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

  1. I am a recovering addict with 7 yrs off of opiates…Most of what I have read sounds like you all need reinformed..And Docter who the heck you are,need to learn about addiction and if you really cared you would learn how to take care of addicts not look down on us!!!!!!!!!!I am very angry over what you wrote.Their are some people who really need this medicine.Those of us who have problems are afraid to tell the truth because we get labeled as bad people,we are sick people with a disease of addiction.Have any of you ever stopped and wondered why anyone would want to live everyday crying over decisions they make to get physically well?I and most everyone I know who got hooked on opiates were first perscribed them by a pcp,or e.r physician.I personnelly couldn’t even swollow pills and turned them down 3 times.Finally he said he could write for liquid.I was a single parent in college and a good person.These drugs took my life away,I was to afraid to tell my pcp that I was hooked once I realized.I thought they would take my children,loose my job,home and everything.Nobody talks about recovery,rehab centers.Telling your docter whats going on without being scared because of docters like you…Their is meds to help but then you have docters trying to charge thousands of dollars to addicts whom are broke.If any of you docters really care take care of who needs you.Find out what meds to detox patients with,tell them they can be honest and its the only way you can help.Tell them that the have a desease and its not their fault…Learn about soboxone!!!!!!And take their insurance please.If you really got into this practice to save lives,save them…….

  2. Simple solution create a nationwide database of chronic pain patients that after an extensive screening are assigned a case number and any doctor can treat patients approved on the database with complete exemption from any retaliation and with whatever medications are needed to manage their variety of health and pain symptoms. Until screened and given the ID for chronic pain, patients would follow usually procedure and current practices including monthly pain clinic visits for refills. A DATABASE AND ONE TIME SCREENING WOULD WEED OUT ALL DRUG SEEKERS MOST DRUG DEALERS AND Chronic pain paitients would not have to go through the agrivation and screening and submitting medical records that seem to disappear when the pain doctor they are seeing is put out of business, just present ID number and doctor punch it in for compplete verified medical history and current medications. I WOULD SUBMIT TO ANY BATTERY OF TESTS ONE TIME FOR THE FREEDOM OF NOT HAVING TO BE ACCUSES OF DRUG SEEKING AND MY NUMEROUS CHRONIC PAIN CONDITIONS ON RECORD AND TAKEN AS SERIOUS PAINFUL UNTREATABLE MEDICAL PROBLEMS THAT WOULD RESULT IN MY NOT BEING DISCRIMINATED AGAINST AND LABELED DRUG SEEKING WHEN I CRAWL INTO AN ER BECAUSE THINK ABOUT IT, THE ONLY REASON ANYONE WOULD GO TO HOSPITAL IN FIRST PLACE IS IF PAIN IS SO BAD YOU THINK YOUR DYING BUT BY SAYING I AM IN PAIN AND NEED PAIN MEDS, YOU ARE LABELED DRUGGIE AND GOOD LUCK EVEN GETTING A SERIOUS DIAGNOSES MUCH LESS PAIN MANAGED.
    I’d love to present my chronic pain card, and after computer verify, a doctor asks me what i need to get pain relief instead of the drama and stress that increases my pain tenfold that i endue everytime i mention pain.

  3. ha ha ha you all think that any doctor acutally cares about you ???they got in to the business to make lots of money. they don’t treat pain because they can still make a boat load of cash treating restless leg syndrome and all these other “made up illnesses” without having all the drama that comes with pain management such as …jail.ect…get a clue and go to canada or mexico they still write scripts. f*ck all these docs and police, dea,fbi, and all there politics

  4. This so-called care giver, “Doctor Pull ‘em” (does this meanie even exist?) is an example of why we need to remove doctors from the list of “privileged” classes, along with Pro Athletes, College Presidents, GOP politicians, some entertainers….
    They think they know what is best for people in chronic agony, even though they have no personal experience themselves.
    The level od compassion is so low with these **holes that they would be better suited to be doing “enhanced interrogations” at Gitmo.
    I wish they’d all slip a disk, and live the rest of their un-compassionate lives in profound, never ending unbearable pain. If they think it’s OK to inflict their opinions on the suffering then it’s the only karma suitable for pigs like them.

    Leon Foonman M.D
    (retired to PItcairn Island)

  5. Like many others who have posted here, I found this website on accident while researching a way to solve my current dilemma.

    For the last six months I have been living with chronic lower back pain. I am not fortunate enough to have a job that offers insurance. I work full time for minimum wage and cannot afford a primary care physician. It’s hard enough to keep food on the table let alone pay for proper health care.

    I have been to the ER twice in the last two months when the pain was severe enough to cripple me. At first they thought I was suffering from a kidney stone but that was quickly ruled out and I was bounced out the door with paper work stating their diagnoses was constipation and to follow up with a primary care physician.

    The second visit to the ER came two weeks later. This time after waiting for four hours and only checked in on once by a nurse I was not greeted by a doctor, but rather the hospital administrator who quite rudely explained that I would not receive care from a doctor in the emergency room as I was not in a critical state of emergency. I explained my inability to afford proper care and asked for advice on how to get to the care I needed. She provided me with the name of a local community based health care program that she was sure I qualified for and advised me that they do not prescribe prescription narcotics. I had not at any point asked for narcotics, but rather treatment for whatever was causing my extreme discomfort. I was immediately and wrongfully marked as a drug seeker.

