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   Have You Ever Ran Out of Meds? (Pain Management board)

12th January 2010
Have you ever ran out of your meds before it is time to get new ones. If so, what did you do when you ran out?

I go to a Pain Management Clinic. They prescribed meds for thirty days. They prescribed me 30 hydrocodone for my club foot and tumor in my knee. My PCP prescribed me more than the PMC.

I ran out of the 30 hydrocodone seven days before my thirty day cycle. I was given a prescription for 90 hydrocodone but cannot have it filled until 1/20. Has anyone ever had a prescription filled early?

I feel very bad. My PMC made me feel pathetic for running out of 30 hydrocodone one week before my thirty day cycle. Also, I know that the PMC has a thirty day rule. I do believe that they should have given me something so I am not in agony. All I can do is lay in bed all day. My pain has ended all of social interactions and life.

Now I want to go back to the PMC and tell them that the 90 hydrocodone is not enough and that they need to write me a prescription for 150. If not, I will be running out again before the thirty days is up. I do not want to make these people upset.

I am not happy with my PMC because I went there to get treated with a strong pain med and then something for break thru pain. I was hoping with this treatment I could get out of bed and start regaining my life.

What do you think that I should do? If you have run out of your meds early what did you do? Thanks.
13th January 2010
I'm sorry, I'm confused. So, your PMC wrote you a prescription for 30 Hydrocodone. Then they wrote you another prescription for 90? Why didn't they just write the initial prescription for 120?? What are the directions on the bottle of 30 (how many pills are you allowed per day)? So, was the prescription for the 90 Hydrocodone your PMC gave you, your next month prescription? I'm just confused why they'd only give you 30 initially and then the next time they see you give you a prescription for 90, but not allow you to fill it until a certain date?? If they wrote you a prescription for 90 they are acknowledging that you need more medication than the 30, so I don't see why they are making you wait until next week to fill it. What was their reasoning?

I do know from experience with my Pain Clinic, my Doctor and her staff are very strict on early refills - under no condition can I call in regarding early refill. Of course I can call with med questions. But, early refills are a big no-no.

I wish I could help more, but I'm just confused a bit by the "two prescriptions" and why your PM Doctor didn't write it as one prescription for 120 in the first place (which sounds like would be close to the number of pills you need for a month). So if you can clarify this, maybe I will be able to offer a suggestion.

Communication while you are in pain management is very important. So, definitely be assertive and let your Doctor know your pain levels and the amount of time your pain is managed after you take your medication and this will help your Doctor figure how much medication you should be prescribed to keep your pain managed. With your issues it might be worth it for you and your Pain Management Doctor to look into a Long Acting medication (in addition to the Hydrocodone). This would allow you take less pills and would only require you to take the Hydrocodone for break-thru pain. Has your PM Doctor talked to you about Long Acting medications at all?

Please provide clarification to the questions I asked in the first paragraph and hopefully I will be able to provide some input.

I'm so sorry you're going through. :angel:

~ Fiona Jo :wave:
13th January 2010
I am sorry you are having so many problems. However, most doctors, and almost all pain management doctors will not permit ealy refills because you ran out. Some will permit picking up scripts early due to severe weather events, holidays, or vacation needs. In those instances, if you were due on say the 15th and picked up on the 12th, you will have to wait until the 15th the next month (assuming a 30 day month). My PCP prescribes my meds and allows me to do this (ie. the Christmas blizzard in the midwest), however if I ran out and called for more, I would be dismissed.

Since you are going to a pain management clinic and were given a prescription for narcotics I assume you signed a contract. You need to read thru that contract and abide by it to the letter. Generally just asking for a early refill because you ran out is considered grounds for dismissal. Yes, I know you are in pain. Yes, I know it's miserable. I don't mean to be harsh, but you need to try to work with them. Most doctors add to dosages slowly as they get to know you and better evaluate your condition and how you react to dosages over time. Start keeping a log of your pain levels, and how it affects your life. Be specific, as in "was unable to fix dinner", "could not give kids a bath", "had to stay home from work", along with the pain levels. I'd record it at least 3 or 4 times a day. Be realistic with the numbers, a log that has all 10's isn't going to be taken seriously. I read your other post and it looks to me that they upped the hydrocodone to 3 a day and added another stronger med (oxycodone), is that correct? If so you need to wait and try that for a minimum of two weeks before calling them again. Calling or going in and demanding more before you have even tried that combination and had a second scheduled appointment is likely to get you dismissed. Certainly taking more than prescribed and running out again will lead to being dismissed and will make it difficult to get treated in pain management in the future. Pain management doctors often test paitients and unless they have already been in pain management and referred because they moved or something are started at very low levels of medication at the beginning to protect themselves and their practice from drug seekers. I'd guess that this is what this doctor is doing. I would try to work with them for at least a couple of months. Again, I'm not trying to be harsh or not take your pain seriously, but it takes time to get to an appropriate dose in pain management. Better to be miserable for a short time and have long term treatment than be dismissed and not be able to get treatment in the future.

