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Feature: Pain Patients, Pain Contracts, and the War on Drugs

Pain contracts. Pain management contracts. Medication contracts. Opioid contracts. Pain agreements. They go by different names, but they all mean the same thing: A signed agreement between doctor and patient that lays out the conditions under which the patient will be prescribed opioid pain medications for the relief of chronic pain. (To see a standard pain contract, click here.)

http://stopthedrugwar.org/files/oxycontinpills.jpg
Oxycontin pills
For some of the tens of millions of Americans suffering from chronic pain, opioid pain medications, such as Oxycontin or methadone, provide the only relief from a life of agony and disability. But with the Office of National Drug Control Policy's ongoing campaign against prescription drug abuse and the Drug Enforcement Administration's (DEA) ongoing crackdown on physicians it believes are prescribing opiates outside the bounds of accepted medical practice, the medical establishment is increasingly wary of pain patients and adequate treatment of pain is a very real issue for countless Americans.

In recent years, doctors and hospitals have turned increasingly to pain contracts as a means of negotiating the clashing imperatives of pain treatment and law enforcement. Such contracts typically include provisions requiring patients to promise to take the drugs only as directed, not seek early refills or replacements for lost or stolen drugs, not to use illegal drugs, and to agree to drug testing. And as the contract linked to above puts it, "I understand that this provider may stop prescribing the medications listed if... my behavior is inconsistent with the responsibilities outlined above, which may also result in being prevented from receiving further care from this clinic."

"Pain agreements are part of what we call informed consent," said Northern Virginia pain management and addiction treatment specialist Dr. Howard Heit. "They establish before I write the first prescription what I will do for you and what your responsibilities are as a patient. They are an agreement in order to start a successful relationship that defines the mutual responsibilities of both parties. More and more states are suggesting we use agreements as part of the treatment plan with scheduled medications. Such agreements are not punitive; they protect both sides in functional way."

If Heit sees a cooperative arrangement, others disagree. "This is really an indication of how the current DEA enforcement regime has created an adversarial relationship between patients and physicians where the doctors feel the need to resort to contracts instead of working cooperatively with patients," said Kathryn Serkes, spokesperson for the Association of American Physicians and Surgeons (AAPS), which has been a fierce critic of criminalizing doctors over their prescribing practices. "The pain contracts are a tool to protect physicians from prosecution. He can say 'I treated in good faith, here's the contract the patient signed, and he violated it.' It's too bad we live in such a dangerous environment for physicians that they feel compelled to resort to that," she told the Chronicle.

"Patients aren't asked to sign contracts to get treatment for other medical conditions," Serkes noted. "We don't do cancer contracts. It is a really unfortunate situation, but it is understandable. While I am sympathetic to the patients, I can see both sides on this," she said.

"There is no evidence these pain contracts do any good for any patients," said Dr. Frank Fisher, a California physician once charged with murder for prescribing opioid pain medications. He was completely exonerated after years of legal skirmishing over the progressively less and less serious charges to which prosecutors had been forced to downgrade their case. "The reason doctors are using them is to protect themselves from regulatory authorities, and now it's become a convention to do it. They will say it is a sort of informed consent document, but that's essentially a lie. They are an artifact of an overzealous regulatory system," he told the Chronicle.

"When this first started, it was doctors using them with problem patients, but now more and more doctors and hospitals are doing it routinely," Fisher added. "But the idea that patients should have to sign a contract like that or submit to forced drug testing is an abrogation of medical ethics. Nothing in the relationship allows for coercion, and that is really what this is."

The pain contracts may not even protect doctors, Fisher noted. "When they prosecute doctors, they can use the pain contract to show that he didn't comply with this or that provision, like throwing out patients who were out of compliance. The whole thing is a mess."

http://stopthedrugwar.org/files/michaelkrawitz.jpg
Michael Krawitz (photo courtesy Drug Policy Forum of Virginia)
It is a real, painful mess for a pair of veterans trying to deal with chronic pain through the Veterans Administration -- and it is the drug testing provisions and the use of marijuana that are causing problems. Michael Krawitz is an Air Force veteran who was injured in an accident in Guam two decades ago that cost him his spleen, pancreas, and part of his intestine. Krawitz also suffered a fracture over his left eye, received an artificial right hip, and has suffered through 13 surgeries since then. He had been receiving opioid pain medication at a VA Hospital in Virginia, but things started to go bad a year ago.

"Last year, I refused to sign the pain contract they had just introduced there, and they cut me off my meds because I refused," Krawitz told the Chronicle. "Then I amended the contract to scratch off the part about submitting to a drug test, and that worked fine for a year, but the last time I went in, they said I had to do a drug test, and I again refused. I provided a battery of tests from an outside doctor, but not an illegal drug screen. That's when my VA doctor sent an angry letter saying I was not going to get my pain medicine."

Krawitz has provided documentation of his correspondence with the VA, as well as his so far unheeded complaint to the state medical board. As for the VA, some half-dozen VA employees ranging from Krawitz' patient advocate to his doctor to the public affairs people to pain management consultants failed to respond to Chronicle requests for interviews.

For Krawitz, who has used marijuana medicinally to treat an eye condition -- he even has a prescription from Holland -- but who says he is not currently using it, it's a fight about principles. "I will not submit my urine for a non-medical test," he said. "The VA doesn't have the authority to demand my urine. It's an arbitrary policy, applied arbitrarily. The bottom line is that we vets feel very mistreated by all this. Some of us have sacrificed limbs for freedom and democracy, and now the VA wants to make us pee in a bottle to get our pain medication?"

The imposition of pain contracts is not system-wide in the VA. A 2003 Veterans Health Administration directive on the treatment of pain notes that "adherence with opioid agreement, if used" should be part of the patient's overall evaluation.

Krawitz is preparing to file a federal lawsuit seeking to force the VA to treat him for pain without forcing him to undergo drug testing. For Tennessee vet Russell Belcher, the struggle is taking a slightly different course. Belcher, whose 1977 back injury and spinal fusion had him in pain so severe he couldn't work after 2000, was cut off from pain meds by the VA after he tested positive for marijuana. Belcher said he used marijuana to treat sleeplessness and pain after the VA refused to up his methadone dose.

"It's a wonder to me that some vet ain't gone postal on them," he told the Chronicle. "They pushed me pretty close. To me, not signing the substance abuse agreement is not an option. If you sign it you're screwed, if you don't sign it, you're screwed. I complained for months about the dose being too low, but they said that's all you get and if you test positive for anything we're kicking you out. When the civilian doctors would find marijuana on a drug screen, they told me they would prefer I didn't do that because it was still illegal, but they didn't kick me out of the program. I was using it for medicinal purposes. I have tremendous trouble sleeping, muscle cramps that feel like they'll pull the joint out of the socket. I had quit using for a long time because of this mess with the drug testing, but then they wouldn't increase my pain medicine. I thought I have to do something; it's a matter of self preservation," he said.

"The pain clinic at the VA has discharged me from their care and said the doctor would no longer prescribe narcotics for me unless I attend the substance abuse program," Belcher continued. "They aren't going to be satisfied until I spend 30 days in the detox unit." While Belcher would like to join Krawitz in taking on the VA, in the meantime he is looking for a private physician.

When asked about the veterans' plight, Dr. Fisher was sympathetic. "They made Krawitz sign a contract under duress with forced drug testing as a condition of his continued treatment," he pointed out. "That violates basic rights like the right of privacy. There is no suspicion he is a drug addict. They want to treat all patients as if they were criminal suspects, and that has little to do with what the nature of the doctor-patient relationship should be."

Dr. Heit, while less sympathetic than Dr. Fisher, was decidedly more so than the VA. When asked about the cases of the vets, he explained that he would be flexible, but would also insist they comply with the terms of their agreements. "In the end, you have to choose whether you want me to do pain management with legal controlled substances or you want to use illicit substances, but you don't get to choose both," he said. "I don't disagree that marijuana may help, but the rules are it's an illicit substance. I can't continue to prescribe to someone who is taking an illicit substance."

And here we are. Patients seeking relief from pain meet the imperatives of the drug war -- and we all lose.

Permission to Reprint: This article is licensed under a modified Creative Commons Attribution license.
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hey bud you should still be

hey bud you should still be proud. there are more people out there that want to help  who are proud of you with out knowing you i am a peace time vet {ft. hood} but i am proud of my time there so you meet a smart a$$ to hell with them you have something to be proud of

ADA Complaint

Dear Sir,
I am a disabled Vet from a spinal condition. I am no doper but I have used marijuana on occasions when all else fails to relief the pain. I would like to sign your complaint but if you feel I would taint it I fully understand. Let me know your thought if you would please I have had no Pot in my system for over 16 months.
Sincerely,
Russell Belcher

VA pain med BULL*%$#

Not sure what an ADA complaint is but, something needs to be done! I too have had the same problem with the VA.