    Out of desperation I got in contact with the community based health care clinic she advised only to find that I do not qualify as I make 65 more dollars a week than their cutoff. I can barely pay my bills and afford to eat as it is. My only option to qualify for this service is to request less hours at work so I can qualify for free health care.

    I am at a point where I am afraid I am going to loose my job over this all together. I am not able to fulfill my obligations at work labor wise due to this on going pain and I’ve been marked as a drug seeker by the local ER already.

    America’s health care system is an utter joke. I’m struggling to survive financially and cannot afford proper treatment and have no relief from my pain. I was classified as a drug seeker by my local hospital before even speaking with a doctor.

    I am in pain, immensely stressed, and now living in a constant state of depression and pain. I have had thoughts of suicide over this.

    I have no one to turn to. No family who can help and most if not all of my friends are struggling to survive as well.

    I am currently taking twice the recommended safe limit of over the counter pain relievers, ibuprofen, naproxen and tylenol. It barely works and it causes more problems then it is solving.

    I can’t even turn to the very people who are abusing the medical system by selling their prescription pain killers on the street as I cannot afford it.

    While this is not entirely on topic to the discussion at hand, it is somewhat relative because I was marked as a drug seeker. People do seek drugs when there is a need. It is your responsibility as a doctor to make the distinction between a drug abuser or seeker and somebody who has a genuine need.

    If you cannot make that distinction then you should quit being a doctor and seek a profession that you can handle. You have an obligation to help people and you are failing in doing so by your own admission.

  6. I find it a shame the medical profession will not give patients the benefit of doubt. I have been very sick suffering from RSD most of my life. Recently my doctor retired and I’m stuck trying to find a new doctor to manage my care, its impossible! I went from being on 4 very strong medications to 1 and this was all my idea. After reading the article above I feel as if I have no hope,I feel the medical profession has addicted me to these medications then kicked me to the curb, if what you are saying is true I’m contacting a lawyer. The medical profession has made more than 1 million dollers from all the testing surgerys and office visits. Years ago I dreamed of dying due to the pain I suffer everyday. Doctors have no compassion anymore and you better believe I Danielle am going to do something about it! Nobody should suffer because of the many who abuse the handfull of us that actually need help can not get it and thats wrong. You doctors took an oth and I do not see one of you upholding it you only want the old mighty doller! I have no respect for the medical feild its all politics anymore not caring which is what a doctor should do!

  7. I too cannot find a doctor to prescribe narcotics for my chronic pain because they are scared to death of the federal government. I just don’t know what to do anymore. I am about to lose my mind.

  8. If you’re happy not to allow quality of life by moderating properly the medications for your patients then you should become an advocate for euthenasia.

    It is a shame that Denmark is more advanced in this than Australia or the US.

    I too hope you never have to experience chronic and disabling pain.

    (oh yes- additional to my previous comment, I have been in chronic pain for 7 years bar 1 month. The first 5years I stayed only as high as panadeine forte.)

    As to the woman who’s not touched the meds – I don’t know how you do it. In the other matter, I hope to God you get justice. You can’t go through both :(

  9. Your post makes me angry.

    I have experienced now hyeralgesia, oestrgen lowered, no libido, going mental, losing memory and so on with oxy.

    As of Monday I am going cold turkey. Off everything. I spent 3mths of hell last year withdrawing from a completely different group of meds to re tollerate to it as it’s the only stuff I can take.

    I can’t get into hosp to get off the meds. I have MRI’s to show legitimate reasons for pain since a hit and run accident 2 years ago.

    If you only give pain relief to those who are effectively pall care then I think you are a disgrace. Did your oath include to do no harm? Psyhologically, by refusing to help a chronic condition or not help someone get it solved if possible then you srew people up.

    Maybe you should join a Chronic Pain group on FB and see the HELL we face.

    Hopefully after I go through hell and get rid of all the meds come Monday and follwing weeks, the dr’s here will have no excuse to not help me get help with a pain clinic and prescribe something for the pain so I might have quality of life. Potetially electrode implants.

    Seriously. If faced with living a life of serious pain or opting out. I would choose euthenasia. Shame that dr’s cannot see the sense that their animal equivalents (vets) can. Given the oaths drs subscribe to when they get their permission to work with people. Do no harm. That includes psychological.

    There is a difference between quantity and quality of life.

  10. I am going to show you another side of the coin here. WHAT about those of us who are deathly afraid of all pharmaceutical drugs?

    I have cervical stenosis, torn annulus, cervical disc herniation contacting spinal cord, bulging lumbar disc, thoracic hemangioma’s, bilateral carpal tunnel syndrome, de-queverains tendonitis, severe bilateral TMJ, jaw dislocation, lock jaw, moderate arthrois of the condyles, Cervical dystonia and more.

    I have NEVER once taken a prescribed pain pill for any of these things. I had a hysterectomy in 2009 to remove a 10 cm fibroid between my rectum and lumbar spine, I had ibuprophen in my IV after surgery, and went home with a bottle of tylenol codiene #3.

    I am in the medical field. Well, I used to be. I was molested by a Doctor I worked around in the Hospital. I told on him, I was fired for same.

    I have been in litigation for years. I just learned this MONSTER accused me of drug seeking from him, naming specific drugs I inquired about and asked for scripts for.

    I have years of random drug screens for employment, loads of medical records and not once is there a time I ASKED for any drugs for ANY of my painful conditions, because I have a FEAR of them!

    I suffer greatly in pain, I can’t lie down and sleep with my dystonia, I could go on and on….

