Anyone ever experience this with their family doctor, or GP?

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gtrplayer
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So, most of you probably know that, prior to being placed back on hydrocodone for my pain, I was on Suboxone for a pretty long time. While I was being treated with Suboxone, I felt great. Since being dismissed from my Suboxone pain management group, I have searched and searched for doctors who use Suboxone (or zubsolv, or any of the other buprenorphine sublingual films) for chronic pain. 

Well, I have since been referred to two pain management doctors, neither of which have been worth a darn. I told my family doctor that I needed to be in a pain management group that uses Suboxone for pain (because hydrocodone, or any pain medication that alters my mood results in me having mood swings- up when the drug kicks in, and down when the drug is clearing. I hate the feeling of false senses of well-being because I know that the medication is responsible for it. I dislike any drug that I can "feel" starting to work.) 

The first time I told him that, he sent me to a doctor who was listed in the Suboxone Dr finder, and also used Suboxone for pain. However, my first visit with this doctor he made it clear that he didn't use Suboxone for pain because it's a mess with insurance. This doctor, however, was an extremely arrogant, and lazy, dr. So, I went back to my doctor, and asked for a referral to somewhere, anywhere, else that used Suboxone. The place he sent me this time told me they never use Suboxone, so I had to be put back on hydrocodone, and I hated it. Naturally, I went back to my family doctor, and this is where things get weird.

My doctor suggesting that I look up IU Pain Center, and call them and ask if their doctors use Suboxone. I did, and after I told the receptionist that my doctor advised me to call them and ask whether their pain management doctors use suboxone as a pain treatment, she promptly, and succinctly, told me that "we do not discuss treatments over the phone. If your doctor really wanted to know, he should have called." I agreed with what she said, and started wondering, "Is my family doctor even trying to help me?"

In short, he put the responsibility on me to find a doctor who uses suboxone for pain, which seemed to me to be a very stupid way of finding a doctor. First off, HE is the doctor. HE is the one who has colleagues that he could ask. Even if he didn't want to try to find a Suboxone pain management dr, he would have had his staff try to find one. I know NO other doctors aside from my own. So how in the world am I supposed to even begin to find a pain management dr who uses Suboxone. Needless to say, I am very upset with my Dr because he always told me that I am like a son to him, since he knew me before I was a patient because I used to take my grandma to him, sometimes 3 times a week when she was really ill. My family doctors admitted that he almost took the 8HR onilne course to get certified to Rx Suboxone because of the benefits it has over regular narcotics (Yes, I know Suboxone is a narcoti). 

It just seems really odd for a doctor to put the responsibiity of finding a pain management dr who uses a specific medication, off-label, to treat pain. Surely he has colleagues he could ask and find one Dr who uses Suboxone in their pain management practice. Does anyone else think that my doctor was wrong in putting the responsibility on me to find a Dr? Also, isn't that technically the first step of dr shopping? No doctor's office is going to tell me the specifics of their practice, such as what drugs they use the most. They would tell my family Dr though, but he doesn't seem to view this as a priority. It's been almost a year, and I still am on hydrocodone and my doctor doesn't seem to want to help me, hence; he had me try to find a pain doctor who prescribes suboxone, and told me onceI found one, he'd refer me to them.

Maybe I am just being overly sensitive to the whole thing, but I don't think it's normal for a doctor to tell a patient to call another pain doctor and see what drugs they use. No office is going to answer that question. My doctor even told me to go on ProPublic.com and see which doctors prescribe suboxone the most, and then research those doctors and see if they are a pain group. Sorry, but to me, that is something that the dr is supposed to do, not the patient.

Any thoughts?

P.S.: I know I ranted and went off on a tangent here and there, but it wouldn't be a true post from me if I hadn't gone off on a tangent. It's becoming more and more normal in my posts for me to lose focus on what I am talking about, and just go from one rant to another. Guess it's time to have the ADD treated again:(

 

Rocker Dan
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pain doc's

Dear gtrPlayer,Suboxone is mainly for opoid cravings a deterent there are some fantastic medicnes for pain.if you have a problem when a pain med stops working please obtain a round the clock 12 hour extended release such as morphine or oxycontin at two per day or avinza which is a morphine 24 hour pill.You may also need instint release Oxycodones or percocets for breakthrough pain (which means if your pain spikes or more medication when needed)I am sure this is what you need having read and liked all your posts!!! Please feel better!!!!RD