I've had 3 surgeries on my lower back and have to get my pain meds off people I know with scripts. My pain tolerance is high so it is only needed every so often.  I had 60 pain pills after my surgery in Oct. 09 and in June 2010 I asked for some to keep around (I still had 3) so when I needed them I'd have them.

The problem is I told the mental health staff to shove their medication (All of them - they tried them all) and started smoking pot for my PTSD. It was other vets at the PTSD clinic that told me to stop taking the poison they were "Pushing". They were right. Taking the poison they gave me made me not want to leave the house. Started smoking pot and was back at work in no time. It keeps me from playing Army in my sleep (That really spooks my family) and keeps me from choking the shit out of people who really deserves it.

They don't know how close some of them have come to pushing me over the line of sanity. Having been assaulted by a drill sgt. and suffering a fractured neck and nothing was done to him has been brewing in me for 30 years. Now I'm in the fight of my life for disability after working though the pain for 30 years - Lets just say they should be glad I'm smoking pot.

The people at the VA can't be too smart in the first place - Who else but a dumb-ass would knowingly, continuously piss-off a bunch of guys who have been taught buy the best, to kill people and break things. They really don't used their heads! They better hope we all smoke pot!

If I can help with your complaint I'd be glad to.

Retired VA employee 100% disabled, also collatral duties as

EEOC Investigator, Please contact me, we have to have a lot more to file as a group on the same policy, this will be a Federal EEOC case and not a state. I will explain.

 

Thanks Willie

Vet getting shit on

Hey another Desert Storm Vet here and I am going thru the same. Actually sitting here out of the damn med's and they are sitting at the pharmacy counter when they should be here. All over their bullshit piss management. When did the lawabiding Vets become the criminal? Breaks my heart that the power's that be how we secured their all mighty oil stockpile over. Are going to do this to the slaves involved not right, they at least owe us the care we need from un-healed wounds. PA pissed off, I'm in contact my E-mail Brother's!!

HI'THERE

JUST WANTED TO KNOW IF THE MEDICATIONS YOU GET ON LINE ARE GOOD ONES FOR THE PAIN,AND DON'T YOU NEED A DOCTOR TO DO THAT ON LINE PHAMACY IF NOT CAN YOU GET ME IN TOUCH WITH ONE THAT WILL HELP. THANKS SOMEONE IN PAIN, YOU CAN LEAVE A MESSAGE ON THIS BLOG FOR THE ONE WHO CAN'T FIND A DOCTOR, IN WILKES-BARRE,PA NEED HELP

PA pain management

I live in Bangor,PA and see a pain management doctor in East Stoudsburg. He is currently prescribing me 30mg oxycodone, 10mg cyclobenzaprine, 300mg gabapentin and 800mg iburophen. They do random urine tests but as long as you take the meds you are suppose to there are no problems. Let me know if you want to know where to go for help. If you send me your email I will send you the name of the clinic.

Pain doctor in Pa

Hi
Saw your post. I run an adventure kayaking biz here in Hbg, hurt my back severely in an accident several years ago. Need a pain doc as mine left the area, can you help?
Thx

re: Pain contracts

I have absolutely no problem with signing a pain contract. I know that I am not only protecting myself, but my doctor as well. He does treat me with opiates. I have fibromyalgia and CFS among other things, and although even opiates cannot bring my pain level down to "0", I am very willing to live with a 4 or 5 on the 1-10 scale. Without these meds I am often at a 10, and after several days at this level it feels like a "20", if there were such a thing. The pain contract feels like a very small price indeed to pay for some relief. I had been treated for my pain for years in WA, but then I moved to AZ and could not find a doctor who would prescibe opiates under any circumstances, despite pleas from my psych doctor that he did so. I finally found the doctor I now have, and swear he is an angel. If I am protecting him by signing this contract, I can be reasonably sure he will be practicing for many years to come. BTW, he is not a 'pain specialist', but a family practice doctor who's specialty is palliative medicine. He treats 'all' of me, not only the pain. I know I am in good hands with him, as he does not blame all my symptoms on FM. but carefully checks each one out, and sends me for the entire battery of tests once each year.

pain contracts

To Anonymous:  First I have to say I am not a combat veteran, but 1000 per cent of my heart and soul fill with pride at the bravery you have all shown, the courage to deal with the way these bureaucrats have and are treating you. In 1974 I was "clasified"P-III"...appealed then was denied for "acne." I now think maybe that was a good thing.

You said you had "no problem with signing pain contracts  because "I am not only protecting myself, but my doctor as well." Yes, my unknown Brother, you ARE protecting your doctor, but all respect intended, you are placing yourself in grave danger.." These "contracts" illegal contracts of adhesion designed ONLY to protect the doctors.

I underwent Pegasys interferon chemotherapy for a year (2001/2002) even though because of PTSD, Anxiety issues, and depression, I was NEVER supposed to be on it in the first place.  Within 6 months, the side effects and body chemistry changes had me on 240mg of methadone a day for three years. After the failed chemo, I VOLUNTARILY with the help of my old family doc cut that down to 150mg of oxycontin with 6mg of klonopin. Then, the Feds jumped in and told my doctor he could no longer prescribe opiates to any "SSI, SSDI or DSHS patients. I was on a pain contract then, with NEVER a problem.  However, I was able to find one doc that accepted me, though never believed despite evidence I was trying to get off these meds. Like many here, I do have degenerative spinal injuries,  was forced into a new contract in March of this year.which at which time I couldn't think right, nor remember. By then I had dropped from 6' 2" at 205 pounds to 158.3 pounds.

I developed pneumonia and strep in late September of last year and by March, I had lost over 25% of my lean muscle, from an opportunistic "syndrome" called cachexia (kah-kek-see-ya) which results from the liver refusing "outside" nutrients until the body can no longer function and from then it is one of the most horrifying ways to go there is.All the organs are"lean muscle" and as the deterioration progresses, the lean mucle "connective tissues melt, ultimately causing rupture after rupture, surgeries for eating, breathing tubes, peeing and crapping tubes and so much agony I watched two of my best friends (both ex-Rangers!" lie there at about 90 pounds unable to talk, move or gain any relief despite being put on a "no-restriction" pain pump.  The pain and fear in their eyes have haunted me ever since..

.On August 9th of this year, I was given my monthly meds. Part of the contract said I have to use any person if my doctor was unavailable, so this was done by someone covering for someone who was covering for a doctor who was covering for mine!  I was treated like a dog from the gate, but ultimately got my med prescription.  I went to the pharmacy, and was given the wrong meds, which I never saw until I opened the bottle the next morning (Saturday)  and then had to tell them, so the pharmacist asked me to bring my meds in on Monday if I could wait that long.  I could and did.

He came out Monday, replaced the meds and as I had to take them right then.  I stopped by my (both terminal because of the "poisons" being pumped into them, then hit the bank and stopped to get the special nutrients anf fluids I have to have during these 100+ days. I came out and had left a digital camera in he cup holder (forgetting again) which was the "lure" from some asshole who broke into the car, got my camera, some tools, a change jar with about 50 bucks and the meds.

Called police, had a report made out, went back to pharmacy and found I'd been given right meds, just3 times stronger by mistake, which explained why the "fatigue attacks I've been having" hit me like a brick that day.

The upshot is even with a history of decreasing dosages, and increasing weight loss...after 5 months of "therapy" I had actually gained a pound and was stable at 155 for 2 months, they used the theft to kick me out (never had a "bad" UA, requested early refills, los or misplaced meds before...not only did they kick me off the program, referred me to a "pain management specialist (I had just seen one on the 9th who was quite concerned about my "not having enough pain management" ) the place I was referred to has a history of accepting referrals, making appointments, the on the day of the appointment, "cancelling them -not to be seen" by which time it is too late.

In ten days, from the 9th to the 19th, I had lost 12 pounds (I never got my refill until the 13th, and had to cut all in half for 2 days...even though all the medical literatures verifies "cold turkey" withdrawals from klonopin cause many deaths even in otherwise healthy people. The combo, cold turkey kills way more. The combination of advanced cachexia, PLUS w/d's from the combo (pain management clinics cannot prescribe any opiates with any benzodiazepines.  

The referral was faxed on August 14th, despite calling as instructed, leaving two messages, and telling my PCP, I'm down to about 10 days.  Normally you'd think, at that point go to the ER, right? Wrong! Not only are all Emergency Doctors "ordered under threat of suspension and  criminal charges," you are the "flagged" as an abuser, and you'll never be seen by anyone. Of course, the "doctors" think they've covered their butts, but the legal doctrines of "patient abandonment," "intentional negligence" and "infliction of emotional distress" (especially with emotional/mental health issues) as well as the collateral effects on family and loved one's as they watch their son, daughter, mom, dad, husband/wife and close friends. "Wrongful death actions are appearing more on court dockets. Of course, in my case...there's no time for that to be effective, but I truly hope my story can and will educate America's Last True Heroes, BEFORE it is too late for you as well.

