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My Pain Doctor in WA state Raided, I am without my meds! Help!?!

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    #31
    Been involved in the PM world for over 10 years. I don't see where the 100.00 is all that out of the norm. I pay 40.00 co-pay and insurance takes care of the rest. On a rush basis, the doc may be protecting himself because the insurance takes 2-3 months to realize. Most doctors don't give meds on the first visit, regardless. The feds pose as patiences and try to nail an understanding doc who doesn't do his homework. Quite the risk. So other than your med bottles, I'd arrive with all the records you can get. Sorry for your situation. Been through simular situations. Most important is you've got to control your temper. Any temper will get you an invitation to the door.

    Good luck.
    No matter how cynical I try to be, I just can't seem to keep up with how bad things really are!

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      #32
      im in washington also and cant find a doctor willing to prescribe pain medicine for my condition. Anyone out there know of a doctor that will take care of me? Thank you

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        #33
        No one seems to be posting a name of a doctor that will write a script for pain meds. Some people just dont understand people in real pain which is really sad. I mean what are the medications out there for. if someone knows of a doctor that will prescribe pain meds please write it or pm me. Thanks so much for your help.

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          #34
          This is an odd thread, all these people from Washington posting in the same thread and knowing the same raided doctor. Sounds like he may have been one of those shady doctors who hands out Narc scripts for cash.

          Either way, as others stated, i think almost all pain doctors only take patients after getting referred to by a patients primary doctor.

          That's how it worked for me. I'm a quad and for many years i dealt with almost daily foot pain, but i never did anything about it. Well, i had a surgery for my bad acid reflux and they gave me Roxicet to take home for the pain. By fluke, i noticed that it helped dull some of my foot pain. I told my primary doctor about this and he referred me to a pain management doctor in the hospital. He evaluated me and had me try 5mg tablets of Oxycodone, with a max of six per day. It's helped quite a bit with my foot pain, but i go out of my way to never exceed my limit even on bad day where taking more might help. I don't want to become big time addicted to Oxycodone and he's careful to try and make sure none of his patients are abusing it.

          If you just call a pain clinic asking for Narcs right away without getting referred from a primary doctor, i think they'll be leery.

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            #35
            pain doctor raided

            I would sure like to know what doctor was raided. I have an idea, but there are other doctors in that spot.
            Thank you
            Lynn

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              #36
              I'm also from Tacoma, and if you have medicaid, you need a referral from your PCP. When I had Blue Cross, I went to a surgeon in Seattle for my neck surgery to fix my bulging disks, but was offered no rehab or anything else. I had to learn to walk again - yep, had a hard time with it prior to surgery, but as I said, the Blue Cross allowed me to go see a specialist without a referral.
              As for the $100 "deposit" - RUN (or roll) LIKE THE WIND! You'll be in the same boat you're in right now in no time flat - that's not an acceptible practice, and the DEA is really harsh here in Wa. Please check into Virginia Mason in Seattle, then the UofW - paying all that cash must be hard on your wallet, it would be mine. Good luck

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                #37
                pain treatment in Washington state

                Until I read this article two years ago in the Seattle Times I wondered why it has become increasingly more difficult to find MDs who will prescribe pain meds since I moved up to Washington state to retire; I only wondered what would happen next:

                seattletimes.nwsource.com/html/health/2003715474_opioid21m.html


                Now I hear about this raid and worry that soon I may have to move back to California, where although it was still a hassle, I was able to find compassionate docs who would treat pain. But I fear that Washington state may be fighting an influx of abusers and is making life impossible for patients who have real pain problems. This is the news on the clinic closed in Tacoma:

                http://www.komonews.com/news/37757099.html#IDComment14075886

                My low dose of MS Contin 30mg bid hasn't changed for ten years, and I am virtually tolerant, yet no pain clinics are taking new patients in the state with the above news article. The low re-imbursement rates in Washingon state are a contributing factor as well.
                If I had known that Washington state was so hard on pain control prescribers I would never have moved here. Now I don't know what to do. Neither did Craig Hospital during my re-eval in May this year. After 33 years of this pain I'm thinking suicide is my only option, since there doesn't seem to be any understanding or concern about chronic pain patients in this state. I just woke up with a nightmare, and my legs were spasming worse than ever and the pain at the ten level. Maybe I've overextended my stay here on the planet.

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                  #38
                  jb, have you tried any pain meds other than narcotics? I'm just wondering if you're dealing with neuropathic pain to any extent, where narcotics really aren't effective and you have to try other avenues.

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                    #39
                    Considering the adverse reports coming out on long term use of acetominophen, and hence Norco, or Vicodin, I think the fibromyalgia patient in the article may be in worse shape than she thinks. It is not only finding a doctor. It may turn out to be finding a narcotic which does not contain acetominophen.

