BACK PAIN AND PAIN MEDS

Every pain program I consult to, and there are dozens of them, is monitoring medications, especially narcotics, much more closely that ever before. You are expected to fill your meds on time, not early, and be responsible with them. Your doctor is neither the police, nor your parents. Having a good reason to be out of meds early is not the same as being on time. Whether you overconsumed, lost them, or they were stolen matters less than you think. Whether or not we believe your story matters less than you would think. Everybody gets one or two or even three free passes and then your doctor will probably confront you. No matter the reason, you are not a good candidate for strong pain meds if you cannot manage them. This morning a patient was outraged that she had to bring her meds with her to an appointment where she was filling her narcotics a week early so she could go on vacation. She was angry that we did not "trust her." The angrier she got, the more inappropriate. If she had the last week of her meds, why was it such a big deal to bring in her meds? Why does she think that the rules don't apply to her, that she is so special, she should be above everyone else? At best, she's being narcissistic, at worst she's using aggression to cover up being noncompliant with her narcotics. This happens all the time, the kind of interaction most patients never see but affects how pain doctors practice medicine. Be responsible with your meds, and if you run out, don't think your reason is important. It's not.

Dr. Tim