Tigg.
13th January 2010
Fiona,

When I went to the Pain Management Clinic, I was prescribed 30 hydrocodone. The care givers at the Pain Management Clinic told me that it would take a while to find out which medication works for me. I told them that my PCP gave me more than 30 hydrocodone for a month. I was told to contact them if I ran out. Due to the fact I chose to go to Pain Management because I thought they could get me on a better treatment plan that my PCP; a treatment plan that would allow me to be able to get out of bed and into physical therapy. Now that I am in Pain Management I cannot get any other medication from any other sources. That is fine with me because I prefer to have my medication given to me from one source. I feel really horrible and like I am failure because I ran out of 30 hydrocodone in the thirty day cycle.
13th January 2010
hydrocodone is the weakest of the narcotic meds and will likely not get a bedridden person out of bed. I would go in and be direct with a request to take a longer-acting stronger medication and then a short-actinng for breakthrough pain. If they are out of sorts because you asked for a specific type of PM (not specific medications, just a medication profile), then in my opinion, you are not out much

. I would then go elsewhere. Just my two cents.
14th January 2010
When I went to my Pain Management Clinic I was prescribed 30 Hydrocodone. I ran out of the 30 Hydrocodone before the thirty day Pain Management Cycle. The thirty day cycle is January 20. When I went back to the Pain Management Clinic for my followup, I told them that I ran out of the 30 Hydrocodone. I felt very judged. At my followup appointment, I was given a prescription of 90 Hydrocodone which can be filled on or after January 20. I feel as though I made a mistake in taking the the prescription for the 30 Hydrocodone the first time I went to Pain Management. Now I am afraid that the same thing will happen with the prescription of the 90 Hydrocodone. I do not want to be a problematic patient. Both of the hydrocodone prescriptions are from the same place and will total 60 days; two thirty day cycles. My next appointment is in mid February. Thank you everyone for all of your advice. It really does help and I greatly appreciate all of you.
17th January 2010
KDEL, The prescription bottle for the Hydrocodone/APAP reads "Take 2 to 3 Tablets By Mouth Daily If Needed." I did not question the prescription amount because I just thought that it could be refilled when needed. I did not think that it could be refilled after two days or an unreasonable amount. I did think if I took 3 tablets a day it could be refilled after 10 days even if it was before the 30 day cycle.

Someone asked the question regarding if I had prescriptions from different doctors. No, all of the prescriptions are from The Pain Management Clinic. The new prescription for 90 Hydrocodone was given to me when I went back to the doctor. My appointment was 9 days before the 30 day cycle was over.

Irene, I feel so bad for you! Having chronic pain is difficult enough to deal with. I hope that you are able to find a peaceful place to live. Until then the lock box idea is great along with a lock on your door. I do not know enough about Pain Management to know if your doctor will flag you because your medication was stolen from you. The rule at my pain management clinic is lost or stolen medication / prescriptions will not be replaced. The rule does not state if your medication is lost or stolen you will be red flagged. Does you Pain Management Clinic have a Psychiatrist? Mine does and talking to the Psychiatrist has been helpful for me. I hope that this never happens to you again.
24th February 2010
Only times I ever ran out of meds was because I couldn't get my refills. Once because doc went on vacation without assigning my case to any of his colleagues. Second time, I was [COLOR="Cyan"]snowed-in and couldn't get to pharmacy for 4 days. I could have called EMS but given the weather I am sure they had their hands full, would have felt silly calling them. So I suffered for 4 days, stayed in bed with my heating pad and made a lot of calls finding anyone who was still delivering food seeing as the whole valley was snowed-in.

I think its been mentioned several times already but instead of asking for higher dosages try asking for different meds. Everyone metabolizes drugs their own unique way. Personally, Vicoden or any hydrocodone based drug does nothing for me. Flexeril will knock me out but percocets don't. Which is the exact opposite of the reaction my brother, same flesh and blood pretty much, has. Percocets will knock him out but not the slightest drowsiness from Flexeril.

So look at alternates instead of more... MORE is usually a [COLOR="Red"]red flag for drug seeking behavior.

Keep us in the loop, :round:
Michael
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