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Can My Pcp Abruptly Stop My Pain Management Meds?


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#1 TiredSgt

 
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Posted 26 March 2011 - 06:48 AM

Hi, I've not been on here in a long time, you guys helped me get my 100% rating 3 years ago, since then, I've also been awarded 100% SSD. But anyways, here's what happened. The VA said I violated my pain contract when I moved from one state to another and received pain meds from two separate facilities (which I did).

I have serious heart problems, CHF, ICD/Pacemaker, high blood pressure, chronic back pain, and a host of other medical conditions, all treated by VA doctors.

I've been reading that abruptly stopping narcotic pain meds can cause stroke, serious withdrawal symptoms, spikes in blood pressure, and basically 30-60 days of hellish torture to which my body simply cannot endure.

My current primary care doctor said he was going to discontinue my pain medication for violation of a pain contract I signed 7 years ago. Yep, the VA has had me on narcotic pain meds for over 7 years, now, just all of the sudden they want to abruptly STOP dispensing them. In my mind, any doctor in their right mind knows the affects of withdrawals and putting someone with a bad heart, high blood pressure, chronic pain, coupled with psychiatriac conditions (PTSD) is unequivocally and absolutely cruel and inhumane. My body simply can't take it, stopping my meds is not civilized after 7 years of being on them.

Can someone give me some advise please? I'm not saying I'm an addict (I took them as prescribed) but "on occassion" I did take 1 extra pill when I felt really super bad. Over the years my body has indeed became both physically and psychologically dependant upon this chemical in order to function. I told the VA (it's noted in my records from 2008) that I think I'm becoming dependant upon these pain meds and would like to stop. What does the VA do? Send me to a psych doctor who prescribed a powerful drug called xanax and UP my dose of pain meds! Now fast forward to 2011 - I moved to another state and received scripts from my prior state and the state I live in now. The old VA from my former state automatically sent the meds in the mail, I was surprised to get them in fact, they just arrive out of the blue one day, so I kept them. Now the NEW VA found out about this and wants to stop ALL PAIN MGT? I can't take it...I'll die. I have a heart of an 85 year old man and can hardly get around as-is, I can't imagine what's going to happen when my meds run out in 2 weeks.

Can someone please give me some advise. I have an appt with my PCP on Wednesday March 30th 2011 to "discuss" why I received meds from two different VA facilities.

Thanks - if you can call me on the phone and talk, I'd appreciate any advise, all I know is 7 years, 9 months of pain meds, my body IS in fact dependent upon these drugs and an abrupt halt will cause a stroke and I could very well die. The drugs are opiate-based, semi-powerful and do indeed relieve my pain and make me feel "normal".

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#2 jbasser

 
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Posted 26 March 2011 - 08:07 AM

Did you inform the VA you were moving and was this an automatic renewal?

If you did inform them then it is their fault and not yours.

Write a letter to both Patient Advocates adn explain what happpened.
You are caught up in VA red tape. If you have medicare and parts B and D, I would send all VA medicine back to the VA and go outside the VA.
Just document everything that you do.
Dont take any crap off of the VA.

J

#3 Pete53

 
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Posted 26 March 2011 - 09:36 AM

John is right but if you can I would go and speak to the patient advocate first. Sometimes they can fix problems like this on the spot. If that does not work go to the Administrator.

I do not have a pain contract with VA but I have a prescription for hydrocodone 60 for 30 days and xanax 120 for 30 days and guess what meds by mail screws up on delivery.

Yes you are in a bad situation for an abrupt withdrawal.

I wish you the best. When this is over and fixed I hope you should consider a complaint to the VAOIG. You have been treated poorly by the VA

Anyone who takes their meds that are prescribed are not addicts. You are dependent and the VA should recognize this.

#4 john999

 
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Posted 26 March 2011 - 10:54 AM

I have a opiate contract with the VA going on 6 years. To discontinue your pain meds without a gradual withdrawl is really malpractice unless the VA can prove you are selling your meds or not taking them. What kinds of meds do you get? Because I live in Florida I use the VA due to many pain clinics that are not legitimate. I would use a private doctor in the future if I were you. The opiate contract you sign is like a bear trap. I think you can beat this by explaining this mistake the VA made. I understand why you want an extra supply of the meds you got since the VA could change your meds in the future.

#5 TiredSgt

 
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Posted 26 March 2011 - 01:17 PM

I have a opiate contract with the VA going on 6 years. To discontinue your pain meds without a gradual withdrawl is really malpractice unless the VA can prove you are selling your meds or not taking them. What kinds of meds do you get? Because I live in Florida I use the VA due to many pain clinics that are not legitimate. I would use a private doctor in the future if I were you. The opiate contract you sign is like a bear trap. I think you can beat this by explaining this mistake the VA made. I understand why you want an extra supply of the meds you got since the VA could change your meds in the future.


I receive hydrocodone 7.5/APAP 500, 150 per month (in my former state, I received hydrocodone 10/APAP 500), sometimes I do indeed take an extra one or break one in half and add it to my normal dose around lunchtime, so I'm glad to have some extra put away. But the fact is: My V.A. doctor specifically told me over the phone that I had violated my pain contract and possibly federal drug laws, and wants to see me next week, and quote "he doesn't want to continue pain management and will forward this recommendation to his director." I told "ok, see ya next week."

If I could go back in time 7 years, I never would've started on opiates for my pain management, they do indeed help ease the pain, but NOW my body is physically and psychologically dependant on hydrocodone, and with my bad heart, I'm afriad of death due to withdrawals (I've ran out before due to mail delays and have experienced withdrawals first hand for 1-3 days over the years) It IS NOT fun!

I'm considering going into a 30 day detox here in Florida which will monitor my heart 24/7 and rid my body of opiate dependency, it's very expensive, but I think in the long run, it will be well worth it to get this monkey off my back, it's my opinion that long-term opiate usage increases pain associated with injuries, makes one dependant upon the drug in order to function and re-wires the brain to not produce natural chemicals because they're being replaced with synthetic feelings and emotions. If anyone out there doesn't believe this, STOP taking your opiates for 5 days, starting right now. I bet you my next 10 checks that within 5 days, your body will feel like it's been ran over by a steam roller, your heart will pound, you'll sweat profusely, then get the chills, you'll get grumpy, anxious and eventually you'll find yourself bed-ridden, begging for a pill. I've watched my father go thru this (he died in 2002 btw), I've seen my mother go thru this, my sister and I've experienced it myself. Sudden opiate withdrawal can be fatal for the meek, weak or elderly.

When I get my white envelope with pills every month, there's 3 long pieces of paper inside the package, it specifically states "this drug can be habit forming" and "when used for extended periods of time, this medication may not work as well and may require different dosing" and "It is not recommended for use for long term periods or in high doses." Yeah right. Nobody deserves to be on opiates 7 years, the VA could've changed my meds to a more long-acting drug, tapered me off an put me on a non-opiate drug for pain (which I requested in 2008)yes, it's documented, gave me a tens unit, etc, none of this was ever discussed. Seven years of pills - that's their answer. In fact, pills is the VA's answer to everything. Got a headache, pills, feel depressed? Pills, back hurts, Pills, carpal tunnel? Pills, stub your toe, Pills, can't sleep? Pills, feeling a bit anxious are you? Here's a pill. How about getting to the ROOT of the problem? Instead of masking the symptoms with pills...IMO, VA doctors are legal drug dealers, they get people addicted, then don't want to deal with the addiction when someone "violates a pain contract."

I think my mind is already made up to pay the 3,500 and check myself in for the duration, at least I'll be monitored by people who actually care and tell the VA to take their "pills" and stuff them where the sun don't shine. The program is guaranteed to get you off opiates, and from what I've been reading and the Youtube vids I've watched - you actually FEEL BETTER being OFF opiates.

I got my 100% rating due to CHF and other cardiovascular problems, only 30% on my back, 50% PTSD, 10% hearing, 20% cervical injury. I would like to think any doctor worth his salt would not be so cruel as to totally take a veteran off his meds without appropriate taper and/or something to counteract withdrawals? I'm worried about our meeting next week for sure. 1. Will he accuse me of being an addict? 2. Will he try to press charges for prescription fraud? 3. Could he stop my meds immediately? 4. Could I face criminal charges? 5. Could he refuse any further treatment regarding my other ailments? At least if he does cancel my meds totally, I have enough to slowly taper off with and hopefully ease the symptoms associated with opiate withdrawals.

I do plan to take the pills to show the doctor that I've not abused them, but I did take a few extra ones here and there as needed when my body ached beyond my normal threshold. I'm too old and tired for all this BS from the VA, guys, it's got me worried sick.

What do you think my VA doctor's decision will be?

#6 john999

 
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Posted 26 March 2011 - 02:25 PM

I have withdrawn off of percoset before. You can do it yourself by reducing your dosage over a few weeks. The VA pain clinic doctors did tell me that I never should have been on opiates even though I have a SC DX of chronic pain disorder. How many hydrocodones do you take every day? I have a feeling you don't take that many. You are not a drug addict by any means. If you still have the drugs you got from the other VA give them to the doctor when you see him. Did you sign a certified mail receipt for both sets of drugs? The VA should probably have tried you on a long acting type of opiate. The trouble with many of those (morphine, methadone, fentanyl) is that you build tolerance to them as well. They have more side effects also including notorious constipation for morphine. I would tell the doctor that I was confused about where I would be getting my hydro and was afraid I would not get it on time so I took what was mailed to me. The VA gets their underware in a knot because they believe that most vets will sell their drugs for money if they get the chance. If you had taken a drink a day before your last urine screen you would be in trouble as well. I think I would just begin to taper off on my own and go see a regular doctor and explain your problem and see if you can get scripts from him for the vicodin. The VA will be watching you like a hawk in the future. The VA has screwed with me over opiates and getting them on time. It really bugs me as well. I tell them that I take the exact dose so that if it is two days late in getting to me it is a big deal. They sent my opiates to the wrong address one time and blamed me for it.

