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my son was involved in a motor vehicle accident and has suffered from chronic pain ever since. he had been on hydrocodone for three years and suggested to his doctor that he go to pain management in hopes that they would monitor his liver to keep from any problems. he went to his pain management appointment today and was told by the doctor that they dont see patients of his age (25) and that all they could do was prescribe him tramadol in which gives him headaches, nausea, vomiting, itching, sleeplessness, clenched jaws, and leaves him jittery. once he went to his primary care cause it took 4 months from the request to get into the pain management program and requested a refill of his prescriptions and his doctor told him she would write one last time but not to come back since he asked to have another doctor monitor his pain management. back ground on his injuries are a crushed pelvis, and extensive nerve damage. why are doctors not sympathetic to people with valid reasons for seeking proper and effective pain management. the poor boy can hardly walk for christ sake and the doctors knowing they can urine test him to make sure he is taking them properly and call him in for a pill count as well wont help him cause he failed a drug test for marijuana when he was 18 and think he is some drug addict because of it. any suggestions on how we can get him help would be greatly appreciated
2 comments on this topic
27. March - 12:23 am
He is in a bit of a tricky situation. Unfortunately, the DEA and state laws have very strict rules for pain management clinics to make sure that people don’t just go to them to abuse prescription medications. When patients go into a pain management program, they have to promise that they won’t go anywhere else for pain medications, submit to periodic drug testing, and more. If they do anything at all that happens to violate this agreement, they risk being booted from their pain management program. You sign this paperwork upon your first visit to the pain management clinic.
It should not take that long for a referral to go through. I believe that there is a 72 hour processing time. If you have an HMO, and it does sound like you do; they can be extremely slow, but 4 months is just too long. If that is the doctor’s waiting period, ask if there is another doctor on your HMO or insurance’s network that can get him in sooner. Most pain management clinics are known to be able to get patients in quickly, most of the time.
Most of the time if a doctor looks at your history and sees that you are in a pain management program, they will refuse to refill or write scripts for medications prescribed by the pain management doctor. I have been referred from a pain management clinic to a neurosurgeon, and I STILL have to go to the pain management doctor for refills. After I have surgery, the neurosurgeon can take over. It is so complicated these days.
Unfortunately it comes to this; the doctors don’t want to get into legal trouble or have their liscences revoked for non compliance to the law. Therefore they strictly enforce the laws. Since your son was caught with marijuana in his urine, he was booted from his pain management program. He also (most likely unknowingly) went to another doctor for a refill. It is not that they are not sympathetic; they just want to stay out of jail, keep their liscence, and reduce the risk of malpractice lawsuits. Any of these things can ruin their life/career in a heartbeat. This is why they act this way to your son.
Right now, ask your primary care doctor for another referral to a pain management clinic. Be upfront with the primary care and pain management doctors about his history. He has to make sure that he doesn’t have illegal substances in his urine, and to make sure he gets his medications from the pain management doctor only. Some people don’t realize this, and just sign the forms to get them out of the way. Patients are bombarded with forms when going to a pain management clinic for the first time, and it is so easy to pass them off. Hopefully he can get on another pain management program. People do make mistakes.
It is hard to deal with chronic pain, and hopefully he can get to where he can be comfortable again. Also, if he experiences adverse effects when taking Tramadol, then he needs to discuss this with the doctor, and possibly list this as a drug that he is allergic to.