wrong, because his office was just closed down suddenly and all his medical records were taken away.  I’m sure this is the Lakewood, WA  physician who lost his license for inappropriately prescribing opiates.  She was a caricature of the opiate-seeking  patient.  She had not just one of the ill defined painful conditions that are impossible to exclude, but at least three.  She had been prescribed both Oxycontin, as well as large doses of “breakthrough” oxycodone.   I am not accepting new pain management patients into my practice.  This made it easy to explain that I would not be able to treat her for these problems with opiate medications.  Actually the abuse of opiates have become such a rampant problem that I don’t know of a physician in the county who is accepting new pain management patients.  This is sad for patients new to the community with legitimate need for pain medication, but just an impossible position for physicians.  Any physician who becomes known as accepting chronic non-malignant pain patients would be quickly overwhelmed by the droves of new patients needing pain medications who would show up to receive care.  Years ago a wise older physician (he was probably as old as I am now, and likely far wiser) told me we all have our albatrosses.  These he described as very needy and difficult patients that you’d just like to find a way to get out of your practice.  He explained that if we all just keep a few then no one will be overburdened with too many.  Otherwise they will just keep circulating in the medical community, and all of us will still need to take care of them.  It’s best to just buck up and keep doing our best for them.  These days I feel like these patients are not like rare albatrosses, but rather like common crows, just everywhere, and dashing in to pick me apart like road kill.

There seem to be so opiate seeking patients now that an open door to see them would just overwhelm anyone.  Cynically yet realistically I know that this is in part because no one physician will knowingly prescribe the quantity of drugs that they want, so they need to have multiple physicians prescribing their meds who are unaware of each other.   (this problem to be the subject of another post soon)  Anyway this episode made me smile because this patient was either incredibly naïve, or a very good actress.  I suspected the latter.  Most opiate seeking patients are very smooth and make me at least feel like maybe I should try to help them by seeing if I can help them manage their pain with less opiates and good care.  In my experience this very rarely works, because the customer really just wants the drugs.  I know that although there are some patients for whom opiates for non-cancer pain is the best available treatment, there are so many professional patients who resell the drugs on the street and others who are addicted to the meds and overuse them in vast amounts, that as primary physicians we are in an impossible position.  We either become suppliers of the prescription drug culture, or we turn away some appropriate patients.  Which is worse?  This depends on your viewpoint, but at this point I generally just say no.

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168 Responses to Can’t find a doctor to prescribe pain meds?

  1. people with cronic pain.can not get nothing.but people with no pain can get pain meds.so whats up with that????I HURT WITH ARTHRITIES AND ONLY GET OVER THE COUNTER MEDS.

  2. It really sux when you are in pain and dr.’s won’t give you anything because they think you are faking and you are a drug addict when you have had 7 back surgeries. I have 3 scars on my back over 6 inches long and 2 over 3 inches long and I am faking pain just for medications? I live everyday in excruciating pain and can hardly walk. I am on disability and they keep trying to make me go back to work. Did I mention I can hardly walk much less concentrate on work. I had one PM dr. and one day he just told me he could not treat me anymore? No reason what so ever. I was fine taking oxycontin 4 times a day and had a good life with very little pain. I was on them for 10 years. Since then I have had 4 surgeries to repair the problem with it only getting worse. I will take anything I can find because I can’t find a dr. to treat me. Two months after the last surgery they cut me off pain meds and I am hurting like hell right now. It is ridiculous not to give someone pain meds after 7 surgeries. That ought to be proof enough that I am in pain. For young people that go just for the pills offer them back surgery and see how fast they run out the door. Piss on the DEA!

  3. I have degenerated disc des. I’ve had it about 2005 . I was doing well had pain meds an tried to Orkney out at the America time becareful, one wrong move, I’d go back to hospital, now it’s 2015 , not no better old , diabetes , arthritis ,HB ,DEA has went around the country taking Vicodin an any thing with it in off the market state wide.2 things I’d like to say,1 it would be fine ,if people could take codeine / or Morphine. No not me, no shape or form . Allergy deadly. I have friends who get OxyContin , an Tylenol 2s/an3s.OnOn! But me 59year old women in pain constant ,they give crap, take new meds weekly praying it will somehow work, but ever does. I tell the Dr s all the time there in the street u can buy them. Plus they just took a poll ,yes drug overdose are down Pharmacy drug down, but Heron is up even in suburbs ,really w/death,high school …..hay I’m just saying . I’m all fore stopping kid dying. For sure, but us old people in chronic pain need help. We can go on like this. I hope some one reads this and makes some changes fore us, this is not a quality of live. Darlene. Anderson

  4. My son was hit by a van coming home from work on his motorcycle. His leg was attached by 2 tendons. He is in pain 24/7, he now has 2 herniated discs and hip problems. He has terrible depression, and cannot get any help for any Doctor. It seems to me that there must be a Doctor that knows how to tell if the patient really needs the medication or has a problem. I am writing this for my son. I do not drink. smoke, or take drugs. Unfortunately, I know my son needs help for his pain. I can’t stand seeing him like this. He is not an addict, he is is pain.

