View Full Version : need help! i think im pretty screwed!!!
04-15-2007, 04:00 AM
Ok WELL i have been posting here for a while now and Ive always tried to give advice to people and always told them to BE HONEST to their docs..well i think i sincerely fucked up this time..moderators--->Sorry for the 'F' word haah. Ok well I suffer from chronic pain in my ankly and knee. I was born with a club foot and I have had 6 surgeries and all but one have made it worse. 2 years of semi-pro football built up massive amounts of arthrities in y ankle and warped/destroyed some of the joints. I had an anke fusion for my last surgery and it didnt work and i hurt all the time...bad. So i am still finding a decent dose to take and im working my wayon gettin there so right now i take OC 40mg 2 times a day and percocets for breakthrough pain..usually 2 every 4-6 hrs, so thats 20mg and i get 240 percs a month. Well a couple of weeks ago i went to an amusement park and i took all my meds with me because i cant even sit down without being in pain so walking=horror. So i take them ALL with me (why i took all i have no idea, i guess iw expecting to take more than i was supposed to because i KNEW i was going to be in pain). To get to the point i lost the bottle with the combined oxycontin and percocets. It was a little later than midmonth so i didnt lose 240 of them but over 140 percs and quite a few OC's as well so there is a happy ass janitor somewhere. none the less I pushed towards the car and rode rides alogn the way back..so halfway there i was in horrid pain...i hobbled back to he car and let my siser and her friends who i took, go for the rest of the day. I was rollig in the car inhorrible pain for 5 hours tilthe park closed..drove home WITH A STICK SHIFT. Starte to lay down fell asleep and woke up with another pain....cramps in my thighs and extreme restlessness..it was the DT's and i as pissed.
ok i gotta make this short so here is the point. I have OLD lorcets, tramadol, muscle relaxers and some ambien and xanaxa friend gave to me..all of it was prescribed to me except the xanax and taht was for panic attacs i was having from my surgery bills and my pain not being handled. So to combat the DT's i took lorcets and tamadol,,,they had no pain relief but kinda helped with the withdrawals. I couldnt sleep so u took a xanax...didnt work..so i researched online if i could take my ambien..(reason i took xanax first was because i wanted o save the ambien for a international flight i have to take here soon). Finally iw ent to sleep and woke up later exhausted crampy etc etc...Another dose of tramadol flexeril for the cramps and lorcets later on..did that for 3 days till i had an appt and a refill for percs, but OC's werent till later..but guess what...TADA SURPRISE....FUCKEN....DRUG.....SCREEN........my god are u serious. First i signed a narcotic treatment contract stating i cannot take anything by any other doctor with out his approval or consent. The xanax wasnt even mine and i took tramadol..lorets...flexeril....xanax...ambien all within 3 days time and a narcotic management contract. I have another appt in 2 weeks and since i have no OC ive been taking DOUBLE the percs and i hope he doesnt call a med count on me next visit. should have told him and been honest and upfront but now im in a huge hole and i dont know if i can get out of it. Ive always been honest with him and turned in meds I didnt use and always been truthful and I hope that rescues me because im in soo much pain i cannot live without meds right now. I dont know what to do.
any thoughts yall?
04-15-2007, 04:36 AM
lets hope it works...does he have to report that test to anyone?
if so you might be fucked...but if not ...you two have from what you said a nice relationship so he may disregard...
did you take the piss test the next day after consuming the no-no pill?
how long does that shit stay in your piss?
i couldnt imagine it would be that long...3 days?2 days?
you may have lucked out....
04-15-2007, 04:56 AM
Dude, the only way I see a doc buying that (I'm not a CPer, but did have to deal with the methadone clinic take out rules, occasional bottle counts, etc.) and the only way if I lost bottles for a count or even lost empties when they had to be returned, the take outs were gone unless I filed a sworn police report stating they were lost or stolen and the circumstances involved. This never happened to me but did to others, they would do a serum test and shit to make sure you weren't really drinkin' 'em all the first couple of days. I don't know, maybe too late now, but if ya ever lose another C-II script like that and can't find it, I would immediately fill out a police report, sign it, get a copy, etc. (I technically think one is required to do this anyway when they cannot account for C-IIs or research C-Is) That may help with the doc and your credibility, especially if there's no oxy in your system, but if it did work and he kept you on it would probably only ever work once and he'd probably add other stipulations to the "contract" like carrying only days supply with lock box, or travel supply and none more, etc. Guess it depends on the doc and how much pain he's ever been in throughout his life, right?!?!?!
