oxycontin and the dreaded pill count

[porcelina]

my girlfriend is having a bit of a crisis over a certain situation, and she fears that her PM doctor is going to cut her off from her oxycontin...she asked me to post her question on this forum and get your opinions, experiences, or advice...SO...i am doing just that...here goes:

she is prescribed oxycontin 40mg twice daily and oxycontin 20mg once daily...she got her scripts filled september 9 and ran out of everything exactly two weeks later on september 23...the nurse at her doctor's office gives her a call (on my girlfriend's cell, she doesn't have a home phone) a day later on september 24 and says "the doctor would like you to come in today for a pill count"...she immediately replies with "i am out of town"...the nurse then says "when will you be back in town?"...she replies with "i will be back in 2 weeks"...the nurse then tells her to call the office as soon as she returns back into town...now, mind you, in 2 weeks she will be due for her next script and obviously a pill count would do no good since she would be "out" of her script anyway...so, of course, this may look suspicious...and because of it looking so suspicious, she is worried about getting cut off anyway...

any replies would be appreciated...thanks!!!

[KiloByte]

Fucking nosy doc

[nick]

I'd make the most of a bad situation.Make your,sorry her,next appointment as usual and when there apologise for being out of town(have a good story of where she's been) and ask if he'd like to arrange a pill count soon,appear as if she wants to cooperate.


I'd also keep my fingers crossed and look into other sources........just in case.

[LorTabitha]

What Nick said... Also, make sure she's ready for a "whiz quiz." She should make sure she has OC in her system on her next visit.

[Young Professor]

What Nick said... Also, make sure she's ready for a "whiz quiz." She should make sure she has OC in her system on her next visit.

I would agree....I think it's highly probably that she be asked to do a UA.

Any idea what brought on the pill count request? Is this SOP @ her Doc's office? Or, has she had issues before? Pill counts are usually reserved for the patients on "probation"....At least @ my clinic.

Given the circumstances, I think she did about the best thing she could do. Lots of good reasons why one would be out-of-town. Also, I think is reasonable to think she'll get a call again in a month or so.

I wouldn't worry about getting cut off for looking suspicious....One actually has to do something to get cut off....Like come up short in a pill count, fail a UA, skip a bunch of appointments, get busted for illicit drug use, & etc. People go out-of-town all the time.

I would be interested to know how/why you got called for the pill count....Whether or not it's a "random" thing @ your clinic.

Good luck,

YP

[nick]

I should point out that you should ALWAYS make sure you have the drug that you're rxed in your system when you actually see your doctor.

[Narkotikon]

Yeah, is this just a random pill count as per policy at her PM clinic, or is this because she's been in trouble in the past there?

If she's not been in trouble, I wouldn't really worry about being cut off. Going out of town isn't a good reason to cut someone off, unless she's done this several times before. But, from what you've said, I don't get the impression that that is the case. I think she'll be fine. I do think she'll have a UA done when it's time for her next appointment, and she needs to have oxy in her system at that time. I also think she should take it easy on the useage of her script (I know, easier said than done), because I think it's likely that she will be called in soon for another pill count.

But, unless she's been in trouble before (i.e., suspected of drug use, misuse of her scripts, failing UA's, fiending behavior, etc.), I don't think she's in any way going to get kicked out. I mean, doctor's can do just about anything they want to patients, but people do go out of town a lot. Just make sure she has a good reason (family emergency, relative's death / marriage, work reason, e.g.), and I'm sure all will be fine. Good luck.

[jersey_emt]

One actually has to do something to get cut off....Like come up short in a pill count, fail a UA, skip a bunch of appointments, get busted for illicit drug use, & etc. People go out-of-town all the time.

I see this mentioned a lot when people list things that make you look 'suspicious' to a doctor. But I never understood the missed appointments one....someone who is looking to abuse pain meds...why the hell would they miss an appointment where they would get new scripts to fill (and more drugs to take)?

[oxymoronluvr]

they might want some proof that she was out of town too. so try to get something of that nature if possible a bus ticket stub. air fare stub. perhaps you can pay someone to "rent their pills" for the count? but if you take in short pills or do something to avoid the count you will get busted.