  5. The end is near? 57 year old male with two many injuries to name, the final was a drunk inducide attempted vehicular homicide while I was on a touring MC death from heart failure and choking on shatered teeth,shattered back, skull, now all titanium. may the four drunkin youths in brunswick burn in hell for what they did to me!
    Was forced into on coming traffic by these monsters, been in painmanagement for almost 10 years now,3 of these doctors have lost ther license,no fault of mine or there’s, just targeted for termination by DEA?
    Was on the largest dose of fentynyl a human can recieve legally,never asked to go that high thats just where they took me because of the pain scale score I gave when asked on each visit, to me no matter what they give you or I should say I pain is going to be present no matter what. I wasn’t drug seeking my history of injury is well documented there can be no dispute to this, never screwed up with a pill count or a toxscreen untill with my final Dr. was warned of dismisal on three seperate occasions however if you do some research on the accuracy of toxscreen, I think you will be shocked that a persons quality of life could based on the accuracy of a test with so many variable’s.
    There is no doubt that the system is ascue and we are in big trouble if you find yourself here, because to the best of my intelegence level there are no answer’s,not from a doctor, a lawyer,a hospital,a government worker alias (COM)or anyone else out there including our wonderfull politision’s, that have pretty much legislated everything but morality including this delema I’m facing.
    so just for argument sake if anyone out there can answer the question? ” can a patient discharged from opiod therepy for non-
    compliance, get back into painmanagement for the same therapy,or is he banned from it for the rest of his natural life?
    And for the record I’m already well aware that this type of treatment is available to the paitent anywhere outside the JUSA
    will check periodicly to this site to see if anyone comes up with a solution, and to them I say run for office I will concider you in the same caliber as a Ron or Rand Paul, God Bless,
    Ken

  6. I just do not understand where our government has any right to interfere in the/my medical industry/history. They use the so called “statistics” to say that the opiate use has tripled and overdoses have tripled, the government is/does manipulate these to their advantage. Our government is the worst corrupt criminal in this whole mess. People who live in pain everday suffer from just more than pain. I was on very good terms with my pain management doctor of 5 yrs, ALWAYS took my narcotics in at EVERY visit, which was every 2 months, NEVER cancelled an appointment, had to drop a urine at EVERY visit, I NEVER had a dirty urine. After 5 yrs of treating me, with no issues, I went into my appointment as usual, they came back to me after taking my narcotic for count and told me I was off 24. After a minute of wondering how, I remembered that I was in a hurry that afternoon, not thinking, the weather was horrible that day, a big snow storm and I really didn’t want to make the hour drive in it to the dr office so with my mind being preoccupied, I had forgot to grab my pills out of my weekly pill counter that I put them in for Sun-Sat., an honest mistake. I explained to the girl that’s what happened and she left the room. She came back a few minutes later, by this time it is 3 p.m. and tells me that I will have to drive home, get them and make it back by 4 before they leave. I was a bit appalled at the way she said it, but I told her the roads are horrible, its a snow storm out there and it takes me 45 min on a good day to get home, so I refused to drive all the way home. I never would of made it back to the office by 4, being that I NEVER had an issue in 5 yrs I couldn’t believe they were treating me like a drug addict. The next thing I know, my dr. of 5 years comes in yelling and screaming at me, telling me he wont lose his license n so on. I just sat there, stunned not understanding what was going on. His last words to me, “I cannot treat you anymore.” I left the office not knowing what just happened. I got a copy of my file, wanted to know what his reasoning was on paper, and all that was wrote by him is “no reason was given for my count being off.” Then 3 months later his office just up n closed, no reason to his patients. I am now unable to find any pain mgment dr who will treat me once I mention that I went to him for 5 yrs., I did therapy, did injections, did all that. I had a severe reaction to the injections so the only way I can be treated is with pharmecuticals and no other dr wants to do that nor have anything to do with me because of this dr. I am also in Ohio, so that doesn’t help my cause either. Idk, this post kind of got off topic, but our government has scared these physicians into writing no prescriptions stronger than vicodin. We are no longer a FREE COUNTRY, we have surveillance EVERYWHERE, the gov’t taps our phones, computers, everything. We no longer have hardly any of our rights and civil liberties. They say its for our safety, that is just their scapegoat. What do they do for pain? Our government is just a huge joke!!

