Fentanyl patches vs. MS Contin

[jerets]

Hello everyone,
I am going to a PM doctor for the first time. I am trying to get on a CII. My insurance is very good so I doubt I will be seeing a script for methadone, so I am curious what the best medication is to request? I am going to assume that I'll either be scripted Ms Contin or patches. Ring in with any other options you may think I have -- I doubt OC's will be an option. So I am asking... which is better Fentanyl patches or MS Contin? If MS Contin, which brand?
Thanks everyone,
jerets

[nick]

They coud hit you over the head with a hammer.MS of fent,it's ALL good.


Sorry,I'm drunk and listening to Robert Johnson.

[Oxy-Ftbllboi]

Thats pretty strong stuff to get right away brother my best guess is a low dose of OxyContin liek 20-40mg and then percs for break through pain and remember when u see him, you have breakthrough pain like no bodies buisness..sometimes it even puts u back in bed for hours! but if you could get MSContin or Fentynal patches like nick said..there both freakin sweet. My G/F is a nurse here in NC and shes in the SICU Level I trauma and they use fentanyl all the time. a mix of that and Ativan (lorazepam) and its called Snowing them. 'snowin em' because you get a real high relaxed buzz where u see blurry white (kind like weed) and u cant move like ur stuck in a blizzard...so go with fentanyl :)

[trainwrecker]

Fentanyl is far superior to MS contin. Instant release morphine is somewhat better, but that contin shit is horrible.

[insaneike]

Fentanyl all the way. msC sucks IMO.

'nuff said :cloud9:

and fentnayl is the ONLY thing(smack and dialudid dont even help HALF as good!) that helps my pain in the slightest. Fent is truly a godsend for pain!

[Narkotikon]

Yeah, my guess is that you'll get something like OxyContin then Percs for breakthrough. I've never been to a PM doc, as I have no legit reason to go, but when I was talking to Flipside, I learned that some states have a law requiring those patients being on an extended release med for the majority of their meds. Sounds fine to me. You can always crush and shoot or snort. Now, to your question, if I had to choose, I'd choose the MS-Contin over Fent. It's nowhere near as strong, but the morphine rush and high is just so delicious. It's like it was crafted by the Wicked Wtich of the West in her Poppy fields to keep the Munchkin's in line. I love morphine. It's deliciously warm, cocooning, euphoric. I swear, if I was on a high enough dose of morphine, and Hitler was in power, I'd be right with him and his agenda. You know it's wrong, but that's how good it is. I do like Fent. Don't have much experience with it. Just one Actiq pop and a few lower-dose patches, but it's too short acting for me. I'm all about quantity. I remember when I first started using drugs, which were E, K, and Cid, I felt like it was a waste of money because it wasn't as long lasting, plus I never got off on E or Cid, and I know I had really good stuff. The only thing of those that I liked was K, and that's more of an opie in my opinion. I'm just wired for downers. But yeah, morph is the bomb. It's like a good dream gone bad though when you get too deep into it. If you can limit your dose (I'm assuming you're asking to see which would be better to get for both pain relief and recreational value), the w/d shouldn't be too bad. Morph Morph Morph. Gotta Love it.

[jerets]

Is MS Contin as good as Oxycontin? Which is better and why? I'm assuming since I take around 30mg of Hydrocodone and it is not enough relief, that I would need 30-40mg OC or 50mg of MsContin and then something very small for breakthrough pain. Any opinions on that?
Thanks everyone,
jerets

[Narkotikon]

In the heirarchy of opies, it goes hydro, then oxy, then morph. Meaning, hydro is weaker than oxy, which is weaker than morph. If you take 30mg of hydro (which really isn't that much at all), that would be equivalent to maybe 20-25mg of oxy, and 15-20 of morph. That's just guessing. The difference is also in effects. Oxy is produced from thebaine, which IMO gives it a speedy effect. When I am on oxy, I feel like cleaning and socializing. When I'm on morphine, I feel energeting for a few hours once it kicks in, then it fades to a wonderfuly dreamy place that I'd give anything to live in for the rest of eternity. Morphine really is God's own medicine.