#7 TiredSgt

 
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Posted 26 March 2011 - 04:30 PM

I have withdrawn off of percoset before. You can do it yourself by reducing your dosage over a few weeks. The VA pain clinic doctors did tell me that I never should have been on opiates even though I have a SC DX of chronic pain disorder. How many hydrocodones do you take every day? I have a feeling you don't take that many. You are not a drug addict by any means. If you still have the drugs you got from the other VA give them to the doctor when you see him. Did you sign a certified mail receipt for both sets of drugs? The VA should probably have tried you on a long acting type of opiate. The trouble with many of those (morphine, methadone, fentanyl) is that you build tolerance to them as well. They have more side effects also including notorious constipation for morphine. I would tell the doctor that I was confused about where I would be getting my hydro and was afraid I would not get it on time so I took what was mailed to me. The VA gets their underware in a knot because they believe that most vets will sell their drugs for money if they get the chance. If you had taken a drink a day before your last urine screen you would be in trouble as well. I think I would just begin to taper off on my own and go see a regular doctor and explain your problem and see if you can get scripts from him for the vicodin. The VA will be watching you like a hawk in the future. The VA has screwed with me over opiates and getting them on time. It really bugs me as well. I tell them that I take the exact dose so that if it is two days late in getting to me it is a big deal. They sent my opiates to the wrong address one time and blamed me for it.


Yes, I did sign an orange card the postman brought for both packages of meds, so in their eyes, I'm guilty. As far as alcohol, I've not drank a drop in over 10 years, not even a sip of beer or wine - zero. I take 5 or 6 Lortab 10's per day, I'm prescribed 5 a day, but sometimes take an extra here and there, I'm sure everyone is guilty of this at some point.

I called the detox facility today, they can accept me Friday morning (April 1st 2011) at 8:30am, they told me I have to be in "day 2 of withdrawals" and no more Lortab after Tuesday night, I told them about my heart condition and they told me that chronic withdrawals don't start until day 3 or 4 and peak-out at day 7, so don't worry. They're going to prescribe me a drug called Suboxone, starting at 8mg per day and over a course of 2 months wean me off completely, I'll stay approximately 2 weeks "in patient" for counseling, meetings or whatever they do?, then return to my home for weekly follow-ups/meetings. I told them "ok, see ya friday then." The first place that wanted to accept me told me over 3k dollars, which I was prepared to pay, but this place is a bit cheaper, with the same guarantee of freedom from opiates.

When I go see my doctor this coming week, I'm taking every narcotic pill in my house and placing them on his desk. I'm going to tell him that IMO, it's malpractice to prescribe dosages of hydrocodone 10 x 5 a day to ANYONE for 7+ years. I'm going to also remind him about the statement "this medication is not to be prescribed for more than 21 days." The VA has turned me into an accidental opiate dependent person (addict, I hate that word), they knew what they were doing, they also knew it was wrong; although it happens a million plus times a month all across America. I want my old self back, even with the pain, it's got to be better than being harassed, threatned and put through hellish withdrawals, not to mention (like you said) "watched like a hawk" because they think I'm selling my meds or abusing my prescription. I'm too old for that and those games. They can have their pills, and their pain contract - I'm officially done with the VA "doctors". I have Medicare and BC/BS, I shouldn't have problems finding a doctor.

I'm more mad than anything, but I also realized that the VA got me addicted to a powerful opiate, now they think they can just "stop". It doesn't work that way, people can die from withdrawals especially those who have heart conditions or very old. And I have chronic heart conditions (ICD/Pacemaker) valve problems, clogs, you name it!

As a final note, it seems I only turn to Hadit.com when I have problems, you guys helped me get my 100% VA AND 100% SSD a few years ago, then I walked away. I'm gonna start participating more and sharing what I've learned with my 12 year fight with the VA and and my 2 year battle with SSD. I'll start answering the simple questions I've read on here, what I done and how it helped me.

Thanks again guys/gals. If you have any suggestions on how I should deal with my doctor this coming week, I'd sure appreciate the input. I don't want to be harsh with the guy, but on the other hand, I'm NOT going to be accused of dealing/abusing/selling/fraud, etc. I'm gonna tell the truth, (the bottle came in the mail, totally out of the blue, so I took them and put some away for "stash"). The VA made me what I am, either help me get back to normal (no opiates) or show me the door, and I'll never walk back through it. It's obvious my doctor is mad, he wants answers and he's also spoken with my previous doctor from my prior state I used to live in).

I am considering filing a section 1151, coupled with a lawsuit against the V.A. and my previous 4 "doctors" for NEVER giving me a thorough exam (NO MRI, XRay, nothing - just doses of opiates), also, I feel they owe me something for 7 years of pain/suffering, creating an opiate dependent person, then "cutting me off", damaging my neuro-system in my brain with large dosages of pills over the past 7+ years. I'm quite sure my doctors "notes" includes exams which never happened, I have NEVER had a VA X-Ray or MRI for my back (upper or lower) past the year 2004, I just told them it "hurt" on a scale of 1-10, I told them 7 or 8, then it started...a big ole' bottle of pain killers. LOTS of them, over the years, that was their answer to my pain...give him a 'script and get him out of here....next! Whatever wrath I face tuesday with my VA doctor will be re-dealt 1000 fold before the end of 2011.

When I moved FROM Florida to the previous state I lived in for 2 years, my very first VA appointment lasted approximately 5 minutes, he mostly read his computer, asked how my meds were doing, he pecked my knees with a rubber hammer and that was it. Follow up exams (every 6 months for med re-newals) were 3-5 minutes long tops, no exam, no xrays, no nothing...just refilled all my meds and out the door, just like hearding cattle in/out, in/out. They (the VA) have awoken a sleeping giant, I know the games they play, the false notes, the false exams, all I have to do is prove it, which will be quite simple.....show me an xray, mri, or any shred of physical evidence that warranted 7+ years of high dose opiate treatment? Is a lawsuit or 1151 even plausible? IDK? I have to do some calling around monday. In fact back in 09, I wanted to placed on a non-narcotic pill called Tramadol, this is noted in my records also, I was refused and kept on Lortab 10. in 08 I told my psychiastrist I felt I was addicted to hydrocodone, he noted this in my record and also my cardiologist "recommended discontinuance" of opiate treatement - this is also documented in my cardio files in the year 2009. What does the VA do? Give me some more opiates!

I need some advise, the pills aren't the issue anymore, it's what they've done to me, changed my personality, turned me into an accidental addict, changed my natural body chemistry and when I asked to be taken off YEARS ago, I was given MORE. Indeed, Nobody stuffed them down my throat, but to anyone on opiate treatment, you KNOW HOW IT IS...you CRAVE THEM, and after just a few months, your body NEEDS them, and you fear withdrawals. IMO, this is neglegence, malpractice and abuse of patients, not to mention they (opiates) ruin lives, even it taken as prescribed - if you can't flush them, you're an addict. And being an addict is not fun.

thanks for reading my rant. One Very Tired Ex-Sgt

#8 john999

 
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Posted 26 March 2011 - 05:16 PM

Sgt

Make the VA do the right thing and withdraw you! You can get the script for Suboxone yourself. It is a narcotic as well. I took it and it made me itch like hell. I think you are over-reacting to this. I would not hand some private guy 3000 bucks if it is was my own money. It sure as heck does not take two months to get off your dope dose. I got off much more powerful drugs in a week cold turkey. It was not fun and I did learn the meaning of the phrase "kicking the habit". I would take 5.5 pills a day for three days and then 5 pills for three days and so on and you will be clear in about a month. You do not have a horrible habit. You are not taking 25 lortabs a day like an addict. You have chronic pain. Make the VA treat you for it. Give them back the stash and tell them you are thinking about suing them for malpractice. They made a grave error by sending you this double dose of dope. It is on them like when they sent my narcotics to unknown address in Maine by mistake.

#9 TiredSgt

 
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Posted 26 March 2011 - 07:09 PM

Sgt

Make the VA do the right thing and withdraw you! You can get the script for Suboxone yourself. It is a narcotic as well. I took it and it made me itch like hell. I think you are over-reacting to this. I would not hand some private guy 3000 bucks if it is was my own money. It sure as heck does not take two months to get off your dope dose. I got off much more powerful drugs in a week cold turkey. It was not fun and I did learn the meaning of the phrase "kicking the habit". I would take 5.5 pills a day for three days and then 5 pills for three days and so on and you will be clear in about a month. You do not have a horrible habit. You are not taking 25 lortabs a day like an addict. You have chronic pain. Make the VA treat you for it. Give them back the stash and tell them you are thinking about suing them for malpractice. They made a grave error by sending you this double dose of dope. It is on them like when they sent my narcotics to unknown address in Maine by mistake.