                    It is surely too bad that some abuse opioids, because when they do, it becomes much harder for those who really need it to purchase it at a reasonable cost. I was given IV opiates at my first bigtime pain clinic, in VERY HIGH doses, and it did absolutely nothing for my central pain. I have not taken any opiates since. I am not very big on opiates anyway since they make me nauseated. After my last two spine surgeries, I preferred to just tough it out, rather than take pain meds. My central pain was bad enough without my being nauseated as well. Plus, I didn't want to vomit and possibly interfere with success of the bone fusion in my neck. If I can live with CP, I can certainly endure postoperative pain which is peanuts compared to CP.

                    This all points to the need for a way to measure pain. I have not seen any efforts to study this, beyond the hopelessly vague 1-10 rating scale, pretentiously called the "analog" scale for measuring pain.

                    There are MANY indications now for functional MRI. Dr. House even had an episode last season (season three) where he used it. However, I have yet to see anyone with central pain whose pain has been studied with fMRI. This is unfortunate, since if anyone SHOULD be so studied, it is those with central pain.

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                      #40
                      jb, please see a counselor about thoughts of suicide - been there, tried that - in Wa it's sad if you kill yourself, it's a crime to not complete the job (anyway, the cops get in on it) there's other options besides narcotics & opiates - they can help bring the pain to a tolerable evel, and unfortunatly, that's about all we can ask or hope for right now. My prayers are with you.

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                        #41
                        In summary, neuropathic pain is a very common and unsolved problem. In Germany, one study alone identified over a quarter million people who have neuropathic and suggested that this population is not being adequately cared for. Several studies provided some insight into why tricyclic antidepressant drugs are toxic and how amitriptyline may slow gastric emptying........ Finally, the field of central pain management is beginning to understand and accept the use of opioid therapies for neuropathic pain.

                        Treatment of Neuropathic Pain Disorder: A Review of Recent Studies
                        By wiseyoung

                        Neuropathic Pain: A Review of Recent Publications
                        by Wise Young, PhD MD
                        W. M. Keck Center for Collaborative Neuroscience
                        Rutgers University, 604 Allison Rd, Piscataway, NJ 08852-8082
                        15 December 2008
                        Last edited by jbpara; 10 Aug 2009, 4:18 AM. Reason: reference added

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                          #42
                          Dear Rev: please don't patronize me; I've been a pharmacist for over 35 years who has tried all medications, and other modalities. I am not having a problem with my prescriptions, including an opiate, but only posted the links to clarify a previous question about Washington state narcotic prescribing issues. I've been in pain 33 years after being shot by a robber in my pharmacy, and am well aware of end of life issues and advanced care directives. I am retired for ten years now, after losing my employment after the neurosurgeon who removed the bullet in my spine in '75 tried an unsuccessful second laminectomy ten years ago, and prescribed MS Contin. I applied for a DREZ lesion but was not a candidate because of such a high injury for a para.
                          Last edited by jbpara; 10 Aug 2009, 4:26 AM. Reason: was logged off before finishing

                          Comment


                            #43
                            Please do not be so quick to repeat the claim that opiates do not have a place in the treatment of SCI neuropathic pain. Many of us with long-term injuries have had to listen to this DEA-fueled propaganda, and now that a recent review article has documented that there is both a place in first-line therapy and as an adjunct, there is no need to make people with new injuries suffer from chronic pain as us old-timers were forced to do. At least I have temporary relief, and perhaps if it were not so difficult to get prescribed could get beyond breakthrough pain days. Unfortunately, MS Contin does not last 12 hours, and an increase in dosing intervals would probably reduce these horrible pain episodes. jb


                            Wise Young: Treatment of Neuropathic Pain Disorder: A Review of Recent Studies

                            Treatment of Neuropathic Pain Disorder: A Review of Recent Studies
                            By wiseyoung

                            Neuropathic Pain: A Review of Recent Publications
                            by Wise Young, PhD MD
                            W. M. Keck Center for Collaborative Neuroscience
                            Rutgers University, 604 Allison Rd, Piscataway, NJ 08852-8082
                            15 December 2008