[Boudica]

I was on ms contin for about 6 yrs., and I was still in living hell from pain. I've never gotten any euphoria from morphine, ever. Perhaps I've just a weird body chemistry, because the stuff was garbage for me. That's why my PCP referred me to my PM Doc. She had raised my mscontin dose so high that it just couldn't get any higher and she didn't know what to do with me. It depends on the condition that you're seeing a pm doc for, and the level of pain that you're in, what you've taken in the past, what worked for you and what didn't, etc. These are the kind of questions the pm doc is going to ask you. So, if you can let us know more specifically what you're seeing the doc for, it would help folks here to answer your question. Heidi and Roxi Stardust both have extensive knowledge in Pain Management, so they are good to ask questions to. I've got 10 yrs experience with them, w/3 different docs (not all at the same time!!), so I can help from the experiential point of view, but it would help a lot if I knew what your pain issue is about. I finally got lucky 2 yrs ago, when I was referred to my currant pm doc. She gave me oxy and oxyfast right out of the gate, then added fent via Actic, then Fentura later on, for breakthrough. Fent is pretty ass kickin' stuff, in my expierence, and oxy products have worked best of all for me. Maybe I can help w/ how to talk to the doc if ya let me know a bit more:)

[jerets]

Maybe I can help w/ how to talk to the doc if ya let me know a bit more:)

I have Scheuermann's disease and Schmorl nodes on my spine. I have had back pain almost my entire life but not intolerable until the past 2 years and worse of the past 6 months. I have a long history of degenerative joint disease in my family and scoliosis on my one side of the family (the side most of my genes came from). I have had percocets which seemed similar to the Hydrocodone. I've also been scripted Soma and Xanax in the past as well. The Hydrocodone/Soma combination helps a lot but does not even come close to provide long enough relief. 1-2 hours tops and mild pain for the next hour and back to square one. Any further advise is greatly appreciated. I have an appointment in a few days. I do not fully understand my condition even -- I just know that it is painful and have been referred by my PCP to this PM doctor. I have been using telemedicine for almost a year now. I will be taking a full MRI with me along with diagnosis.
Thank you,
jerets

[Boudica]

Good lord, darlin', sounds to me like you are a prime candidate for a long-acting non-wimpy pain med, with something equally strong for breakthrough attacks. Man, I KNOW all too well the kind and level of pain you are having to deal with, and if you haven't gotten suicidal yet, you will if you don't get proper pain control. With your family history coupled with a recent MRI you should have no trouble getting decent meds and enough of them to get some quality of life back. Whatever you do, don't ask for a specific drug at your first visit. Like, don't go in there and say " I think that a big fat dose of oxycontin or morphine would do the trick, doc." That's a red flag to docs, what they consider "drug seeking behavior". However, DO NOT BE AFRAID OF TELLING HIM/HER HOW SERIOUSLY YOUR LIFE IS BEING AFFECTED BY YOUR PAIN! Don't mince words or downplay your condition. Don't minimize. Come from the heart, let your pain be heard. Tell the doc what a day is like for you. Tell the doc how endless nights are for you and exactly how much you dread having to face every day with the pain you have. Let this doc know that you've reached the end of your rope and you are sick of it, that you are exhausted from it and that you would give just about anything to be able to reclaim parts of your life that you've lost due to your pain. Tell 'em about the things you used to enjoy doing, that you have had to let go of because of your pain. Tell 'em how depressing your life has become because of this. You want to express your life experience with pain, because in doing that, you become "human". A real person sitting in his office pouring your heart out, and not just some patient who's trying to get over on him/her. Trust me, they can tell when it's all too real for you. It's up to you to convey this reality to them. Ask for the docs' suggestions, tell about what helped in the past, but let 'em know that you are way beyond that point now. Ask him to educate you about what your options are, and let him know that you do realize that it may take some time to land on the right "formula" for you. Everyone is different, and a good pm doc will be very willing to try out different combinations of meds until you both find what will give you the best pain management. Be an active participant in your pain care, think of your pm doc as part of the team that you are paying to help you get your life back on track. Come to your appts. prepared. Write any questions and concerns that you have down on paper and take it in with you. You'll score big points with him right from the start, just by having your shit together when you come in. Make notes to yourself to help you stay on track during your appt. You will save yourself and the doc a lot of time and frustration by doing this. Doctors LOVE patients who do this, and you'll thank yourself for it. And, do not forget to let the doc know just how much you appreciate his help. You don't need to use "overkill". Just be sincere, and let him know from time to time that you are very glad that your pcp doc referred you over to him. When he really is helping, it will just flow naturally, because you WILL be grateful if this doc can get you out of pain. It can be surprising sometimes, how much a doc will extend himself for you when he feels appreciated. Tell him that you plan on doing some research on pain management options and new treatments, meds, etc. as soon as you're feeling better. If you're like me, when you are hurting it's just too overwhelming to even sit up at your pc for a while to research stuff. But docs love patients too, that are well and currantly informed. And, if what he gives you at your first visit doesn't do the job, tell him next visit. I really can't stress that enough. Speak up. You're there to get relief, and you won't get it unless you let the doc know how you're really doing. And finally, if this doc does not give you the time, attention and help that you need, keep your searchlight on 'till you find one who does. This is your life, and it's too short to waste it being in pain. My apologies for this post being so long, but folks in severe pain out there who aren't getting the treatment they desperately need and deserve ...well...it just makes me nuts. I've been down that road, and I just can't stand seeing folks in pain when it CAN and SHOULD be helped. Whew...OK, I'm done...for now, anyway. I will be sending good and positive vibes your way. Do let us know how things go for you, I really do care.:)

