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    An_249517 posted:
    I went to a new pain management doctor yesterday and i have never been to one before.I receive 180 perocets a month from my normal doctor and im suppose to take 1-2 every 4 hours they are 7.5.The pain management doctor told me it was to much and gave me 5 mg of methadone every 8 hours.They told me to bring my pain meds to the appointment anyway i took my percs and muscle relaxer with me and the doctor gave me a script for the methadone and took the rest of my percs and muscle relaxers is it normal for them to just take the pills from me.I think thats weird and never heard of a doc doing this.
    mommiedavis4 responded:
    This is normal for them to take your pain meds when they prescribe something different. We aren't "Allowed" to keep any pain meds we aren't currently taking. They think we are all "Junkies" looking for a "high"!!
    ctbeth replied to mommiedavis4's response:
    Dear Mommie Davis and Anonymous249517,

    Yes, this is how it is, and has always been done, far as I know.

    I am an RN and long-term neuro pain management patient.

    The Percocet that anon was given is a shorter-acting opioid medicine; the Methadone is longer acting.

    This is accepted as proper protocol for long-term pain management.

    If your prescription for controlled medicine is changed, then there is no reason for you to have the former controlled substance. You should not be taking any more-or-different opioid than is prescribed.

    The Percocet also should not be given to anyone else. This is illegal.

    If your pain is now being treated with Methadone, you should not also be taking Percocet, or any other med not prescribed for you.

    If you are not lookin gto "get high", sell your meds, or give them away illegally, why would you want to keep a controlled substance that you can no longer take?

    It could be dangerous/ fatal for you to take Percocet at the dose that was prescribed before your pain MD changed you to Methadone.

    So, to answer the question: Yes, it is "normal" protocol for you to return controlled meds that you are no longer prescribed.

    They do not think that "we are all 'Junkies' looking for a 'high' "; they are obeying the law and attempting to limit the number of controlled substances that are no longer an active prescription.

    Your keeping them would serve no purpose other than a nefarious agenda (stockpiling lethal amounts/ combinations, selling them, giving them away)

    Allowing you to keep the med that you are no longer prescribed would be illegal and unethical.

    Why, may I ask, would you want to keep Percocet that is no longer prescribed for you anyway?
    cweinbl responded:
    It is an axiom that chronic pain patients can better manage their pain when using a long-acting opioid. The short-acting opioid (in this case Oxycodone) can then be used for breakthrough pain. So, a doctor that wants you to use a long (or longer)-lasting opioid is going "by the book." But when she or he takes away your Oxycodone, then you are deprived of a pain medication that we know works for you. That's a bad thought. I would be furious to have that happen.

    Unfortunately, today many physicians play a trust game with new chronic pain patients. I have used my internist for all of my medications for the past 40 years. It helps that we are lifelong friends. My point is that he trusts me. So whenever we have changed pain drugs, he took my word for it that I had stopped the prior drug before starting the new one. Sadly, in most cases, this trust does not exist. In a pain management milleau, doctors see literally hundreds of new chronic pain patients each month. Because there is no basis for trust yet, they want you to give them all of your medications.

    I can tell you that everyone has a unique body chemistry. We respond differently to the same medications. What works for me might not work for you - or it might work too well, leaving you asleep or in a mental fog most of the time. That's why physicians must allow chronic pain patients to try every and any on-label and off-label combination of medications. The operative word here is ":combination." Many of us require a long-acting opioid AND a short-acting opioid, PLUS an anti-depressant (to inhibit the reuptake of Seratonin), PLUS an anti-inflammatory (to reduce the pain from osteoarthritis, PLUS an anti-convulsant (to reduce neuropathic pain). None of these drugs would be nearly as effective on its own, as all of them are combined. Take my word for it. I've tried dozens of combinations of medications over 40 years. It took YEARS to comprehend the precise combination of opioids and off-label medications that work best for me.

    My recommendation is to play along with the physician and try to build a climate of trust. It could take a year or more. Conversely, if you already have an internist or family practice physician that you have been using for many years, you can ask if they would consider prescribing all of your drugs. This trusting physician would likely not demand that you surrender your existing supply of opioids. It's realistic to have one physician prescribe all of your medications in the first place. It reduces the risk of prescribing contraindicated medications prescribed by a physicians unknown to each other.

    Here is the bottom line. Only through tyring virtually every combination of pain medications and realistic off-label drugs can you determine the combination best for your unique body chemistry. After that, your physician should be willing to prescribe those drugs. If she or he will not do it, then you'll need to find another physician.
    finn2 replied to ctbeth's response:
    I have a pain management doc I was referred to by my primary doc who had been prescribing Hydrocodone and Tramadol to me over a year or so, My pain management docs never asked me to turn in what I had left, I still have it. I'm prescribed Oxycodone (breakthrough) and Morphine (long acting) now, If they would change my meds I'd hate to turn in what I had leftover. This is why. Even though I like my pain docs very much and they say they trust me and have been most helpful, I always have this dread feeling that suppose one day they decide to not prescribe anything for me again. The thought of living with the pain with no help is so horrible. And what the DEA is trying to do worries me when I read that pain docs in Florida won't prescribe meds anymore, so it wouldn't surprise me if one day all pain docs would be cutting back on their patients' prescriptions. So if I was asked to turn in the leftover meds I wouldn't want to, I paid for them and would rather keep them in case I was denied a new prescription one day. At least I'd have a little so I could feel better as long as possible. I know one day I'd run out but I would rather postpone it as long as possible, who would choose pain sooner? Your questions made me uneasy as thought you were insinuating that mommiedavis4 was wanting to keep her old meds as if she were using them in a bad way or for a bad purpose. Drugs are expensive and we have paid for them. But to keep my docs happy and stay on good terms I would turn them in if they insisted and I hope they never do. Trust is something you need with a pain management doc.
    ctbeth replied to finn2's response:

