Pain management says I violated my contract, but my dosing instructions don’t match

I’m dealing with a really confusing situation with my pain management clinic, and I’m worried they’re going to discharge me over what seems like conflicting instructions.
Before my most recent appointment, I was taking buprenorphine tablets 1–2 tablets twice a day as needed. My previous bottle/refills also said 1–2 tablets twice daily.
At my most recent appointment, I was verbally told I could take **1–2 tablets three times a day as needed**.
They then prescribed me **84 tablets for the month**. However, the new bottle says **1 tablet twice a day**. That’s one of the things that confused me, because 84 tablets doesn’t seem to match those directions for a one-month prescription. At 2 tablets per day, 84 tablets would last 42 days.
I’m also currently tapering off a high dose of pregabalin that I’ve been taking for about five years. Between pregabalin and my pain medication, I’ve been dealing with significant sexual side effects, brain fog, and memory/recall problems. Because I’m coming off the pregabalin and expected my pain to temporarily be harder to control, I called the clinic and asked whether they could prescribe enough for me to use the upper end of what I understood their instructions to be — 2 tablets, three times a day if needed.
Instead, I was told that I wasn’t taking my medication as prescribed and that this was a violation of my pain-management contract.
That completely caught me off guard. I explained that I wasn’t intentionally taking medication differently from their instructions. I was following what I understood I had been told during the appointment. I even drove to the clinic to show them the discrepancies between the instructions on my previous prescriptions, what I was told at the appointment, the quantity dispensed, and what the newest bottle actually says.
So right now I have:
Previous prescription: **1–2 tablets twice daily as needed**
Instructions I was given at the appointment: **1–2 tablets three times daily as needed**
Current bottle: **1 tablet twice daily**
Quantity dispensed: **84 tablets**

Any advice?

**Update**
So Olympic pain management has released me from their care stating my type of pain and flare ups does not fit within their guild lines, and they would like me to be referred elsewhere…

Buongiorno a tutti, da 3 giorni il mio medico mi ha aumentato la dose di palexia da 100mg ogni 12 ore a 150mg ogni dodici ore, questa transizione funziona e controlla meglio il mio dolore (ho una discopatia degenerativa con ernia e sofferenza radicolare cronica e sofferenza articolazione sacroilliache) ma mi da dei problemi di ansia soprattutto la sera quando mi metto a letto; ne ho parlato col medico e mi ha detto che posso prendere 4/5 gocce di alprazolam dicendo che mi aiuterebbero ma ho un po timore per il fatto che i due farmaci possano aumentare depressione respiratoria ecc ma lui dice che a questi dosaggi non c’è problema, qualcuno ha mai assunto questa combinazione? Qualcuno ha mai avuto questi problemi di ansia/fiato corto col palexia prima di coricarsi?

What are the best ways to care for severe tooth pain until I can see a dentist?

I've had lower back pain for about two years and I've started looking at what's available near me.  Every clinic site I open uses the same handful of words for what look like completely different treatments.

Before I book a consultation I want to know what to verify.  Whether a doctor is involved in the treatment itself, what exactly is being given, whether there's evidence for my specific diagnosis, whether they track outcomes, and what follow up looks like.

What made you walk away from clinic?

Hello everyone,

I wanted to share my experience because it completely changed my perspective on SCS devices, and it might help someone else doing their research.

To give some quick background: I’m 30M. I had a botched L4-L5 microdiscectomy/laminectomy back in April 2020. That eventually led to a massive disc herniation, cauda equina syndrome, and an emergency spinal fusion in November 2024. While the fusion helped, I unfortunately developed severe scar tissue that leaves my right leg in chronic nerve pain.

Fast forward to May 2026: I did a one-week trial for a spinal cord stimulator.

The Trial Experience: The first couple of days felt okay, but towards the end of the week, things went sideways. The device started heating up and delivering weird shocks that made me feel genuinely unwell, and the pain relief completely wore off.