Thank you ALL, from the bottom of my heart, and I sincerely apologize for what our "Golfer-In-Chief" has allowed to happen to so very many. In closing, I hope no one is offended by my praying for you all.

Respectfully,

Vinny Setala

 

 

     

 

Veteran's Narcotic's Contracts

I had signed a Veteran's Narcotics Contract for many years and had never used illegal drug's in my life, I went to a 35th high school reunion and was partying with friends I hadn't seen in over 30 years, there was some illegal drugs being done in the hotel room over the course of 2 day's, including some smoking of cocaine and marijuana, all I did was dring alcohol, however upon my next visit to the veteran's hospital about three days after I had returned to my city, my urine showed positive for cocaine, I tried to explain the situation to my primary care physician however they took me off all my med's within 5 days, I am told by other veterans that they had similar situation's happen to them, and after reestablishing a period of clean urines they were given back their narcotics, however my primary care physician is declining to put me back on them, he say's after I violated my contract he under no obligation to ever put me back on them, he say's it's totally against veterans policy, I have agreed to go through the SATT program and be tested for clean urines and do what ever it would take to get back their trust, but he say's it no use, I am disabled 100% and really need my medications to live my life somewhat normally, anyone have any situations or remedies or other veterans with any knowledge concerning Veteran policy?
Please help....Buck in Gainesville Florida

buck7583@bellsouth.net

Honest isn't always the best policy, but for me it worked out.

I started to become ill when I was 17 years old, I become progressively sicker with 1 autoimmune disease after the other.

I was once a healthy young man, and now I am lucky If I have enough energy to go out to the doctor. I only leave the house to see doctors.

I am 22 now and after years of suffering I took my pain control into my own hands. There were no doctors in my city to help me and no one would prescribe anything, not even non-narcotic pain relievers.

I decided to self medicated with Methadone which was wrong.

Finally after much time on Methadone (self medication with no doctor) I got into the ONLY pain specialist in my area.

The first thing I was presented with when I entered was a contract which I signed, I didn't know the urine test would follow.

I did the test and I FLUNKED. I tested positive for Methadone even though I had no prescription for any type of narcotic.

The doctor asked me how the drug made me feel when I used it, I stopped him explained I had been self-medication for pain control and not to get "high". The doctor paused for a while...he then reviewed my case and told me he would find a sensibile solution for this problem and that it was wrong for me to self-medicate but that someone should have intervened a long long time ago to help me with my pain issues and illness.

I walked out of that appointment with medication for the first time since I became ill, and for once, I realized someone understood me and didn't jump to conclusions and throw me out for being "dishonest" or a "drug seeker".

Not many of these good people exist but there are some doctors who will believe you and treat you with dignity and not rush to judgment and who will not label you something you are not.

This doctor took the time and used compassion to realize that I had no other choice but to medicate or to suffer even more than I already do now. When people are suffering from pain or illness they will self-medicate themselves...who can blame them?

Good luck to all of you who are looking for help with your pain. It took me over 4 years to get to this point but now I know I will be treated like a human being and it feels GREAT. That's all I ever wanted......nothing more, nothing less.

It is painful to be in pain.

That is a very encouraging story. I have had such a struggle looking for the solution to my chronic pain. I believe every pain sufferer can sympathize with you and Michael Krawitz.

I suffer from acute chronic pain on nearly a daily bases but I have always wanted to live a normal lifestyle. Since birth I have dealt with disability and chronic illness and until recently, had no one who was willing to listen to my difficulties. At age five I was diagnosed as having an un-identified form of Cerebral Palsy. To this day I still cannot pick up a pin a write on a piece of paper quite right.

I am unable to work and have been legally disabled for eight years now. I receive a small amount of SSI, not enough to live on, so I go to College to make ends meet. Normally I live in destitute caused by the chronic pain. People look down on me because I am impoverished.

I was a relatively healthy teenager and attempted to join the army but could not due to chronic ear infections. It pretty much started when I was seventeen, some peculiar adult onset ear condition and it has deprived me of that which so many others take for granted. I have been to hundreds of doctors who say they cannot fix it, half of them could not even figure it out.
Just recently a pain specialist diagnosed me as having gloscopherngial neuralgia.
Which makes sense because my grandfather is dying from a rare and relatively un-classified neurological disorder, similar to pseudo-Parkinson’s disease...

One of my previous physicians had discharged me from their clinic for not wanting to go to a pain clinic, where I had already been. I did not particularly relish the idea of traveling hundreds of miles while being in constant pain and leaving unfinished work to be done. I did not ever refuse, I just said I did not want to go, that I have done it before, and this regiment that I have been on over the last year-and-a-half is working great. I disagreed, but did not refuse. Biggest error I have ever made.

They had me on a 130 mg of Oxycontin and Percocet a day and then just told me to get lost. They did not slowly reduce my dose nor did they send me to any other doctors and I had been going to this clinic for well over a year. I was making straight As in college and was able to take trips to visit aging family members.

So I was basically just kicked out the door for no apparent reason. This drastically altered my lifestyle, and not for the better. But I figure business is business, once a doctor makes their decision, there’s nothing else to be said.

There is nothing personal, right? It is after everything, just business.

Well that is what I figured until I got another primary doctor.
My last physician agreed to a pain therapy regiment but I had to sign a contract of course. I submitted to the drug tests after having taking 8-12 Percocets a day for pain along with Valium, and Zoloft, 5 drug test were done on me total, at the same clinic, 3 of them during the same day.

Urine Drug test#1 :Negative(Same day)
Urine Drug test#2: Negative(Same day)
Blood Test#1: (Same day) Positive but for Methadone and nothing else. Methadone and NOTHING else.
Urine Drug test#3: Opiates and nothing else.
Urine Drug test#4: Opiates and methadone.

I realize that Methadone tests are a separate test for the urine but for goodness sake, the blood test took weeks to get back and when it did it was a GM-CS test and should have revealed the right medications in my system. The same day I got the blood-test results, they said they did a final urine test on me but without first telling me the results of my blood-test.

I was cut off of my medications because they said I was not supposed to be taking the methadone and I was not taking the methadone. They did not believe me. They said I could be selling them. Makes sense from an objective standpoint. I voluntarily went to Detoxify at the hospital twelve hours after. The hospital naturally did a drug screen on me and I came up positive for opiates and benzodiazepines just as I should have. Thus the prescribed Percocet and Valium. But the hospital did not find any methadone on their test. They found what I had been taking the whole time.

So I approached my former physicians office about this and they said they would not accept the hospital drug screen as evidence. Apparently I have quite the reputation in this little town and I am not sure what to do about it. I went off of the medications for two weeks, at least, and the pain was so severe I had to withdraw from an entire semester. Also after two weeks of being totally clean, my pulse and blood pressure would not stabilize. Once I started taking the pain meds again, my vitals stabilized after a week or two, and once the pain was under control my pulse went back to normal and I did not have to take the pulse and blood pressure medicine anymore.

Discipline assists control the effects of the pain somewhat. One of the benefits of having a Christian school education is acquiring discipline.

I do so feel sympathy for the doctors who might and do get taken advantage of. Yet still after this last debacle, I cannot rid the feeling that I was lied to just to get rid of me and not one person at that clinic was concerned with what was going to happen to me. They were not concerned whether I lived or died. It is true too, because I got an infection and a high fever, had nowhere else to turn to, and called that clinic and they said and I quote "Don't you get it? We dont want you to come back here! Now stop bothering us!"

So I did. Went out of town, sick, very sick, and found a clinic that would treat me.

This really happened.

Doctor’s definitely need more slack in order to properly fulfil their patients needs.

I am still in school, barely, but hanging in there nevertheless and will graduate college with my degree by 2010 or so. I have never sold a single pill to anyone in my entire lifetime. I do not drink, I avoid caffeine and rarely leave my bedroom, let alone leave my house and go prowling the streets at night to find some hapless bystander to sell my own much needed prescription pills to.

Now I do get a small amount of medicine a day but have to go on a four hour trip to the pain clinic to acquire it every month. The DEA’s crusade is destroying quality of lifestyle in the health system.
If doctors and patients have to have pain-drug contracts, they need to afford the patient the benefit-of-the-doubt and allow for, at least, a slight amount of unforseen circumstances. People should not be punished for making errors, the errors should be corrected, not flaunted and crushed against the patients and doctors. Sick and injured patients have a tough time of it as it is without having to endure neglect and humiliation.

The war on drugs is becoming a war against the average everyday, law abiding American citizen who unintentionally gets caught in the crossfire. Metaphorically speaking.