  7. They have made it next to impossible to establish and maintain a long term relationship with any pain doctor, not to mention they have horrible bed side manner for the most part. I have mild to moderate stenosis in 4 places, spurring in my back from numerous car accidents and haven’t hade any imaging done in almost 3 years. Throughout this time I have been seiing pain doctors however establishing a new long term doctor who will write my meds is not impossible, just cumbersome. I would appreciate any help locating a quality compassionate caregiver. Ideally an internal medicine doctor.
    Thank You
    Joe

  8. My pain doctor thinks I have a disk that leaked on to my sacral nerve, causing the agonizing pain in my genitals and pelvis that I have 24 hours a day. I also have interstital cystitis and endometriosis. Yet to this quack, I would just have “vague, unverifable” sources of pain. That’s because virtually all sources of pain are(to this incompetent’s way of thinking) “vague and unverifiable” unless they involve cancer or an xrayable fracture. This physician obviously is lacking in diagnostic skills, and would prefer to let patients suffer than possibly give pain meds to someone who isn’t quite suffering enough for his satisfaction. My pain doc has me go to a lab every month , pee in a cup, and prove that I’m taking my meds. It’s that simple. Obviously this guy just doesn’t want to be bothered because, as another commenter stated, he can make more money treating other illnesses.

    That’s what it boils down to for this physician and most others: money and giving a shit. He clearly doesn’t give a shit, and can make just as much or more money treating other conditions that aren’t as much of a hassle, so to hell with patients who have suicidal levels of pain. Dude, let’s hope there’s no such thing as heaven or hell because you aren’t going to fit through the eye of the needle. That burning pain I feel everyday will be yours for eternity.

  9. My heart goes out to you and all others like us. It has a lot to do with money.
    I was seeing the only opiat Dr. In town after both of my injuries. I was almost off drugs from the first (work) when a drunk driver hit me at 45 mph while on my mountain bike. I was so depressed at this point that I was seeing a counselor who rx vallium. My pain Dr. Said it’s either pain pills or vallium and now he’s going to watch me like a hawk. Well he did more than that. He wanted full access to my entire life treating me like a child. I don’t like to be invaded or told what to do and he fired me. I am also screwed because I have a red flag and can’t get help so now I have to live at my parents house as I am disabled I am just sucking up oxygen I feel.
    I have lost everything and everyon all because they say no. I would be working at something if i could think about something else besides pain. Fucking pain.

  10. Kathy. please try kratom, it is legal in the US and natural. Has the pain killing effects of opiates in high amounts. there are several amazing vendors online, try kratora. I also am in pain from sciatica, and after being taken off medicine I started to control my own pain with kratom. Don’t give up the fight, this will return your quality of life, I promise. I hope you read this before it’s too late.

  11. Wow. You’re a total piece of shit. So what if someone wants to get high? Life F%$#&*& sucks enough that it’s no wonder so many people would rather drug themselves into stupor than deal with it. What’s even worse is that you use this pseudo-moral position to justify outright hurting innocent people – and then you blame the recreational users for YOUR decision to hurt innocent people!

    Really, all drugs should be available OTC. If someone does a (real) crime, sober or not, they should be held responsible, but adult patients can make their own decisions about what they put into their bodies. At least in free countries. Not only would this eliminate the majority of crime and danger associated with drug use, but it would also make sure that pain patients have a constant supply of what they need – both things your article fails to address. It also provides people with more reliable and less traumatising to discover self-euthanasia methods should they ever decide to follow that path – an option that all free human beings should be entitled to.

    You should be relegated to an optional ‘consultant’ and ‘advisor’ rather than ‘gatekeeper’. Doctors like you can’t be trusted as gatekeepers. That much is crystal f&%^$#@% clear. Your lack of compassion truly disgusts me.

  12. Why are you guys even entertaining this guy it’s clear he’s the one with the problem here get a life dude.

  13. With all respect to our Dr I pray if ever your in need of anothers Dr Mersey he gives it on the flip side people are completely completely to blame if you go see a Dr and they refuse your request remember their not as dumb as you would like to think they are I have been in pain management 14y now without fault so if you lost your PM Dr you messed up not your Dr.