    To HEAR this MONSTER lie like this had about put me over the EDGE. I will not REST until this monster who calls him self a DOCTOR, is exposed for this molestation and defamation.

    This is the other side of the coin and for all those who aren’t afraid to take pain meds or other for their conditions, I ENVY YOU!

  11. I was very interested to hear a doctor’s POV on this issue. As a patient with legitimate sciatic pain due to spinal stenosis it has become increasingly difficult dealing with overly patronizing physicians whom stare at me down their noses whilst doing their best to find holes in my stories so they can prescribe me flexural, and naproxyn as if it worked the first couple of times I appeared in urgent care. Why the multiple visits? Due to the wonderful healthcare system I happen to be one of the millions of uninsured Americans out there, and urgent care and the ER are the only places I am able to receive treatment without upfront payment. Your lack of intuition and perception are only matched by your obvious deficit in empathy, and I believe you and many doctors out there are made the worse for it. Who knows? Maybe that woman you spoke of was legitimately in pain, and after you treated her as if she was an addict she was forced to self-medicate, and was arrested for possession of a controlled substance, and now caught in the revolving door of the criminal justice system no other doc will take her claims seriously. Good work upholding that hippocratic oath to do no harm. Sorry if I appear cynical here, but my sciatic nerve feels as if it is being run through a cheese grater, and the only comfort I can get is from this ibuprofen, and even that is ripping my stomach asunder. Bowel movements are supposed to be black, right? Just something to rattle around in your head. Again, sorry if I sound catty, or overly aggressive. This issue just kills me.

  12. I have degenerative disc condition in my cervical and lumbar spine. Right now, at this moment, I have sciatica burning down my left leg like a burning electric shock, to the point where parts of my calf are numb. I have MRIs to prove my condition, and I have 1 of 30 pill script for Norco 10 left, which was given two months ago. My pain mgmt doc won’t refill my script without seeing me in person, but he can’t see me for two more weeks (made the appt weeks ago). My GP won’t bridge my script because “I’m not the diagnosing physician”. I’m a law abiding person, but right now I feel like looking for a heroin dealer or a putting a pistol to my head. Between the nanny state we live in, and chicken sh*t doctors like you, people in chronic pain are contemplating suicide. There’s real people out here, man… but do go bury your head in the sand. I hope for your sake that you never develop a degenerative condition like this… I wouldn’t wish it on my worst enemy. Think about that the next time you presume to lecture people about how you are so put upon… you are poor excuse for a doctor. Do no harm… bullsh*t!

  13. We are back to the days of ”if anyone talks, NO ONE gets recess.” I’ve had bad chronic back pain from an injury sustained 10 years ago. Doctor today told me I have degenerative disc disease. I beg to differ, even though x-rays showed nothing. I injured it and it has hurt 24/7 since. I get the regular b.s. since I’m 26. Naproxen, mobic, and hearing how they dont prescribe opiates.

    My life is awful. I hurt all the time, I have no energy or motivation from my pain. What do I need to do to get pain medicine? I know how it sounds, but since you don’t know me, just believe I am telling the truth. Don’t judge me for wanting to be pain free, even if the side effect is an itchy nose and euphoric feeling. Suicide has been running through my mind since my last doctor visit went the same as 10 years ago.

  14. The desperate want of assigning blame over pain medicine abuse to the poor is akin to the equally false claim that the less fortunate and systematically disenfranchised who cannot afford to pay their medical bills (and the opportunists who file ‘false’ malpractice suits, another favored illusion!) are the primary reasons for the the criminally high cost of health care in the US. Pure bunk! The sort of lie that George Carlin referred to as an “all America business decision.”

    The US is controlled via The Big Lie (manufacture of consent, strategic perversion of language and meaning) This is how elites, who own and control the dominant outlets for dispensing info/data into the society, turn the tables, placing blame squarely on those the system uses and exploits at every turn.

    Clearly GREED, authoritarianism and classism play no part! (sarcasm, for those who require it be spelled out)

    This is why so many dupes in the US will vehemently fight against any measure that’s actually MORAL and would benefit them, their families and their fellow man. That’s how bass-akward it’s become in the US; morons diligently, passionately, vehemently fighting against supporting humanity’s best interests because to do so would reveal their lack of “conservatism” i.e. the era’s preferred euphemism for FASCIST

    The primary reason why so few doctors are compassionate enough to *do their job* and prescribe pain medication to those in need is primarily one of many such draconian manifestations of a deeply sick, fascist country that champions right-wing tenets, classism and Profits Over People as its religion (although it’s still in many ways a country deeply in DENIAL over that fact)

    The police state’s phony “war on drugs” (a right-wingers WET DREAM, as is the equally phony “war on(OF) terror”) propaganda has infected the public mind to the extent that many of the society’s disciplines and professions are comprised of individuals raised within this diseased social environment/mindset that endorses apathy and carless negelct while, of course, promoting those qualities as being the exact opposite of what they actually are and represent. No different than how millions can be convinced (via their TV) that the wholesale slaughter of millions of Iraqi families constitutes “spreading democracy and defending freedom.”

    The US is a BRAINWASHED populace. The stratagem is: LIE BIG! The Orwellian “do-gooder” lip service is relied upon for imposing and allowing for all sorts of evil and anti-democratic measures, including the DESIRE of medical community to refuse and deny people relief while blithely dismissing their plight in the name of abiding top-down, police state ideology/hierarchy. I’ve experienced this first-hand numerous times, as well as from various friends and family. The only people routinely receiving pain scripts are those from the Profe$$ional Class … it’s their children who then in turn find it, get hooked, and/or sell it to other kids because that’s the chief lesson taught from mom and dad’s obsessive careerism: making a buck is ALL that matters. And the social managers wonder why these kids WANT to be high within such a diseased corporate culture?!

