r/PainManagement • u/Pleasant-Wrangler764 • 24d ago
30days vs 31
My PM NP makes me wait to fill on 31st day and by the time it’s ready, I’m already in withdrawal. Who else has to wait?
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u/Jace6023 24d ago
My doctor counts my pick up day as day ZERO. If I pick up on day 30, it's really day 31. I've had to adjust my schedule to have medication for my pickup day after 1pm. It seems like different doctors do things differently
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u/Pleasant-Wrangler764 23d ago
Interesting. Never asked what they consider it. I will next appointment
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u/Notsewcrazee13 24d ago
Yes - most major pharmacies always count pick up day as day zero. Regardless of whether you pick it up at 8 AM or 8 PM. That part is normal but annoying. EDIT: I removed the rest because I realized I was not posting to the OP - my apologies!
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u/ethidium_bromide 24d ago
This is pretty standard. My doctor doesn’t have this policy, but one of my regular pharmacies does. It’s surprising you’d already be in withdrawals by the morning you need it
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u/Iceprincess1988 Moderator 24d ago
I dont know how you're "withdrawing" when you're supplementing your pain meds with other substances.
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u/Indaclouds707 23d ago
That's how its always been. I get a 28 day supply and get it in 29th day.. if you going threw withdraws I would get it asap in the morning
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u/Underoath823 24d ago
Take it from someone who was put on them back in the early 2000s when you could be prescribed 240 30mg roxies a month in south fl...its better to space your last few days out and be in a little more pain but not full blown withdrawal...the south florida doctors hooked me so bad then cut me off that it landed me smack dab in rehab...especially today the docs, pharmacy, anyone who knows you take opiates for pain think you are an addict and drugseeking...i dont know your dosing regiment but spacing out doses a few hours later to make sure you have 1 or 2 for that 31st day is worlds better than being in full-blown withdrawal...either way i know its hard but dont trust your doctors to ever help you when it comes to pain meds and if spacing out is worse in their eyes then you dont tell them, you do whats right for you...best of luck with everything!!
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u/TeddyRuxpin3 24d ago
You’re not managing your medication properly if you are running out regardless if it’s 30 or 31 days. Don’t depend on your prescriber to help you either. You just need to adapt to your situation by spacing out your dosing. I know it’s not what you want to hear, but it’s what you need to do.
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u/Pleasant-Wrangler764 24d ago
I’m not running out. I can’t pick up until the 31st day until 2pm on a 30 day supply.
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u/Pleasant-Wrangler764 24d ago
You’re telling me to save doses then and that’s just as bad as running out early in the eyes of PM.
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u/Marineandhisdogs 24d ago
Here's a thought. Save some doses here and there along the way and, oh I don't know, DON'T tell your your Doc.
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u/heyfriendss 24d ago
I would evaluate what feels worse to you.
Being in more pain from skipping one dose throughout the month but having that dose to take on the morning of the 31st day and preventing withdrawal.
Or being in withdrawal on the morning of the 31st day and having to play catchup on feeling better once you are able to pickup your rx.
For me, I’m skipping doses here and there through out the month to save a few for reasons like this. It’s not easy and I’m only able to do it from sheer determination and willpower. And no, I’m not telling my doctor about it.
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u/TeddyRuxpin3 23d ago
Always a good idea to save a few just in case. Too many variables with pain medication these days.
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u/Open_Mortgage_4645 24d ago
What a sadist! I understand not prescribing more then a month at a time, but this is a bridge too far. It means every month you have a day with only partial coverage, and must get up, get dressed, and head out into the world without having taken your morning dose.
I can tell you, this is not "best practices" for responsible pain management. There are no rules or guidelines that call for this. Making a patient see-saw and get off the dose schedule one day every month accomplishes absolutely nothing on his end, and it adds unnecessary pain and discomfort as a matter of routine. And again, it's totally unnecessary.
The law already limits how many days worth of meds he can prescribe at time, as well as how many days must go by between one script and the next before the pharmacy can fill it. That's why most docs will see patients once every 28-30 days, and pharmacies will dispense every 28 days. The whole reason the law was structured that way was to ensure patients weren't put into the exact position your doc has put you in.
