Sweet talk a doctor and win drugs
July 1, 2008 5:08 PM Subscribe
How do I obtain "good" pain meds from my doctor?
I'll be seeing my doctor soon about a recurring pain. He prescribed vicodin at the initial consult when the pain was most severe. Now, many months later and following up. The pain is persistent but less severe. But I want vicodin again. What should I say to him? How can I coax him into writing me a prescription for what i want (without coming off like a total addict--which I admittedly am--please no motherly scolding).
I'll be seeing my doctor soon about a recurring pain. He prescribed vicodin at the initial consult when the pain was most severe. Now, many months later and following up. The pain is persistent but less severe. But I want vicodin again. What should I say to him? How can I coax him into writing me a prescription for what i want (without coming off like a total addict--which I admittedly am--please no motherly scolding).
This post was deleted for the following reason: you can't reallt do this here. -- jessamyn
Speaking as a physician, I have to say that if you're intelligent enough to turn to AskMeFi for advice, you're probably intelligent enough to know that the more you try to "coax" your physician, the more suspicious of your intent he/she will become. As DecemberBoy points out, this could be more of a problem for you than it's worth.
You're also probably smart enough to know that your doctor has an obligation (legal and moral) to balance risk and benefit in prescribing medications. While the risk of a bottle of Vicodin is admittedly small, it is still not zero, and is greater than the benefit if in fact your pain is truly improved. And of course you if you're conscientious enough to turn to AskMeFi for advice, you're probably conscientious enough such that you wouldn't want to try to "coax" another person to violate their legal or moral obligations just you can enjoy the mild buzz of a Vicodin.
I could be wrong, of course, making these assumptions just from your presence on AskMeFi, of course, but I like to think that people here are well-intentioned.
posted by scblackman at 6:12 PM on July 1, 2008 [1 favorite]
You're also probably smart enough to know that your doctor has an obligation (legal and moral) to balance risk and benefit in prescribing medications. While the risk of a bottle of Vicodin is admittedly small, it is still not zero, and is greater than the benefit if in fact your pain is truly improved. And of course you if you're conscientious enough to turn to AskMeFi for advice, you're probably conscientious enough such that you wouldn't want to try to "coax" another person to violate their legal or moral obligations just you can enjoy the mild buzz of a Vicodin.
I could be wrong, of course, making these assumptions just from your presence on AskMeFi, of course, but I like to think that people here are well-intentioned.
posted by scblackman at 6:12 PM on July 1, 2008 [1 favorite]
Best answer: Depending upon your ailment, it may be quite normal to be able to cope (with gritted teeth and OTC meds) during the day but need something more powerful to get to sleep and stay asleep at night in the final stage of recovery from whatever it was.
posted by Martin E. at 6:15 PM on July 1, 2008
posted by Martin E. at 6:15 PM on July 1, 2008
Response by poster: scblackman: I'm looking for answers to my question not life lessons. As a physician, under what conditions have you been prompted to administer narcotic medication. When does a patient need it? Under what circumstances is it necessary?
posted by Jason and Laszlo at 6:17 PM on July 1, 2008
posted by Jason and Laszlo at 6:17 PM on July 1, 2008
scblackman: I'm looking for answers to my question not life lessons. As a physician, under what conditions have you been prompted to administer narcotic medication. When does a patient need it? Under what circumstances is it necessary?
scblackman's answer makes it clear he's not going to answer that question given that in your post you admit to an addiction to vicodin and this seems to be the main drive for wanting more.
basically, you came on here asking people how best to help you feed your addiction to a controlled substance.
posted by violetk at 6:29 PM on July 1, 2008
scblackman's answer makes it clear he's not going to answer that question given that in your post you admit to an addiction to vicodin and this seems to be the main drive for wanting more.
basically, you came on here asking people how best to help you feed your addiction to a controlled substance.
posted by violetk at 6:29 PM on July 1, 2008
I'm looking for answers to my question not life lessons.