    Ha…yeah, of course they do. Of course they do. Never underestimate the power of denial.

  15. What the *$#^ is wrong with you people. None of it makes any sense and neither do you people. Letting our government come in and tell us how to live. Who #%^&*^$% cares if their getting high off it. We got people in pain here. Let them get high off it. Quit giving the government higher authority over people lives and they lose the power to govern yours. Its getting pretty stupid people. Freaking illegal to even grow a %&*#$@%^ poppy plant. Gimme a break this has gone too far. Why are you cowardly doctors not standing up for people??????

  16. It is a shame that drug addicts ruined all this for all of us that need pain medication, i’m so mad anymore i cannot find any help not even vicodin, i mean come on i go to a pain clinic and the girl tells me we only write opana, and mscontin, i am afraid of trying new pills so i told her i wouldn’t want to try them and to just give me vicodin, her response, we don’t write viicodin….Why? That is my question i know from reading about opana over the internet that vicodin is not bad like opana, and I HAVE NEVER ABUSED ANY PILL EVER, even for severe pain 1 vicodin es helped me, it’s like tylenol, it has tylenol in it, And it helps very much with pain, and so far i hear you become tolerant i have not yet 1 still works just as good, and i’d love to find out if i can turn a doctor in for not helping me i have so many problems like DDD, bulging disks on back and neck, arthritis, and fibromyalgia, and you know what medication they wanna give me cymbalta, that is an antidepressent, i mean come on, these doctors better go back to school, i can’t even live a normal life anymore because of always being in pain, but the 1 vicodin a day helped so much and the doctor took them off me after i said they were helping. Makes no sense to me at all.

  17. First off, I know this is an old article, but I have to say something about it…

    I was searching for reason why it is so difficult to get prescribed meds to manage pain when I stumbled across this joke.

    Dr. Pullen, you have got to be kidding me with that tripe you’ve posted. It is absurd that someone in your position would do such a thing. You’ve given up due to the bad apples of society. You’re just going to quit doing the right thing because of your inability to distinguish between who is seeking drugs to sell on the street and who is in legitimate pain? You’re pathetic. So much for that “oath” you doctors hold so dear, eh?

    The reason we have these problems nowadays is because of your colleagues (and likely you if your article reflects anything of your demeanor in person) who handed out opiates like they were suckers at a pediatric practice; gave them to patients who now sell these drugs on the street and are the cause of the prescription opiate deaths each year. It’s YOUR job to spot such individuals and in order for you to better your chances of spotting the drug seekers is to develop a relationship with them BEFORE prescribing powerful opiates. But now you’re not even willing to do that. You just turn new patients away without even trying. I wish everyone’s job were that easy and simple. Doctors are more willing to prescribe tramadol which significantly lowers ones seizure threshold and the toxic Tylenol as opposed to the hydrocodone or oxycodone which are much safer on the body and liver.

    So, how about getting off your soapbox and doing your friggin’ job correctly? Stop whining about not being able to spot drug seekers, develop a relation with the patient instead of, “not accepting new pain management patients into my practice” and actually helping those people who are in pain? Or is it that you can’t make a quick buck going this route therefore you refuse to do it?

    It’s quacks like you that were the reason I could not have shoulder surgery for 7 months for a labrum that was completely torn in half and a stabilization of my shoulder. While I don’t expect to be 100% pain-free, I do expect to have my pain managed to some degree and I can’t even get that done because doctors like you refuse to do your job.

  18. Like so many others I found this website on a search. I have a “sprained ankle”. I have been dealing with this for 3 months and since this is a workers comp case I have to see the doctor that my attorney sent me to. I have seen him twice and still waiting to have an mri. There is pain and swelling still. The doctor told me that he could not give me vicodin because he is concerned about his license and that my sprain does not cause enough pain for him to prescribe me pain meds. He did give me Tylenol 3 and I hope they work. I told him that they make me sick but that was the only thing he can give me. I felt as if he was belittling me and treating me as if I am “JUST LOOKING FOR PILLS” which I am not. I was in the emergency room two days ago because the pain was so severe. I have thought that doctors were to be there for treatment and relief. I have a desperate fear of taking too much of the medication or becoming addicted. I just can’t understand why a doctor can’t help relieve my pain so that I can function during the day. As it is I can’t do too much but I would like to be able to go to the bathroom and not be in pain. There are times when I feel like I am at the point where I am ready to just cut my foot off so that I don’t feel the pain.
    Thanks for letting me get this off my chest.

  19. I can understand turning away patients who are 1) unknown to you and 2) already needing and/or taking narcotics. I think that the only solution for many is to establish a long-term relationship with a physician and then move toward appropriate treatment. To ask for opiates on a first visit is sure to raise an MD’s eyebrows. That said, I’d like to offer some compassion for those who find themselves in the unenviable position of truly needing these medications and lacking access to the physician who originally prescribed them. With the disaster that is our current health insurance system, I wonder how numerous they are.