Hey, thanks for the reply, maybe I am over-reacting a bit, but honestly, the VA did in fact turn an ordinary guy into a dope addict and that's the bottom line. Long term opiate usage alters the brain and usage over 5 years does permanent damage that can never (at my age) be reversed, opiates totally shut down your receptors and your body forgets how to produce natural opiates, because they're being replaced by synthetic opiates. I don't know much about this area, I just started reading about it, but they're not good. Besides, No xrays, no mri, no ct scans, no "physicals", dude, they just gave me Lortab 10's like it was halloween candy. This is not (IMO) medicine, like I said earlier, the MOST I ever received as far as a "physical" was concerned was a couple taps on my knee with a rubber hammer. He did mention that I'm in Afib and I told him that I'm always in Afib 99% of the time. I've lost all respect for VA doctors in general.

I'll take your advise and take my PCP my stash because I'm going the suboxone route starting on friday (unless my PCP has an alternative plan that is pain-free and withdrawal free) to get me off these chemicals. I've slowed waaaaaaaay down on my Lortab intake since three days ago, I'm down to 3 1/2 per day and I feel just fine (#10's). But when I go lower, my nose runs, my body aches, my eyes water, my skin crawls, I get grumpy with my wife, I ache, itch, can't sleep and my mind races. This pill I'm seeking Friday called Suboxone takes all that away and most importantly, the cravings.

I doubt the VA prescribes Suboxone? That's on my list of phone calls come Monday. The only reason I can't quit cold-turkey like everyone else does, is because of my heart condition - the spikes in BP, racing heart, anxiety could be my death ticket, that's not a chance I'm willing to take.

I think the VA has mis-dosed me, got me addicted, and done irreversable damage to my body on a molecular structure. I've found cases where the VA has overdosed patients and the spouse has sued for wrongful death/malpractice/over medicated, etc, and won - you can do a simple Google search and pull up hundreds of cases. I realize my Lortab addiction is not that strong, but take into account I have a heart of 75 year old man with a "longetivy" of 5-10 years...(per the VA of course). But the fact remains, I'm addicted because of the VA doctors and years and years with not one single shred of physical evidence to support opiate treatment at such high levels.

I'll leave it alone and quit bugging you all - but I will post key and important updates as this saga unfolds, I can't really do anything till Monday and Tuesday after my appt with my VA PCP. I have lots of research to compile, tabulate and organize into a manner appropriate for presentation to my attorney. She got my SSD in record time and doesn't particularily care for the VA's treatment of patients anyway. I'm sure she'll find my case unique, intriguing, attractive and possibly lucrative.

Google Medtronic Sprint Fidelis Lead Settlement - they settled out of court for 263 million dollars last year, I have 3 of their faulty leads implanted......it all started with ONE guy complaining.

#10 Michellee

 
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Posted 26 March 2011 - 07:33 PM

So are you still having pain? I mean your willing to go to detox but what about your pain? Sounds like your saying in addition to everything that you don't need all these pills and the pain pills are more of a problem. Personally, I would love to not to need my pain pills (management) cause most of us know that we will pay later for long term use. But the other side of that is that a certain level of pain can be quite harmful too. It all depends on how much pain your system can handle. I had unmanaged pain in the past that would jack up my blood pressure cause me to throw up, faint and almost commit suicide. My pain was so unbearable between on scale of 1-10 its around 8-10. I have no diagnosed heart disease, nor high blood pressure px. I don't know how your pain tolerance is but obviously when they perscribed your pain meds you must have communicated that you needed them for a high level of pain. So I am curious as to what your going to do for pain management or alternative to pills after your detox or maybe I missed something. I think your jumping the gun and need to take one step at a time. I think its a good idea to go to Patient advocate and maybe even the medical director and explain what happen here. I can understand the automatic renewal and the mail situation but then you then turn it around and start sounding like your blaming someone for treating you with long term pain management (pills and your mad because of it)?? Did you not need it and ask for pain management? You can refuse pain management. I have not heard of the VA forcing anyone to take pain meds. Now if your saying you don't need it anymore and want to do detox that's your right but I wouldn't I bring that issue along in response to what your doctor is doing. Your right being pulled off so abruptly and if you are addicted as you stated can cause serious complications.

#11 TiredSgt

 
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Posted 26 March 2011 - 09:31 PM

So are you still having pain? I mean your willing to go to detox but what about your pain? Sounds like your saying in addition to everything that you don't need all these pills and the pain pills are more of a problem. Personally, I would love to not to need my pain pills (management) cause most of us know that we will pay later for long term use. But the other side of that is that a certain level of pain can be quite harmful too. It all depends on how much pain your system can handle. I had unmanaged pain in the past that would jack up my blood pressure cause me to throw up, faint and almost commit suicide. My pain was so unbearable between on scale of 1-10 its around 8-10. I have no diagnosed heart disease, nor high blood pressure px. I don't know how your pain tolerance is but obviously when they perscribed your pain meds you must have communicated that you needed them for a high level of pain. So I am curious as to what your going to do for pain management or alternative to pills after your detox or maybe I missed something. I think your jumping the gun and need to take one step at a time. I think its a good idea to go to Patient advocate and maybe even the medical director and explain what happen here. I can understand the automatic renewal and the mail situation but then you then turn it around and start sounding like your blaming someone for treating you with long term pain management (pills and your mad because of it)?? Did you not need it and ask for pain management? You can refuse pain management. I have not heard of the VA forcing anyone to take pain meds. Now if your saying you don't need it anymore and want to do detox that's your right but I wouldn't I bring that issue along in response to what your doctor is doing. Your right being pulled off so abruptly and if you are addicted as you stated can cause serious complications.

Nice post and some good points! Yes I do have back pain and cervical spine injury (on the 1-10 scale) my pain hovers around 4-5 on a daily basis, when I over-do it, the pain esclates to a good 6-7 point at which point I take my pain pills and lay down for an hour or so. I have DDD and two herniated discs and a bone-spur in my neck bone that pinches a nerve when I bend my neck at a certain angle, so yes, I do indeed need the pain meds for medical reasons.

What I don't like is the dependency part, and being suddenly cut-off. As for pain management after my Suboxone detox, I don't know? It's NOT going to be opiate based and that's for sure. They do long-term damage: Effects On Brain Chemistry: Opiates have also been shown to cast a long-term negative effect on brain chemistry. Through constant stimulation of key pleasure centers within the brain, and its reward system, opiate users are conditioned to want more and more of the drug. In extreme situations, sudden withdrawal by chronic users in poor health may prove fatal. This phenomenon makes it impossible for users to quit without help, as their never-ending euphoric state leaves them unaware that they are addicted. Such euphoric feelings may last for years.......

The article goes on and on, many pages of the negative side-effects of long-term opiate use, it's way too much to copy/past here, it's an easy Google...the bottom line is this: In the long-run Opiates RUIN lives, not save them. They've even been proven by the AMA to increase pain, not decrease pain. The doctors can label it "Pain Management" or "Management" all they want, but the bottom line is they're deadly, they destroy your brain, do permanent damage, your body gets addicted and your mind becomes psychologically dependent upon opiates and you cannot function "normal" without them and your receptors that produce "natural" opiates die. You become an addict for life. Is this life?

I bet there's members in this forum who've sat down and counted their pills out to the date worrying about running short, waiting on the mailman, counting the days till their 'scripts arrive, postponing engagements or other activities because of pills. It's not your fault, it's the V.A.'s fault, and they should be held accountable just like Medtronic Sprint Fidelis was made to be held accountable to the tune of 263 million (out of court settlement). Cha-Ching for me $$!

There's other management practices available for pain besides pills, how about getting to the root of the pain? Nerve blocking shots, nerve deadening singes, surgeries to alleviate the root of the problem. That's not the VA way, the VA way is prescribe and overdose patients on Pills, I've seen it for decades. The pills aren't my issue anymore. My issue with the VA is over prescribing pain killers in general, they killed my dad with oxycottin and morphine and other deadly cocktails of pills, same with my wife's father, same with my uncle and my step-father (suicide from VA prescribed pills) - all dead because of VA over prescribing pills instead of finding and eliminating the root of the pain. Well, it's not going to happen with me. I have rights and recourse in action.

There is no justification for being an addict, especially an accidental VA induced addict. In 7 years don't you think that someone, somewhere would say "hey, let's take an x-ray, MRI or Cat Scan, let's see what's going on here?" The VA failed in this area. I said my pain is "6 or 7" they said, "ok, here's some more pills." Nice doctoring huh?

Pain is not the same day to day, some days my pain is 3-4, sometimes I aggravate my back or neck and it jumps to 7 or even 8, and on rare occassions I feel little to no pain at all (while on pills of course).

My friend crushed his back digging up a tree stump and messing with a backhoe, his private doctor prescribed oxycottin for 20 days, a couple surgries, a few more pills, put him in physical therapy, gave him a machine that shocks his nerves, a backbrace and more physical therapy, now he's almost back to normal....all without pills! He is pill free to this very day, he deals with his pain, he learned to live with it. He understood that pills cause pain over time, not relieve it. Now, I'm in a boat where pills cause me pain, if I don't take my pills, I hurt, but the pain is escalated due to pills.

I can only speak for the 2 VA hospitals I've visited, yours may be great with great doctors who actually care, but MY experince in MY VA hospitals has not been good, they are simply pill dispenseries, 'script writers with 100's of patients on their case-load per day. I'm just a number, another 'script to stamp.