I don't think there is an answer to your question. You seem to want some magic code words that you can just say to a doctor and obtain narcotics with a 100% success rate, and such a thing just doesn't exist. It really depends on the doctor and his or her philosophy on prescribing narcotics. The only applicable advice is to not be forceful about it and take your chances.
posted by DecemberBoy at 6:37 PM on July 1, 2008
I don't think there is an answer to your question. You seem to want some magic code words that you can just say to a doctor and obtain narcotics with a 100% success rate, and such a thing just doesn't exist. It really depends on the doctor and his or her philosophy on prescribing narcotics. The only applicable advice is to not be forceful about it and take your chances.
posted by DecemberBoy at 6:37 PM on July 1, 2008
scblackman: I'm looking for answers to my question not life lessons. As a physician, under what conditions have you been prompted to administer narcotic medication. When does a patient need it? Under what circumstances is it necessary?
You know what -- I have a few minutes, so I'll address this.
Pain medication is necessary when patients have pain. The choice of pain medication depends on a large number of factors: severity, interference with normal activities of daily living, underlying medical conditions (co-morbidities), expected duration of treatment, prognosis (expected duration of pain), to name a few.
I administer narcotic medication to patients when they have pain that won't respond to non-medical interventions (rest, ice, compression, elevation) and won't respond to non-narcotic medication (e.g., non-steroidal anti-inflammatory medications), or when non-narcotic medications are contraindicated, such as the use of ibuprofen or naproxyn in patients with underlying bleeding or platelet disorders.
For patients in your circumstance (not the self-admitted drug seeking, but rather the recurring pain that is less severe), I'd try to understand what is causing the pain (some injury that hasn't properly healed) and address the underlying cause. In addition, if you've been doing fine without narcotics for the "many months" that you state, then I would begin again with non-medical interventions, and escalate to non-narcotics pain medications if you still had pain, and wouldn't escalate again to narcotics unless you clearly weren't responding to maximal non-narcotic treatment.
Any patient who shows up in my clinic having been off narcotics for pain and says, "Hey Doc ... remember that pain from 6 months ago ... can I still have Vicodin for it?" is asking for a more in-depth evaluation of their pain and their motivations.
posted by scblackman at 6:49 PM on July 1, 2008
You know what -- I have a few minutes, so I'll address this.
Pain medication is necessary when patients have pain. The choice of pain medication depends on a large number of factors: severity, interference with normal activities of daily living, underlying medical conditions (co-morbidities), expected duration of treatment, prognosis (expected duration of pain), to name a few.
I administer narcotic medication to patients when they have pain that won't respond to non-medical interventions (rest, ice, compression, elevation) and won't respond to non-narcotic medication (e.g., non-steroidal anti-inflammatory medications), or when non-narcotic medications are contraindicated, such as the use of ibuprofen or naproxyn in patients with underlying bleeding or platelet disorders.
For patients in your circumstance (not the self-admitted drug seeking, but rather the recurring pain that is less severe), I'd try to understand what is causing the pain (some injury that hasn't properly healed) and address the underlying cause. In addition, if you've been doing fine without narcotics for the "many months" that you state, then I would begin again with non-medical interventions, and escalate to non-narcotics pain medications if you still had pain, and wouldn't escalate again to narcotics unless you clearly weren't responding to maximal non-narcotic treatment.
Any patient who shows up in my clinic having been off narcotics for pain and says, "Hey Doc ... remember that pain from 6 months ago ... can I still have Vicodin for it?" is asking for a more in-depth evaluation of their pain and their motivations.
posted by scblackman at 6:49 PM on July 1, 2008
Let me refine the 2nd sentence in my statement above: Pain medication is necessary when patients have pain that won't abate with non-medical treatment. Which pain medication to use is based on the factors I describe, and then some.
posted by scblackman at 6:51 PM on July 1, 2008
posted by scblackman at 6:51 PM on July 1, 2008
This thread is closed to new comments.
Don't, however, try to doctor-shop and scam doctors into writing scripts that you don't even need at all. That's a dick move and only makes it harder on people living with chronic pain that really need narcotic meds. Once the pain is gone, get your shit illegally like everyone else. Or, better still, quit taking it. I can tell you're not really a "total addict".
posted by DecemberBoy at 5:27 PM on July 1, 2008