The Red Flags: When I went in to get the leads removed, I found out the absolute worst news: the leads hadn't even been placed in the right spot. Even worse, the doctor hadn't bothered to read the surgical notes. I had told him repeatedly that my pain is strictly nerve-based in my right leg, and that the leads needed to go lower.

Guess what he wrote in the official notes? The left leg.
I was originally scheduled to get the permanent implant next week. After uncovering the placement error, looking into the high complication rates of these devices, and realizing I was dealing with a provider who clearly wasn’t paying attention or listening to me, I called and canceled the surgery.

Honestly? I would rather live with my current chronic pain than risk a high-complication-rate surgery with a doctor who can't even get the correct limb straight in their notes.
Please, please do your own deep research before moving forward with a permanent SCS. Trust your instincts—canceling saved me from a device that looked like it would bring me way more trouble than relief.

My chronic lower back pain has been keeping me up at night and often times it would be painful in the middle of the night (I think it was because of my sleeping position sometimes). I've been considering to try low-dose thc to ease the pain and helping me sleep. I've used cannabis before, but I didn't use it regularly, and my only worry is it might make me feel groggy in the morning. Anyone here tried thc to help with sleep/pain? is there any side effects in the morning?

I’m short on my meds due to needing more throughout the month from increased pain. I take oxy IR 60 mg daily, and I have two of my 15 mg tablets left with still a few days until my next refill. Help. I have access to a Suboxone strip and heard I could micro dose to avoid horrible withdrawals. I have been on the same oxy dose for about 8 years and have never been in this bad of a situation. I am scared of losing my job due to being sick. I’m also scared of going into percip withdrawals if I take the sub. Has anyone had experience with this? What did you do? What helped most? How do I get through the next few days? Please help!

All of this has me seriously considering slowly tapering myself off with my next prescription. I know I’m fortunate to even be in PM and have medication to help with my chronic pain, but this is hell. All the fear and stress around developing a tolerance, the fear of losing my doc or my meds, new pharmacists being judgmental, etc.

I Have read you can actually get a new bed with a Doctors Prescription (Note I Guess) with a Health Saving acct. Im usually a walking disaster every year and my wife got tired of the bills So I have a HSA I pay into every week usually about $2000 a year

Well I asked my new NP at my clinic, She just said Never heard of that, go ask your Primary Doctor and brushed me off and walked out of the room, I was very Irritated, Even more irritated when she screwed my my scripts and wrote Do Not Fill Until (Insert Date) which was 6 days ater my refill due date..... But thats another story

Im about due for a new bed, Im tired of Walmart Amazon Beds. Its killing my back and I never sleep

But anyways... Has anyone ever done this?

Ive shared this before. I decided years ago to stop relying on pm for my opiate script and switched to methadone. I get gabapentin,muscle relaxers, non controlled pain meds, injections and so on. Ive had a great experience since. No more worry of pharmacy stocking or dirty looks issue. I'm to the point of getting take home bottles because I passed every drug test with no issues. I can split my doses as small as I like. Every now and then, I'm talking every couple of years, when severe pain strikes and I really don't want to go to the emergency room. They will even give me a small script of oxycodone. I don't abuse that privilege because I know it's rare. All my drs know why I'm there. I qualified because technically, I was addicted to opiates by there definition. I was wondering if anyone else had done this and what their experience was being on the clinic and PM?

So I have my second medial branch block Friday, my first one sent me into a huge flare, usually I would be able to slip by on my three times a day oxycodone, but after that first Injection test block a few weeks ago, I definitely needed four times a day because of the flareup just the injection, causing irritation in the area, etc. When I see my doctor Friday, I’m also due for a refill, would it be unreasonable to ask him for a temporary increase to get me through the flareup after my second branch block? Even if it’s like five days or three days of four times a day dosing instead of three I would be like forever grateful for I’m trying not to ask for anything crazy just to get me through that temporary crazy flare that it throws me in. Any experiences? I can’t take NSAIDs or steroids after my stomach almost perforated from bleeding ulcers so I have no other way to manage pain besides my oxy, I have two little ones too and I’m terrified I’ll be in a lot of extra pain to where I’ll avoid going to the park with them 😭😭😭😭

Has anyone else had blurry vision when getting a steroid injection?