[jerets]

I haven't had suicidal thoughts but sometimes wondered if it's worth it to be alive if I'm going to be in pain all the time. It took me 45 minutes to get to sleep last night because my back wouldn't let me relax enough to get to sleep. I am starting to hate my body more every day. I am so afraid this doc is going to say, "ahh you don't need meds, you need more phsyical theropy". I've done the exercises, stretches, and I work out at a gym when I can stand to and try and build up my ab muscles. I do not want a chirocruncher or surgery or anything else. Medication used to work for me. My family has tried everything to avoid and it if it hasn't made them worse then it just made them more frustrated. I am about at the end of my rope and I am counting the hours til my appointment... if it doesn't turn out, I don't know what to do

[jerets]

What is comparable to 25-30mg of Hydro in OC and MsC terms? I've heard that 20mg of OC doesn't provide the same relief as four 5mg percs because they are not absorbed the same. Is this true? If so what should I be aiming for? I am sure I'll just have to take whatever the doc gives me but I would like an idea if before I take it if it is too much or too little.
Thanks,
jerets

[Narkotikon]

What is comparable to 25-30mg of Hydro in OC and MsC terms? I've heard that 20mg of OC doesn't provide the same relief as four 5mg percs because they are not absorbed the same. Is this true? If so what should I be aiming for? I am sure I'll just have to take whatever the doc gives me but I would like an idea if before I take it if it is too much or too little.
Thanks,
jerets

Are you talking about taking the OC whole in comparison with the Percs? If that's the case, then no, they wouldn't absorb in the same rate. Also, the Percs have APAP in them, so that sort of boosts the pain relief factor, not that I'm a big fan of APAP.

Hydro is weaker than oxy and morph, so you'd need less of oxy and morph to get the same effects. In theory, 25-30mg of hydro would be like taking 20-25 of oxy and 18-23 of morph. But you have to remember that oral morphine isn't very efficient. You only get about 30% of what you take orally, so that may require more, especially if you have a tolerance.

[Incognito]

Thirty mg of hydro should be equianalgesic to 20 mg of oxycodone, and about 40 mg of oral morphine. As far as dosing schedule, i get the oxycontin 3 times a day as it only seems to last about 8 hours for me.

If you wanted the oxycontin equivalent of taking 20 mg of percocet, you want to get at least a 40 mg Oxycontin.

Your new doc should titrate you to a level that eases your pain. Just tell him how effective or ineffective your current dosing is. He will probably use that as a baseline and go up from there while keeping in close contact with you until he gets you to a level that keeps you comfortable.

[jerets]

So if 30mg of Hydro is no longer working for my pain, I would want at least 40mg of OxyContin to substitute it for my baseline pain? I have read that they make MS Contin that lasts 24 hours and one that lasts 12. I would not my med spread out over 24 hours. I would rather it last 8-12 hours when I really need it than when I am sleeping.
Thank you,
Jerets

Thirty mg of hydro should be equianalgesic to 20 mg of oxycodone, and about 40 mg of oral morphine. As far as dosing schedule, i get the oxycontin 3 times a day as it only seems to last about 8 hours for me.

If you wanted the oxycontin equivalent of taking 20 mg of percocet, you want to get at least a 40 mg Oxycontin.