  20. O.k.. Everyone here seems to have a valid point. But what about those of us who were MADE into these ‘drug seeking addicts’, by doctors who were ‘legitimately trying to help’? They get overwhelmed by the masses that they, in part, had a hand in creating, then the law – or lawyers, scare them off – and they are immune to the mess they’ve left behind.
    The truth of the ‘legitimate cases’ is that you guys cannot tell the difference – and you are so scared of jail or lawsuits that you no longer even try… this is FACT.
    The ‘legitimate cases’ are doomed to spend the rest of their lives buying pills off the street or spending it in extreme pain. This is SAD.

  21. dr. pullen i have 2 herniated discs l4.l5 and l5 s1 i have been in pain for over a year i have no job or money my mom will pay what she can can for me but without percocets i cannot function sometimes i drink cause i cant stand the pain but my doctor is very stingy with pain meds but when i do get them even a 5mg perc a day i dont want to die so much so much for opiates causing depression

  22. It’s absolutely a crime that I cannot be treated for my physical conditions. And why? Because some people abuse drugs.

    I have a lot to say, most of said already. But one thing I did not see was anyone taking any action. Well, I gotta tell ya, with what I experienced this month at pain management, and what I’ve read here…I am going to contact my State Department of Health, for starters. Patients with chronic pain Have A RIGHT TO ACCESS OF CARE and HUMANE TREATMENT. We need legislation to help the patient and protect the physician at the same time. I’ve had it. The only thing, I cannot do it alone. I have been living with chronic back pain for most of my life, but its been debilitating and disabling for the past 6 years. Obviously, I have good days and bad days. I don’t want my up and down life to stop me from pushing for change. We must come together and push forward for change.

    If anyone is with me, send me an email kelly.lucas.3 at gmail dot com.

    I will build a web site to promote the cause, and anyone interested in helping with any aspect of this should contact me. This includes Doctors, Nurse, and Patients alike.

    I am a Registered Nurse left disabled at age 36 by a botched back surgery. Had to be fused, but never able to work again. Suffer daily! I can relate to so many comments on this page, its incredible. Chronic Pain sufferers should never be treated like trash. I know I was…. and it’s starting again. I have had it.

    I encourage you to join me. Again, I need doctors and patients alike. We must identify the full nature of the problem so that we can tackle the issues and find a way to treat those who need it without dragging a physician to jail.

    And yes, it will require some sort of legislative push. I don’t have it all worked out, but will with your help.

    Be agents of change. Stand for something. And let’s end the needless suffering.

    By the way, if you are not depressed and you have chronic pain…. you will eventually become depressed. It;’s a matter of time. Just because someone has depression and they go to pain management, this does not mean they are drug seeking. Hardly.

    Best Wishes to all!!
    Kelly

  23. Oh… and all of the examples of what I cannot do I stated above are when I am on my medicine… I can’t imagine what it would be like without but I know that I would not live… So I can’t even be normal when I take as many pills as I do. I’ve tried oxycontin… it wasn’t effective like I thought it would be… I tried fentanyl… Lots of problems with that… The patches are meant to last three days but only last a day and a half… My doctor was able to get them for me every two days which still didn’t work. To get the pain relief I needed I took nearly the highest dose available and the side effects were to great… I’ve done clinical trials for slow release morphine products but the breakthrough pain was unbearable…

    So my issues I discussed are with 240 percocet each month. Think about that…

  24. I stumbled upon your post while researching possible ways to get my percocet cheaper because I just can’t afford it. I am 26 and have been a chronic pain patient for all of my adult life. I constantly take my pain medication and the truth is I am always still in pain. My family doctor is a godsend because if I did not have him I know I would have died by now as I am not a strong enough person to live with the excruciating pain without medication. I love my doctor because I know he is the reason I am able to see my kids grow but when I moved I thought about switching to a closer physician so I would not have to drive to his office each month. I was treated so horribly by the doctor I saw that before I left I was in tears. I’ve never been treated so much like a piece of trash. I do not choose to be in the pain that I am in! Even though I take 240 pain pills a month I am always in pain still because it is not strong enough. I’ve done tons of testing, I’ve tried a lot of different medicines and even some trial studies but I’ve never been able to get to a point where I am comfortable. I’ve never been able to say that I enjoy living and although I am only 26 I can tell you with absolute honesty I do not fear death anymore. I’ve been bankrupted by medical tests and treatments and still I’ve never gotten an answer as to exactly what is causing my pain. I now know that there are at least six medical problems I have with my spine and in the past few years my joints have begun to give out. I must receive shots in my shoulder and knee because I keep getting worse. When I have x-rays done the technician usually will have a look of awe on her face at what she sees and I’ve even been called a liar by one when I told her I was not involved in a car accident.

    My point in posting is that I understand the issues you have being a doctor but it seems that you cannot imagine what a pain patient must go through. People commit suicide because they cannot handle the pain and if for just one day you were able to experience what I go through to try to live a regular life you would have a brand new outlook. I know it is difficult for doctors because there are a lot of abusers out there but you cannot group everyone into the same class! Doctors need to give us a chance and review our medical records before they pass judgement and treat a person like a worthless piece of lying garbage. And before rejecting every single person that asks for help how about you treat them and do tests for yourself. Do not give medicine until you are 100% confident they are in severe pain. You are not forced to give me medicine but if you would just look at the problems I have you would be able to confidently say that this guy needs my help. I am 26. I cannot play with my children like a normal father can. I cannot pick my kids up and I cannot go on rides at amusement parks. I cannot go on vacations because I can’t sit in the car that long and I have a difficult time keeping a job because of my issues. I was told by my doctor to go on disability but I cannot afford to do that and feed myself and my kids let alone buy my medicine. I am in terrible pain and getting up each morning is the worst part of my day and sitting at a desk at work is excruciating as well. I cannot move out of state for a job promotion or family because no doctor in the country wants to deal with anyone that actually have problems.

