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Old 07-13-2017, 10:47 PM
 
Location: Exeter, NH
5,200 posts, read 4,204,940 times
Reputation: 5453

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My elderly relative is at his wit's end, so I'm helping him in this search:

Are there ANY rational, humane Pain Management Doctors in middle or southern NH (or Mass. or Maine?) who DON'T have an absolute, no-exceptions rule of ONLY prescribing a 28-day supply of Schedule III pain meds, with the next office visit on the 28th day?

I'm talking about for patients with long-term & well-documented medical history, 100% compliant, never-abused-anything, on minimal dose of the Schedule III pain med, for a chronic pain lifetime condition.

The Pain Management doctor he's been going to recently admitted he simply has an arbitrary office policy that leaves my sick relative no flexibility for exceptionally painful months, and which has caused several horrid periods of withdrawal when a crisis made him miss an appointment (plus delay "fitting him in" the always-overcrowded schedule).

We'd be VERY GRATEFUL for the name of a doctor that doesn't take the Government's insane over-regulation, and then find a way to make it even worse.
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Old 07-14-2017, 12:47 AM
KCZ
 
1,548 posts, read 763,870 times
Reputation: 4337
The state and media have regulated and terrorized physicians into prescribing practices that aren't helpful for patients with legitimate narcotic requirements. My understanding is that physicians are required to follow the practice you described for 30-day prescriptions and followup office visits for patients with acute pain. Probably your relative's doc is following that procedure for everyone.

Sorry I can't answer your question. Good luck with your search.

https://www.nhms.org/resources/opioid
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Old 07-14-2017, 11:39 AM
 
2,660 posts, read 1,272,420 times
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Quote:
Originally Posted by NHartphotog View Post
on minimal dose of the Schedule III pain med, for a chronic pain lifetime condition.

The Pain Management doctor he's been going to recently admitted he simply has an arbitrary office policy that leaves my sick relative no flexibility for exceptionally painful months, and which has caused several horrid periods of withdrawal when a crisis made him miss an appointment
Two problems here. 1. Narcotics are not a good choice for the management of chronic pain, according to recent research, regardless of what the makers (I'm talking about you, Purdue Frederic) of narcotics say.

2. "Horrid Periods of Withdrawel" means the person is already addicted, needing escalating doses of medicine, I suspect. A Dr. of any kind is right to be wary of such a patient. What reputable doc wants to contribute to narcotic addiction?

I'd look for someone who can manage the pain without narcotics. There are several approaches for chronic pain.
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Old 07-14-2017, 11:46 AM
 
Location: Exeter, NH
5,200 posts, read 4,204,940 times
Reputation: 5453
Quote:
Originally Posted by KCZ View Post
The state and media have regulated and terrorized physicians into prescribing practices that aren't helpful for patients with legitimate narcotic requirements. My understanding is that physicians are required to follow the practice you described for 30-day prescriptions and followup office visits for patients with acute pain. Probably your relative's doc is following that procedure for everyone.

Sorry I can't answer your question. Good luck with your search.

https://www.nhms.org/resources/opioid
True, moronic NH politicians have imposed the "no refills" rule, that means the patient in pain must physically go back to the doctor's office every month (I'm sure that causes no extra pain, or risk if the patient can't find someone to chauffeur them).

But the NH doctor has full legal authority to give a 33 day supply for the month (i.e., 33 pills if taking one a day)--while the doctor my relative goes to has arbitrarily decided to only give out 28 days of pills (so the patient runs out the day of the next appt.). Stopping many of these meds will make you VERY sick the next day, if you've been on them for a while. Nobody would take these "for fun," and most pain patients have NEVER experienced any sort of "high" (unless relief from pain for a short time can be called a high).

Miss the appointment, and you have to wait until they can "fit you in" for another appointment, and naturally they are insanely overbooked (thanks, government bureaucrats!). To add insult to injury, you then get to the appointment to say "Hi," repeat yet again that nothing's changed, the pain is not out of control, nothing changed with your Primary Care doctor (which the computer already told them).

NOTE HERE: bureaucrats claim all these appointments will make sure the doctor keeps on top of handling pain levels--but if my relative is in a period of extreme pain, and would like a handful of extra pills for the next month but not permanently (which he's done twice in 14 years), he gets the lecture "Sorry, but NO....Did you know that more people die from overdoses than car accidents!"

Keep in mind that 30 pills for a month is STILL the standard everywhere (except NH), and there's no reason in the world to refuse a couple of lowest-dose Schedule III pain pills to someone who is at ZERO risk for "abusing" any sort of drug (he doesn't smoke, drink, or take ANY pill he doesn't absolutely have to!).
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Old 07-14-2017, 12:02 PM
 
2,660 posts, read 1,272,420 times
Reputation: 2513
The issue is not "abusing" the drug in the way you're thinking. The issue in my book is wrong meds to the wrong patient who is now physically addicted, an adict in more blunt terms. You yourself suggest the real problem is withdrawal and lack of "a handful of extra pills for the next month"!!!

Sounds like the problem is more addiction management than pain management. Have you thought about that?
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