The Feds Are Ruining Pain Management


So in their long-standing war on preventing people from getting high, the Feds are now ruining relationships between doctors and patients.
I started seeing my pain management specialist almost 7 years ago when his practice was brand new. I was basically forced to see a pain doctor because my primary care physician at the time was effectively refusing to treat the pain that I’d been complaining of for years: low back pain so debilitating that I could barely stand or even walk at times. His proposed method of treatment every time, lose weight, strengthen my core. I had been doing Pilates for years before he sprang this nugget of wisdom on me, but I took it to heart and also took up bellydancing, which is not just core intensive, but whole body intensive. I had been doing it for 3 years, but often had to take hiatus from it and the Pilates because when my back hurts so badly that I have to crawl to get to the bathroom, dancing and Pilates are a bit out of the question. The pain that had plagued me since my teen years was becoming more severe and more frequent. I found myself in my doctor’s office often begging them to do something. I was talking to the physician’s assistant one of these visits and she gave and exasperated sigh, threw her hands in the air and proclaimed, “All I can do is give you some pain meds!” I told her, if that’s ALL she can do then do it! If she can’t fix me, at least treat the pain. She said she would, but that she wasn’t going to just write me a prescription whenever I asked. Gods forbid I actually go through life pain free. At this point I didn’t even have a diagnosis for what was wrong with my back. I was told it was weak muscles, despite my core intensive exercises, or that it may be sacroiliitis, an inflammation of the tendons in the sacrum and iliac area, or that it may be fluid buildup between the pelvic bone and sacroiliac area, but that it DEFINITELY wasn’t anything structural. They did do xrays, and noticed some slight scoliosis, but dismissed it as being too minor to be of any consequence.
I finally got very angry for being shrugged off so many times. Even if they didn’t care how difficult my life was when I left their office I had to live with that pain every day. I insisted on seeing a pain management specialist, and said I wouldn’t leave the office without a referral to get an MRI.
The first pain management doc they sent me to wasn’t at all concerned with the fact that I hadn’t gotten my MRI yet. He did more xrays, noted a slight tilt to my hips (which is due to the curvature of my spine) and informed me that my back pain was the result of one leg being shorter than the other, which gave me an awkward gait. He said he could give me a shot in a nerve cluster in my leg and all my problems would be solved. It sounded like a bunch of hoodoo quackery to me but I figured I’d let him try it. He pinched my inner thigh so hard it left bruises for weeks. I was screaming in pain and he had two nurses hold me down while he administered the shot. Now my back hurt AND my leg hurt. I went back to my Dr’s office, showed them the bruises and asked if there was a REAL pain management doctor they could send me to.
She said there was a doctor just starting out who had very good credentials and so far they’d heard nothing but good things about him. I called his office and they said they’d schedule an appt AFTER my MRI results reached their office. This instilled nothing but confidence in me. From the very beginning he was nothing but kind and attentive. He explained my MRI. He said I’d had multiple disk ruptures, likely from my spinal curvature, my spine was rubbing against my disks when I moved. I had an annular tear in one disk, it was leaking fluid and causing inflammation and pain. The other disk had lost fluidity to the point that it was no longer providing enough cushion between my vertebrae. Several other disks were showing signs of early degeneration. I continued to see him because he always balanced quality of life over methods of pain relief. I wanted options that didn’t make me a zombie. I wanted to be able to live and be in as little pain as possible, and he tried his very best to do that.
Fast forward a few years. The Feds now want all pain patients to do random drug tests to ensure that they’re taking their meds, not selling them, and that they’re not taking meds other than what’s been prescribed to them. I have to sign a form that says that if my insurance doesn’t cover them I’ll be financially responsible. I tell him I’m not going to sign it, I was a substance abuse counselor for christsake, I know all about addiction and I think I’m safe. Besides, I know I’ll be hit up with a ton of charges and I can’t afford them and it’s a stupid rule anyway. It’s for the government’s peace of mind, it lends nothing toward my treatment. He tells me if I don’t sign I can’t get narcotics, it’s the law. Then he tells me that he knows I’m in pain and he knows I need to be treated, and that it’s not that he doesn’t trust me but that he’s been burned before so he understands why they want to enact such a protocol. He tells me a sob story about a woman who was a professional psychiatrist who had been coming to him and paying out of pocket, and it turns out she was doing the same with 4 or 5 other doctors. So he pleads with me, sign the form so we can continue treating you. I signed it, because I trusted him.
After my first random drug screen I was immediately hit up with an $80 fee. I was livid. I called and threw a fit and said $80 was absolutely ridiculous for something I don’t need and didn’t want to consent to in the first place. They told me from now on I’d have to go to a lab to get them done but I wouldn’t get my prescriptions until I did it. I went to the lab, I was still charged $80. They said they’d look into it. Charges kept accruing and I had started to become very ill from MS, which I didn’t know at the time. I lost my job. Then the office manager at my pain doctor’s office called and said that I couldn’t come in for another appointment until I paid half of what I owed. They wouldn’t let me talk to the doctor, wouldn’t let them fill my prescriptions, and wouldn’t let me do anything until I handed over $200. I didn’t have it. I had to go through withdrawal when I ran out of pain meds because chemical dependence is a terrible thing. After finally scraping the money together I went in to my appointment and told the physician’s assistant what happened. She looked shocked. She said she had no idea they’d done that. For a long time afterward I wasn’t made to do any random drug tests and the doctors were REALLY nice to me. I got a free epidural shot and was told that as long as I paid my copays my debt was forgiven. I said that was fine.
Then the drug tests started again and the bills started coming in again. I talked to my doctor about our agreement and he said he’d take it up with the office staff.
The bills just kept coming in and kept coming in and soon I owed over $500. Yesterday I spoke to my doctor again. He told me that they could charge off the lab fees (about $200) but they still have to charge for the test kits and for the “girls”, meaning the office staff doing the tests…basically charging me extra for them doing their damn jobs. Needless to say, I was pissed. After 7 years, and being one of his first patients, it’s all going to fall apart because the Feds want to make us do tests that help no one. It’s all for show. A random UA doesn’t change the fact that I’ve got 30 days supply of narcotics at any given time and can abuse them at will if I so choose. It wouldn’t stop me from selling them if that was my whim, all I need to do is take one before my appointment. It’s absolutely ridiculous.
I’m disabled, and many people on long term pain management are. We can’t afford to be nickel and dimed by the doctor’s office, insurance company, and everyone else who doesn’t want to take responsibility for a test that we don’t need, doesn’t further our treatment, and does nothing to prevent anyone from abusing or misusing their medications.
If the Feds want to make us do this, they need to pay for it. End of story.
So now I’ll likely have to go to my primary care doctor with a long list of specialty meds and beg that she take over my prescriptions. She might say no, and I’ll be screwed. I’m certainly not going to roll the dice with another pain doctor, wind up with a guy like my first pain specialist and STILL owe him hundreds of dollars for unnecessary drug tests.
They are not helping anyone! Nobody cares about the fact that people live in constant pain and there are very few non-narcotic options. That’s not our fault.
My back is getting worse. I now have a bulging disk in my neck, so it’s spreading. I’m only 34 years old. I have to live with this for the rest of my life and may have to settle for subpar care because I can’t afford to prove to the government that I’m taking my meds properly and just don’t want to live with constant, mind numbing pain. Is it too much to ask that I be given a somewhat normal life?