    I cannot live a normal life as it is. I do not need a scared doctor making me feel worse than I already do. You have good reasons for being scared but why is it so difficult for a doctor to make a decision based on test results? You do not have to just throw medicine at people when they walk in the door. Make them work for it by going through the proper steps like I’ve been doing for the past 8 years. You will find that many are not lying based on the test results and those that you do not confidently feel need narcotics should be sent elsewhere.

    Please just reconsider what you are doing to the people that really need your help. There are good people out there that already live a terrible life of pain. They don’t need it worsened by being accused of being a drug addict just looking for drugs by those that they need to help them. Please just reconsider because even if the fad does pass, it will be too late form many people. You are talented and need to trust your own judgement.

    Thank you

    P.S. I still can’t afford my medicine… I haven’t found any program that will help pay for narcotics. Just depression pills and stuff like that. Mind blowing how those of us who are in pain get the shaft from every aspect of society…

    Thank you for allowing me to post my frustration.

  25. I know exactly what all of you are going through. I have arthritis and bone spurs through my upper spine, shoulder, hips, and knees. I can’t even take my dog for a walk or clean my house without being in severe pain let alone taking care of my 3 children. I have been through therapy several times, have had the cortizone shots a couple of times and have had 2 knee surgeries. I have had a few doctors tell me they know that I’m in a lot of pain, if they know how much pain I’m in, why won’t they prescribe anything to me?

  26. this is a joke i been trying for 10 years to get help i can to get out of bed most days for 2 to 3 hrs and i have 4 kids i like to see u walk this this kind of pain ooo wait if u havent been throw it then you wouldn’t know it hurts to sit stand and take care of a family others i know get pain help and don’t even have no pain i live day to day cring most of the time and i get crap but deal with the pain it cant be bad wtf do people know unless they go throw it themselves have 4 different things wrong and no insurance and still no one to help i wish u could have one week with this maybe just maybe u change your mind

  27. You should not be a dr! If you can’t read an MRI or cat scan ect. And tell that the person has obvious problems, you don’t need to be a dr. I hope you fall and blow out a couple disc! Will see how long it takes you to pop some of your pills!!! I would not wish my back pain on anyone, but after reading what you wrote I wish it on you!!!you could not handle my pain ! All of you drs are pigs.

  28. here is good evidence that both pain and opiate use often cause depression. I’d wonder that if your sister goes through detox, get off her opiates, if her depression would improve. At this time there is no data to suggest opiates help depression. We have no individual tests available to look at the brain chemistry of individuals at this time. Why do some people abuse opiates? GOod question, but little good comes from opiate abuse.

  29. Pleeeeassseee!!! Give me an answer as to what I can do to help my sister! I love her more than anything and wish it was me that was suffering depression more than her. She is only 24 and I’m 27. I’m currently pursuing my Master’s Degree in Psychology and for a class of mine, I am doing research for a paper and ‘Psychology Today’ had an article on opiates and depression. Have you heard of anything like my story at all??? Anything for my research (mainly for my poor sister which is why I chose Psych. in the first place), would be greatly appreciated on my behalf!

  30. Dr. Pullen, have you ever done a study (I know that Harvard has) that proves some humans may actually NEED opiates to replace the receptors they are lacking in their brains? This lack of mu receptors in their brains, sometimes block the natural “feel good” chemicals we all need such as endorphins. This may be the reason for some to get “addicted” because their brains actually need synthetic opiates. Others who don’t get addicted to opiates at all, simply have the natural brain chemicals they need to feel good.

    A little off topic, but my sister is taking Cymbalta along with Abilify (for her depression) and Lamictal (to stabalize her mood) and Kolanapin (for her sometime anxiety). She also buys oxycodone 15 mg on the street because it simply makes her get through her days because her depression, at this point, seems to be “treatment resistent”. She is diagnosed with major depression, anxiety, and PTSD. My other question to you regarding this is : if opiates were used for years and years in the past and were considered a fairly safe drug (of course if not abused), and now the other four meds she is taking haven’t been studied long term, wouldn’t it be in the best interest of the patient to be giving them something that we know is fairly safe, AND something that actually WORKS??? This boggles my mind! Instead of her not being able to get out of bed on all four meds, she could be perscribed like three oxycodone 15 mg’s per day forever and be happy!

    In order for doctors to figure out WHY the masses are abusing pain meds, they need to look into the brain chemistry of each and every patient.

  31. I have RSDS, a neurological disease that causes SEVERE chronic pain. I’ve been on opioid painkillers for a decade. If it weren’t for the painkillers, I would be crippled and my quality of life would be next to nothing. I’ve been treated like an addict by most of my doctors, pain specialists, family and friends. Here it is: OTHER PEOPLE DO NOT LIVE IN MY BODY, SO HOW CAN THEY KNOW HOW I FEEL? I didn’t ask for RSDS. It was a result of a terrible car crash back in 2001, that I wasn’t even the driver at fault. I need my meds! Honestly, will the struggle to find and keep doctors that will give me my meds ever end? I just want a good and better quality of life…… I’m only 29. Oh, and did I mention that I live in Ohio? This state must be the strictest state in the country for opiate prescriptions. I’m ready to order pain meds online from overseas, but I really don’t want to get ripped off……

  32. I think Dr’s need to take a second look at modern practice. I myself have been suffering from 1 herniated disc and 2 bulging discs. My primary referred me to an Ortho who gave me bottle after bottle of Percocet but did little else to alleviate my condition. I went for injections, physical therapy 3 or 4 times etc… Finally, he stopped treaing me altogether so I went back to my PC. He just gave me script after script after script saying “there is little else we can do.”