By any means necessary, I welcome your feedback and input Dear Reader...
snailrg@msn.com

I was called for a pill caount

My primary care doctor at the Va hospital in Togus, Maine called me to come in to count my opiate pills. I said I had no transportation but could be in on Monday, 3 days away. The nurse told me that the Contract that I had signed states that I must come in within 24 hours if asked for a pill count. The nurse told me to borrow a neighbors car. Keep in mind that I have taken 2- 750mg vicodin and I explained this to her. She says drive.... and the bottle that my vicodini is in states that I do not drive. HMMMMM! Who actually backs these contracts. Will the doctors boss take his side? This is so frigging frustrating. I have to call my doctor every month to reorder my prescription. Yes I take more then he prescribes me. I am a 325lb 36yo man with major back problems. I have had the surgeries, the injections and so on. The only thing that works for me is the opiates. And yes, I am addicted. I am addicted just like that ant anxiety crap they prescribe me but you do not see you mental health doctor make you sign a contract for Klonopin. Klonopin is more abused than opiates. I have been taking opiates for 4 years and not once has my doctor increased my dosage even while knowing that I need an increase for my pain. WTF

Life is very hard?

... I have problem with my back, knee, and neck.... I just can't take Lortab and OC Because I just end up with ADDICT and my liver and kidney are about to DESTROYED! So I go to Clinic and take Methadone... Understand... I am DA with UNDER SSD and Medicare and Medicaid and Well care insurance.... However, the clinic will not ACCPECT my all kind of insurance... and ALL MY INSURANCE was told that they will PAY for my methadone rx so I only pay 1.05 for one full month of methadone... But Clinic make me pay 430 dollar every monthly... So How can I solving problem and get this work out? So Clinic told me they accpect insurance for Suboxane... But.. My insurance will not cover it since I am DA with pain problem... So I need something to help me with pain too.. (sorry for my English grammar since English isn't my first language... I am use American Sign Language.) JLearH@aol.com

start a legal movement

to stop this nonsense.

We are patients, not criminals and should not be treated as such..

What we do outside of the doctor's office is quite frankly none of their business..

If you are selling your meds or buying illegal drugs it is a matter for law enforcement, not your doctor.

Let them do their job for cripes sakes.

I will be happy to sign anything that is legal to stop this.

narcotic contracts

I signed a narcotic contract with a doctor about a year ago and recently at an office visit she told me she didnt think I was benefiting at all from the narcotics and took me off of them and put me on multiple non narcotic meds. I tried the new meds for about a week and they did not help the pain got so bad i ended up going into the er, the next morning i called my doctor to explain the new combination of meds was not helping me at all I did not even ask her to put me back on the narcotics she simply had her nurse call me back a very rudely told me "absolutly not she will no longer prescribe the narcotics to you" then she proceded to tell me "if a different provider feels comfortable doing this for you, you can go ahead and try that" so I did set up an appointment with another provider who did put me back on the narcotic. now a couple of weeks later I get a letter from the first doctor I spoke of telling me I never complied with any other referalls she had given me besides wanting the pain medication and that she has recently been informed that I am getting narcotics from a different health care facility therefor she will know longer provide narcotics for me ( which I thought was already established befor I went to a different doctor) and she will no longer see me. OK fine but now what I am worried about is what does this do for my permanent record - which by the way I did contact my current/new provider and told her I do not want the narcotics any more and asked her if we could come up with a different solution. like I said i have a concern about how this will effect me I am currently a student studying in the health care field I do not need a drug seeker label I feel as though my reputation is being slandered but i will admit i didnt follow through with all the things I should have I just wanted the pain to go away i feel as if im to busy and have to many other things i need to take care of or do instead of things such as physical therapy. does any one know how this horrible misunderstanding and neglect from myself is going to affect me. (I feel like Im in trouble or something)???????

no record

there is no permanent record other than the notes and records of doctors that you have seen. Just dont mention the doctors that you have seen that have bad records on you

are you sure?

I'm wondering about the records thing because while at my PCP he was able to pull up every time I had been at 2 different emergency rooms and exactly what they perscribed and what treatment I received. With medical records being made digital I'm worried that excluding a doctor who has bad info about you could back fire.
What do you think?

Thanks,
Le Mara

Cant find a doctor

Please help. Im in really bad pain due to neuropathy. I spent 1 year in the hospital with 6 surgeries, a colostomy,complications,then mersa suegery then more complications then after the dust cleared I ended up with a fistula and neuropathy. I have bad cramps and burning sensation on my ankles. I walk with a cane because I cant move my right ankle up or down,the nerves are totally shot. Only a person with severe neuropathy knows how painful it can be. I used to be a pro soccer player and know I cant even walk. I know what its like to feel pain because of lifting weights,running and pushing myself to the extremes to perfect my soccer craft so what Im trying to say is that IM not a girl man or a wus complaining about unjustified pain. I havewas on liquid dilauted in the hospital sometimes up to 8mg so I have built a tolerance to pain meds, and it seems like only opiates or oxydose oral solution has worked for me but after having surgeries and a pain doctor in Arizona I moved to Dalla and I cant find a doctor to treat me and give me the opiates I need to relieve my pain,My PCP prescribed me my oxydose but not nearly as much as I needed and told me she would only do so until I found a pain management doctor and after doing so for a year she dropped me. I had and been having a big problem finding a pain doctor who accepts my insurance Medicade Evercare and when I finally did he treated me like a drug seeker and would not prescribe the opiates that I was on for a year but offered non opiates and said he would not prescribe me what I was on as if I was taking it to get hi. I told him that if I wanted to get hi I would do cocain (Im no a drug user) and not oxydose oral solution which tastes like crap and makes me sleepy. Since then Im out of meds and feel like pulling all the hair out of my head or am starting to entertain the thought of commiting suicide due to the unbearable pain.How can I find a doctor to give me strong medication that I know a least for now works on me even though these past few years I have built a tolerance to it. My family thinks Im an addict but they dont understand that I need the meds for my pain and not to get hi. Most if not all doctors I have me are shit and treat you as a guilty drug seeker until you prove otherwise. What can I Do. I bring my medical records to meetings with new doctors but up to this point no luck finding a compasionat (sp) doctor willing to take care of me. I dont know what to do. Sorry for the misspelled words Im writing fast and in pain.

HELLO CAN'T FIND A DOCTOR

I MYSELF WENT TO PAIN MANEGMENT FOR FIVE YEARS THEN WENT TO A DENTIST, THERE THEY TOLD ME THAT THE PATCH I WAS ON DIDN'T HELP DENTAL PAIN BY THE WAY I HAD FOUR TEETH PULLED THE VERY NEXT MONTH THE DOCTOR SAID THAT HE WAS NOT GOING TO TREAT ME ANYMORE AND STOP TREATING ME. BECAUSE I GOT MOPTRIN 600MG AND AN ANTIBOTIC I DID NOT GO TO ANOTHER M.D. LIKE THE CONTRACT SAID BUT ANYWAY MY OWN DOCTOR THAT SENT ME TO THIS PLACE WON'T EVEN GIVE ME ANYTHING. NOW I'M STUCK WITHOUT A DOCTOR AND NO PAIN MEDICATION I'M HOPING I CAN GET ANOTHER DOCTOR AND I WONDER IF THEY WOULD KNOW ABOUT THIS IF I SAY NOTHING TO THEM IF I DO FIND ONE AND ITS BEEN ALMOST A YEAR BECAUSE NO ONE WANTS NEW CLINENTS BUT THEY DO HAVE MEDICAL RECORD NUMBERS HOW DO YOU EXPLAIN SOMETHING TO THAT DOCTOR FOR THE HELP I NEED CAN SOMEONE TELL ME THAT IN WILKES-BAREE ,PA PLEASE HELP ME THERE MUST BE A DIFFERENT WAY AROUND THIS, I NEED A DOCTOR CAN YOU HELP WITH THIS THANKS.

Devil Doctors and their Evil Agreements

First, I do not suffer chronic pain, so for those of you who feel I have no credibility to comment on this article, I will save you the additional pain of continuing to read this comment.

My opinion is that Doctors are NOTusing pain/opioid agreements 1) to trample on the rights of those with chronic pain 2) because they don't care about their patients, or 3) because they enjoy masochism. My *wild* guess is that Doctors are using these agreements (contracts) to minimize liability.

Based on the comments I have read, I can understand why many of those on this forum have no love for doctors. Having said that, it seems like a far stretch to blame them for using these agreements. Does a compassionate doctor = someone that does not care about losing their practice, career, and source of income due to a lawsuit? If someone can prove that no doctor has ever been sued for prescribing narcotics to someone who, unbeknownst to the prescribing physician, was also taking illegal drugs, ultimately leading to injury, then you've got a point. Otherwise, doesn't it make sense to try and understand the reason doctors are using these agreements? Maybe its just more fun to bitch.

Compassion = Compassion
Prescribing powerful pain narcotics to someone that the doctor 1) knows is taking other potentially dangerous medications/drugs or 2) doesn't care whether they are or not = stupid, not compassionate.