Now to finally answer your question - yes, I do need "something" to relieve my pain, but NOT opiates, I can't take NSAID or IBprofen, so I don't know what the course of action will be? Long-term damage has already been done to my body - all caused by opiates, opiates prescribed without ONE single shred of physical evidence to substaintiate or support opiate treatment (and getting me addicted). My very fist 'script was given to me very quickly so the doctor could call "Next!" and I was hurried out.

Yes, I am mad, I'm mad at the VA for prescribing pills for 7+ years, I'm mad they suddenly cut me off without warning, I'm mad because I found out what opiates can (and have) done to my body, I'm mad at my doctor for not realizing that a person should be given an x-ray BEFORE prescribing pills, I'm mad at the VA in general for writing scripts to veterans just to get them out of their hair and move on to the next patient, the whole system stinks and they need to be held accountable for their over prescribing habits.

Medtronic Sprint Fidelis Faulty Lead Litigation is the perfect example. Next it's going to be Veterans Administration Faulty Prescription/Opiate Dosing Litigation. It's malpractice (at least in MY 2 V.A. Facilities) and I can prove it.

#12 GuaymasJim

 
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Posted 26 March 2011 - 11:18 PM

TiredSgt

If you go into your appointment spewing this nonsense about the VA "turning an "ordinary guy into a dope addict," you will more than likely get a strong reaction. However, it most certainly won't be the reaction you seem to desire. You have absolutely NO chance of prevailing in a malpractice suit! Every single complaint you have made here is a KNOWN side effect of long term opiate usage.

Like many others on hadit, I have been managing my chronic extreme pain through the use of opiates, non-narcotic medications, diet, lifestyle changes, counseling, and other methods for years. I have been doing it for more 40 years. If you have not been abusing the medications (and I have no reason to believe you have), then you are no more a drug addict that I am; and I am most certainly NOT a drug addict. I find it offensive in the extreme to be labeled a "drug addict" based solely on your obvious lack of knowledge!

There is a huge difference between "dope" and "medication." There is also a huge difference between "addiction" and "tolerance." I suggest you use your internet access to explore those differences. Using these words interchangeably is doing you, me, and tens of thousands of other veterans (and civilians) a horrible disservice! I, for one, resent the hell out of it.

Many of us have fought for decades trying to get AND maintain appropriate and consistent pain management from the VA. Our worst enemies were the entrenched VA bureaucracy and blind ignorance similar to what you have expressed here. In spite of both, chronic pain sufferers won a big battle with the help of the Joint Commission in 2001:

Rapid improvement in pain management: the Veterans Health Administration and the institute for healthcare improvement collaborative. Clin J Pain. 2003 Sep-Oct;19(5):298-305

BACKGROUND: Poor pain management persists in health care. Although common practice errors in pain management have been identified and standards and guidelines for pain management have been published, improvement has been modest. With the goal of rapid improvement in pain management, a joint Collaborative (Veterans Health Administration and Institute for Healthcare Improvement) was conducted from May 2000 to January 2001.

OBJECTIVE: To improve delivery of pain management to VHA patients and to compare team process and patient report data on key goals from selected study units.

METHODS: Charts were reviewed for outcome and process measures. Measures included changes in percentage of patients with (1) moderate to severe pain, (2) documentation of a pain assessment, (3) documentation of a pain care plan, and (4) documentation that the patient received pain education.

RESULTS: Seventy teams from 22 Veteran's Integrated Service Networks throughout the U.S. participated. Moderate or severe pain on study units dropped from 24% to 17%; pain assessment increased from 75% to 85%; pain care plans for patients with at least mild pain increased from 58% to 78%; and number of patients provided with pain educational materials increased from 35% to 62%.

DISCUSSION: Significant progress toward the target goals was reported during the Collaborative period. This improvement needs to be viewed in the context of a VHA system-wide effort to improve pain management. Data suggest that a program of team formation, goal identification, testing and adaptation of recommended system changes, sharing and feedback of process and outcome information can produce significant change in pain management in a major health care organization.


As some point you told your VA doctor that you were experiencing a high level of pain and were prescribed a medication for that pain which happened to be an opiate. The VA was legally obligated to treat your pain. If you are either unwilling or unable to follow the treatment plan, then you have an obligation to speak up. You obviously have a problem with your pain treatment, so it is up to you seek a remedy. Labeling your fellow veterans as drug abusers is NOT the answer. The correct answer can be found below.

Pain Management: Drug Tolerance and Addiction

Some medications used to treat pain can be addictive. Addiction is different from physical dependence or tolerance, however. In cases of physical dependence, withdrawal symptoms occur when a substance suddenly is stopped. Tolerance occurs when the initial dose of a substance loses its effectiveness over time. Addiction and physical dependence often occur together.

People who take a class of drugs called opioids for a long period of time may develop tolerance and even physical dependence. This does not mean, however, that a person is addicted. In general, the chance of addiction is very small when narcotics are used under proper medical supervision.

Addictive Pain Medications

Opioids, a family of drugs that have effects similar to those of opium or morphine, can be addictive. They include:

  • Codeine
  • Oxycodone (including brand name OxyContin)
  • Morphine (including brand name MS Contin)
  • Meperidine (including brand name Demerol)
  • Hydrocodone (including brand name Vicodin)

Who Is at Risk for Addiction?


Most people who take their pain medicine as directed by their doctor do not become addicted, even if they take the medicine for a long time. However, some people may be at a higher risk of becoming addicted than others. People who have been addicted to substances in the past or those with a family member(s) who are or have been addicted to drugs or alcohol may be at increased risk of becoming addicted to narcotics.

How to Prevent Addiction

The key to avoiding addiction is to take your medicine exactly as your doctor prescribes.

Share with your doctor any personal and/or family history of substance abuse or addiction. Your doctor needs this information to prescribe the medicines that will work best for you. Any fears about addiction should not prevent you from using narcotics to effectively relieve your pain.

Remember, it is common for people to develop a tolerance to their pain medication and to need higher doses to achieve the same level of pain relief. Such a situation is normal and is not a sign of addiction. However, you should talk to your doctor if this effect becomes troubling.

You can continue your research:

Pain management standards

On January 1, 2001, pain management standards went into effect for Joint Commission accredited ambulatory care facilities, behavioral health care organizations, critical access hospitals, home care providers, hospitals, office-based surgery practices, and long term care providers. The pain management standards address the assessment and management of pain. The standards require organizations to:
  • recognize the right of patients to appropriate assessment and management of pain
  • screen patients for pain during their initial assessment and, when clinically required, during ongoing, periodic re-assessments
  • educate patients suffering from pain and their families about pain management
http://www.jointcomm..._Management.pdf

I'm done.

Edited by GuaymasJim, 27 March 2011 - 12:28 AM.


#13 TiredSgt

 
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Posted 27 March 2011 - 06:33 AM

Like many others on hadit, I have been managing my chronic extreme pain through the use of opiates, non-narcotic medications, diet, lifestyle changes, counseling, and other methods for years. I have been doing it for more 40 years. If you have not been abusing the medications (and I have no reason to believe you have), then you are no more a drug addict that I am; and I am most certainly NOT a drug addict. I find it offensive in the extreme to be labeled a "drug addict" based solely on your obvious lack of knowledge!

There is a huge difference between "dope" and "medication." There is also a huge difference between "addiction" and "tolerance." I suggest you use your internet access to explore those differences. Using these words interchangeably is doing you, me, and tens of thousands of other veterans (and civilians) a horrible disservice! I, for one, resent the hell out of it.


Sorry if I offended, but let me add this, I'd be willing to bet that you've had at least 1 x-ray, MRI, Cat Scan or some other form of physical assessment diagnosing your pain. Well, I have not. And no, I'm not going to my appointment next week spewing off about lawsuits, malpractice, etc, that would be foolish. I'm going to let my doctor do most of the talking and answer his questions honestly. I'm going to explain that over the years I've built up tolerance and occassionally ran out of my meds, due to delays in mail, family theft or taking 1 or 2 extra during the course of my 30 day supply. So when I received the extra bottle, it was a relief and pleasent surprise to me knowing that I had a nice stash tucked away in case of an emergency.

I've prepared 3 separate folders for three possible scenarios - I'll just have to wait until my appointment with my PCP to see how it plays out. I am going to ask him one question though....."What exactly did my last xray or MRI show was wrong with my back, so I can tell my new doctor?" I'm sure he'll squirm in his seat, because you know what: There is no xray no MRI, nothing (except for 1 xray in Feb 2004).

Yes, I do believe the V.A. is liable for not seeking the root of my problems, a bone scan, mri, current up-to-date xray, they should've done something over the course of 7 years other than dispense pills. I'm happy your pain is managed, you obviously have a decent doctor and are dealing with a decent VA, but I'm not.


About 5 years ago my wife went her private dr complaining of constant neck pain, the FIRST thing he done was order an xray, next an MRI, he put her on opiates (hydrocodone 7.5/APAP) for 60 days. Meanwhile, he scheduled a surgery and put a titanium plate in her neck which practically cured her pain. She does not take any form of pain pills, maybe an occassional advil or alieve. Had she went to a VA hospital, they would've doped her up, raised her dosages to mask the pain, NOT treat the root of the pain. My pain can be cured with operations (grind off the bone spur in my upper neck for starters). They're simply too overwhelmed to fool with such nonsense, give 'em pills, move 'em out.