BeavisMom62
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GP

As I work for a neurologist, I can tell you that we do the same thing. Not with sub but most times we make a referral, etc. If it was just one or two patients ok, but in all honesty, there isn't enough time in the day to do that for most patients. I agree with you, sometimes things like your problem should be done by the doc or staff, but besides the time problem sometimes docs don't have it any easier than if you make the call. I seriously doubt your GP has colleagues that deal with subs. Lots of patients assume doctors have a network of other docs that they can just call up. But usually colleagues are local docs that are in the same field of medicine.
We always get asked by patients moving out of state if we can refer them to a neuro in another state. How would we know? Its not the same but similar to your situation.
Wish I had a better answer for you.

BeavisMom62
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I wonder, since you get ups and downs, besides using a long acting pain med, if an antidepressant or something similar would help. Wellbutrin comes to mind cause it's usually gentle and effective or Cymbalta cause it helps pain and mood. Just a thought.

gtrplayer
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I know about Suboxone's FDA

I know about Suboxone's FDA approved use being that as a detox ot opiate replacement therapy drug, but buprenorphine was intended to be a pain med, never really caught on here in the states, so it was reformulated and rebranded.

Here is the link I try not to send  frequently because it lists the drs name. However, I don't care anymore who gets his name or knows he exists. The author of the article is the suboxone dr I visited for many years. My own aversion to painkillers, and how they generally make me feel crummy, is one major reason I agreed to try suboxone. Prior to the Suboxone, I was on Norco 10/325 *3/day along with Avinza30mg capsules. 

As for the antidepressants- You are correct Beavia mom. I was on Cymbalta 90mg (60+30) when I was on Suboxone, and it truly did help. When I took it with my previous regimen of Avinza + Norco, I don't recall it being as effective.

I will admit this ahead of time because it should go without saying, but I am dependent on my meds in order to have a life. I've had the pain since my wreck, and I know it will always be there, but the treatments will undoubtedlty change as I age.  Part of what I found to be so pleasant about being on Suboxone for my pain is that it took away the mini-withdrawals that I would have throughout the day if I took my Norco. I know a lot of ppl who see someone posting that they are on Suboxone for pain purposes automatically think, "why, couldnt you control your intake of med xyz?", and that just isn't my case. 

As with all meds, individual results will vary from patient to patient. 

trollop
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The good ole Family GP...I feel your pain GTRPLAYER

Iv'e got a good one for you...now I think your GP and my GP are cousins!!!  For many many years I was on Norco but back years ago it was combined with 650 or 660 mg of Acetemenophin and was Rx'ed 4x/day.  Years of this caused liver damage not only from the med but also I was young and dumb and loved to go clubbing w my friends and drank on top of it all even though it says clearly not to do so on the lable!!! But that's the mind of a twenty something, mine anyway.  So...a new GP since I moved out of state, had me on the same meds but now after bloodwork finding my liver enzymes to be high, very high I was Rx'ed Norco 10/325. After 2 total's of cars and years of pain and tolerence, I was referred to a pain mgmt. clinic by my GP in my new state after 15 years of his care only.  The PM clinic closed down, hence that put an end to the only truly helpful thing...epidural injections. I was also Rx'ed the oxycodone 30mg & morphine 30 for breakthrough. Now obviously I didn't begin at that dose to start but that is where it ended. I was given a taperdown dose before the closing.

Back to my good old trusted GP in pain and he tells me he is unable to write any new pain med Rx'es. I couldn't see the rationality of that since he wrote me the Norco's to begin with. He also would not write my Soma script either but so graciously alowed me to take 300mg Gabapentin 3x/day along with my Xanax 1mg 4x/day, upped my Zoloft to 100mg.  2years later I am still denied a pain med and he told me after the clinic closed that he would refer me to a good Dr. for injections anytime I needed. I have been to PT with no signifagnce and a lot of time and gas wasted. My last appt. I asked for that referral for injection and he tells me that we have to approach this from the beginning!! I'm thinking WTF is this guy talking about??? Why is he treating me this way?? I have never cheated on him with the exception of a visit to my old GP when I went to my home state for a family visit. I paid cash for everything and my prescription history was never brought up.  I am still in the same situ between a rock & a hard place.  I am taking his &??$ because I'm afraid I could end up in a worse situation without my only saving grace being my Xanax.              I'm seriously considering going to a psychiatrist because my GP is making me crazy.Yell