04-15-2007, 02:11 PM
Yeah I know....I was 3 hrs from home and i never really thought about filling out a police report. I know the test was to make sure i was taking my meds and not getting rid of them and i doubt that therre would even be trace amounts of oxycodone in there becaues its been soo long since i took them..well i guess not soo long but a couple of days. I didnt really panic but i was really taken over by the WD at the time i didnt think straight...all i thought about was how to make this horrible feeling go away. This whole freakin ordeal wasnt my fault but i turned it into something horrible. And i dont think that the doc would report you to the police unless u basically told him that u were getting rid of you meds. The docs a good guy and in the times past i have turned my meds in when they need to be discarded and i took all of em as directed unless it completely didnt help. So i think my credibilty is pretty high, but it might not be anymore. I think i handled it innapropiately and i guess im ready to take the consequences...but damn man this shit sucks!
Tell him the truth and you should have filed a police report.
Oh and taking ALL your meds was very dumb.
Sorry and I hope it all works out.
04-15-2007, 03:45 PM
i got tossed out of pain clinics cause of med counts, the doc asked where my 90 percs were and i said i had forgot them then he said take them to ur pharm and have them call me. and nothing. then i got tossed. i was using tons then and no docs gonna beleive that i had that much pain. chances are if u filed a police report cause those are NARCOTICS then u would have prob gotten off. i tried the stolen meds thing so many times and no docs gonna beleive that unles u back it up. that will be on ur med record bro. sorry for ur loss. i kno some people cant manage without opiates for pain and i feel bad for u man. i kno i am an addict and i will use every one of those pills before the count is called and just get tossed anyhow lol. so i dont even do the pain clinic route anymore. i was in the cleveland clinic pain clinic for a while but they didn't do shit as far as meds. sorry for the swear word
Badly Drawn Girl
04-15-2007, 03:49 PM
Man, that sucks. I know most doctors allow a one time early refill. Pills got stolen, lost, dropped in water... usually after that first one though you are shit outta luck if something else bad happens. I was able to pull it off twice with my doctor and I wasn't lying. But after that I was on a contract that I could not, under any circumstances, refill early. I have no advice about the drug test but I think your best bet is to come clean with your doctor if you feel like he/she will be understanding. Best of luck to you.
04-15-2007, 10:34 PM
This is a hard one. Much depends on your history with the doctor you see. If you have been on his service for five years and never lost a script, never pissed dirty with anything more serious than benzos and pot. many doctors would allow you one pass. Any doctor that immediately cuts a patient off after long term opioid orders without making detox provisions at the very least is, IMHO, guilty of malpractice.
The ability of your doctor also depends on the state you are in. I am sorry I have no idea the policies of your state medical board, nor any fellows I can think of to call and ask.
Personally, I would look at a patient with a trend toward self management of lost medication as a risk, and most doctors are also going to feel this way. Things those proacticing look for are compliance (not changing dosage on one's own) and evidence of tendencies toward self-medication with controlled substances to treat one's own medical problems. I do not personally agree with either of these concerns necessarily. Many who still have unresolved pain escapate dose on their own, and self-medicating is not always indicative of present or evolving abuse patterns.
On the other hand, deception and secrecy ARE legitimate indications that a patient is into an abuse problem. Normal pain patients who lose prescriptions call their doctor's immediately if they lose a script, often in dire panics. Also, it is never too late to file a police report, you can probably even do it via email if you like, depending where you were when you lost the script bottles. If you are a fiend though, I recommend avoiding contact with the police.
If you medicate yourself through to your next appointment without being caught being short of pills by your doctor, then it becomes merely an issue of faking a drug test. Of course only a very careless person who is on any sort of supervised opioid program who does not have frozen urine containing the right metabolites for approved drugs only should have any problem here.
Going out on a limb here, I am going to guess from the tone of your letter that you are not exactly a model patient. In this case, telling your doctor the truth could be fatal.
On the other hand, many doctors are flattered by trust from a patient if the returned trust on the part of the doctor has not already been mauled. If you have a good relationship with your doctor, and he trusts you because you have always played straight with him, well, the implications are obvious. But since you are convinced already without talking this over with your doctor that you have a huge problem, I worry that you already know what the outcome will be if your doctor finds things out. In this case, I would go with my gut and try to tough it out.
DO NOT PUT YOUR HEALTH AT RISK. If you get too sick, or if you end up sick from eating old expired medications, I do not thing hessitating to see a doctor at that point is too terrible an idea. You are already in violation of your treatment contract as far as I can tell, but these "contracts" are not "do or die" to most doctors in once in a five year period emergencies type situations.
Good luck. I hope my ramblings help.