Our litigious society is likely more to blame than the Doctors. It is the fault of Doctors that act like drug dealers and get caught; it is the fault of addicts that flummox Doctors into prescribing pain meds, then sue them when they get injured - everyone else suffers (literally) due to the poor judgment of the shallow end of the gene pool. I guess you would have to pay an exorbitant med mal insurance policy premium to begin to understand why Doctors are trying to protect their asses.

Certainly, if you explain this away by simply demonizing those in the health care industry (of which I am not a part of), assuming they have ill will against all those with pain, then who cares about trying to understand why they have taken the actions discussed in this forum?

Yea!!Maybe it's more fun to bitch. What an assinine statement

I am a disabled veterans who broke his back in 1977 and had to have a L4-S1 Fusion. Since that time and after working in communications for over 20 years climbing telephone poles, towers etc. In 1986 I was diagnosed with pseudoarthrosis, crack in the fusion is what it amounts to. Now I have a whole sheet of secondary symptoms caused by the injections and pushing my back way beyond it's limits. I started having steroid injections sometimes 6 in a month, that should be a years worth by the way. Anyway in 2001 I was totally disabled from all the damage done to my back. In that 7 year time frame I have been discharged from 3 clinics because they said my dose of opiates was to high and it may bring the DEA down on them. The highest does of anything I been on during that 7 years was 400mg of morphine a day. The other reason these jackass doctors let me go is that I refused to have anymore injections done in my lower back. The last injections I had was in 2005 because that jerk doctor threatened to let me go if I didn't at least give them a try. Like the other 15 years worth I had them didn't count. I let him give me 6 to the tune of $3500, 5 months later he let me go sighting he was affraid the DEA might bust him for having me on to higher dose of meds, 400 mg Morphine every 24 hours. The lower end of my spine looks like a damn jig saw puzzle. The majority of the time these doctors that do get busted and loose their license is because they don't keep their records in order.
Don't preach on something you know very little about.

IN PAIN''''

I MYSELF SIGNED A PAIN CONTRACT, FOR 5 YEARS I DID GREAT BUT THEN I HAD DENTAL PAIN WENT TO THE DENTIST HE SAID YOU NEED FOUR TEETH PULLED THEN I TOLD HIM I WAS ON THE FENYTAL PATCH HE TOLD ME THAT DOES NOT HELP WITH DENTAL PAIN SO AFTER HE WAS DONE I GOT MOTRIN 600MG AND AN ANTIBIOTIC ONE MONTH LATER I WENT BACK TO PAIN MANEGMENT THEY TOLD ME THAT THEY WERE NOT GOING TO HELP ME ANYMORE DUE TO GETTING MEDICINE ELSEWHERE I TRIED TO EXPLAIN ABOUT THE DENTAL PAIN AND HOW I WENT TO A DENTIST AND NOT GIVIN THE SAME MEDICINE THEY DIDN'T CARE,SO NOW I NEED ANOTHER DOCTOR IN PA' CAN ANYONE HELP ME WITH THIS I THINK, THAT THEY SHOULD HAVE CHECKED MY RECORD AND THE LENGHT OF TIME THAT I WAS GOING THERE WITH NO PROBLEMS. ANY WAY CAN I GO TO ANOTHER DOCTOR AND WOULD THEY FIND THIS OUT. PLEASE HELP.

drug testing/privacy rights

I don't know if this subject has been broached here or not.( I can't find it) but does anyone know where I can find NY state policy on drug test by Dr's for patients who are taking narcotics ? This seems inherently wrong to me and against my civil rights. I just found out about this and am appalled .

band together

Instead of just whining on website's, let's get together and complain.I'll join in anything legal to fight contracts for medicine I need.

Not to mention it's a violation of the constitution and quite frankly it's none of the doctor's business what I do when I leave there.
I have nothing to hide, I only take what is given by my doctor.
I'm insulted by the insinuation that I am buying and using illegal drugs by being forced to take a urine test,

guilty until proven innocent

I hear you! There doesn't appear to be ANYONE out there that is in our corner legally OR medically. These draconian contracts and the ua tests are demeaning and insulting! I'm as transperent as glass! I worked for the government for over 30+ years before my disability left me totally crippled, near blind and in continuous pain. Now I have to pee in a cup and have been told that I cannot even drink alcohol (because of my pain meds). I've never abused any drug, always had one pharmacy and made sure that all my doctors were kept abreast of everything that I was doing! Pee in the cup! Bring in ALL your meds to be counted! WTF??? I signed the damned contract...they waited until I no longer had any pills left...and now they treat me like an abuser! They wonder why there is a black market or why people 'go postal'...? This is why. We need representation and we need compassion. I will do ANYTHING to bring this about....until I can't take it anymore. Then Pffffft! I'm not afraid of death, I am afraid of the screaming pain. I live in a box. I'm hooked to an oxygen tank and I cannot walk and barely see. I don't own a car. I see...no one! Yet I'm labelled a 'drug addict'....and made to sign a contract. *grin* Only for so long... Let's try to get things started?! Be well!-Al (aatwood77@ct.metrocast.net)

What course of action can i take to protect my self

My case may be unique in that I stopped taking pain meds after 2 years with out suggestion from my doctor.(4, 5/325 norco a day). I was just tired of being dependent on opiates to get out of bed every day. It was hell, but I stopped cold turkey, It took my digestive system 5 months to recover. I have scoliosis and degenerative disc and cupped joints at L5/L6.

More to the point after a year of trying to deal with the pain and being narcotic free (unless you count pot, I don't) I decided to let my doctor know that I wanted pain meds to use when needed and not on a daily bases due to the addictive nature of the drug. Over the next few months we found a regiment that worked for me. One 10/325mg norco twice a day as needed for pain. He prescribed me 45 pills for 30 days. If you do the math it works out to 22.5 days worth of pills as prescribed. I currently take it for about 4 days then none for three days. During my last visit I was asked to take a ua. My doctor was short to point and gave me no time to ask questions before he left the room sending his nurse in with the paper work. She was short but told me the test was random (yeah right 50% of all chronic pain patients are tested) and to check if I was using the meds I was prescribed.

The nurse hands me the paperwork and I notice The request for a panel #7 drug screen and to test for hyrocodone and alprazolam. Hmm, I don't remember signing a contract for the xanax, but then xanax has a tendency to help you forget those kind of things.

I'm currently waiting for my test results to come back showing no hydrocodone since I had not been using it for the past 3 days due to constipation. Xanax will be there since I take it every day. Then there's the issue of thc possibly being there. I guess we will see.

In my opinion the whole contract thing is flawed. How can I be tested for a drug my doctor knows I don't take every day, don't get prescribed enough to take every day and have that test helled against me and in my record as a negative. It's not fair, it's not right, we are all victims of some ones statistical experiment. What we need is an advocate to fight against these contracts or allow for the contract to be amended.

Where does a contract end and a new one begin. During the time I had stopped taking pain meds I had a visit to the dentist. With respect to the contract I had called my doctor to see if it was ok to get pain meds from the dentist. His response was "if your not getting pain meds from us then your contract is no longer valid, it's fine". When I started taking norco from my doctor again a year later he never had me sign a new contract. I also made it very clear that I didn't want chronic pain treatment just enough meds to take care of the pain when it's unbearable. I don't wan't to be dependent. Is my doctor not listening or is there something else going on.

Has anyone had this experience or know what I can expect. What can I do If my doctor tries to cut me off? Can I dispute the any negative notes or flags from being entered in my medical file? If I get cut off what's the likely hood of getting pain meds from another doctor? Should I be worried about loosing my anxiety meds. If so it just puts the public at risk. Not a threat just a fact from some one who is tired of this countrys Fd up rules and regulations. Take my tranqs away and there's no telling what I'll do. That's why I take them.

This could be me! It's a

This could be me! It's a "Twilight Zone" type of moment for the doctors when you just need what you need when you need it - not all the time on some regimented schedule. They are very worried about themselves all the time. It's odd they let the patients in on that. We come to them for help and they lean all over us with their conditions of treatment. It's often their way or no way. They won't take the time to listen to you no matter how rational you may be. You are looked upon with suspicion. It is tough to get help. I want to say I understand about your anxiety meds. I take them too. Doctors should not be police.