    All controlled meds should be prescribed by one MD.

    Since the 7.5 mg Percocet was prescribed by a different MD than is prescribing the Methadone, this both leaves both MDs liable and may prevent the latter MD from prescribing any controlled meds if the 7.5 Percs are not relinquished.

    The way that pain management patients are treated these days, I think what we out to err on the side of caution lest the insurance companies dig up a reason to cut off all of our controlled meds.

    If the MD wants the patient to take Methadone and Percocet together, he/ she can prescribe it.

    If the patient is not prescribed the Perc, but is prescribed Methadone, there is no reason that she/ he should have a stockpile of opioid that could lead to an overdose.

    If you pay privately for your meds, you should be refunded. The MD can alert the pharmacy where the RX was filled to both collect the meds and refund the patient per pill.

    Most MDs will not prescribe controlled meds if the patient has a stockpile of meds that another MD has prescribed.

    My pain management MD does collect all leftover meds when a new med is prescribed. This may not be the usual procedure.

    I would think that the situation could be more that it was a different MD who prescribed the Percocet than that she has the Percocet
    _swank_ responded:
    I know this sort of thing happens a lot and I understand the reasoning. However, I would never ever give leftover meds back to a doctor. These are meds I pay for and you never know when you might need to take one. In addition to that, how do you know you can trust your doctor not to take them himself or sell them? That sort of thing also happens.
    nikkita22 replied to ctbeth's response:
    No, I am new at this but "you all" Docs, nurses, et al, are not the police, or law enforcement.
    nikkita22 replied to _swank_'s response:
    I so agree, these people are not "the police". OMG I cannot beleive I am even reading this.
    smann68 replied to finn2's response:
    Finn2, I agree with you. I would turn over the leftover med's if asked to, but I sure wouldn't want to. It's not b/c I want to sell them or that I have a "nefarious agenda". I paid for them and for those of us in a tremendous amount of pain, it's very scary to think that one day you may need something and not have it. When i was trying out diffirent med's to see what works best for me, my doc usually let me use what I had bought before switching me to something else. I have a lot of diffirent specialist who prescribe meds based on their specialty and they can all keep up to date on what's being prescribed to me using their computer system.
    ctbeth replied to smann68's response:
    it's not meds from different MDs that is the issue; it's controlled meds from different MDs that raises a problem.

    If you have a med contract with a pain management MD and you have controlled meds from another MD, this could be a violation of your contract.

    With the current situation of the crack down on opioids fro nccp patients, we had best be more-and-more careful.
    ctbeth replied to nikkita22's response:

    No, the DEA is not the police, they are far worse.

    They are, indeed, policing our pain management MDs.

    Some members of this community have already had their meds messed with.

    Kaiser Permanente's new by-laws forbid opiate pain meds from being prescribed for pain other than cancer.

    A woman posted a week-or-so ago that her pain meds got cut- just like that.

    There is a discussion still active about the new rules and restrictions regarding MDs prescribing opioids.

    You are sadly mistaken: the DEA IS the police, in a nuclear sense, on steroids. They can shut down and prosecute your MD (and mine) in a heartbeat.
    ctbeth replied to _swank_'s response:
    My only concern is that, with the DEA breathing down our pain management MD's necks, that any violation of our pan contracts, no matter how we may perceive it, will be viewed as non-compliance and we'll lose our MDs and meds.

    There is a witch hunt and we are the witches!

    Such a capricious attitude toward our controlled meds can be our kiss of death.

    If I were to take just ONE of a med that I'm no longer prescribed, but still have, and were to be urine tested- BAM!
    I have violated my contract, lost my MD, my MD has volumes of documents to complete and may have to fight to keep his license, and I may not be able to secure a new MD.

    While I do believe that the pendulum will swing in the other directio, to the past, "Pain in what the patient says it is", and "treat the pain whatever it takes",.

    This WAS how NCCP ( non-cancer chronic pain) treated over the past twenty-or-so years.

    This is NOT the case today!

    There is proposed legislation that will limit what and for how long our MDs can prescribe.

    This is time to be scrupulous in our behaviour.

    Again, I am 100% serious: There is a witch hunt and WE are the witches!

    Caveat Emptor!
    nikkita22 replied to ctbeth's response:
    OK, I'll take that did not know (told you I was new at this)

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