  14. I lost 4 family members to suicide over drs like this guy who are wearing a sea hat by the Mr hat and finding an excuse to ignore the oath we take of do no harm.I’m now facing the decision of suicide because my ability to live a meaningful life was ripped away.so while you are smug and judgemental we continue to be added to the accidental over dose numbers.we aren’t accidentally overdosing.no chronic pain patient does.we are sick of you not giving a damn.we did not ask for pain that requires opiates.it is a sin .I’ve been in medicine for 26 years.I’m ashamed of the lot of you.and don’t act like your other victim.that’s ridiculous and insulting.

  15. I see both sides of the issue. If you have money (Michael Jackson and others who died from doctors over-prescribing), you can get what you want.

    My father, who died in excruciating pain from throat/lung cancer and the effects of radiation that made him look like like a holocaust death, had doctors giving him various drugs. The doctor worked for the VA in another state. I saw the enormity of the drugs mailed to my dad. I called the office and said he has a doctor and stop sending drugs. The receptionist said my dad would call and call until he got what he wanted. I said IGNORE HIM. They didn’t. By the time of his death (mid 2008), he was given patches and I don’t know if he was still overdosing on the various meds (it didn’t matter – you do what works) but I think he built up such an immunity that nothing killed the pain except death. The doctors take the hit for doing this.

    My stepmother, who I stopped talking to 20 years before her death, was also addicted. She was great at getting what she wanted.

    But the same year my stepmother died, my mom was in the final stages of lung cancer. She didn’t abuse drugs. I heard her screaming in the hospital from pain. Her screams were real and she was reaching the end of her days. The doctors gave her a self-injecting dose of morphine at home where we cared for her. Drs increased morphine and her system shut down as intended. (1997) Sloane-Kettering increased the morphine for my father-in-law and again, I knew his system would shut down and it did as I watched. They’re big and it’s doubtful anyone would sue them.

    Pullen has to cover his xxxx. I don’t blame him. Don’t like him? Go elsewhere. I will likely be in the same position as many of you in the not far future. We’ll find alternatives and hopefully will not die as many are and will – in massive pain.

    We have a broken system. This isn’t a surprise.

  16. a comment to the GOOD doc . while on opiates, i di not want them, and asked to be reduced as soon as epiderals statred to work until my surgeries. but, i slipped and told someone what i was on and you talk about a magnet …… what a big mistake.. i bought a safe.. and hid it .. i never took more than rx . i respected what i was on, when i was offered oxy contin i refused ,after my husband and i looked it up on line {a drug of choice on the streets , so ,very addictive} and the way they pulled me off , i would have been in big trouble on that drug , I can feel for the doctors who are legit and really care about people and not just the mighty dollar bill.and what they must go through, I learned fast, I took several no’s to my neighbor and schemes to try to get pills from me, before she gave up.But who do they tell? I had no idea? How many people does a doctor see in a day?Then if one is on opiate for an extended period of time then the body stops making its own natural pain producing mechanisms {hypalgesia}not sure of the word ,but anyway i have had to do my own research while they allowed me to be in a severe hypothyroid state for 3 yrs ,i finally requested my labs after my cancer bout ,very lethargic ,still kickin, but never took opiates until it was as bad as labor pains ,every day ,for 6 weeks, so I expect, the people who really suffer will have to suffer because of the ones who do abuse these addictive narcotics, and the mothers who let their kids take rx and do not become educated , or the dr or his aid who does not INFORM THE PARENT about the drug that was rx. this is my 2nd comment after my former one

  17. scoliosis ,ruptured disc, severe spinal arthritis and a few other spine ,nerve damage broken foot 3 yrs ,,arch sticks out of the bottom of my foot ,due to drs mistake , other foot ,students made mistakes and bone is growing downward after 8 surgeries not needed . now they, because of new laws have taken me off pain meds , i lay in pain , barely feed myself my sugars 480 plus , can barely take care of myself any more , no weaning off , no heart check up at 60 yrs old . doing more damage than good .. drs here to kill. not sustain life i will not try to get illegal any thing , maybe my time is just up, due to the medical profession , who put me on opiates when i could not walk ,gave me epiderals mrsa and pic lines and surgeries , now the pain is full blown almost .i pray it doesnt.. i am ready ,if i have to go ,i dont want to but look at what they did to me

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