                            A case for opioid therapy of neuropathic pain. Allen [9] made a plea for rationale multiple drug therapy of neuropathic pain, pointing out that opioids will never replace tricyclic antidepressants and anti-epileptic drugs as the first line therapy for neuropathic pain but that opioids are now full established as effective second- and third-line therapies. In 2006, Dobecki, et al. [9] pointed out that neuropathic pain is a very common condition, affecting nearly 1.5% of the U.S. population. The US FDA has approved five medications for neuropathic pain, including gabapentin, pregabalin, duloxetine, 5% lidocaine patch, and carbamazepine. Other agents with proven efficacy in multiple randomized placebo-controlled trials include opioids, tricyclic antidepressants, venlafaxine, and tramadol. All the these agents have been recommended as first-line therapies for neuropathic pain. So, the field has moved in the last few years, from a budding recognition that some drugs may work for neuropathic pain to formal acknowledgment that they are first-line therapies.
                            Last edited by jbpara; 10 Aug 2009, 5:20 AM. Reason: typos

                            Comment


                              #44
                              jbpara

                              I know I am just going to make you angry, because you are already angry and may probably think I am coming down on the side of those who won't free up opiates where they would be helpful. I am glad MS Contin helped you. I am very sorry to hear you were shot in the spine and you have been through some terrible experiences. I also respect the profession of pharmacy. They are very smart individuals. I am not against anyone taking anything that helps. I have cited Ron Melzack's article in Scientific American on the principle that people in severe pain do not become addicted to opiates.

                              However, I once again hope that we will be specific about neuropathic pain. Central pain is a very small percentage of those with neuropathic pain. Diabetes is by far the largest group, but that is PERIPHERAL neuropathic pain. The cord is excitatory. Therefore, one would expect that peripheral neuropathic pain would respond because opiates quiet the cord. However, the brain is INHIBITORY. Therefore anything that inhibits an inhibitor may cause disinhibition. Disinhibition means that if you quiet the inhibitory part of the central nervous system, there is a possibility that the pain will not be helped and may even get worse.


                              Hence, my earlier post that we have to write and think specifically.

                              I personally spent a large amount of money to try to get help, any help, for severe burning dysesthetic central pain over my body. Part of this was to be given IV opiates. This trial went to extremely high levels, such that anesthesia had to be on hand to prevent my death since they were pushing it so hard. It was kind of an experiment at one of the leading university pain centers. I felt NO RELIEF whatsoever from opiates. What I experienced is valid for me. My experience may spare someone the broken heart who is hoping for relief and finds that opiates do not help.

                              On the other hand, if dosages are at the right level, since opiates may sedate a person, there is a potential that sedation will help the pain, including central pain. It did not do this for me, but I am convinced that for some, it does have this effect. However, there is fair evidence that other drugs may be better sedatives.

                              I believe in access to pain meds for whoever needs it. I think these matters are best left to the judgment of pain doctors. However, my belief in that principle does not change the fact that nearly everyone, from S Weir Mitchell during the Civil war to Dejerine in 1905, to Riddoch in 1940down to the present has come to the conclusion that opiates don't cut it for severe central pain. This position is also the position at the NIH. Frederick Lenz at Johns Hopkins has postulated this may be due to disinhibition. One leading author on the effectiveness of opiates at high doses, who was at Harvard, felt he was getting some results for a time, but I notice that his recent articles do not follow the same line of thinking. Therefore, there must be balance in these posts. I believe opiates do help peripheral neuropathic pain. I only wish they had done more for CENTRAL neuropathic pain in my case.

                              Post SCI pain frequently includes pain which is normal pain. Of course opiates are helpful for that kind of pain and should be available. Post SCI pain is not an exact synonym for central pain. You mention that you were hoping for a DREZ. There is a little argument about this, but the kind of pain for which DREZ is done is commonly considered to be peripheral neuropathic pain. Therefore, one would expect MS Contin to help you. Since the dorsal root ganglion cell bodies are OUTSIDE the cord, the anatomists I have talked to feel it is peripheral nerve injury pain, although it seems there would be a little crossover, since it would be likely that if the dorsal root ganglion is injured, there might be some injury to the cord proper.

                              However, when we talk about the brain inhibiting or modifying pain, at cord level, we are mostly talking about interneurons, which are CORD structures, which come down from the brain to inhibit signal mostly. I am unaware of anyone who thinks interneurons have cell bodies in the DRG. However, DRG science seems to change almost monthly, so I may be wrong about that.

                              "At level" pain falls into the same category. Strictly speaking it should be predominantly peripheral, but some have very severe at level pain, mixed with lesser pains from lower down, which are central pain. I am not sure what you call that. The DREZ is not a recommended procedure for pure central pain that I am aware of. You remember the editor of New Mobility who had the DREZ for central pain but did not have a good outcome.
                              Last edited by dejerine; 10 Aug 2009, 6:19 AM.

                              Comment


                                #45
                                JB,
                                I'm sorry if you felt I was patronizing you - I didn't intend that at all. I won't post again.
                                Last edited by Coleen; 10 Aug 2009, 4:41 PM.

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