Methadone Uses

Question by Carversgirl: Is it safe to tell his Pain Management doctor?
Because I moderate a site for a certain type of rare chronic pain, I get a lot of questions regarding Pain Management. I don’t have all of the answers. Doctors are different. Pain Management contracts are different.

This is a strange situation. My heart really goes out to my friend, who is a single parent, is trying to support more than one child. He can’t work without pain medication. When his pain strikes, if he doesn’t take his medication, he is sidelined. It is a bad neuropathy, possibly the worst kind.

As explained by his Mom, his pain doctor became agitated with him because he had been short on a few pill counts, as well as had some medicine fall out of his backpack, or be stolen. He filed a police report, and still is unsure which happened. He was asked to sign a voluntary discharge, and given a one month’s supply of his strong, narcotic pain reliever, Roxicodone, which only lasts two hours. His doctor also advised him to find another doctor, that he didn’t know much about his illness and wasn’t comfortable writing the amount of painkillers he needed for good pain control. This is what I do not understand, my friend had willingly given up a round-the-clock pain killer, Methadone, in November, because of it’s side effects. Plus, this severance nullified the “pain contract” between the patient and the practice.

By the end of the month, he had secured an appointment with another doctor in the practice. His strong, but short term instant release 30 mg. Oxycodone, even taken 6 times daily, was not carrying him through what were sometimes 20 hour days, between child care and work. He was having to take 1-2 extra daily, to sleep, eat, function, and job hunt, because, he consequently lost his job due to cutbacks. Although he had the pain clinic destroy the majority of his November Rx for Methadone, his long acting medication, which he could not tolerate and work, he had forgotten that he had 20 some odd Methadone left under some paperwork from October in his lock box, forgotten about, until he got desperate one day for Advil, or anything in his medicine box which may help him from going into withdrawals and being in severe pain in front of his children, while seeking other employment. Being a Mother, I get that, when you’re a parent, and chronic pain patient, you cannot stop just because you’re sick, or hurting. Your children’s needs don’t take a break because it isn’t yet time for your pill. If you’re low, or out, you cannot just huddle up and withdraw from them. They need you! So, he took the drug he had worked so diligently to get away from to see him through until his appointment.

He will, in all likelihood, be drug tested, at his next appointment. He came to me for advice. I’m not sure what to tell him, and he’s sort of shy to ask things. I’m not, and I’m not embarrassed of needing pain medication to deal with my condition. Some need wheelchairs, or prosthetics. Chronic pain patients, sometimes, require treatment with opioids for qualify of life or for functionality.

He did not break his pain contract, because he is not in a pain contract at this time. The medication he took, is not a current Rx, but is legally, his Rx. He has already admitted to his last pain doc, a guy who works for the guy he’s seeing, that the regimen of strict Oxycodone 30 is not working! I do not see why he cannot admit to taking the Methadone to his doctor. I do not think they would sever the relationship and refuse him a refill.

My friend is certain that he must not tell the doctor that he had to use the old prescription of Methadone, so that he can get a prescription of something, Suboxone, Oxycontin, something different, and find another pain doctor before the results of the urinalysis come back, so that he may job hunt and care for his children. From what I can tell, he is a loving father. His children are all he talks about most of the time. He doesn’t seem to have time or energy to date anyone. Thankfully, I am married, but my husband is very sick of the chronic pain sufferer’s plight with pain clinics. It has caused us much desperation. I digress.

My friend and I disagree, for the sake of his children’s well being to save his job search and prevent them seeing him in withdrawal, of course he needs a new prescription. He believes the doctor will deny him one if he admits to having to take the Methadone this month to get by. I say, no pain contract was broken. He was under voluntary discharge, and being honest may help him get better care.

Those of you who know anything about pain an pain management, please give me your opinions. I do not want to steer this person wrong with his children’s well being on the line.

Best answer:

Answer by M
I am sympathetic to his plight. My best friend is a chronic pain sufferer who uses the Fentanyl patch, and as such is under a pain clinic contract and jumps through all the necessary hoops to get her medication.
I agree with you in that no contract has been broken. His taking the Methadone even though he had previously quit it because of side effects might show how desperate he was for relief, and show the doctor that he needs a new medication that will work.
If he is drug tested at this next appointment and doesn’t mention the methadone, he will lose his relationship with this doctor and will have to find another. It will be in his records that the doctor will no longer see him because of a failed drug test. This will make it very difficult to find a doctor in the future. The methadone was prescribed by his previous doctor; one at the same clinic where he now goes, right? It’s in his records that it was prescribed to him–within the last six months. That’s a current prescription, isn’t it? If he’s not under contract yet, he should be able to take it.

Answer by Richard
I would not tell him

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