If you don't think you're an "addict" go flush all your opiates down the toilet - see how you feel in 5 days. My choice is NOT to be dependent upon a pill, my choice is to seek treatement for what's causing my pain, not mask it with a pill.

#14 john999

 
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Posted 27 March 2011 - 04:10 PM

If you think surgery will cure your pain you may be in for a rude awakening. You are going off half-cocked and don't know what you are talking about. You read a little on the internet and now you are an expert on pain and opiates. Get a second opinion on your pain management. We are trying to help you from making a mistake.

#15 rwskitch

 
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Posted 21 August 2011 - 09:22 PM

About 10 yrs. ago, during my treatment for Chronic Pain located in several areas, my PCP stated to me that I should have an extra, full prescription of my pain medicine on hand in case of any natural disasters - like the hurricanes we receive where I resided in FL., that way I wouldn't have to be w/o my meds. if such an event transpired.

#16 john999

 
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Posted 22 August 2011 - 08:06 AM

It is good to have a backup supply of your pain meds, but the VA will never agree to that nowdays. Every month I have a day or two where drugs are in transit. This means if I take drugs exactly as prescribed I run out of meds early. I get them by mail.

#17 Missi7

 
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Posted 14 September 2011 - 12:25 AM

John is right but if you can I would go and speak to the patient advocate first. Sometimes they can fix problems like this on the spot. If that does not work go to the Administrator.

I do not have a pain contract with VA but I have a prescription for hydrocodone 60 for 30 days and xanax 120 for 30 days and guess what meds by mail screws up on delivery.

Yes you are in a bad situation for an abrupt withdrawal.

I wish you the best. When this is over and fixed I hope you should consider a complaint to the VAOIG. You have been treated poorly by the VA

Anyone who takes their meds that are prescribed are not addicts. You are dependent and the VA should recognize this.



#18 Missi7

 
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Posted 14 September 2011 - 12:44 AM

John is right but if you can I would go and speak to the patient advocate first. Sometimes they can fix problems like this on the spot. If that does not work go to the Administrator.

I do not have a pain contract with VA but I have a prescription for hydrocodone 60 for 30 days and xanax 120 for 30 days and guess what meds by mail screws up on delivery.

Yes you are in a bad situation for an abrupt withdrawal.

I wish you the best. When this is over and fixed I hope you should consider a complaint to the VAOIG. You have been treated poorly by the VA

Anyone who takes their meds that are prescribed are not addicts. You are dependent and the VA should recognize this.



Have to say that the picture of your profile is one beautiful doggy! Is that yours? I breed Standard Poodles and show too when able.
This site has been encouraging to me. It hurts to be treated so callously by doctors. I hate it when someone puts in your record tested postive for opiates when DUH your prescribed opiates! That just irritates the pee pee out of me!:( ( Maybe THAT is why I lose my bladder from time to time not my back:P ( Sorry) If they want to test for drugs should they not test the level and say the patient is prescribed this and the test is consistent to what they are prescribed? Those little notes they put in files are not harmless. Someone commented about notes put in vets files. I get my record copy of it every so many months to keep up with my own file. And look through it as I have seen some tacky stuff put in it. Weird stuff too.Like commenting on private parts to food items! Good grief! I have never signed a pain contract. That sounds like a legal avoid liability thing to me. I do beg to differ that VA cannot be sued. Malpractice when a va doctor is sued in their individual capacity CAN be effective. Injunction requests depending on the situation also can help. But the vet has to make sure they fill out a Standard form 95 to avoid violation of FTCA ( Federal Tort Claim Act) which gives VA 6 months to respond. If they don"t it is a denial. Yet I do believe a request for injunctive relief can be filed outside the form 95.

I appreciate your comments about vets being poorly treated when docs act like those taking pain meds are dopers. Yikers. I waited for years to not take pain meds. Only when I could not bear it any more and my spine was in such bad shape with every single disc now either abutting the cord, herniated with stenosis, some just bulging, bone lesions, bone cysts, and of course they do nothing but give meds. BUt hey at least I cna walk! When I take the meds I have some active life. Not bedridden wishing I could just die already oh please God take me take me! SO in 2003 I started pain meds on my birthday of all days. Yippee! Pain free day for my birthday! Now I take 10/500 every six hours for pain as needed. Always have some left at end of month. Careful to wait out when pain comes and not time yet for a pill. Use heat tens unit and some ibuprofen.

So today sep 13 I get this letter saying the ONLY vets now that can have pain meds are ones who have surgery or acute injury and only for 4-6 weeks. They are transitioning to un pain med vets everywhere is what my doctor told me. Of course she called after I left a message that it was cruel to not even discuss such with patients just send a letter and say your cut off and oh by the way the last few years I gave you pain meds you did not need them. ( That is my , in essence she is saying...interpretation)

#19 Missi7

 
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Posted 14 September 2011 - 01:25 AM

I receive hydrocodone 7.5/APAP 500, 150 per month (in my former state, I received hydrocodone 10/APAP 500), sometimes I do indeed take an extra one or break one in half and add it to my normal dose around lunchtime, so I'm glad to have some extra put away. But the fact is: My V.A. doctor specifically told me over the phone that I had violated my pain contract and possibly federal drug laws, and wants to see me next week, and quote "he doesn't want to continue pain management and will forward this recommendation to his director." I told "ok, see ya next week."

If I could go back in time 7 years, I never would've started on opiates for my pain management, they do indeed help ease the pain, but NOW my body is physically and psychologically dependant on hydrocodone, and with my bad heart, I'm afriad of death due to withdrawals (I've ran out before due to mail delays and have experienced withdrawals first hand for 1-3 days over the years) It IS NOT fun!

I'm considering going into a 30 day detox here in Florida which will monitor my heart 24/7 and rid my body of opiate dependency, it's very expensive, but I think in the long run, it will be well worth it to get this monkey off my back, it's my opinion that long-term opiate usage increases pain associated with injuries, makes one dependant upon the drug in order to function and re-wires the brain to not produce natural chemicals because they're being replaced with synthetic feelings and emotions. If anyone out there doesn't believe this, STOP taking your opiates for 5 days, starting right now. I bet you my next 10 checks that within 5 days, your body will feel like it's been ran over by a steam roller, your heart will pound, you'll sweat profusely, then get the chills, you'll get grumpy, anxious and eventually you'll find yourself bed-ridden, begging for a pill. I've watched my father go thru this (he died in 2002 btw), I've seen my mother go thru this, my sister and I've experienced it myself. Sudden opiate withdrawal can be fatal for the meek, weak or elderly.

When I get my white envelope with pills every month, there's 3 long pieces of paper inside the package, it specifically states "this drug can be habit forming" and "when used for extended periods of time, this medication may not work as well and may require different dosing" and "It is not recommended for use for long term periods or in high doses." Yeah right. Nobody deserves to be on opiates 7 years, the VA could've changed my meds to a more long-acting drug, tapered me off an put me on a non-opiate drug for pain (which I requested in 2008)yes, it's documented, gave me a tens unit, etc, none of this was ever discussed. Seven years of pills - that's their answer. In fact, pills is the VA's answer to everything. Got a headache, pills, feel depressed? Pills, back hurts, Pills, carpal tunnel? Pills, stub your toe, Pills, can't sleep? Pills, feeling a bit anxious are you? Here's a pill. How about getting to the ROOT of the problem? Instead of masking the symptoms with pills...IMO, VA doctors are legal drug dealers, they get people addicted, then don't want to deal with the addiction when someone "violates a pain contract."

I think my mind is already made up to pay the 3,500 and check myself in for the duration, at least I'll be monitored by people who actually care and tell the VA to take their "pills" and stuff them where the sun don't shine. The program is guaranteed to get you off opiates, and from what I've been reading and the Youtube vids I've watched - you actually FEEL BETTER being OFF opiates.

I got my 100% rating due to CHF and other cardiovascular problems, only 30% on my back, 50% PTSD, 10% hearing, 20% cervical injury. I would like to think any doctor worth his salt would not be so cruel as to totally take a veteran off his meds without appropriate taper and/or something to counteract withdrawals? I'm worried about our meeting next week for sure. 1. Will he accuse me of being an addict? 2. Will he try to press charges for prescription fraud? 3. Could he stop my meds immediately? 4. Could I face criminal charges? 5. Could he refuse any further treatment regarding my other ailments? At least if he does cancel my meds totally, I have enough to slowly taper off with and hopefully ease the symptoms associated with opiate withdrawals.

I do plan to take the pills to show the doctor that I've not abused them, but I did take a few extra ones here and there as needed when my body ached beyond my normal threshold. I'm too old and tired for all this BS from the VA, guys, it's got me worried sick.

What do you think my VA doctor's decision will be?

I cannot understand how anyone can feel better by not having pain meds to reduce pain to a bearable state. I absolutely was in agony before I decided to take the pain meds. Sure there woul dbe less of the effect the drug has but the pain. IF ONE is really in pain the getting off of pain medicine is like committing suicide. Having a ever progressive spine disease and joint disease, among other pain problems. I can NOT live without the power of pain meds. I thank God fro pain meds! If I am not worthy of healing from Him at least there is pain meds to ease the suffering, albeit they do have consequence on the body. So sorry I can not see feeling better by not taking pain meds. Id rather die than live with that pain again.