    Of course, I changed Doctors and am now going to a new guy. The first thing he did without my medical records or MRI was give me Ibuprofen and muscle relaxers. I find this to be appropriate for a first time visit. This man has no idea who I am or how bad my pain is. Just that I am sitting there in severe pain. Reading this put it more into perspective. Was I upset with the visit? Sure. I felt as though he just sat there and minimized my pain. I didn’t show it, I just took my scripts and said, “see you next time.”

    As it turns out, he was testing me for drug seeking behavior. To me, living with this pain, as I have been for over a year, stinks! But, waiting another month for him to be comfortable with my scripting is worth the wait for a Dr to treat me like a human being an not an addict.

    I think this blog is right. If we are angry and upset at our fist med-less visit, Dr’s are going to be reluctant to ever give you anything. We all, including the Dr’s, know that this is frustrating for everyone involved. But in the end, it may help those patients that are willing to survive for a month in order for the Dr to trust his/her patient.

  33. Hydrocodone is a true opiate, derived from opium and as such has all the advantages and disadvantages of an opiate. It helps with perception of pain by acting in the central nervous system to modify the physical and emotional response to pain. It is habit forming, tolerance and physical dependence develop, it often causes itching, constipation, drowsiness, and all the other side effects of other opiates.

    Tramadol is a newer synthetic drug that is closely related to the opiates, but has somewhat less addictive potential, and somewhat different side effects. It is often used to try to reduce the chance of physical dependence. It is sometimes as effective at pain relief as hydrocodone and other opiates, but sometimes is not quite as effective. Hope this helps.

  34. I was wondering if you can explain the difference between tramadol and Hydrocodone?
    I feel for everyone in pain!

  35. I stepped on two rusty nails. I got a bad infection my foot. Turned out to be three different kinds of bacteria. I waited for three days in the worst pain of my life, thinking it would get better on its own. I finally went to the doctor. She wrote a script for antibiotics and no pain medication. I told her that I was in severe pain. A few days later my wound is still no better. I go to another doctor and she sends me to the hospital for iv antibiotics. They do give me one shot of pain medication while I’m in the hospital. They send me home with none, even after lancing my wound. I am in so much pain through all of this that I’m sure that I would kill myself or cut my foot off if I had to endure it too much longer. I told them that I was in the worst pain of my life. I guess they just don’t care. After a few more days of the worst pain of my life, I went back to the hospital. They doubled up my antibiotics and sent me home. I could not walk for a month. I spent two weeks in hell. The doctors could have chose to relieve my pain, but saw fit not to. I think it should be my choice what I put in my body, not theirs. I hate our current system after suffering through this. PEOPLE IN PAIN SHOULD NOT BE MADE TO SUFFER WHEN THERE IS AN OPTION FOR RELIEF. So many are made to suffer so that a doctor doesn’t risk giving pain medication to those who want it for pleasure.

  36. carehumanity- I feel bad for you and I hate these stupid people who abuse these narcotics for a cheap high, and they put people with severe pain in difficult situations and they have to struggle with horrible pain all the time. I’m 19 I have 4 bulging discs, arthritis in 2 facet joints, a cyst, and ehlers danlos type 3. My doctors say I shouldn’t feel as much pain as I do.

  37. Are you serious?? You think her pain is funny?? !! Good god!! I hurt so much i think about die’n everh single day. Nothing but opioids get me through the pain!! Would i love for this not to be the case? Yes! Where is the humanity?? Then someome who needs high doses trys to appeal for less meds and you think that’s funny too?? What is wrong with you people? What about do No Harm?? I know u gotta weed out the abusers but i have interstitial cystitis and i know how very painful it is. Do this : drink a case of beer but don’t void, make sure you have a bladder infection at the same time, drink an other case – don’t void, shove a bunch of glass shards into your badder drink an other case and don’t void … Hold it hold it – ok now stab yourself over and over for about three hours w/all this beer in your bladder then void – but only a little!!! That can be a good day w/IC!!
    I hope god has a plan for docs like you who think it is funny when people need and seek pain relief!!! You could end up in an auto accident and need pain meds. What would you do when no one cared that you are suffering beyond words! My father yrs ago said if my faith were stronger i wouldn’t hurt! I have not talked to him in over ten yrs!! I miss my dad!! Would i rather need pain meds or my dad?? Yup my dady hands down!!
    Please think about your lack of humanity!!!

  38. It is challenging. You need to find a physician you feel you can relate to who will work with you to try to help manage your situation. Pain medication may or may not be appropriate. Good luck.

  39. I always wonder what the doctor thinks about everything. I’m in Tacoma WA .. My husband is in the military .. I’ve lived out here for 2 years, trying to find a compassionate doctor. I deal with so much pain everyday, I don’t even get out of bed half the time. No one will help me. I found a good doctor, he seems nice .. But I just feel like he doesn’t listen to me. I’ve been going to him since July, and he hasn’t even tried pain medication. I know I have fibromyalgia .. But I don’t think it’s just that. He keeps trying to refer me to this spine clinic, but I’m not waiting 3-4 months for an appointment, with nothing to hold my pain over. I just wish I could find a doctor that would give me something, until we can figure out a different method. It’s so extremely frustrating and upsetting. I hate the fact that people abuse these drugs and make it hard for the people that actually need them. And, it seems it’s always people in my age group.