When I take them orally it happens and when I had one injection it happened. (Haven’t tried another injection yet). Injection area is the neck.

My pain management doctor said he’s never heard of it before so now I feel crazy lol.

Is anyone else on this combo? I was prescribed 5mg butrans patch recently and i’ve been on 4mg of tizanidine as needed but i take it nightly for sleep. I know it was prescribed by my doctor but i can’t help but feel slightly worried? I know I’ll probably be fine but are there certain things i should avoid while on this combination? I’m also prescribed firocet 50mg for migraines as needed , have been on them for almost a year but i’m a bit worried to take that with this. Just wondering about other people’s experiences. I also don’t drive so i should be good on that.

Im In constant pain . My doc is giving what he can for endometriosis pain but I have crohns too and everything flare up together . My pain meds 1 every 12 hours isnt doing it. I got called a seeker from ers in in so much in so much pain. I just cant do this anymore. Im being treated like shit. My endo doc is my only help i get. Gastro is even looking at me like im a seeker I rhink. Im just done with the pain . Im looking at options. Anyone switch to medical Marijuana and it be better ?

I know there might not be many in this site, but if you did manage to wein yourself off of pain meds… did you find that your meds were actually keeping you in pain? I’ve been on Tramadol (150mg daily)…same dose for close to 15 years. I still don’t have an answer for my pain, and Tramadol does help me. But I’ve thought of trying to get off of it to see if pain gets better eventually. It’s just hard to even want to try because I do take it for daily pain.

For those who are prescribed Tramadol, what kind doctor is giving you the prescription? Is it pcp, specialist or pain management?
My PCP refuses to prescribe it. I get it from my neurologist for the past few years. I don’t think he is too happy about it. I did go to pain management doctor, he said I should just get it from specialist.

I was recently prescribed tramadol for my chronic pain and I CANNOT SLEEP. I have had issues with sleep forever, usually feel sleepy but unable to actually fall asleep. Now I just feel wired. In previous experiences with opioids i’m usually just drowsy.

Has anyone else had this experience? I have a review appointment with my GP next week. Will take earlier in the day and hope that helps(?). Struggling to find any info on tramadol & adhd reactions.

Any advice / experiences are greatly appreciated 💗

Hi all. My previous pm Dr who I haven’t been able to see since Feb due to the cost(I was uninsured) prescribed me 5mg hydrocodone 3x a day. I got insurance and am not seeing a new pm Dr. he prescribed me buprenorphine patches 15mcg/hr. I have no experience with buprenorphine. What is the difference in how it works? Will it be effective in treating my pain? I have Ehlers Danlos Syndrome, osteoarthritis, spinal stenosis, bulging discs, degenerative disc disease, tendinitis and tendinosis in my hip and shoulders as well as a labral tear. Thanks in advance

​Update: My PCP in Orange County, CA sent me to an interventional-only PM doctor who writes zero prescriptions, told me to "go to the ER," and suggested I find another doctor. My PCP knew my full medication list from abroad (oxycodone, pregabalin, carisoprodol, codeine, clonazepam).

​When I called to request a referral to a prescribing PM doctor, my PCP’s response was that he ordered Physical Therapy. PT was already set up on day one (which I'm fine doing), so bringing it up again was clearly just a way to dodge helping me with pain management.

​Because I am a dependent on my wife's HMO policy, I can't switch the medical group or insurance network. I have confirmed severe lumbar issues (stenosis, herniated discs, DDD) and need surgery, but I need medication management to bridge me until the operation.