#20 Pete53

 
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Posted 14 September 2011 - 10:04 AM

Missi7

We have two golden retrievers and the picture is a representative picture of our beloved Sasha who passed at age 15 two years ago. Sydney is a red golden and Sophie aka Soapy is a blonde. We have keep 2 dogs and sometimes three cause dogs are social.Our dogs are special and make our life better. Our first golden McKensie helped me get out of house and would always go with me.

I am prescribed 60 10/350 hydrocodone's a month. I take one in am and one when I go to bed for pain. Y'all know the kind of pain that wakes you up. I have been very careful to take as prescribed and have of course had to deal with Meds by Mail that comes late on a regular basis.

I also take xanax another med that I have problems with getting on time from the VA. I have been prescribed xanax for over 20 years from VA.

Fortunately for me I have a Medicare HMO and when the VA fouls up my Doc writes what I need.

I hope that we all get better treatment from the VA.

#21 net_vet

 
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Posted 28 September 2011 - 04:07 AM

I cannot understand how anyone can feel better by not having pain meds to reduce pain to a bearable state. I absolutely was in agony before I decided to take the pain meds. Sure there woul dbe less of the effect the drug has but the pain. IF ONE is really in pain the getting off of pain medicine is like committing suicide. Having a ever progressive spine disease and joint disease, among other pain problems. I can NOT live without the power of pain meds. I thank God fro pain meds! If I am not worthy of healing from Him at least there is pain meds to ease the suffering, albeit they do have consequence on the body. So sorry I can not see feeling better by not taking pain meds. Id rather die than live with that pain again.




I have read a lot of post. I can say I have had my share of the pain pill games the VA can dish out. My PCP was in Waco, Texas. He is also My Sons (Jr) PCP. The PCP screwed up my sons medication, and my son wrote ccongress. Needless to say, I was then retaliated against. My pain meds was coming late, time waiting between refills, hard time getting refills, You name it.. I did not push the issue(Much). I knew I was in the process of moving to Temple,TX. so I changed pcp to Temple. I am the type that keeps my cool, and seen my new pcp, not even mentioning a word about the past bad experience. I even got my medication increased due to building up a tolorance went from 5/500 hydrocodone to the 10/500 90 each month. Prior to comeing to temple, the waco PCP refered me to the pain clinic doctor, he was a jerk. I had a fractured disk, plus crushed cervical, compressed nerves in my neck from va surgery. Anyway this "pain Clinic" tried to put me on morphine. I had neve taken the pill type, maybe had a few shots while in the hospital after surgerys. I found out morphine did not agree with me, and was having adverse reations. I took the Morphine to the va pharmacy, and turned them in, I requested they do a pill count, and note it in my records. Also reported the adverse reaction to the pharmacy(important). Then I contacted the Pain Clinic doctor, told him about the adverse reaction with the Morphine, he phones back screaming on the phone like I was trying to seek drugs. Then he shut up when he found out I had turned the morphine into the pharmacy. So then he prescribes oxycodone IR. It only help reduce the pain for about 1 hour(it looked like a little sugar pill, would go straight through me). I phoned him again, he does more screaming on the phone, he is mad because this time the patient rep is on his back. I could see the trouble he was going to be, so I used the contract he had me sign, and fired him for breech of his own contract.

Now my new doctor, prescribed 10/500 hydrocodones, this went well....Until I went to get a refill........No refill my doctor was not around. I did go through withdrawls, ended up at the va emergency room to get my blood pressure reduced. Felt like my heart was going to explode. It took 4 hrs to get my blood pressure reduced. The emergency room doc, gave me a partial refill prior to leaving..Come to find out my doctor was absent due to a family medical emergency. I now use secure messaging, and requested an alternative way to have a prescription refilled when my pcp is not available. I would not put it past the VA as to trying to setup veterans just to see if they have other pills on hand. In my case I did not, they sure tested for all the drugs in the emergency room, I was clean, and in full blown withdrawls.

It is just aggravating, even the last increase of my pain meds did not reduce the pain, my tolorance is very high. I even think going through withdrawls, and back on the pills again even raised my tolorance more, shocked my whole system. Recently the doc switched me to the 5/500 oxycodone 60 a month, to me is no more stronger than the 10/500 hydrocodones 90 a month. I told the pcp I would try the oxys, but if it did not work I would let them know. I am in the middle of working it out.

#22 net_vet

 
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Posted 28 September 2011 - 08:30 AM

I cannot understand how anyone can feel better by not having pain meds to reduce pain to a bearable state. I absolutely was in agony before I decided to take the pain meds. Sure there woul dbe less of the effect the drug has but the pain. IF ONE is really in pain the getting off of pain medicine is like committing suicide. Having a ever progressive spine disease and joint disease, among other pain problems. I can NOT live without the power of pain meds. I thank God fro pain meds! If I am not worthy of healing from Him at least there is pain meds to ease the suffering, albeit they do have consequence on the body. So sorry I can not see feeling better by not taking pain meds. Id rather die than live with that pain again.


When I see my shrink, he is always telling me take half a pill, meaning any opiate, or Lorazepam. Took me awhile to catch on, and start reading between the lines. So now the night prior to my Urine, and blood test. I only take a half of these pills. It shows up as I am taking the right amount of my medication. Locally they say do not take pain meds the morning of your urine/blood test as it will show to much in your system.





#23 net_vet

 
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Posted 28 September 2011 - 09:24 AM

Hi, I've not been on here in a long time, you guys helped me get my 100% rating 3 years ago, since then, I've also been awarded 100% SSD. But anyways, here's what happened. The VA said I violated my pain contract when I moved from one state to another and received pain meds from two separate facilities (which I did).

I have serious heart problems, CHF, ICD/Pacemaker, high blood pressure, chronic back pain, and a host of other medical conditions, all treated by VA doctors.

I've been reading that abruptly stopping narcotic pain meds can cause stroke, serious withdrawal symptoms, spikes in blood pressure, and basically 30-60 days of hellish torture to which my body simply cannot endure.

My current primary care doctor said he was going to discontinue my pain medication for violation of a pain contract I signed 7 years ago. Yep, the VA has had me on narcotic pain meds for over 7 years, now, just all of the sudden they want to abruptly STOP dispensing them. In my mind, any doctor in their right mind knows the affects of withdrawals and putting someone with a bad heart, high blood pressure, chronic pain, coupled with psychiatriac conditions (PTSD) is unequivocally and absolutely cruel and inhumane. My body simply can't take it, stopping my meds is not civilized after 7 years of being on them.

Can someone give me some advise please? I'm not saying I'm an addict (I took them as prescribed) but "on occassion" I did take 1 extra pill when I felt really super bad. Over the years my body has indeed became both physically and psychologically dependant upon this chemical in order to function. I told the VA (it's noted in my records from 2008) that I think I'm becoming dependant upon these pain meds and would like to stop. What does the VA do? Send me to a psych doctor who prescribed a powerful drug called xanax and UP my dose of pain meds! Now fast forward to 2011 - I moved to another state and received scripts from my prior state and the state I live in now. The old VA from my former state automatically sent the meds in the mail, I was surprised to get them in fact, they just arrive out of the blue one day, so I kept them. Now the NEW VA found out about this and wants to stop ALL PAIN MGT? I can't take it...I'll die. I have a heart of an 85 year old man and can hardly get around as-is, I can't imagine what's going to happen when my meds run out in 2 weeks.

Can someone please give me some advise. I have an appt with my PCP on Wednesday March 30th 2011 to "discuss" why I received meds from two different VA facilities.

Thanks - if you can call me on the phone and talk, I'd appreciate any advise, all I know is 7 years, 9 months of pain meds, my body IS in fact dependent upon these drugs and an abrupt halt will cause a stroke and I could very well die. The drugs are opiate-based, semi-powerful and do indeed relieve my pain and make me feel "normal".


It sure sounds like the VA is at fault. I have turned opiates back into the pharmacy because of adverse reactions, and they acted like they did not know what to do with them. Who is to say you did not phone the pharmacy to try finding out the procedure to turn them in? The VA is always sending out double prescriptions, they know it happens all the time. As far as that goes, it is all in the VA system, and it was not doctor shopping. When you sign for prescriptions you do not actually know what it is until you open it. You could tell them you flushed them. It is not uncommon for medications to overlap when changing doctors. You prob have a lot of othe scripts with your old doctors name still on them, they are not gonna hassle you about it, only the opiates, because most va pain clinic doctors are rejects, so it makes them feel big when they are in control of your pain.




#24 autumn

 
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Posted 02 January 2012 - 10:43 PM

just adding my .02 worth ...



it is odd that certain meds from VA are late or the ones that show up twice in a month and one Rx you didn't order. Pharm tells me doc ordered them. for my shots i have to take i'm glad they do. you never seem to have issues getting anti-depressants though. i mean, lets face it, the VA has a love affair with them.

and as pete mentioned the kind of pain that wakes one up and/or doesn't let you sleep and once in awhile brings a tear or two. i have that, thanks to ms and spinal issues. pain meds help my quality of life. that probably doesn't make sense to some folks. i waited years before taking anything.


> I have never signed a pain contract. That sounds like a legal avoid liability thing to me

sounds like it to me. i don't think i signed one.


