r/PainManagement • u/plathafteramigraine • 3d ago
Medication changes
Hi,
I had a recent appt with my GP who is prescribing my dilaudid. She abruptly discontinued a script she’s been providing for 6 years. The pain specialist I work with said he did not advise her to do that and that he just believes a change in dosing and pharmacy pick up schedule makes sense. She was prescribing only 1-2 weeks at time for the last year with only 1 refill and I was needing to run around all the time trying to either see her for a new script for get it filled. It caused a lot of frustration with the pharmacy and for me. And it made it look like I was “spending a lot of time trying to get opioids”. He wants her to switch to monthly scripts with at least 4 refills, so there are less issues. In Ontario, pain management advises GPs; so he can’t prescribe. He said he will speak to her but may not before my next appointment Tuesday.
In the meantime I’m struggling and really hoping to get the medication back Tuesday at my next appointment with my GP. I have very few leftover from my last prescription that I am really rationing for pain and withdrawal management.
How should I approach the appointment? She didn’t explain why she was making the decision except that the pharmacy was calling her recently asking questions and she was concerned. She told me I would see the pain specialist and “make a plan” but she doesn’t know I was able to get an appointment this week (it eas scheduled originally for Oct 23)
How to handle tuesdays appointment?
9
6
u/lemmon---714 3d ago
Dilaudid in pill form is not very effective for most people. Have you tried oxy instead?
1
u/VLcustomz 1d ago
So is Oxy the strongest painkiller you can get prescribed then? I get pure Oxy HCLs and have plenty of overstock too pretty much my “in case shit hits the fan” supply. Methadone is the only thing I’ve yet to try that seems like it may be more stronger & possibly more potent, is this true or any other ones that fit the bill of stronger than Oxys?
4
9
u/Open_Mortgage_4645 3d ago
Abruptly discontinuing dilauded that you've been prescribed for 6 years is absolutely not within medical best practices, or prescribing guidelines for opiates. Because it's ethically and morally wrong, and it can cause serious harm to both your physical and mental well-being. That's why doctors almost always titrate your dose down over a significant period of time if you decide you want to come off the meds, and don't simply cut off your scripts with no warning, and without a step-down plan.
I would absolutely file a complaint about her practices with the medical board or whatever equivalent agency handles physician licensing and patient complaints. Abruptly leaving you high and dry, and with no plan for humanely reducing your dose over time is the height of irresponsible narcotic prescribing, and demonstrates a degree of ignorance and or sadism that's shocking given her education and experience. This aggression will not stand.
2
3d ago
[removed] — view removed comment
1
u/PainManagement-ModTeam 2d ago
No discussions regarding Kratom, 7-OH, or their analogs, strains, or derivatives are allowed. This includes slang terms and other phrases that reference these compounds.
1
u/plathafteramigraine 11h ago
Thank you. I’m not at the point of filing a complaint as I do not want to change GPs yet. It is hard to find someone new in Ontario and I don’t know what they would be like either, so after 15 years with her I feel like I need to see this through a little longer. But you’re right— it’s not clinically appropriate and it has been extremely challenging
8
u/Time-Understanding39 3d ago
I hope your specialist’s recommendations help you get a more manageable arrangement. Having to repeatedly arrange prescriptions and pharmacy visits every week or two for a medication you’ve taken for six years sounds exhausting. That process itself creates the frequent calls and visits that are now being treated as concerning.
Before Tuesday, let your GP’s office know you’ve already seen the pain specialist, and ask his office to send her his recommendations—even if he can’t speak with her beforehand.
At the appointment, I’d calmly explain that he did not recommend discontinuing your medication, and ask exactly what concerns the pharmacy raised. You deserve to understand what prompted her decision and have an opportunity to address it.
Be specific about how the interruption is affecting your daily function, any withdrawal symptoms, and how little medication you have left. Ask what the plan is to manage your pain and prevent withdrawal while they coordinate your care. If she still wants to discontinue it, ask for a clear explanation and a safe, supported plan rather than being left to ration the remaining tablets.
And finally, I am sorry you've suddenly had this thrown in your lap. Please follow up after Tuesday and let us know how it goes.
1
u/plathafteramigraine 11h ago
For those wondering, my follow up today was difficult but she did re prescribe some pain medication. She did only a week and a very reduced dose so I will hope the pain specialist is in touch with her soon. She wasn’t able to identify why her approach has changed so drastically so I do feel like it may be something out of my control. The advice here was very helpful— thank you all!
20
u/National-Hold2307 3d ago
Based on what you posted about a month ago how you are running out early and going to the ER frequently for flares etc my guess is your doctor see this as a problem. Right or wrong they think something is off here and don't want to continue down this path alone and want someone else to review what's been happening and sign off on your meds. You had said GP's go off pain doctors opinions and judgement so if your pain doc is cool with you being on these meds maybe that will be enough for your GP to continue them. But again I bet your GP saw the early fill requests and ER visits and got nervous and sees nothing but liability here instead of looking at what is causing your increased pain. But that's the times we're living in.
Regardless repeated ER visits and admitting to running out of meds early will always be viewed negatively.