I GOT CUT OFF OF MEDS ONE TIME THAT I TRIED TO DODGE A COUNT AND THE NURSE SAID, "WELL TAKE THE BOTTLE TO A PHARMACY" I SAID I COULD NOT COME IN FOR THE COUNT CAUSE OF NO RIDE, HE SAID TAKE THEM TO A PHARMACY, IT DIDN'T HAVE TO BE MINE. JUST A PLACE WHERE A PHARMACIST COULD COUNT MY PILLS AND CALL THE PAIN CLINIC OR DOCTOR.

so note they will tell you to go to a pharmacy if you use the out of town or no ride excuse. so theres no way out of it, and if you don't do that within a period of so many days they will call you in so many days and boot you. i have had it done to me. it is legal.

[ndoftaworld]

Try to set her appts up before a full month. Then count and hold back that many pills (hard to do, I know). If she for example, is planning another trip, set it for two weeks in (I know, she won't get a refill, or maybe a post-dated script) and have exactly enough pills to take in with her. If she initiates the count, by 'accident' of course, and passes, then the level of trust goes up.

That's what I did with my first oc script. I told the doc that I would setup the next appt. for two weeks out, so I could report effectiveness, side effects, etc. and that way I knew for sure I'd have the correct # of pills. My doc wasn't a PM doc though, so no contracts or anything, but he did warn me not to fuck with him, cause he's seen all the tricks to get an early refill.

When I switched from 'done to oc's (the first time on done gave me a rash) I called the nurse two days after filling the 'done script and left a message. The Dr. himself called me back and asked to come in immediately. I 'conveniently' left my 'done at home, which was smart as hell, cause he wrote me a script for oc's but called the pharmacy and told them not to fill it until I brought them the remaining 'done. I was two weeks short in the bottle, which the doc would have noticed and busted me... the pharmacy just took them, filled the oc's and everything was cool.

Tell her to TRY to keep a reserve out of every script, one or two pills, which adds up and is a life-saver if another 'come in TODAY for a pill count' call is received... or @ least she'll have some stashed for a rainy day

EDIT: 999 Posts! Woohoo! I'm a nerd. But a well-informed, well-medicated nerd! FTW opiophile!
Nd

[upstate_007]

-Get a few oxys to make sure she has some in her system
-Be better prepared in the future for this happening. Chances are it will happen again since she dodged the bullet this time
-Get a fake tan to go with the vacation story lol. Just make sure it's something believable. The less elaborate the better.

[Consumed.]

I would buy a plane or bus ticket and that is refundable and bring that in so you have some sort of proof and you dont lose any money... Or maybe cancel a car rental. Cancel something!

[ndoftaworld]

You don't have to be TOO elaborate... unless you think that the doc will ask for proof (and if he does? fuck him, does him prescribing you meds give him control over where you go?), you didn't call in two weeks early asking for a refill, you didn't do anything wrong, that they know of. You just went out of town for a couple of weeks, maybe to visit a new nephew or a sick grandparent?

Have your destination, and maybe a few generic stories to tell, and you should be okay... this time. But seriously, be prepared. They've asked once, next time they won't be so nice about it.

EDIT: Oh, and get her records from that office as inconspicuous as you can, for insurance records for example. Point is, get them BEFORE a note is added about not being available for pill counts, etc. That way you have proof she's on these meds for this condition, should you need to seek a second opinion (if they DO cut her off.)

Nd

[Sinderella]

The main pain clinic in my area does random pill counts on EVERYBODY..It doesnt matter if they have suspicions about them or not. I personally dont attend the PM clinic close to here but have several friends and family members that do and all of them have been called back atleast once for a pill count..Same thing with me and the methadone clinic..I have to come in for a random call back atleast once every 3months..I never know when it might be..My clinic gives out the dry diskettes so its pretty easy for a person to get by with either taking extra or whatever without worrying about getting caught with a call back..The thing I have known alot of ppl to do is to have arrangements made with other ppl at the clinic where if one of them gets a call back dont have all their medications to show them the next morning for their call back for whatever reason then they simply borrow the medication from the other person for a few hours until they get back from the clinic. I mean all they have to do is show they have it then leave..So the person loaning it gets it right back as soon as they leave the clinic no biggie.. Ofcourse I know of ppl that go to the pain clinic that do the same thing for their callbacks..They just have it worked out to where 2 or 3 of them go on different weeks so there is always one of them with medication to get by a call back...I am not condoning this action its just something I have seen others do...

