When someone writes that they are out of medication and their doctor refuses to write a prescription for more — despite their abiding by the directions of how often and how many — it seems a dereliction of duty, especially when the medications are opioids.
Many years ago, I was prescribed methadone.
I was in a Philadelphia hospital, where my neuro-ophthalmologist was employed, at a point where the pain had overwhelmed me and I could no longer deal with it.
I was given increasingly potent opioids, but nothing helped.
Dr. Freidman, the pain specialist, suggested methadone.
“Methadone? No way. It’s addicting,” I told him.
But he assured me, “We often use it for chronic pain treatment. It is worth trying since nothing else has helped.”
I was concerned about being able to get methadone when I returned home to New York City.
“My mentor is there. He’ll give you the prescriptions. Don’t worry,” Friedman said.
Unfortunately, he was wrong.
When I told the doctor, “Dr. Friedman told me you would write the methadone prescriptions for me,” he stood up, said he would not, ended the appointment, and sent me on my way – with no prescription or instructions about stopping the drug.
I am very lucky. I had never had a problem stopping any drug, even codeine (after taking up to 14 grains a day for 8 years), but this methadone was another thing altogether.
I had been on it for only a few weeks. I had a few doses left, but decided to stop taking it. Within a very short time after missing the next dose I started feeling terrible — chills, sweating, headache, and full body ache.
I decided I must be in withdrawal. The only thing that made sense was to take half a pill, and if that helped, to wean myself off methadone by continually reducing the amount I took, halving the dose, then halving it again and again. It worked. Within about a week I was fine.
But there was no reason for it to have happened. The doctor should have at least told me how to get off the drug or given me enough pills to get through withdrawal.
Too often I hear people in chronic pain say their doctor went out of town and they were out of their meds or needed a prescription for refills, but no one at the office could, or would, do it.
Others write of physicians refusing to write any more prescriptions for narcotics, with no explanation or discussion of what they can expect if they stop taking the drugs.
It seems to me that a doctor who does not give their patient enough medication or has no one to cover their patients when they are away is doing harm.
Narcotic medications need to be given sparingly and thoughtfully. When a doctor does give them, it is incumbent upon that physician to make sure their patients do not suffer because they were away or changed their position on the use of narcotics in pain care.
It is another example of how pain patients are not always given the same care or due diligence those with other disorders, such as diabetes, can expect from their physicians.
All doctors explain what insulin does, how it needs to be taken, and what can happen if the patient stops taking it.
Why is it we should expect, and receive, any less?
Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 30 years. She is the author of “A Pained Life, A Chronic Pain Journey.” Carol was accredited to the United Nations Convention on the Rights of Persons with Disabilities, where she helped get chronic pain recognized as a disease.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represent the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.