04-16-2007, 11:57 PM
yeah man i really thank everyone for their posts.. Im definately going to come clean, just to clear my own conscious. But the thing is I really didnt do that much wrong...i lost my pills somehwere in the amusement park...had cazy WD and tried to beat them for two days untill i got my other meds refilled and as soon as they got refilled i took them more than i should, but thats to be expected considering that at a single dose i take 60-80mg of oxycodone and when you take away the oxycontin that leaves percs that try to match that and they go quickly. I know im pretty fucked as far as being a patient with this guy, and i know it to myself, i just think its funny how one accident can lead to soo much other bullshit that causes one to do illegal things. I got hooked on medications BY my doctors and now they are the ones that will try to judge me by their practices. I need the medications, and i still do. Everday i wake up and subcontiously want to quit, but the morning fix to rid my pain and wake me up is just as bad as a guy who needs his coffee to start his day. MY next appt is in a week and a half, but the percs just arent doing the trick to cure the pain and all that acetominophen is killing my stomach so im going to call him set up and appt and just spill it..im sure he has the piss results by now and m going to explain everything. To be quite honest ive only been a chronic pain patient fror a little over a year now. but it hasnt been with this doctor..so im pretty new but his practice is new as well..I was one of his first patients, and the police report..i mean i guess i could have thought about that, but ive never been told by anyone that its what was needed to be done in case of such events. After walking for 3 hours in the park I was in such excruciating pain that the police and consequences were the LAST thing on my mind. But i guess it would not only be the man thing to do, but the right thing to do is just fess up. All the pills i took where legit with scrips..i just nver told the doc that i had them and wasnt supposed to take anythng without the pain docs knowledge..well sorry i forgot..except for the xanax, but i have a RXfor ambien which registers a benzo on a piss test..it all depeds on what kind of tests he ran. FUCK..i dunno i have a camping/fishing trip planned for this weekend..ima do that and calm down, then see him monday..and I will keep you posted.
04-17-2007, 08:45 AM
If you are going to talk to your doctor about this, I think that the doctor is going to worry about "abuse bahavior", but more importantly I think you need to impress upon him that you had an ACCIDENT that caused loss of your meds. I also do not think many doctors are going to be surprised that a man who has been shit on by doctors time and time again would be leary of being candid with a fairly new doctor.
If you are going to talk to hiim anyway, I personally would call his office immediately after it opened and ask if I could possibly come into the office and wait on standby to see the doctor in a few free minutes between other appointments. I'd just get the doctor on the phone if I could, then tell him that, "I am sick, very sick and in terrible pain. We (stress the "WE" here, the problems are not just your's, the doctor owns this problem also.), tell him that , "WE HAVE A SERIOUS BUT MANAGABLE PROBLEM that I DO NOT WANT TO GO INTO ON THE PHONE. Please HELP ME."
If I could not talk to the doctor, I would tell the nurse only that I was sick, in terrible pain, and that I was having a problem with my medication and needed to see the doctor. DO NOT TELL THE NURSE THAT YOU LOST PILLS. If she presses you, and she probably will, tell her that you are in trouble, and are only going to explain the complicated and personal story to the doctor. Tell her is is just too personal. If she contimues to push for details, start like this, "Well, I was naked and near orgasm when the two dwaves and the dog started to get into the action, it was just at this point that, that..." Stop, then ask politely, "Should I go on? I really would rather discuss this with just the doctor."
If the nurse and office staff find out this is a lost pill issue, you will never get in to see the doctor, or by the time you do the entire affair will have been so widely discussed in the office that the nurses might well adversely impact your relationship with your doctor. Nurses are second only to pharmacists in obstructionist antics where opioids are concerned. NEVER TRUST THEM, NEVER CONFIDE IN THEM. Nurses are rarely any help in patient-doctor relationships, but often a powerful negative factor. Nursing staff are responsible for many of the terrible actions attributed only to doctors.
Nurses are not really to blame. They get stuck with doctor like levels of responsibility for outcomes, but have little real power to influence the outcomes. Even though the impact of meddling is mostly negative, nurses can meddle in things like the case at point while telling themselves they are acting only to protect the patient from himself and the doctor from the patient. I rarely believe this. I have had nurse do some strange things. (refuse to administer an ordered 30mg IM MS bolus because "It is just too much! It might kill the patient!" This patient, a methadone client taking 140mg. per day! Nurses and their second guessing!)
Remember, if you talk to your doctor, ask emphatically and cleearly for help. This is an appeal that almost any doctor seeing people regularly will respond to. Few doctors can resist a flat out plea for help.