I dont see where you telling the nurse you were out of town will cause you any major problems if this is the first time youve used that excuse..Just make sure you come up with a good reason for being out of town in the first place and for being gone for two weeks..If the doctor knows you have finacial problems for whatever reason then you dont need to use the "we went on vacation"excuse because that wont look right..I mean who do you know that has money problems and can still afford a vacation a TWO week one no less..The best excuse to use I have seen is a sick relative,Though if using this excuse make up the relative too that way you dont have to worry that the person will actually get sick because you lied about them being sick...A cousin who was put on bedrest because she was trying to lose her baby and already has 3 kids to take care of and needed help..A aunt who just had surgery(non life threatening) but couldnt get around well enough to take care of herself and has no children of her own..You get the picture,lol.. I think you will be okay though.. The ideas of saving a few for when you do go back might be a good idea..Especially if you go back a few days early..


**For the poster that said "But I never understood the missed appointments one....someone who is looking to abuse pain meds...why the hell would they miss an appointment where they would get new scripts to fill (and more drugs to take)? "

I think the missed scheduled appointments thing isnt meaning a missed appt with the doctor you are getting your medication Rx'd from because most of us opies would walk to the appt instead of taking the chance of missing it..That said ALOT of doctors that write opiates for pain want the patient to go have other tests ran,see other specialists,go to physical therapy,ect... and some pain patients are bad about missing those especially any of the diagnostic ones if they arent being as truthful as they could be about the extent of their injury or pain problem and thats what can look bad to a doctor.. And then some doctors will want the patient to come back in a week or two to have some injections or something done and the patient will pull a no-show.. When you have this chronic missing of appts it looks like the only reason you are there is to get the medication and not to find out the reason for the problem or a possible solution..

[oxymoronluvr]

the out of town excuse is no longer working cause the doctors are making u take the pills to a pharma . i asked 3 people today and they all said it has happened to them, the doc made them take it to a pharma.

[ndoftaworld]

I've never had a contract w/ my doc's office, so I'm not sure what it's like exactly...

But to me, if I was visiting an ill relative, or attending a wedding, whatever the heck made me go outta town in the first place, I wouldn't drop all and run to a damn pharmacy w/ a goody-bag of pills (or lack thereof). It might make the doc kinda suspicious if you say no, but he can't drop you as a patient b/c of it. And if you DO refuse, everything had better be prepared for the next appt. Positive urine, not showing w/d symptoms, and truly being sorry for the inconvenience to them (yeah. right.) Then expect pill counts for the next few months, cause they can't prove anything now... but once that seed is planted, they'll water it till it sprouts something.

Hope everything works out okay for ur gf. I know I'd be sweatin' bullets if I was in that situation.

Nd

PS. Try and do what I mentioned in an earlier post, get her records. They are the key to continuing or advancing treatment w/ another doc should the need arise.

[oxymoronluvr]

if you are on a narcotic contract you can discharged at the drop of a hat if you dont follow their directions and do what they say. its happening daily to people.

[ndoftaworld]

if you are on a narcotic contract you can discharged at the drop of a hat if you dont follow their directions and do what they say. its happening daily to people.

Wow. I guess I've been lucky (somewhat) having no insurance. I can't get into a PM clinic cause of it, and so my meds have been scripted by PCP's.

Damn, kinda afraid to get on Medicaid now... then I'll have to go to PM

Nd

[porcelina]

thanks a whooooole lot for all of your replys!!!...very cool of everyone to add their opinions, advice, and experiences...my g/f read all of your posts and her mind has been put to ease a bit...she's still fretting over the whole thing, but it's the best thing she can do to just wait it out and see what happens...i'm sure she'll be okay, just that when she gets her next script, she has to be 100% on count...she says she will definitely be prepared when the next time rolls around...oh, and the both of us understand that once you abuse your meds, it's difficult to turn around and take them as prescribed...so, she's trying really hard these days, and even mentioned to me that she wants to get better, get her life on track, and try another route...

so once again, thanks to everyone for replying...

[pokergooch]

I would make sure that I have caller ID and dont answer the f'ing phone from your docs office unless you have a couple of days til your visit. and even then, I wouldnt answer.

[Young Professor]

I would make sure that I have caller ID and dont answer the f'ing phone from your docs office unless you have a couple of days til your visit. and even then, I wouldnt answer.

This is the best suggestion I've seen yet....Simple AND easy. I'd add one suggestion though....Make sure there is no answering machine / voice mail either. Many pain patients struggle financially and live month-to-month, and therefore can't afford voice mail or a machine.

I'd also make sure on my chart that no cell phone # is listed...Goes hand & hand with the financial thing...Can't afford a cell phone.


YP

[nick]

Yeah,but it's a trade off,they maybe ringing to tell you something important.I'd use an answerphone,you can still say you've been away and just picked up the message.