> I get my record copy of it every so many months to keep up with my own file.

ditto, almost mandatory if we want to protect ourselves from the VA


>If they want to test for drugs should they not test the level and say the patient is prescribed this and the test is consistent to what they are prescribed?

i agree. i had a jerk of a neuro here who would say this and that and not follow through. but he would do those odd pee tests. i thought they were to see how my liver was due to MS modifiying injections. but they never talked about results. records show they tested for street drugs and stuff too. it was like they were/are trying to find something neg to pin on you. they quit asking if i was getting meds from outside VA. i guessed they realized i was telling the truth when i said i wasn't. boy they sure were interested in that though.


> single disc now either abutting the cord, herniated with stenosis, some just bulging, bone lesions, bone cysts, and of course they do nothing but give meds.

i can fully relate, especially about the VA doing nothing to find the root cause and document it. took me years to get them
to admit i had ms and i had to get a c&p to do that cuz no VA neuro would state i had ms. makes you feel secure doesn't it.

> So today sep 13 I get this letter saying the ONLY vets now that can have pain meds are ones who have surgery or acute injury and only for 4-6 weeks.

never heard of this, but i'm not surprized.



>Had she went to a VA hospital, they would've doped her up, raised her dosages to mask the pain, NOT treat the root of the pain. My pain can be cured with operations (grind off the bone spur in my upper neck for starters). They're simply too overwhelmed to fool with such nonsense, give 'em pills, move 'em out

i always thought they did this to reduce costs and avoid documenting a SC'd disability...maybe they are overwhelmed but they do their best to ensure a vet doesn't get a SC'd disability. i.e., most VA's i find are like that. some are way better as some VARO's are but they are few and who can afford to move to a "good VA state"?

good luck to TiredSgt, hope all works out in your favor



#25 Pete53

 
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Posted 03 January 2012 - 10:50 AM

VA Meds by mail is a damn joke. I have endless amounts of meds I don't need but I feel that I have to renew cause if you don't than you can have other problems with VA, However, I have had a prescription for xanax for 20 years and on a regular basis a problem develops. I now get a 2 month supply which has helped. I also get 60 hydrocodone 10/500.

When I go to VA I usually take a xanax and I also take a hydrocodone in the am and when I go to bed. What little sleep I get is helped by not being woke up with pain.

I think that the VA should get out of the prescription business and allow Veterans to get it done at regular pharmacies just like ChampVA does. Just imagine being able to call and pick up a refill just blocks from your home. It would save the VA money cause they still can negotiate the cost of the meds.

#26 autumn

 
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Posted 03 January 2012 - 01:57 PM

VA Meds by mail is a damn joke. I have endless amounts of meds I don't need but I feel that I have to renew cause if you don't than you can have other problems with VA, However, I have had a prescription for xanax for 20 years and on a regular basis a problem develops. I now get a 2 month supply which has helped. I also get 60 hydrocodone 10/500.

When I go to VA I usually take a xanax and I also take a hydrocodone in the am and when I go to bed. What little sleep I get is helped by not being woke up with pain.

I think that the VA should get out of the prescription business and allow Veterans to get it done at regular pharmacies just like ChampVA does. Just imagine being able to call and pick up a refill just blocks from your home. It would save the VA money cause they still can negotiate the cost of the meds.


great idea for VA to get out of the Rx business. that is bound to be a plus for veterans and maybe lessen influence on what VA docs prescribe. i vote they just issue VA med insurance cards so we don't have to go the VA.

i too get extremely stressed going to a VA. used not to be that way. but over the years, the lies, mis-diagnosises, etc has taken a bit of a toll. way too many defense mechanisms go up when i have to go to VA.

good you are getting some rest. so hard for the body/mind to heal a bit without good sound sleep. and chronic pain changes a person after so many years, no question

#27 john999

 
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Posted 03 January 2012 - 02:21 PM

All I can say is that about 10 years ago I asked the VA pain management clinic for celebrex or vioxx and they gave me morphine instead. Since that time I have been on morphine, methadone, oxycodone, and fentanyl. Now oxycodone is considered the number one drug that is abused in Florida with hydrocodone a close second. I used to get 180 oxycodone a month. Now I just get 120. I feel like the VA is putting a target on my back. I have been on the contract for years and never violated it. If I am addicted the VA was the drug pusher that made it all possible.

#28 usmcgirl

 
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Posted 03 January 2012 - 08:47 PM

I signed the same "long term narcotic" contract for hydrocodone....funny thing is when I asked my Doc what it was for he explained it as "if you ever get pulled over while on hydrocodone - you have this to back you up." Ironically he took me off hydrocodone and refuses to prescibe it now. Every pain med (non narcotic) that he has prescribed has not worked for the last 2 years. I asked to be placed back on it recently but he refused again because of the psych meds, saying "because of your PTSD and depression ect, you are more apt to become an addict." So now I just take my other meds and live with the constant pain.

#29 autumn

 
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Posted 04 January 2012 - 11:12 PM

does one have to sign such a contract? who does it protect, the veteran or VA?

#30 usmcgirl

 
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Posted 05 January 2012 - 11:34 AM

the way it was explained to me was that it protects both...the VA and yourself.

#31 justrluk

 
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Posted 05 January 2012 - 11:36 AM

Even as recently as my last visit (last week) it wasn't mentioned...

#32 Charli

 
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Posted 06 January 2012 - 03:24 PM

They are supposed to wean you off but YES they can do it.

I was told that there is a push from the top to wean any vet without cancer off their pain meds. I just had mine reduced by 50% and my quality of life is gone. I called my elected officials and there wasn't much to be done. So I'm trying to find a doctor on the outside to give me my meds. I've told my PCP that I will NOT live like this and so they sent me to the shrink. The shrink asked me if I was going to hurt myself and I said I think you people are doing a great job hurting me and they gave me the speal that they're caring about me. HUHHHHHHH! this much care might kill me.

We had better circle the wagons and start writing every elected official we can or we're all going to lose our pain meds.. I was also told that doctors that do not wean patients off the meds will get lots of pressure to do so.

#33 Charli

 
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Posted 06 January 2012 - 03:25 PM

Every veteran on narcotics (what a nasty word I prefer opioid therapy) has to sign a narcotic contract in order to get pain meds.

#34 Charli

 
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Posted 06 January 2012 - 03:29 PM

All I can say is that about 10 years ago I asked the VA pain management clinic for celebrex or vioxx and they gave me morphine instead. Since that time I have been on morphine, methadone, oxycodone, and fentanyl. Now oxycodone is considered the number one drug that is abused in Florida with hydrocodone a close second. I used to get 180 oxycodone a month. Now I just get 120. I feel like the VA is putting a target on my back. I have been on the contract for years and never violated it. If I am addicted the VA was the drug pusher that made it all possible.

You're not addicted, You're dependent. Addiction is a complex physical and mental result of misuse of pain meds. An addict will do anything for a fix a dependent patient will not. There is a push from the top to wean all of us off our pain meds if we don't have cancer. Quality of life apparetnly doesn't count. I'm putting my affairs in order just in case I can't find a pain management doctor outside the VAMC system. Personally I'm sick of the DEA and some idiots in DC inflicting their BS on me.

#35 stuart7491

 
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Posted 09 March 2012 - 01:44 PM

i recently violated my pain mgt contract by having to vist a local er after a fall i had to pay for the visit since it is not life threating and meds. the current meds would not touch the pain i was in. so being honest i mentioned this and then received a letter stating i would no longer get them because i rec'd from someone else. from what i have read the va was required to provide me a copy of pain management contract. they nevwer did and no documentation in visit that says they did, they gave me other stuff as is in the record, but not that,to they violated. also had rerceived pain med from other va drs. nothing said, but have also had a another dr write, but pharmacy would not fill because of agreement. can i appeal this decision. i also have appt with shrink, canhe write for at least the methadone, i could get by with just them, the oxy 10mg 4x a day really did't do that much. i don't mean to sound demanding but appt with both pcp and pshyc are in 3 weeks any help or direction pointing very much appreciated

#36 GuaymasJim

 
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Posted 19 May 2012 - 06:05 PM

There is quite a lot of information missing from your post that really makes a difference on how to approach this. The VA is getting a massive amount of pressure from DEA to reduce opiate prescriptions because they have become the #1 abused drug in the US. The VA usual opiate contract is similar to civilian contracts except it is much stricter.

Those of us who have been receiving these medications for decades have seen the cycle go from handing them out like popcorn to restricting them to the last hours of a terminal cancer patient's last day. With the news filled with daily reports of "prescription drug abuse/overdoses," this cycle is going to very long and difficult. The VA is looking for any excuse they can find to reduce the amount of opiates they are dispensing--any excuse! You unfortunately have given them several.

The following is neither legal nor medical advice, but I hope it helps a vet understand some of the ramifications of using opiates generally and specifically how the VA now deals with their use.

If you were prescribed opiates at your local ER, did you inform the local ER personnel about the fact that you were already on opiate therapy and under contract? Was the opiate prescription written by the local ER filled at the VA pharmacy? Did you inform them you were already on opiate therapy and under contract with the VA? I haven't seen (nor want to see) your contract, but I would be in violation of mine is I had to answer "NO" to any of those questions.

"so being honest i mentioned this" How (written or verbal) and to whom (Primary VA/private provider, pharmacist, intake nurse); and when (the next day, next appointment, next refill time, when confronted with the violation)? Again, I haven't seen (nor want to see) your contract, but mine requires a bonified and documentable emergency detailed in the medical records of the emergency as well as notification ASAP to my VA provider. The additional opiates would be figured into my consumption and my normal prescription would be adjusted accordingly if needed.

