Flippy - I Rant, You Read

Friday, June 05, 2009

early evening

Drug Addiction Accusations - My Doctor’s (and his staff’s) Response and my pharmacist’s response

Recently, I was accused of faking Fibromyalgia, having unnecessary surgery, and being a drug addict.  Since none of those accusations are true, I had no qualms about bringing up the accusations with my pain management doctor of 2.5 years (I’ve seen him once a month since November of 2006, when I realized that my pain wasn’t cured by my back surgery in April of 2006) and one of the pharmacists I’ve seen at least once a month since I started taking pain meds, several months before my herniated disk surgery.  I know that many Fibromyalgia patients go through the same things with their family members, so I figured I’d write about my experience, as I’ve written about most of my chronic pain issues.  I’m not ashamed or embarrassed to be taking pain meds, and I think that if someone wants to accuse me of faking illnesses and of being a drug addict, it’s certainly my right to discuss these issues publicly.  I didn’t think it adequately addressed the situation just telling my doctor that a family member was accusing me of being a drug addict, without including the exact accusations.  So, I culled them from a couple of emails and printed them out for my doctor (and pharmacist) to read.  I’m not afraid of anyone taking a closer look at the medications I’m prescribed, my behavior when they see me every month, or really anything related to my prescriptions.

These statements were written to me, supposedly out of “concern”, but like the doctor’s office staff said (and I agree), what was written was just plain mean.  This is what I printed out for the doctor/pharmacist to read:  So I expect you will write again “Go Away” let you be with your pills… your next dose, your denial….. I know you will… it’s what I expect right now.  Forget the family Nancy, everyone that knows you and is in contact with you knows you have a drug problem and they are CONCERNED about it.  You have hit bottom.  Yes, I am an alcoholic and the first step to healing is to admit you have a problem.  YOU HAVE A PROBLEM AND IT WILL DESTROY YOU.  This is coming from CONCERN not ABUSE.  If you were completely rid of all of the drugs that are in your body you would totally agree.  I have a very close nit group of people in Los Angeles that I have been consulting with about addictions to opiates(2 doctors in that group). One of my very close lady friends passed away 2 years ago, in her sleep, from mixing the same kind of drugs for a long period of time.  If you were honest with your Doctors, and if they are good Doctors they would be on high alert about all of the over the counter and prescription drugs you are using.  I AM WRITING THIS OUT OF CONCERN NOT ABUSING YOU.  Your life has been lived in a bubble.  You don’t understand the realities of what you are heading towards.  No amount of money, the security of a home, friends and family can help you at this point. I know that 90% of your thoughts are about your next pill to help you wake up or help you fall asleep, help you get through the day. I KNOW THIS WILL MAKE YOU ANGRY - I AM CONCERNED.  Maybe you don’t know what it is like to care about someone just because… I know you will be angry again, your partner will be vicious.  Leigh-Ann knows you have a drug problem. 

I told my doctor that my sister-in-law was accusing me of being a drug addict and I wanted him to read what she had to say.  He tried to be nice, saying that maybe she was “concerned”, but he said that if he felt that any of that was true, I wouldn’t be sitting there in front of him - he would’ve sent me to another doctor for rehab.  He said that he’s always felt that Leigh-Ann and I have always behaved responsibly and have never shown any signs of addiction.  I’ve never needed an early refill of my meds (in fact, the prescription that he wrote for me last week, I put on hold at the pharmacy because I have enough left from my last prescription), I’ve never “lost” a prescription, I’ve never asked for an unreasonable dosage increase (most opioid users develop a tolerance and will end up needing a dosage increase eventually), I’ve never come into his office appearing any different from my very first visit even though every time I see him (or anyone else), I’m medicated, and I’ve never failed any of the surprise drug tests that I’ve been given.  I signed a “drug contract” (see page 2 of the PDF) with his office, and have abided by all the conditions set forth by the office to remain a patient.  All of my opioid prescriptions are written at that office, I don’t drink alcohol with my medications, I don’t take more than prescribed (or I wouldn’t have been able to put my new prescription on hold), I get my prescriptions filled at one pharmacy, and every month I have to fill out a lengthy form to let him know how I’m feeling, what I’d like to discuss, and every single medication I’ve taken that month, including over-the-counter medications like Benadryl and Advil.  I also let him know what medications I’ve taken in my clinical trials, have had the clinical trial doctor fax him my blood work and my EKGs, so he’s aware of every single aspect of my medical care and how it might affect what he prescribes.

I knew that when I gave him the printed out accusations, it would give him the opportunity to question me and to really think about what I take and how it affects me.  I wasn’t the slightest bit worried about shining a spotlight on my medication usage because I know that I take my medication for its proper use, pain relief.  My medication never gets me “high”, nor does it change how I behave.  It either relieves my pain or it doesn’t.  If I’ve taken too much (when I’ve gone to a higher dose), instead of making me “high”, it actually makes me nauseous.  I’ve tried a wide variety of narcotics to relieve my pain, but many of them do absolutely nothing (the morphine-based medications) or they’re too expensive and I can only get them when I have insurance coverage (my pharmacy coverage is only $500, so it’s usually January & February where I get to have my preferred medications) or when I have extra money.  We discussed how he wasn’t happy with the medication I was taking because he’d prefer to have me on a longer acting drug w/ a shorter acting one only for breakthrough pain.  My preferred medication is a Fentanyl patch because it slowly releases the pain meds over a two day period, giving me better pain relief and none of the pain/less pain rollercoaster than I’m on right now with Oxycodone.  However, he knows the only reason I’m taking a medication that requires dosing every six hours is because it’s the cheapest medication I can get that works for me.  I did try Methadone for a month (it’s only $15 or so a month), but the side effects activated my weird bladder problem, so I had to quit taking it after a month.  If a “concerned” someone wanted to pay the $300 difference between the Fentanyl patch and the Oxycodone, I’d jump at it.  I’d be thrilled to have a long-acting pain medication, but I just can’t afford it.  I can’t even afford to try the new Opana ER, just like I can’t afford Oxycontin (most people don’t know the difference between Oxycontin & Oxycodone, but we can just leave it at, I can’t afford Oxycontin) or the Fentanyl patch.  I’ve also tried all of the non-narcotic supposed Fibromyalgia meds like Lyrica.  The side effects of Lyrica made it impossible for me to continue taking, and it’s also not the miracle drug that the commercials would have you believe that it is.  Anyway, it made my feet swell up so much that I couldn’t wear shoes, plus it made me so tired that I fell asleep sitting in the bathroom.  I already have so much fatigue from the FM that I don’t really need anything adding to that.