Left my pain doctor today, after he asked me to give up my civil rights. I can get the anx meds from a psychiatrist.

terminated in TN

First of all, having moved to TN 2 years ago, I have no insurance (unemployed). While living in CA I was receiving treatment including pain management. Having insurance through my employer of course made everything easier. In 2000 I had a diskectomy L4/L5 after the disc actually ruptured. Anyway, it took awhile to get through the right channels but once accepted into the pain management treatment evrything was great and I was never asked to submit to any tests let alone a urine test.
Having NO treatment for almost 2 years and due to the severe pain, employment was not an option. I have worked in IT for more than 10 years- as a certified Network Engineer. The point being I could be a contributing member to society (paying taxes etc.) if able to find relief from the severe sciatica pain.
OK- so out of desperation I pulled my 401K and used it to pay for a PCP ($178.00 per visit), an MRI ($800.00), a Neurosurgeon consult ($280.00) etc. Finally, I was referred to a pain management clinic for injections ($2000.00 each) and the PCP agreed to write a script for 7.5 Vicodin 4 times a day ($100.00 per month). So, now I am finally set up for 3 refills before having to see the PCP again. WHEW! THEN- they asked for a urine test which completely threw me for a loop. I have only had to take one of those once before for a job with Sitel in a call center for $9.00 an hour, here in TN. The job sucked by the way and was a far cry from my not only my skill set but also pay range. I passed the test for Sitel. But, I had smoked MJ a couple days before this appointment- because the PCP had left me without meds for 5 days until the appointment. I failed and have been TERMINATED from not only the meds through the PCP but also the injections. I was given no explanation or any chance to explain myself. I very rarely smoke MJ.
With the treatment I was receiving I felt so much better I began my job search again. Now- I'm back on the couch and half broke on top of it.
Does anyone know how to get a second chance or how to approach a new PCP? People here in TN say that I am blacklisted and will not be able to find any PCP to accept me into a pain management program- period.

Looking for advice if there is any out there!
Thanks,
Le Mara

OLD DOCTORS TRUTH ON PAIN MED LAW VS NEW DOCTORS

HELLO I AM A 38 YEAR OLD MALE,AND AT THE AGE OF 29 WORKING FOR THE TELEPHONE COMPANY I WAS GAFFING A TELEPHONE POLE AND SPIKE ON GAFF WENT IN A OLD HOLE MADE BY PRIOR TECH.,I ENDED UP SLIDEING DOWN POLE AND LANDIND VERY HARD ON MY FEET.WELL KNEES ENDED UP ABOVE MY HEAD AND MY BACK SIDE HITING GROUND AS WELL VERY HARD.AFTER ALL SAID AND DONE I HERNIATED 3 DISC ,ALL3 LEVELS IN A ROW.I HAVE HAD 3 SURGERYS THAT HELPED VERY LITTLE .I SAW A DR FOR PAIN AND HIS TREATMENT WITH PAIN MEDS HELPED TAKE PAIN LEVEL FROM A10 TO A 3.UNFORTIONTALLY I HAD FLAIR UP AND WENT TO ER ,I TOLD DR AND HE SAID SINCE I FILLED ER PAIN SCRIPTS HE HAD TO STOP SEEING ME BUT LAW SAYS HE HAS TO GIVE 30 DAY SUPPLY SO I COULD FIND NEW DR.NEW DR IS NOT KEEPING ME AT A LEVEL OF COMFORT IM HAPPY WITH ,SO I ASK TO BE LET OUT OF COTRACT TO SEEK ANOTHER DR BUT THIS DR SAID SHE WILL NOT AND DOES NOT HAVE TO GIVE ME 30 DAY SUPPLY TO FIND ANOTHER DR.DOES ANYBODY KNOW DR,S OBLAGATION ON THIS MATTER I FEEL AS IF DR IS KEEPING ME HOSTAGE BECAUSE I CAN NOT GO WITH OUT MEDS EVEN FOR COUPLE DAYS,NOT TO MENTION I WONT FEEL GOOD ENOUGH TO LOOK FOR NEW DR WITHOUT MEDS BECAUES IVE BEEN ON THEM FOR YEARS.PLEASE SOMEONE WHO REALLY KNOWS DR,S OBLAGATION TO THIS MATTER RESPONED AT randymcfarland3@yahoo.com THANK YOU FOR YOUR TIME

Please help

I was recently cut off of my methadone for having morphine in my urine. I was referred to a new clinic by my regular doctor, do you think that someone else will fill the narcotics for me even if my doctor is tapering me off of them while I wait to get it to see someone else. I have thirteen inches of metal in my back and a failed huge spinal fusion. I made a huge mistake to take a pill tht wasnt prescribed for me, I will think twice nextime. Do you think that I am done for good with the narcotics? I am currently taking 20mg after 30mg last week and 10mg next week, when I will be going to a new doc... Please help me!!!

What can we do???

I have read many stories on this page that strike home, sadly, but what are our options? Here's what happened to me.
I am 30 years old. I once had big dreams of being a fashion designer, a successful parent,wife,and worker. I worked very hard at every job and through school. At age 24 I was diagnosed with an auto-immune disorder which affects all my connective tissue. Basically, my body can no longer support it's own weight, and I injure myself doing very "normal" activities. In addition to that causing severe,constant,wide-spread chronic pain, I also suffer from migraines, eye issues, depression,and panic disorder. Anyone who's lived with chronic pain knows it has profound effects on mental state and well being. After going through several forms of therapy which did not involve narcotic meds I eventually resorted to pain management. The first doctor I had was very kind and understanding. He had me on Oxycontin,Percocet,and Klonopin, for well over a year. I did sign his pain contract, however was honest about my use of marijuana. He told me "we had to be careful",but never mentioned having to remove me from meds when I tested positive for it. Six months after I had tested positive for marijuana my beloved doctor got married and moved out of state. I had always taken my meds as prescribed and was nothing but pleasant and humble. The next appointment I saw a new doctor. He basically walked into the room and told me that he would be cold turkey removing me from my meds because I had previously tested positive for marijuana. He refused to test me again, and claimed he could lose his license to practice medicine. After two weeks of withdrawals, starving, without sleep, I began having convulsions, my husband called 911. I was so severely dehydrated I was dangerously close to heart failure.I was sent home with three non narcotic medications to lower my blood pressure and stop the kicking, etc. This did not help. The next day I was in an ambulance again. This time I was sent to an inpatient rehab facility where they documented I did NOT have a problem with drug addiction, but my body had, over the course of years, become dependent. I then went through five grueling weeks of full time outpatient care through the Cleveland clinics pain management program. They stress not taking narcotics. At the end of the program I was narcotic free, but had been placed on thirteen other drugs,which left me in pain, and unable to care for myself, anyone else, and unable to complete a full sentence, or thought. Eventually I returned to a different pain management doctor. I was again forced to sign an agreement, forced to give urine almost every time I went.
I believe because I am fairly young, that I am usually looked at as a "drug seeker". All I've ever tried to do is live a somewhat normal life the pain otherwise takes from me. I moved from Ohio to Washington state with my family. Washington does have medical marijuana laws in place. I do know several people who are "legal", but that doesn't mean much to the doctors, or the federal government. I found a family care doc. who was very compassionate and understanding. He prescribed methadone, 10mg. 3x daily, vicoden for breakthrough pain,and Klonopin for anxiety. He was aware that I smoke pot. I have never been dishonest about it. Although I did sign an agreement with him, he never gave me a UA. For thirteen months, I lived an almost normal existence, and then it happened again. My doctor left the practice, I do not know where he went. He was replaced with a woman, fresh out of medical school, not from this country. The first time I saw her she was speaking her native tongue while examining me to her nurse, and seemed frustrated when I politely asked her to speak English. She then had me resign a new contract with her for the pain meds which she told me up front she was not comfortable prescribing me. The next thing she did was cut my medications by 35%, and asked me for a drug screening. I told her that I smoke pot, and didn't want any trouble. She acted as if she was doing me a favor by not doing the test in that visit, asking me to quit. So I did. I was in her office two more times in the next two months, she did not ask me for the screening. I had gone without the marijuana for the sake of keeping my meds. Then I called for my refills. I had called two days prior to running out, as they require. On the third day I was out of two of the three, and had cut back the methadone, as to not run out completely. Although I had made numerous calls to the office, and requested a call back from the nurse, I had heard nothing but "wait". It was Friday, the office would be closed in the matter of a couple hours, and I was facing being out of all meds for the weekend. I had a panic attack at this time. I believed I would be completely ignored, and it caused an attack I otherwise did not need to go through. At this time I smoked marijuana, which at least calmed me down,settled my stomach and detached me from the pain I was in. Thirty minutes before the office closed I received a call from the nurse, asking me if I had gone to pain management yet. Apparently the doctor had made a note that she'd rather I go to pain management, although she made the mistake of not informing me and never sending a referral, the nurse told me the doctor had agreed to fill twelve days of my meds. until I could come in for an office visit, to discuss the coming referral. I told the nurse that I had already scheduled another appointment with a different doctor at the facility, as this one was SO uncomfortable with therapies that had made my life livable. I do not own a vehicle at this time. I had to catch a ride before the office closed. When I arrived, the receptionist pulled my envelope from her drawer which had a yellow post it attached stating a UA was required before I could pick up my meds. Knowing I would test positive for marijuana, and knowing what had happened in the past for testing positive for it, I refused. The receptionist informed me that if I walked out of the building, even to ask my ride if he minded waiting for me, I would no longer be allowed to get my meds from any doctor at their facility . I never even tested positive for ANYTHING but my refusal effectively cut me off. THIS IS WRONG!!! The whole system is WRONG! If you are lucky enough to find an understanding doctor, all is well, and the laws don't (seem to) apply, but of course, the system is run by fear, and according to the whims of the particular doctor. After going through much anguish in the days that have followed, I have come to the conclusion that this so called Doctor deliberately placed me in a situation where I would find it necessary to smoke, therefore entrapping me in this whole hypocrisy. I find it absolutely hypocritical to prescribe medications that,(however much they DO improve life quality when used correctly) are proven to cause long term damage to the body, only to yank them away without weening, which causes even worse issues physically, over something actually therapeutic and harmless as marijuana. The last time this happened to me I followed the protocols, this time I refuse to continue suffering, or go through any other program that would attempt to label me an addict(until the assessments prove otherwise) . I will, at the risk of losing everything in life that has made me stable financially, continue to find my medications elsewhere. Unfortunately, for every one of us who actually needs the medication, there are a hundred more who have found their way around the system, and use prescriptions as income, or as a way to feed the other addictions in their lives. Eventually, I will find myself with another pain management specialist, and (until we stand up and do something about it) will sign another contract, and begin the whole vicious cycle over again. I would like to know what can be done to change the laws in this matter to better suit the patients. While seeking ways to change the system, I will continue the rat race that is attempting to keep myself out of pain on a day to day basis. Any help, advice, or brotherhood/sisterhood is much welcome. astring79@yahoo.com