  40. You are definately in a difficult position. Most physicians will not refill schedule 2 opiates, those that require a written prescription and cannot be written with refills like oxycodone, morphine and others, without an office visit. The standard of care is to assess patients for symptoms of overdosage and side effects of these medications periodically, usually monthly. This is a difficult position for you and your husband. Honestly the $85. month is a pretty inexpensive doctor’s visit these days. I know it can be very difficult though for anyone in your position. I don’t have any answers that really help you.

  41. Can someone please help. We have resigned ourselves that the only way my husband will get any medication for his severe chronic back problems is to go to the pain clinic. He’s been going for 9 months now and there is nothing left for them to do to help him, yet they insist he comes back every single month. My husband has been unemployed, we live with our son, fled bankruptcy & lost our own home. Since there is nothing else to be done for my husband, and since we cannot continue to pay $85.00 a month for the visit, why must he still go every month to get the medication he so desperately needs? All they do is ask him how he is doing, write his 1 month RX and make him the next appointment. Why can’t he go every 3 months? He asked, they said “No – that’s the nature of the beast”?????? What kind of an answer is that? They also told my husband to see if our family doctor will write the meds now. We asked, family doctor said NO, he is afraid of getting audited by the DEA. WHAT ELSE CAN WE DO?

    I too suffer from arthritis & RLS. I use to take pain meds which allowed me to sleep thru the night. Not any more, cause I can’t get any meds and I can’t afford to go to the pain clinic since my husband has to go every month. I am a walking zombie, constantly in pain, and not a very nice person to be around. I can’t work feeling like I feel. I take so many ibuprofin and other NSAIDs in a given day, I’m sure I will end up with liver damage. So you tell me, which is worse, too old people on some pain medications that use to be happy and productive or two old people, both unhappy, in pain, definitely not productive anymore, totally depressed and probably creating more health problems by taking over the counter medicine. How can our Federal Government trump the hippocratic oath and leave us old folks to live out our years suffering like this?

  42. I found this post out of mere frustration and a google search. I have been seeing a fabulous pain Doc in NYC for a number of years now. We managed to find a good balance of treatment that works well for me. It includes Neurontin, Methadone (low dose), Meloxicam, Zanaflex, PT and trigger point injections. I moved to upstate NY and the three plus hour drive to see my Dr. once a month was becoming too physically painful and expensive. So I figured it would be no problem to find a Pain specialist closer by. Boy was I wrong! I have tried all four services in a hundred mile radius (still closer then NYC) and was turned down by every single one. I couldnt even get in the door! No one, and I mean NO ONE wants to deal with patients on medications. Procedures only. Sometimes I think if for some reason my Doc upped and quit I would wind up at a methadone clinic with street junkies! Times sure have changed. I guess I will have to continue driving to NYC? But at this point I consider myself lucky! It really stinks for the good patients. You are treated like a potential drug addict (constant urine tests) and criminal at every turn. And I cant really blame the Doctors. They really want to help, but between drug seekers and the heavy hand of the DEA they are in an impossible situation. Much like OBGYNs, why bother?

  43. This is absolutely a difficult situation, and as a primary care physician it is very difficult to differentiate between the appropriate patients to treat with opiates, the people abusing the meds, and the people simply gaming the system to get inventory to sell on the street.

  44. Yes, it is sad for the patients with a legitimate need and When and if the prescription drug abuse fades, multiple patients will have lived with chronic pain which could have been managed appropriately, but was not due to those who abused the system and those in fear of repercussions of prescribing pain medications. I discovered your blog, because I was trying to understand my new PCP’s reluctance to continue my pain medication (tylenol 3). Over a year ago, 60 pills would last over a month, now it lasts two weeks, so I understand her concern, I was growing a tolerance. It could be. Personally, I feel that I just have more pain due to increased activities with my now 27 and 32 pound twins. After reading some of the DEA regulations, I personally don’t understand the fear of prescribing when there are legitimate (non-malignant) reasons. Mine is a condition in my lower back which a spine surgeon suggested a fusion which I chose not to have. My grandmother has a non-malignant tumor on her pancreas which they don’t want to operate on, because of its location and her age (84). She is on home hospice and receives an injection of morphine 4 days a week, the rest of the week she is on regular strenght tylenol. Activities have to be planned around when she has received her medication. I surely see no humor at all in this situation.

  45. I am hopeful that this epidemic of prescription drug abuse fades as other types of drug abuse have. As a community we might be able to help, we are failing independently.

  46. Dr. Pullen… I cannot tell you how many calls PCMS gets each and every day for pain managment physicians. We spend time trying to educate (optimistic, I know) the patient that they need a primary care physician to treat their ills and if a referral to a pain management physician is in order then the pc doctor will do this. After reading your post, I feel guilty that we are sending these folks to their primary care physician!! But, honestly, where else do we send them?

    It is a huge problem and one we are now discussing at a board level – referrals in general for all types of patients, Medicare, Medicaid, L&I, and pain management as well.

    I welcome any thoughts you have about how we might best help physicians with this group of patients and in the process help the patient as well.

    Hang in… glad you found a titch of humor to help keep you sane amidst the insanity!

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