Your new doc should titrate you to a level that eases your pain. Just tell him how effective or ineffective your current dosing is. He will probably use that as a baseline and go up from there while keeping in close contact with you until he gets you to a level that keeps you comfortable.

[Incognito]

So if 30mg of Hydro is no longer working for my pain, I would want at least 40mg of OxyContin to substitute it for my baseline pain? I have read that they make MS Contin that lasts 24 hours and one that lasts 12. I would not my med spread out over 24 hours. I would rather it last 8-12 hours when I really need it than when I am sleeping.
Thank you,
Jerets

If you are saying you take 30 mg of hydro at one time, and it is ineffective, then 40 mg oxycontin. dosed 2 or 3 times a day, would be a good start for you.

30 mg of hydro is equivalent to 20 mg of oxycodone. You can think of the oxycontin as releasing half of it in the first hour, then the second half about 5 hours later. So for a 40 mg oxycontin, you get about 20 mg of it in the first hour, and the other 20 mg about 5 hours later. This is an overly simplistic view of the time release mechanism, but works for our purposes.

If you were taking 30 mg hydro total a day, then two 10 mg oxycontins, one twice a day,would be about equal.

[bronyraur]

Hello everyone,
I am going to a PM doctor for the first time. I am trying to get on a CII. My insurance is very good so I doubt I will be seeing a script for methadone, so I am curious what the best medication is to request? I am going to assume that I'll either be scripted Ms Contin or patches. Ring in with any other options you may think I have -- I doubt OC's will be an option. So I am asking... which is better Fentanyl patches or MS Contin? If MS Contin, which brand?
Thanks everyone,
jerets

Personally, MS Contin works great for me (100mg 3x daily) and Roxicodone 15mg (Roxistardust's favorite:D) as needed for breakthrough pain.

It all depends on what the doc wants to do with you. From what you've said, you have a completely justified reason to take strong pain medication, but don't go into the appt. thinking you gonna leave with 80mg OCs and 1600mcg Actiq.

It takes time to get the proper pain control-the hard part is waiting to get there (pain relief, that is).

[jerets]

I usually take a 15-20mg of hydro when I first wake up and then I take 5mgs at a time throughout the rest of my day until I hit 30mg.
So I am guessing I would need an OC 20 in the morning with maybe two OxyIR 5mg for break through pain throughout my day if the OC is released as you have described. A few months ago my dad gave me one of his pink OC 20's once to try for my pain and I just chewed it up to get all the pain relief at once (like 4 percs) and it worked very well for my pain but wore off in about 3hours. I won't mention that tomorrow. I've never experienced the OC with the time release part because I wasn't sure if some of it would be wasted or not considering I only had one to try. The OC 20 may be enough if I am able to have two 5mg Instant Release oxycodones. Or maybe even two OC 20's with something less for breakthrough, I'm not sure how they prescribe. If they write the MS Contin instead. Maybe 30mg MS and 2-3 OxyIR. What do you think? Again, this is just to give me a good idea going in tomorrow with approx. what I should be leaving with so I am not walking out with too much!
Thanks,
Jerets

[bronyraur]

Jerets, even though 30mgs of hydro doesn't do shit for you, you'll probably start out on a low dose OC, or MS Contin with something for breakthrough pain.

At your next appt your doc will probably evaluate your pain (and how well the meds do or don't control it)
and then he/she will go from there.

They wanna get you significant relief from your pain, don't expect to be completely pain free.

Hell, I take 300mgs of morphine and 120mgs of oxycodone a day and I still have some pain.

Hang in there man.

[jerets]

Is a month supply of OC expensive if you have decent medical insurance? I have Highmark Bluecross but I was reading online that a month supply of medication could cost upwards of $400!
Thanks,
jerets

[Chemical_Boy]

Is a month supply of OC expensive if you have decent medical insurance? I have Highmark Bluecross but I was reading online that a month supply of medication could cost upwards of $400!
Thanks,
jerets


What is your prescription plan like? Set copays for generic, non-formulary, and formulary? Or is it a percentage based copay?

If you have a percentage pay or deductible type prescription plan, it may cost a fair amount.