CONTRACTS - NO SURPRISE.

All the visits I had with my primary doc have been rush, rush, rush.The VA overbooks the appointment time to see as many vets as possible. So I'm a 30-year Active Duty Vet and he never served this country, I can get past that. But when they rush rush rush through a pain management contract, still have time to make sure there is a nurse witness, do not discuss any Chain of Custody measures, Protected Personal Information (PII), what institute is testing the specimen, and what method of testing is being used, it leaves alot of trust in the sytem to provide the results you are already sure of, considering the consequences that will surely follow -- you can count on it.

I'm of the opinion (as a federal agent now) that there should be at the very least, at the very least, some inkling of "probable cause" by the doctor when they make the vet submit to the contract if he wants to receive his medical benefits for serving our country. There's no parameters established fin the contract or probable cause either. There's alot to risk and alot to give, for getting so little information and hoping everything works out OK. Somebody smart needs to look at this entire process. Betcha there's a HIPA violation around the corner too, or just wait until the next theft of a VA laptop or database with PII stored. It's another way to be a victim, or to lose your hard earned benefits if you are a vet. KILROY WAS HERE.

Who proffits from the sale

Who proffits from the sale of all these extra ua tests?
Do they have lobyists pushing these policies?
My wife had acl and meniscus surgeries but was told she still needs a knee replacement
Her orthopedic surgeon said if she was 10 tears older he would tell her to retire
So she is supposed to wait untill it is "unbearable" and then he will operate
Meanwhile, her "clinic" will not increase her pain meds post op because she signed a "contract" to reduce them
She "applied" to be a new patient at another facility
They said she broke her "contract" with the "clinic" and could not be rx'd pain meds as a new patient
If she gets hit by a bus, will the ER admit her?
She is a saint, but will she get into heaven?
Where will this end?
Who is the customer?
Who is being paid to do what?
Who is serving who?
Demand satisfaction!

pain forever i guess

My doctor is very tight with meds and i have to beg for pain relieve. Even though i Have Rheumatoid arthritis,peripheal neuropathy,heart disease,thyroid disease and to many diseases to mentions i get 3 vicondin a day and nerurotin 3 times a day that is it any more and he says it will cause me to be an addict. When someone is in terrible pain and has to live everyday with it they should get relief.Life should not be one of torture..Thanks,Ayzle

new to these pain contracts

Today I was asked/'forced' to sign a pain contract. I've been on oxycontin (90mg/day) for the past 5 years after a sudden DVT, severe diabetes and rheumatoid arthritis. My old doctor of twenty+ years was diagnosed with end-stage cancer and left his practice leaving me to find another primary care doctor. After 3-1/2 months of intense searching and being called 'drug addict' and thrown out of doctors offices I located another Internal Medicine primary care physician. She is an excellent doctor! 2 months ago the DEA came and yanked her controlled substance license (leaving her standard med license intact!) Again, I' found myself on the street and looking! I'm about as transperent as glass. I have one pharmacy and I only get my oxy from one doctor! Today, on my 2nd 'interview' with the new doctor, I was introduced to this draconian contract that I had to sign or I wouldn't get my refill on my pain meds. I have to pee into a cup (monitored) and bring ALL my other meds to the office next month for them to COUNT MY PILLS, narcotic or not! I was told that if I even tested positive for alcohol that they would refuse my refills! They denied me a supplemental amount of oxy for any 'breakthrough' pain and told me if I ran out of meds or lost them that I could not get them replaced. I worked for the government for over 30 years and have never once been subjected to a pee test! Besides that, I have severe glaucoma and retinopathy so I'm almost blind...I don't drive, can hardly even walk and am hooked up to oxygen 24/7. Why no alcohol? (I don't drink anyway 'cause it reacts poorly with my meds) but still....now I'm not allowed to drink! Which is legal the last time I looked! I do occasionally enjoy abit of marijuana as it eases my tension and allows me to sleep but peeing into a cup??? My pain dose hasn't changed in over 5 years! and still they treat me like I'm a drug addict! My new (soon to be old) doctor claimed that she could lose her license to practice medicine if she 'allowed' me to smoke the random joint! That is an outright LIE!!! In SE Ct. if you mention Pain Management the doctors get this frightened look in their eyes and most slam the door in your face! I wrote a scathing letter to the DEA about this crap. When they finally did respond it was to wash their culpable hands with, "Go to the ER" They just don't get it. The tighter the noose the larger the black market. Prohibition didn't work. I live in a box...I see people only when I venture forth to a doctors office, about 1xmonth. How am I hurting anyone by smoking pot once in a while? I'm on the fast track out of here but they seemed intent on regulating my bowel movements! wtf? There is not a legitimate Pain Management Center for 50 miles in any direction from New London. I barely subsist on disability pay and cannot walk. I have no car. Now they insist on counting my pills! I'll be damned. It's better off to be dead than to be a puppet. I have the insulin and about 30 minutes...death doesn't scare me, living in pain does. Screaming, crying, breathtaking pain...and they're worried about their damned medical license and big brothers regulatory dildo. I'm glad I know just where I stand in the evolutionary process of modern America. The War on Drugs isn't brought on by altruism, it's brought on by greed and big pharma. Why?

dilaudid

i am 50%sc for prostrating migraines but i do not use the va health system because i have been told that it would be a waste of time as they would not give me the meds that i take that work fairly well. i see a private doctor that has prescribed me 120 dilaudid 8mg, 120 tylenol#4, and 45 xanax 2mg monthly for the last 3 years. no contract. i am afraid to go to a vamc here in pa because they will give me morphine and/or methadone candy and klonopin which do not work and make me sick. what a shame. if i go to the va and try to get my meds, i will be considered a drug addict and made to sign a contract and thrown into some group. i am so glad that i have a plan through medicare. anyone get dilaudid 8mg from the va?

VA healthcare

They call it healthcare but what they provide is far from it. I have been going to the va for a service connected injury, 50%. I suffer with pain 24/7, I have had my dosave increased once from 5mg to 10mg of methadone and I take 5mg of oxycodone for break tbrough pain. The dose does nothing to relieve any pain I have. I requested to be weaned off methadone because the withdrawal is horrible if they are late sending my Rx. They put me on tramadol 50mg, it's like taking nothing. I'm in so much pain I think suicide would be more humane and I did atempt to take my life and failed. I took what I thought would do the job & my husband found me & took me to the hospital. I was in no real danger, the ER doc said I have built a tolerence to the medication. They worked when I first started taking them 10 years ago but now they have no affect at my present dose and barely any at a higher dose. I still had pain on a scale of 7 out of the 1-10 they use to determine your pain level. I can't go on living with this pain so I figure I have two choices, ask for a med change & higher dose or go to an out side doctor for my treatment if they refuse. I'm lucky my husband has good insurance and I feel for those Veterans that don't and have to put up with their crap. I have stayed with the va because of the ease of having my medical records available for when I go for reevaluations of my disability, but I can work it out if I have to with an outside doctor. The va acts all bewildered when when asked why the suicide rate is so high for Veterans. They don't care as long as they can collect that paycheck and make it to retirement, they have cushy jobs and no compassion or conscience. You can't fight them so what are our chances for better care? It may ly in making the public more aware of our plight by having demonstrations with signs letting them know whats going on. But one person won't make a difference, to take down a bully it takes a community just like union members on a strike. I wish you all much luck in your future in pain control.

the pain contract I was made

the pain contract I was made to sign left me feeling like I was a common drug street addict signed under derest it was either or I have fibromyalgia and it hurts I only have Lortabs thats all I have troble sleeping the pain is bad at night now I am afraid to take them so now I am here in pain and don"t know what to do I get so tired of doctors looking at me like I just want drugs what comes next??