If he asks for details on the phone, I would tell him, "I am in withdrawal, and have had my entire pain management literally collapse. Everything that hurt before hurts even worse now.. Why did I wait so long to call? Because of the risk of having to spend the rest of my life in agony because doctors shut down on me completely 'cause they think I am not complying with drug use as ordered. Out of fear, I tried to manage this with help and advice off the Internet. One of the doctors on the forums told me I should call your office immediately and tell you the truth. She told me that any doctor worth his or her weight in dung would understand my terror and anxiety. Please work me in for a brief visit today. I will come in immediately, AND THIS WILL SAVE ME FROM HAVING TO GO TO THE EMERGENCY ROOM. Can I come in?"
Very few doctors who order pain meds in large amounts wants to have a patient turn up in the local ED due to what other doctors are going to view as mismanagement. Pain doctors in particular are sensitive about the way they look to fellows, and they try hard to keep their patients out of the emergency department (ED) with problems directly rooted in their prescribing trends.
Also, by telling him you talked this over with another doctor is of small but real value. It lets you explain why you finally called him after trying to manage the problem without his help. After an attempt to tough it out, and after much consulation with the doctor(s) on the forum, and after you realized it was either call him or hit the ED, you knew then that you should have called him the moment the pills were lost. Seeing the light, you then called first, before following advice to go to the ED for help if your doctor was unable (NOT "unwilliing", do not use this word) to help.
If you do this, DO NOT WASTE THE EXPERIENCE. There may never be a better time to raise and address issues such as inadequate dose, breakthrough pain, concerns about the liver strain Tylenol containing products carry, etc. In this context, you should offer that from here on out, you will NEVER take your big script bottles out of the house. Ask him to order empty "carry bottles" (These are the smallest available pill bottles. The pharmacist labels them as if they were the normal bottle so that you can use these to transpost drugs about for daily use in a legal and safe fashion, but only a few days worth of medication. While it IS illegal to carry loose pills or unlabled pills, small carry bottles make it legal, and keep the largest reserve of your drugs at home or in your hotel safe if you are traveling) to secure the bulk of each month's prescriptions from this type of massive loss in the future.
Ask him what his concerns are. Ask him how he wants you to handle any future emergencies, even though he is going to tell you in response not to lose your pills (again or else), and he is going to tell you to be fast to notify him immeditately of future problems. Listen carefully to this, and do not forget what he tells you. He will mean every single word very seriously, but there may well be an elelment of threat also. (Presented the same way you did your threat to rat him out to his fellow by an ED visit. Just remember, if it comes down to a power stuggle between you or your doctor, he will win, and drop you like a hot potatoe. Avoid being boldly confrontational, but do NOT ACT LIKE a condemned man or an refugee, do not wheedle, whine or plead. Remember, you are a man of some modest but real dignity, not a beggar.
In other words, remember that you are the consumer here, and the doctor works for you. Keep your dignity, and act as if you regret your choice to manage this problem on your own, and also reiterate your fear of getting screwed out of pain control. Do NOT MENTION SUICIDAL IDEATION, or even long term ideas about whacking yourself if you are ultimately forced to live in uncontrolled pain. Doctors hate this shit from opioid users, and like tears, most are going to see this as manipulation.
If you do see him, make it plain you hurt and are in a highly emotional state. Tell him what is in you that he can and will detect with a U/A. Cry if you feel like it, but not during the negotiation phase of your visit. Keep the emotion to the first part of the visit, and let it drain away as soon as he assures you it will be okay and that he will help you. Have an explanable basis for your fears abot going to him right at the start. Blame this on bad advice (much off the "Network of a Million Lies", i.e. the Internet) and past problems with A SINGLE DOCOTR who you should not name.
Some doctors will take all this in and immdiately cut a patient off. Be aware of this risk. It is real.
But IF YOU ARE GOING TO TALK TO YOUR DOCTOR ANYWAY, this should help optimize your chances for a good outcome. Waiting does not seem to me of any real value, and waiting like this only compounds the insult to the doctor. Nearly every doctor wants to know about patient problems as soon as possible. (Don't confuse this with docotrs avoid a patient's calls etc. for other reasons...hyperchondria, scheming etc.) Doctors expect the trust of their patients, and when it does not seem forthcoming it makes them suspicious. Yet most doctors know about the problem of people in pain being misread as dope fiends, and you might be okay because of this.
Best of luck to you.
04-17-2007, 09:21 PM
Anyone dealing with a doctor for managment of chronic pain, especially non-malignant pain, should check out the CME at the following URL:
If this fails to work, try:
Thi CME (Continuing Medical Education) course is for credit only for professionals, but is incredibly informative for veryone. It is titled, "Advances in Opioid Analgesia: Maximizing Benefit While Minimizing Risk". It is an advanced discussion of the considerations for long term opioid use in patients, intended for physicians. I think everyone will find this informative.
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