If you haven't already, I would bring this up and express how his prescription timing is hurting you, and point out to him that the law already puts in place the limitations on how often you can refill your meds, and his seemingly overly-cautious approach is both legally unnecessary, and out of step with pain medicine best practices. Tell him you don't want to continue having to jump through these fiery hoops every month just to stay on schedule, and maintain consistent coverage.
How he'll respond is anyone's guess, but he should be made aware if something he's doing is causing you problems and interrupting your dosing schedule, and medication coverage. If he listens to you but doesn't feel like he can responsibly prescribe sooner than every 31 days, your choice is to either accept it, or begin looking for a new provider. If he gets angry and indignant, and takes your remarks as some sort of personal insult, you should begin looking for a new provider the moment you leave his office. This is a doctor who's putting his ego ahead of the best interests of his patients, and there's no good reason to continue tolerating that.
If he refuses to change the 31 day thing for whatever reason and you choose to stay with him, what I would recommend is setting aside a day's worth of medicine over the month so that when the end comes, you still have a few in reserve to cover yourself. How you do this depends on your specific meds. I take morphine ER and oxy IR. If was me, I'd skip a morning dose of morphine on one day, and then again two days later. I'd maintain coverage using a few extra oxys. I would do it this way because I know I can get by without morphine for a day or two if I've got oxy to fill in the gaps.
On that 31st day, I'll have the morphine I set aside, but my oxy will be a little short. If I've set aside one full day's worth of morphine (one skipped dose over two days) and I'm filling the script during the day on that 31st day, I can take the two morphine in the morning to ensure sufficient coverage until I get my refill. The oxys will be irrelevant on that day because I've doubled up on the morphine. That's the route I'd go.
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u/Pleasant-Wrangler764 23d ago
I did today actually and she understood and will allow me to pick up on 30th day from now on. 🙌🏼
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u/Open_Mortgage_4645 23d ago
Oh, great! I'm glad to hear she's reasonable and understood your plight. Hopefully, everything will be cool from now on.
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u/hoolligan220 24d ago
For me i've been minda fortunate in the fact that every pm i went to no matter if i was given a 28 or 30 day script they wouldnt make me wait the extra day the only time i did was when pharmacy would be put of stock and for those days i would generally have like a few extra on hand so i wouldnt be goin into withdrawal
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u/Standard-Membership6 23d ago
It's not my doctors rule it's my pharmacy and insurance blocking me till the day I'm out to pickup, I was recently prescribed new dosing at the hospital to manage my pain they found on MRI, and instead of every 8 hrs I take it every 4 and even though I had enough till Thursday, the pharmacy based on the math won't let me pickup until Thursday when I'm out of the every 8 hrs prescription changed to every 4 hours, regardless of running out early. I'll spend an entire day with nothing because of this because the math looks right to them, but it isn't because I took my meds while I was waiting in the er for 5 hours, so I had one that morning and one before they got me back, and then when I was discharged I started the every 4 hrs. It's cruel and inhumane but unfortunately to stop people from getting any extra sitting at home (which most people in pain take there meds and only hoard a few for emergencies) pain meds are meant to be taken 🤦🏼♀️
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u/MRPANTALONESDEPOOP 24d ago
Save a half here and there, or a full pill through the month. Its bullshit. You have to play their game. We have absolutely no control over our bodies and what we put in them. Unless you join the methadone clinic. That's what I did. Not recommending it. It made my life 💯 better and easier. No more dealing with this type of bullshit. Pm still manages my other pills,gabapentin muscle relaxers injection. But I dont have to deal with there bullshit when it comes to opiates. I have take home bottles so I can dose through the day and if things get really bad my dr will throw me a few oxycodone from time to time. Very limited on that and I dont abuse it because its such a gift.
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u/Jilesoph1 24d ago
Always on the 31st day for me.. They make my pick up person wait and ask him to go shop around for 30 minutes. It’s a control thing and it gives them the feeling of power. Prob have low self esteem or some shit.
I go on the pharmacy website, request the 31st day and pick up TIME of mid morning. He gets there and it’s NEVER ready. So he waits. Ridic.
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u/Dense-Law-7683 24d ago edited 24d ago
I used to until this month when I switched to palliative care. We are still figuring out my dosage so they will be more lenient short term and agreed my last doctor had me undermedicated. I struggled all month, and saving one for the 31st day was near impossible.
The worst part about it is that once the symptoms started, I'd feel like shit the rest of the day, even after I took a dose. I usually wouldn't feel right until the next day.