It should be allowed.

 

 I am a vet also. The VA policy is if it is legal in your state to smoke Medical Marijuana it is not a violation If your provider agrees - Good luck with that. We vets gave way too much and we neede to fight - I am being blackmailed into going to a pain clinic after a long time - no infractions, just eithyer go or no pills. that sucks and I am goingg to fight it.

A.

I am a 40 yr. old Gulf War

I am a 40 yr. old Gulf War Veteran 1991 Desert Storm and, live on morphine and, hydrocodone. The Va half-ass keeps me going on my meds, due to their damn mailing policy. Like today, I had called last week to get my hydrocodone refilled but, they again screwed around and, now it will be after the first of the year because they are sent from Tennessee. Incompetency reigns supreme once again. The DEA can look at my meds whatever as long as they don't delay them GOT ME?

It's Unfair

While I understand that some people do earnestly deserve their meds, some of you (weed heads) need to be thankful that you get any thing at all. If weed helps you so much with your pain than why don't you just use that? I'm sick of people like you getting more amounts of pain meds than someone like me who really needs it. My last pm  who I had to fire only would give me crappy 5mg of percs, when I'm a dialysis patient who has severe chronic pain all day every day and perc barely touches the pain, yet I don't go from place to place seeking drugs or use illegal drugs, I try to be honest and I still get screwed over while they give all the strong pain meds to people who "lose" them or use illegal means to relieve their pain. It does not matter that you smoke mj to get rid of your pain, what matters is that your doing something illegal, whether you feel a lot of people does it or not. It still doesn't make it right, you should be glad you get any thing at all!!! I'm sick of you all getting the strong pain meds that I deserve. It gets so bad that I want to stop doing dialysis and go through hospice. So really you have nothing to complain about and you need to remember that its people out there with worse diseases than you that you're taking all the stronger needed pain meds from,instead of complaining just stop doing things that are illegal so that you can stay in the program!!

you are a fucking loser...

you are a fucking loser... who the hell are you to make a judgement about  someones pain level just because they smoke marijuana.....I hope you get your pain meds taken away and you live a long miserable life. You sound like a typical drug seeker to me.  If your doctor only gave you 5mg....there must be a reason.

Pain contracts and loss of med ins.

I have a question that I need some help with. I had Kaiser for insurance and was on a pain contract with them, well i got laid off from my job so lost my insurance. Now I dont know what to do. How do I go about keeping my contract with another dr, or is my contract now void since I losr my insurance. I am so confused and am in soooo much pain,please somone help me. Thanku

drug test

what if you were denied meds and signed no contract, and cant take nsaids because of a history of bleeding ulcers?..others have said just go to another dr. but i fear then i will be called a dr. shopper. i have been smoking pot since i was 11 years old after i was abducted n sexually molested while a knife was held to my throat. pain psych calls my weed use " a form of self medication"..as others here, drs fear dea so they arent much help. ive had two surgeries most recent spinal chord stimulator. which is nt helping, but while it was being installed my head slipped in the holder and cut my skull. im in more severe pain now than b4 the surgery. holding onto hope in south carolina.

Can anyone help me?

Can anyone help me please?....I just moved here to Vancouver, WA from out of state and I'm having a hard time trying to find a doctor or pain management clinic who will keep prescribing my oxycodone rx. I was legitimately diagnosed with chronic pain, but there are so many people out there who abuse the medications that it's hard if not impossible for us who actually need them to get any help. It's extremely frustrating. I have a broken hip (2 metal plates and 8 screws) and also a broken vertebrae in my lower back along with a herniated disc. Since I no longer live where I can pick up my rx from my old doctor he will not send me my rx or call it in since it is a narcotic. Anyway, I was wondering if anyone knows of a clinic or possible doctor who can help me..?

Thank you to anyone who can help.

narcotic usage contract

I have been on the same medications (Keflex & norco 10) since I feel 25 feet onto concrete in 1989 in which    I shattered my heel into 9 pieces, broke and dislocated my right elbow requiring 2 screws to hold it in place and broke my right  wrist in 2 places. I have been treated at the same medical office for the last 6 years. My regular doctor moved to away and the clinic hired a new doctor. I went in to get my medications refilled and after the new doctor came into the room he seemed surprised I had long hair and a beard. he even commented "oh, my your hair is long" I explained In was part of a renfaire group and my role was that of the guild mage or wizard. The doctor ask why I was there,  I replied to have my foot checked and to renew my medications. I had to explain to him that I have ostiomylitus in my heel/ankle with screws still holding the two together. The ostio infection is inbeded in the marrow of my heel and ankle and when I'm on my feet to much or I walk to much the infection becomes active and builds up until pressure blows of the drain hole in my foot.  This new doctor told me he had no problem refilling my meds but... I had to sign a drug contract. if I refused I wouldn't receive my meds. He told me it was a standard form but when he handed me it I noticed it had my name printed on it. I read the papers and found it lacking on the part of the dr offices obligations. I did say That I would have to submit to random testing and if any abuse was found, they were allowed to inform all medical and law enforcement of my abuse. It said in no clear terms that they could publicly give my private medical info to anyone they deemed needed it. it said other things that if signed, would allow them to give my medical info away without my being able to do anything about it. I noticed this so called contract said what was required and expected of me but said noting about what the doctors office was required to do. If it's a contract then it is supposed to be equally   fai  r fair to both parties. This "contract" only favors the other party.I refused to sign under duress (which is what that is, sign or no meds,)I decided to see if this is legal, forcing people to give up their patients right in order to be treated.

I was so offended because I know I was ask to sigh this only because my hair is long and the doctor viewed me as a criminal or an addict.

Tis is unfair to those of us that are not abusing or selling our meds 

pain contracts

I suffered in pain for YEARS without any medicine. when I could stand it no longer, I would go to the ER and they would do their usual miserly here have a few pills and that would have to sustain me. as I grew older my pain grew in intensity, so much that I had no choice but to find out what the hell was up. I have degenerative disease of my lower back, and my xrays were proof that I had a lot of problems that could not be addressed with talk therapy, acupuncture, chiropractic, and walking it off. I eventually was forced into a pain contract. my problems increased ten fold. for now the clinic I go to gives me shit every month. every GODDAMN month my wait to refil gets longer. this time their foot dragging put me in the hospital WITH A PULSE OVER 106, HIGHEST BLOOD PRESSURE IV EVER HAD AND ALL BECAUSE I WAS IN WITHDRAWAL FROM THEIR NOT KEEPING TO THEIR OWN GODDAMN PAIN CONTRACT.  If i had just one lawyer who had the balls to stand up to this bullshit id lay my burden down and cry for joy. but no, they dont exist here. so I suffer the pain of someone who cant deal with it any more. they dont care. NO ONE GIVES A GODDAMN ABOUT ME IN THE LEAST. HERE IN THE USA BECAUSE WE ARE EITHER VETS  OR LOSERS ON MEDICAL ASSISTANCE SO THERE FOR WE ARE CATTLE. THIS HAS TO STOP AMERICA, YOU CANT KEEP BEATING US UP. LASTLY AND MOST DRAMATIC WAS THAT THE FEDERAL GOVERNMENT LIFTED THE BAN ON OPIOIDS HAVING TO BE CUT WITH TYLENOL. IM GUESSING PEOPLE WERE DIEING FROM LIVER DAMAGE. I HAVE NO LOVE FOR WHAT THIS COUNTRY HAS DONE WITH THEIR INSANE DRUG WAR.

my higher power

I have been  under pain management care about 10 years, Ive been through hell.  I recently moved from Texas to Kentucky to find out my trouble has just begun.  I have a pain pump which no one within 100 miles takes care of, Im finally established with a new Dr. but he wanted to change everything. This month I was told by my Dr I had a positive urine for alcohol, actually it showed 2 months previosly.  And this is the only positive Ive ever had in 10 years. Now he says Im noncompliant, he demands first I go to CHURCH, get affadavid from pastor, saying Im going to services, I have my own beliefs and higher power, I dont go to church.  Also I have to get 2 people to sign affadavids stating I dont buy, sell, or transport illegal or prescription drugs.  Now besides enraging me, this does not improve my many health problems, including my pain.  Strangers dont need to know my health or anything else for that matter.  Now if I dont comply with his orders, he is stopping my narcotics or not even going to see me, for what, having 1 drink in I dont know how long, what or who does he think he is "GOD" himself.         Very Stressed

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