[jerets]

I just called and found out. They gave me the price for 90 tablets (which I'm sure I wouldn't get):
OC: $20 for the generic. $246 for the brand. $60 if the generic is not available.
MS Contin: $20 for the generic

Wow! $246 for the brand -- thats crazy. The Roxi/IR oxy is very cheap! Crazy you pay all the extra money for the med to contain a time-release chemical! hah
jerets

[Chemical_Boy]

I just called and found out. They gave me the price for 90 tablets (which I'm sure I wouldn't get):
OC: $20 for the generic. $246 for the brand. $60 if the generic is not available.
MS Contin: $20 for the generic

Wow! $246 for the brand -- thats crazy. The Roxi/IR oxy is very cheap! Crazy you pay all the extra money for the med to contain a time-release chemical! hah
jerets

Yeah, it's a fuckin racket if you ask me. . .but I hate the goddamn pharm companies worse than I hate just about anything.

Oxycodone is so damn cheap, I mean you can get percs for nothing even without insurance.

[Incognito]

If you are prescribed oxycontin, it would pay to call around and see which pharmacies carry the the Watson brand generic (ABG's). They are almost identical to the brand name. If you wanted to do this it would pay to find out before you fill the script, because most pain docs like for you to stick with the same pharmacy. I used to get brand name myself, but recently switched insurance and have now tried the Teva generics and the Impax generics. The brand name (and ABG's) seemed stronger to me than the other generics. There are several threads in oxycontin forum concerning generic OC's and how much they suck compared to Watson brand if you are interested in reading them.

[jerets]

What generics are the worst and which ones are the best? I have a few pharmacies to pick from and I'm not sure which has what. But just so I have a general idea because i'm going to go to my first appointment tomorrow without taking any meds in the morning, because I am sure he will want to write me something to take me off the hydro.
Thanks :)!
Jerets

If you are prescribed oxycontin, it would pay to call around and see which pharmacies carry the the Watson brand generic (ABG's). They are almost identical to the brand name. If you wanted to do this it would pay to find out before you fill the script, because most pain docs like for you to stick with the same pharmacy. I used to get brand name myself, but recently switched insurance and have now tried the Teva generics and the Impax generics. The brand name (and ABG's) seemed stronger to me than the other generics. There are several threads in oxycontin forum concerning generic OC's and how much they suck compared to Watson brand if you are interested in reading them.

[superman]

being an IVer i'd take the MSC over fentanyl any fucking day. Though a big blast of fentanyl will lay ya down good, tolerance seems to grow much faster than w/ morph, and duration leaves much to be desired

EDIT: if it doesn't turn out, I don't know what to do

simple; go back to your primary doc and tell him the PM doc you saw was a quack. he knows you, he will understand.

no need to suffer when there's 1000's of docs out there

as for learning about all these painkillers, I'd just forget about it for now. go in, take what they give you. then be honest about how much it helps, or say it helps slightly less than it really does.

you will do far better playing a sheep than playing doctor. you have to let them make the decisions, while tactfully padding thier ego/nudging them in the right direction

[jerets]

I just got back after waiting in there forever! They are putting me on time-released Hydrocodone. I have a fracture in my T12 that I need to get further X-rayed, have to take a UA for drugs, and will be getting a TENs Unit and a steriod shot in 10 days. I wish they would have supplied me with better medication. They do not believe in "break-through meds because it builds a tolerance too quickly". I am sort of frustrated but what else can you do but go through the motions...
Jerets

[nick]

I just got back after waiting in there forever! They are putting me on time-released Hydrocodone. I have a fracture in my T12 that I need to get further X-rayed, have to take a UA for drugs, and will be getting a TENs Unit and a steriod shot in 10 days. I wish they would have supplied me with better medication. They do not believe in "break-through meds because it builds a tolerance too quickly". I am sort of frustrated but what else can you do but go through the motions...
Jerets

Keep "going through the motions".Rome wasn't built in a day and all that.


Worst case scenario-find another doc.

Good luck man.

[RoadHead]

I just got back after waiting in there forever! They are putting me on time-released Hydrocodone. I have a fracture in my T12 that I need to get further X-rayed, have to take a UA for drugs, and will be getting a TENs Unit and a steriod shot in 10 days. I wish they would have supplied me with better medication. They do not believe in "break-through meds because it builds a tolerance too quickly". I am sort of frustrated but what else can you do but go through the motions...
Jerets

sounds like you need to find a different PM dr. if they will not give you BT meds because it builds "tolerance to quick" then they have pretty well told you that their policy sucks.

they want you to take a UA, use a TENS unit, plus get injections? sounds like they want your $$$ and nothing to do with your pain.