Gives you more freedom,without having to abandon all communication.

[BigPoppy]

If the nurse didn't ask you to take them to a pharmacy when she called, she prolly isn't going to call back if you already told them you were out of town. Shut your phone off for the remaining 2 weeks, and if the nurse ask why your phone was off say you forgot your charger. I think you are allset. just incase make a fake flight itinerary on priceline.com. It's pretty easy just go through the steps as if u were goin to buy it, at the end it will give you a scree to verify your trip data with your name and seat, print that page out, and the payment info is on the second page, throw that page out and you have a golden excuse, worked for me ALOT.

[oxymoronluvr]

or u can change Ur number lmfao. i don't think running from them is a good thing to do. blow the first call off. and if they call again be sure to not blow them off. if they demand a call back, give them a call back. you have to play the game. this is serious shit, if you don't play the game and you signed at the dotted line on a narcotic contract then off to find another doc, and they don't legally even have to give you a months script when they boot you cause of an infraction of a contract. if u goggle narcotic contract you will find one. i found several. i will not post them due to size ha ha. but if you signed one they are particular and its a tight situation.

my best advice to you would be to do what they think that someone that is addicted/dependent or likes the feeling produced by these pills WOULD NOT DO. just do what you think a normal person would do.

and i am not saying that she is an addict just giving you some advice.

[ndoftaworld]

^^ Yep, MANY non-abusers lose their pills while sitting on the shitter, opening the bottle, and, POP! All the pills land either in the toilet, sink, or tub... and you aren't stupid/crazy enough to start diggin' em out.

Happened to many non-junkies that I know of or... flying down the interstate and needing to dose. Open the bottle, ROAD BUMP, and... shit, my whole script flew out the window. Damn my luck, hehe.

Don't know what to do, I guess just to be safe, start looking for another PM doc in ur area. One that (hopefully) you've heard good things about. Then jump ship and tell that nurse to kiss your narcotic lovin' a$$.

Sry for the shit ur going through, it'll work out, eventually (aren't you SO tired of hearing that...?)

Nd

[Westside]

I know it would be extremely hard to do, but here's a suggestion for the future. when you get your new rx, put the whole Rx away, i mean, you can take out 2-4 pills, but put the rest away where you won't touch it. keep that bottle buried somewhere, and FORGET ABOUT IT. Use this in case of emergency ONLY. If the doc calls for a pill count, you're covered. That way you can do whatever you please with your current Rx and still be safe. I'm assuming since you've been out since the end of week 2 that she's currently not on anything? If she can make it that far, she can make it another month without anything. Tell her just to imagine how they'll feel after a month and 2 weeks break. A 40 will feel like an 80 to her.

Just a suggestion though, what do I know, I'm not a PM patient.......yet

[KiloByte]

I know it would be extremely hard to do, but here's a suggestion for the future. when you get your new rx, put the whole Rx away, i mean, you can take out 2-4 pills, but put the rest away where you won't touch it. keep that bottle buried somewhere, and FORGET ABOUT IT. Use this in case of emergency ONLY. If the doc calls for a pill count, you're covered. That way you can do whatever you please with your current Rx and still be safe. I'm assuming since you've been out since the end of week 2 that she's currently not on anything? If she can make it that far, she can make it another month without anything. Tell her just to imagine how they'll feel after a month and 2 weeks break. A 40 will feel like an 80 to her.

Just a suggestion though, what do I know, I'm not a PM patient.......yet

Good luck trying to pull that one off.

[Westside]

Good luck trying to pull that one off.

You've never been able to control yourself with pills before? I can, it's ridiculously difficult though, and like I said, it's just a suggestion. but there's something rewarding about knowing you ultimately have control, and have seen it.

[nick]

You've never been able to control yourself with pills before? I can, it's ridiculously difficult though, and like I said, it's just a suggestion. but there's something rewarding about knowing you ultimately have control, and have seen it.

If control was an option we wouldn't be having this conversation.

OxyM,is right.It's their "game" and(eventually) we have to play by their rules because often it's the only "game."

[ndoftaworld]

If control was an option we wouldn't be having this conversation.

OxyM,is right.It's their "game" and(eventually) we have to play by their rules because often it's the only "game."

But... unlike communist Russia, we CAN choose to say fuck their rules and find someone else to play with. Still rules, of course, but possibly more lax or more compassionate... if not, yellowpages.com is a godsend

GL,

Nd