ROFLMAO 
TJ
This is so frustrating on many fronts. One angle that I havenât seen in this thread is that several care providers have lost the right to prescribe the pain meds. This can happen if they have âtoo manyâ [how do the regulators determine how many is excessive?] patients on pain meds. Some of my physician friends can no longer see patients on pain meds even if they did not prescribe them.
Zananne, I think now that youâve got a diagnosis from a well-respected expert in the PsA world, you wonât have a problem finding another rheumatologist who will be willing to carry on with your PsA care. The hardest part is getting the diagnosis.
The whole issue of opioid meds is so terribly difficult: it puts doctors in a really difficult position, and leaves patients out in the cold, suffering. Do the PCPs know why it is you are taking the tramadol? The problem, of course, is that it can take quite a long time before a Psoriatic Arthritis patient finds a treatment that works, when a PsA drug trial takes at least three months. And in the meanwhile, pain meds are one of the few options available. Have you discussed prednisone with anyone?
Itâs so frustrating, and Iâm sorry that you are suffering because of rules that are intended to solve a problem that you arenât part of.
Seenie
That is very true. EMR exchange has identified at risk patients. All too often patients visit several docs seeking pain meds, what they donât understand is every script is reported, every request is reported and every fill is reported (and entered into a national Data Base.) It makes perfect sense.
TJ
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Wondering if this gets to the state level and varies by stateâŚpeople who have not shown addictive behaviors should still be allowed low levels of pain medsâŚ
Every patient is not the same adthis should only be between you and your dr.
This was my main issue with my prior PCP. We had a 6.5 year relationship. They know I am not an addict. But when they saw my score on the questionnaire, they clearly didnât take that into consideration before they sent off a RX for Narcan to my local, small town pharmacy. They werenât willing to go to bat for me, and say, âI donât care what she scored, I KNOW her!â after a pretty long, and I thought, good relationship. Now each and every time I go to my pharmacy, I am treated like a junkie. And obviously when looking for a new Dr. this is going to keep coming up. Not sure what Iâll do when my current script runs out. Nearest pain clinic it about 1.5 hours away. I am calling my Rheumy tomorrow to see if they will prescribe pain meds for me. But Iâm not that hopeful, as they mentioned before that itâs not something they typically do, prefering to let the pain clinics handle it. And they are so far away.
Thanks for letting me ventâŚagain. 
I have heard of other people saying that about pharmaciesâŚthe pharmacy should be neutral , and have no opinion âŚit should be between you and the dr. Period⌠in our area , there are many pharmacies, and if any attitude was shown at one i would surely changeâŚthat is not their place to me
Vent away! 
Thatâs:woman_judge: how we can survive this malady!
As a clinic director before retirement, I understand the issue from both sides. it sounds like the PCP is following current regulations related to prescribing pain meds. Even pain specialists must record the scores and order the Narcan. They can lose their license to write prescriptions and/or license to practice medicine. Several physicians I know have lost the rights to write pain meds and are on probation with risk of losing their license completely. If they are the PCP and some other provider prescribes the meds, it puts him in a rough situation â if your score is âhighâ, does he report the findings or risk not reporting and potentially being culpable? While you are frustrated, please be mindful that most medical professionals are equally frustrated. The legislators are the ones who have the power to change the systems. 
Perhaps someone in our group could draft an eloquent letter with our concerns that we can copy and send to our representatives? 
Regards fellow FM comrades!
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To make it worse, the federal regs are overlaid with state regs that vary from state to state and if that werenât enough State medical societies/associations hoping to stem governmental oversight, became proactive with new practice guidelines muddying the waters yet again. AND THEN to pile on even further recent research has inconsistently confirmed (inconsistent only in time/dosage) that hyperalgesia is not only NOT rare, but can happen in days to weeks, consequently what prescriptions are being written are for much lower doses and for very short periods of time including post operative analgesia. It is inconsistent in time of recovery from hyperalgesia some say months, some years some say the damage is permanent though some improvement can occur.The sad thing is that while the USA uses 90% of the pain meds in the world, the USA has not figured out how the rest of the world is doing it. (pain management) and doing it comparatively well.
My personal belief is the billions of dollars being awarded to the states in the law suits involving then manufacturers of the âsafeâ drugs and the lies they used to sell them that lead to this situation instead of bloating the state treasuries to be wasted on pork projects by the politicos, should be used to fund academic research into effective analgesia and programs that works for chronic pain patients.
TJ
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A little update - I saw my Rheumy on Thursday. Had a great appointment. Spent nearly 2 hours with his nurse practitioner. I felt heard for the first time in months. She was kind and professional at the same time. She updated him and then we sat down and talked all together about how to manage the pain long-term, (trying a new med for the PsA, continuing with PT), and the pain meds so I can work in the short-term, (they wrote me prescriptions for 3 months of tramadol, my anti-inflammatory and gave me a referral to a pain clinic). I left feeling more hopeful than Iâve felt in quite a while.
I know none of this seems specific to my fibro, but I also I know that when the PsA is bad I experience even more nerve and muscle pain. The two feed off each other. So anything I do to relieve the psoriatic arthritis pain will help the fibro too.
So at least for the next several months, I can continue seeking a new PCP without the cloud of what to do about the pain meds hanging over my head.
Just wanted to thank all of you for your thoughtful responses and your great information and advice. I feel so grateful that my sister found you all and invited me to join.
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Thatâs good news! It feels so good to be heard! Iâm glad youâre feeling hopeful!
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Zananne1, I know you wrote this Aug 29, but i just logged on and it is listed near the top still! AnywayâŚmy doctor who has been treating me for over 10 years retired! I went in for my monthly visit and was handed my full chart and told BYE BYE dr. is retiring, good luck! Basically THROWN TO THE WOLVeS! Now, I have SEVERE fibro and other issues with both hips and 1 knee being replaced and still need the other. Trying to find another rheumatologist,pain dr was HELL! I went through the same thing including calling PAIN DRs. that my insurance company gave me. PAIN dr. WOULDNât give pain meds since I had already been on them! I have been on a Duragesic patch and oxycontin for breakthru pain and was literally almost ready to try to buy it on the street somewhere! On the last 5 days before I ran out, I got an orthopedic dr to help me. He gave me the same patches but lowered the oxy (which is fine) as I try not to use them. I am going thru a terrible flare up that just wonât stop for almost 2 weeks now and I have HAD IT!! This illness SUCKS and NOBODY but like minded souls like us understand it!..Unless I can find a dr wh HAS FIBROâŚthey will NEVER understand it! Just try to hang inâŚI feel my life rushing by while I lay in bed dozing on and off cause I donât really sleep, and sitting on the couch cause I have NO energy to go to the store of out with friends. I have literally had the last decade whizz by and wonder WTF is the point of my damn life. I wonât kill myself because of my family but I can say that I have thought about it many times. I hope you find something that helps you. debbie xxx
So sorry youâre having such a hard time too. It is so difficult to find people who can relate to our unique issues and understand our pain. I hope you are able to find a great Doctor who will help you get, and stay, as pain free as possible! There must be someone out there for us, right?
I have fibro and degenitive arthritis all over my body. My doctor is kind of weird about pain meds. Iâve had her for 3-5 yrs but what is going on with the opioid epidemic Drs. are kind of paroniod about it. I even lost my license for several mos because I had knee replacement surgery and I wasnât getting my medicine correctly so my sister and I raised cane about it especially the pain med so he reported I was hooked on morphine which is not true so I lost my license. Ingot it back but I went through a bunch of hurdles had my doctorâs write to DMV. Itâs really crazy what we all are having to deal with this. I hope you find a doctor that is passionate.