My doctor isn’t some back alley drug pusher.  He’s a board certified pain management specialist (as is every doctor in his office), and he’s also the Medical Director of Summerlin Hospital’s Rehabilitation Center, and the Chairperson of the Patient Safety Committee.  He’s a stickler for the “rules” and makes sure that his patients aren’t going to get him in trouble with the DEA.  I’m not worth losing his license to practice medicine, so he wouldn’t let me slide by just because it’s easier to write a prescription to make me go away.  He said that he would be willing to discuss anyone’s “concern” regarding my medications if they made an appointment to see him.  Whether or not he’d charge his regular fee of $95, I don’t know.  I didn’t ask.  We also discussed how so many people freak out when they read about people dying from taking Oxycontin.  However, the reason people die from taking Oxycontin is due to abuse…and combining it with alcohol.  I don’t abuse my meds and I don’t combine them with alcohol.  My doctor has seen me approximately 30 times in the past two and a half years.  The last time the person who accused me of being a drug addict saw me was on Xmas Eve.  And before that, I don’t even recall, but it was months before that.  Unfortunately, Leigh-Ann and I have had really bad FM flares due to all the stress we’ve been under (let’s just say that accusations of drug abuse, faking illnesses, and stealing people’s pets…don’t help), so we haven’t been to most family functions for the past year.  We’re not out partying, we’re not avoiding people, we’re sick.  We conserve what little energy we have for the things that we absolutely have to do, like get groceries and go to the doctor.  So, who would have a better grasp of how I’m doing, my board certified doctor who sees me every month, or a recovering(?) drug addict/alcoholic who has seen me once in probably close to a year?  Oh yeah, and not to mention, my partner, who sees me every single day.  Do any of you who know us think that Leigh-Ann would let me abuse drugs without doing something about it?  No, of course not!  She knows what I take, when I take it, and she sees that it relieves some of my pain…and doesn’t make me “high”.

I also let one of women at the doctor’s office read the “accusations”.  She, too, sees us every single month and has been working at that office since before we started going there.  She read the accusations and thought they were ridiculous and “mean”.  She kept repeating it over and over, “That’s so mean!”

Finally, I took the paper in to my pharmacist to read.  Her mouth was literally hanging open in shock while she read everything.  She repeated what I said earlier in this lengthy diatribe - I don’t “lose” my prescriptions, I don’t get early refills, I don’t come in “shaking”, and unlike many of her customers, I never tell her that I’m in a hurry to get a prescription.  In fact, if it’s late or she’s busy, I tell her to fill other people’s prescriptions before mine, because I can wait, and I don’t want her to have to ever stay late or rush because of me.  I’ve never freaked out because they had to order the meds because they didn’t have enough in to fill the prescription.  Oh, and I let one of the regular pharmacy techs read the accusations, too.  She laughed and said, “No, a drug addict is the people who say they’re weaning off a drug, and then come back in two weeks because they’ve run out.”  Believe me, they see their share of drug addicts at the pharmacy.  I can honestly say, with a clear conscience, that I’m not one of them.  Not one single person who I showed the accusations to has even had to think about it before rejecting it as ridiculous.  Also, I’m pretty sure that an actual drug addict wouldn’t be showing that to every Tom, Dick, & Harry, because it’s naturally going to make people think about it more if they have any doubt whatsoever.  No one has any doubts about my use of pain meds.  I use them properly and carefully.  In fact, I tried to get my mom to go with me to my last doctor’s appointment, so she could discuss it with him if she wanted…she said that she didn’t want to go, because she didn’t think I had a problem.  Now, don’t you think my mother, of all people, would be one of the people most concerned about me if she thought there was a problem?  Now, if my mom, my partner, my doctor, and my pharmacist aren’t worried, I think I can safely say that no one else should be accusing me of being a drug addict.

One more thing that I’d like to add - I discussed with the doctor that the person making the accusations was a recovering drug addict/alcoholic (this is something she wanted to post in a comment, so it’s not something I’m making public that she wasn’t willing to do on her own), and his opinion was that a person who uses/used drugs to get high or as an escape or whatever, probably couldn’t understand other people being able to use narcotics responsibly, as prescribed.  I don’t have a single speck of an addictive personality or gene or whatever causes drug addicts or alcoholics to use substances to get high versus relieve pain or go to sleep or relieve anxiety or whatever use a particular medication has.  I have medication left over that he prescribed for me in August of last year to help me deal with my fatigue.  It’s medication that an addict wouldn’t be able to let sit unused in a drawer somewhere, but I didn’t like how it made me feel, so when I didn’t absolutely need it to function, I didn’t take it.  I have more than half of the bottle left, and when I take any of it, I take a tiny little portion of what was prescribed.  I actually took all of my prescriptions with me, so the doctor could do a med count if he wanted.  He said that it wasn’t necessary.