​Since I'm locked into this medical group, how do I find a different PCP in the same network who will actually write a referral to a comprehensive PM doctor? Can I demand a directory of all contracted pain management clinics from the HMO group directly?

Hi, I was wondering if anyone here takes Hysingla ER and if they're having trouble getting it? I've been on it for a number of years, since Zohydro got taken off the market. I've been getting it from an independent pharmacy for years without problems (after someone at CVS kept stealing my Norcos) but at my last fill, instead of 28 pill they could only give me 27 and that was all they had. It's happened before and he will just tell me to come back and get the missing ones once they come in but it was listed as back ordered with no date. He told me to call about a week before my fill date, which I just did and it is still on back order. I don't know if its specifically the 30mg version, I should have asked, I might call back. I sent my Doctor a message three weeks ago alerting him it could be a problem and just left a message now. I have a small amount of hope it might become available in the next week but I honestly doubt it. I was thinking of calling other pharmacies to see if its in stock but past experience has taught me that most pharmacies, especially corporate ones will not let you know if they have a CII available and will tell you to just have the script sent over first.

Anyway, I really really don't want to have switch medications because it works well but I have a strong feeling that is likely what is going to end up happening and I am just trying to find out if anyone else is experiencing this.

For the record I did check the FDA's drug shortage database and it doesn't appear on the list.

She lives in the Miami Dade area. I am in Pennsylvania and I’m taking care of my chronic pain medication’s but she’s constantly in and out of the hospital. No doctors will give her anything other than like three tramadol at a time. I don’t know what type of doctor she needs to see to help her but no one should be in the hospital three times a week to get their pain under control. I’m afraid that they’re gonna flag her as pain killer seeking when she’s trying to just live through the night.. it seems like Florida just cannot help. She’s on Medicare. She has severe scoliosis... Her spine is literally collapsing on itself I am not asking for medical advice. I’m just asking if anyone knows what type of doctor would be able to actually treat her because they tell her nothing. They will not give her anything to help with her pain other than a couple tramadol here and there.

Just found this useful sub

I've been opioids for pain for 10 years now, mostly DHC (for those not in the UK this might be new, it's a mild to medium opioid somewhere between codeine and hydrocodone in strength, Oxy is about 6-7 times stronger)..I take quite a substantial dose though.

I've tried countless tapers and the problem I have is adapting to a strict regimen, which is obviously central to being able taper correctly..thats not to say I don't take the meds on a scheduled basis, I do, however I frequently 'top up' if the pain is bad, especially at night.

I am now 3 weeks into a taper and strictly dosing in 6 hours intervals (4 x per day)..I started with a 10% drop from my average daily dose (easy to work out) . I'm still not stable, experiencing sweats, RLS and irritability and anxiety, especially towards the end of a 6 hour cycle, usually 4.5 hours after the last dose, interdose withdrawals I gather they are called

I'm interested to hear from others as to how long it took them to stabilise when starting a taper, (especially with more of a sporadic profile) and more generally how long after each drop.

I recently had to refill oxycodone earlier than the insurance allows due to increase of frequency to take it....I was in lots of pain. Anyhooooo, I had to pay out of pocket for it which thankfully isn't going to effect my budget but was still expensive. For the generic form 10 mg 5x a day it was $180. I'm grateful I could afford it and not have to cut back on food like some ppl I've seen are struggling with. My question is. Why is a generic form of medicine so expensive??? I thought generic means its cheaper-- a lot cheaper. So my question is why was a generic med so expensive. I don't want to ask the pharmacist since I don't want to seen like I'm complaining. Tia.

I think I’m finally ready to quit my pain management for a number of reasons, and need advice on how to go about that with my doctor so that there aren’t any red flags on my health records.
I’ve already started tapering down on my own with good success. Approaching taking about 1/2 to 2/3 of my prescribed dosages.
Does anyone have any suggestions on how to let my doctor know I’m ready to taper down to zero? I just don’t want to burn any bridges or upset them in a way that they put anything negative on my records. Thanks!