i would go back to your PCP and let him know that he can treat you just as well as the PM dr, and for a LOT less money. see if he will up your dose or find another PM dr, one who gives a shit about YOU and not just your $$$$.

sorry to hear of the shit you went through but there are a lot more dr's out there. it may take a bit of time but sooner or later, you WILL find one who will be decent, and at least somewhat generous with the rx's.

good luck

[jerets]

Ya I really feel like this place just wants $$$ and thats all. They never asked me how long I've been taking Hydrocodone or how well it works. I spoke up and said that it's not working very well anymore and they decided to write more of it, just time released. They have to have it compounded by their place (more $$$ for them). They wouldn't even give me a pain medication today... I can't get it for a week! They want to do this injection in my spine and told me they can do 20 injections / hour ($$$). And want to try TENs units and maybe a nerve block! They were running 2 hours behind schedule and I didn't even see the doctor I was scheduled for, another doctor in the practice walked in my room as I was leaving and introduced herself. I'm mad
jerets

[superman]

I just got back after waiting in there forever! They are putting me on time-released Hydrocodone. I have a fracture in my T12 that I need to get further X-rayed, have to take a UA for drugs, and will be getting a TENs Unit and a steriod shot in 10 days. I wish they would have supplied me with better medication. They do not believe in "break-through meds because it builds a tolerance too quickly". I am sort of frustrated but what else can you do but go through the motions...
Jerets

WOW

I've never had a fructured bone, my lower back x-ray doesn't show anything, never had a UA, never had a steroid shot, don't know what a TENs unit is and i was able to get 100x5mg percocets on a 3rd visit to a GP. on the 4th visit, after a car accident he gave me enough oxy's to last 2 weeks.


You're getting a fork in the butt, bitch to your primary doctor, and if he doesn't fix it right there and then by giving you some real fucking painkillers then tell that cocksucker he's an asshole and go find a new doctor!

EDIT: if it really is a fracture, then you need to get doped up, don't do any lifting, have good posture and let the shit heal
EDIT2: now that i tihnk of it the steroids would likely serve to slow the healing process and possibly cause incorrect healing? this i am just guessing at

[Chemical_Boy]

Not all pain docs are created equal. Some opt for the interventionalist approach. . .nerve blocks and all that. One pain doc I went to didn't deal with medicine at all- he left that up to the primary care doc. All he did was surgical type procedures- nerve blocks, epidural type things, and who knows what the fuck else. He was a good doc at what he did and all, but it wasn't for me.
Really look into the possible side effects/ negative outcomes if you decide to get nerves burnt. It works great for some people, but can cause problems in and of it's self.

When I decided to go to a pain doc again, I called around and asked if they did medication management for chronic pain before I decided who to go to. My current doc still looks at physical treatments- which I have no problem with. . .I mean hell, if it works. . .- but he is also not afraid to write some scripts. Not that I am inundated by prescriptions for pain meds, but he gives me enough to be effective.

Not believing in BT meds seems a little funky. It seems to me that is a pretty standard method of dealing with chronic pain while on a timed med. WTF? It just tells me that they are not a medication management type facility. Like I said, that is fine for some, but if you want to be medicated you might look elsewhere.

Also, keep in mind, don't be too pushy. I am not saying that you have been. . .It's just a word of advice. If you know too much it may work against you. Let them do the leading. Good luck bud.

[jerets]

Well listen to this, they called me back. They over looked the part on my paperwork that stated that I am experiencing milky urination and said that I will need to see my PCP to check for an infection first. He told me that I need to be home to sign for this medication that they are sending me that "may or may not be covered by insurance". I never even saw the doctor I was supposed to see. And I asked him on the phone what the differences were between this hydrocodone compound and an oxycodone time released that I can pickup at a pharmacy, because I've taken that in the past. And he told me, "Oh, we don't write Oxycontin for anyone because it has a high street value". I couldn't believe that. 2 1/2 hours of waiting to be seen really upsets me and I will be looking for another place. What do you guys think? There has to be a line with weeding out drug seekers and weeding out their business with poor customer service.
jerets

[jerets]

MY GOD! STEROIDS CAUSE BONE FRACTURES AND MAKES PREEXISTING FRACTURES WORSE! I can't believe this place. That has got to be grounds for malpractice right there. A doctor didn't even prescribe the injection, a PA did! Unbelievable.
Jerets