Yes, the VA is required to give you a copy of the contract at the signing. If they said they gave you a copy, the law usually sides (presumption of regularity) with them much like when they say they have sent notice of a C&P exam or the annual TDUI questionnaire when they really have no way of knowing whether or not they did actually send the forms. I am certain that you will not be able to obtain restoration of your opiate therapy based on whether or not you received a copy of the contract. You obviously knew your were under contract with or without a copy as you read and understood the requirements when you signed it (Hopefully!).

"have also had a another dr write," If the "another dr" who wrote the additional prescription was not covered by your contract, then I can almost guarantee that the VA will view that as even another violation.

What "but pharmacy would not fill because of agreement?" If it was the VA pharmacy, even the attempt to have it filled was probably noted and reported as another violation.

"also had rerceived pain med from other va drs. nothing said" Those other VA providers are aware of the contract as it will pop up on the VA computer screen when they attempt to enter an opiate prescription. Your PCP was also automatically notified and had to sign off on it. The VA pharmacy is supposed to act as a gate keeper by keeping track of multiple opiate prescriptions so they see the contract also.

Your best bet is to discuss this in detail with both your PCP and mental healthcare provider. It will probably be an uphill battle but be honest and straight forward and you may get back under contract. If "the oxy 10mg 4x a day really didn't do that much" and the methadone is helpful TELL YOUR PROVIDERS. If you are new to this type of therapy, you might not realize that with regard to opiates, more is not necessarily better in fact it may be much worse. Also, it you use more than is necessary or more often than is necessary, the medication may stop helping at all. Another important point, it is common for patients on long term opiate therapy to experience an increase in pain intensity not only the original pain but pain caused by different conditions. Finally, one of the biggest dangers of using opiates is that they are usually combined with acetaminophen (Tylenol) which is extremely harmful to the liver. The strict daily allowable limit of opiates is more a limit on acetaminophen than the actual opiate. I certainly hope that your providers, VA and private, explained all of this to you when they wrote the prescriptions and especially when you and your provider signed the contract. It it wasn't discussed, then I highly recommend that you bring it up the next time you have the opportunity.

Except for the occasional jerk, I believe most providers do really want to help patients, but, with DEA's opiate policy, their jobs are truly on the line. The determination of the proper use of opiates, or any other medication for that matter, legitimately belongs to the FDA, the doctor, and the patient, but so far no one has made me king so we have to deal with what we have--draconian non-medically determined DEA restrictions and regulations on opiates.

You should be gradually weaned from almost any medication rather than just immediately cut off. I cannot tell from your post whether or not you still have enough medications to last until your next appointment, but if you are experiencing withdrawal symptoms, report them to your provider immediately! Common withdrawal symptoms are: severe discomfort, including diarrhea, abdominal pain and cramping, vomiting, runny nose, eye tearing, yawning, sweating, agitation, restlessness, twitching and tremors, back and bone pain, and intense craving for the drug.


IF THESE SYMPTOMS ARE SEVERE--GO TO THE ER!

If you do get back under contract for opiates, you are going to be labeled as a potential abuser and even more strictly monitored.

So, my advice is to adhere strictly to the terms of the contract and if a situation arises where there is ANY question, ASK your VA provider, first if possible, AND DOCUMENT EVERYTHING! Having said that, I would not personally allow my health to deteriorate any further just because of an unreasonable bureaucrat and/or bureaucratic policy-but that's just me.

#37 whatsupwithat

 
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Posted 30 May 2012 - 11:41 PM

Hello folks, during service I became a Type-1 insulin dependent diabetic. Anthrax vaccinations shut down my pancreas. After separation, I hit rock bottom with alcohol and the prism of street drugs. This irresponsible me 'saw the error of my illegal activities' August of 09. Facing a strict prison sentence I emerged from rehab a sober law-abiding citizen again (from alcohol and street drugs) 6 months later. A year or so after separation, and early in my diabetes I was prescribed hydrocodone 5/500 then 7.5's for diabetic pain. Of course, at the same time I signed the VA rights release. I called to renew my hydro prescription religiously for approximately 8 years. Eight months ago I needed renewal and was informed by my 'physician' that I would have a urination and lab before he would renew. I performed the request, got my medication but the next day mail told me I violated VA policy, marijuana use: so no more VA narcs. I do smoke and will never understand why we can self medicate with alcohol freely without medical benefit accepting the horrible risks associated but someone can't med with MJ when it's a proven diabetic nerve-pain reliever among other uses. Such a political contradiction. Regardless, last weekend I seriously screwed something up in my lower back, went back to the Jack C. in Muskogee and after being denied by my 'physician', his boss and the patient advocate, I have been labeled as a narc hunter. Yes, I have had a couple of Ozzy episodes with these providers and admin, and...5-6 YEARS ago, the 'label' would have been true. I haven't had anything but OTC in my system since November 11, excluding Naproxen and Methocarbomol from the VA-E.R. Wonder drugs that don't do anything to the jack-hammer in my back. I have legitimacy with this lumbar injury, but have cried wolf too many times? Is this the kind of mentality vets are dealing with? Could someone let me know if there is another course of action besides relaying my new injury with these 'buddy-system' dictators? I don't care about being monitored for illegal drugs, if these people would look past my history and actually do something for my back. The pain has caused me to loose a decent welding gig, which I can weld anywhere but really don't feel like spending a fortune on a private physician just to be able to work. Who can I talk to about signing the release again, or is it just a one time deal? I'm at my breaking point.

#38 troyez

 
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Posted 07 September 2012 - 01:11 AM

I've signed the pain med contractseveral different times over the last 10 years that I've been prescribed opiods (oxycodone) through the VA in Illinois - I'm currently rated 60% disabled for 3 herniated (1 ruptured) discs in my lower back, elbow tendonitis, and plantar fascitis in both feet. The pain meds are mostly for my back, which has progressively gotten worse, and thus I need to take more and more meds, and for the last year I've asked to see a pain management doctor to get the dosage increased - I've taken the same amount for 3+ years now, which isn't working - in order to do my job I have to take half of my day's dose first thing in the morning!

I was just urine tested Tuesday morning and I got a call from my VA doctor yesterday telling me that I tested negative for marijuana AND for opiods, and that the last urine test showed no opiods in my system either (I wasn't told though)! The doc told me that pain management wanted to stop the pain meds and I was completely floored - oxycodone is the only medication that actually helps with the debilitating pain and sciatica and they want to stop giving it to me! I told my doctor just that and that their tests had to be wrong and that I'd take a polygraph or whatever would prove that I was taking my meds! The doc discussed the matter with Pain mgmt., called me back, and told me that he believed me (and told them as much) and got them to fill the script week-to-week, with a weekly urine test to see what was going on. He said that I might be metabolizing the meds at a different rate and that we'd figure this out.

I was actually shaking with anger after he initially told me that they were going to discontinue the medication - I take them as prescribed (sometimes more when the pain is worse - it happens too often lately with the amount of pain I've been having), I am NOT selling them "on the street," and I've only ran out early and asked for a re-fill once (last month actually). Maybe the last time I had to provide urine I had taken too much medication, and it showed up as too much in my system, I don't know. Does the VA play head games, trying to get you to stumble so they can snatch the rug out from under you? Why do they treat vets like criminals, like we can't be trusted, and that we'll lie before telling the truth?!?! I held a top secret security clearance (TS/SCI) the entire time I was in the Army, and it can actually still be used should I get a job needing it today! But this bureaucratic government entity can flippantly call me (and countless other honest vets) a liar and make me jump through hoops, just to relieve the pain that was caused while I was their employee!!!!! That's why I was shaking (as I am right now!) as I tried to fathom this insult.

Thank God my doctor is a stand-up guy who actually cares about his patients. I hope he can figure out why the meds aren't showing up on the urine test, if not I guess I'll be blacklisted and forced to find a civilian doctor, which I can't afford.

Anyone had the same (non) results on their drug screening? If so, what happened? Can/will my state representative help me? I don't know what to do here, this is absurd to me.

#39 Charli

 
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Posted 17 September 2012 - 11:17 AM

The big problem here is that the VA does NOT have a pain management system in which all modalities of pain management are used. Massage, acupuncture, opiod therapy, psychological therapy and more need to be used together to control the pain. I recently got upgraded to 50% disability due to my back but no increase in pain meds or other treatments, EVERY VA should have a pain management team so that veterans get the treatment they earned and deserve.. The only way this is going to happen is for us to organize, write letters to elected officials, newspapers, etc, and generally just make life miserable for the government until we get what we want. I think we need a review board when someone is said to be in violation of their pain contract. I also think the DEA needs to be disbanded. The war on drugs was lost before it ever started and we could restart our economy by treating people as adults and legalizing everything and make the consequence for infringing on someone elses rights huge. But unless we become politically involved we will continue to be controlled by others.

#40 Charli

 
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Posted 17 September 2012 - 11:22 AM

First you are physically dependant and your body would need more meds to get the same results. Go to the patient advocate and the newspaper. Both can help you. Also go to every veteran organization you can find,. Call your elected officials. This is the fault of the VA. How do they know you didn't return the meds? Or that they never got to you. This is exactly why I do not get meds mailed. I simply told the VA we live in a rural area and things get stolen (not a lie). If you go through withdrawals go to the ER.




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