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Refused to prescribe fentanyl and hydrocodone. Seeing pain management doctor. What am I suppose to say?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
My neurologist had the nurse call and tell me he wouldn't be able to write my fetanyl patch any longer because 2 other docs had written me hydro scripts in the last 2 yrs. I had never been told I couldn't take for other pain problems( hurt ankle and sinus infection). I used to see pain mgt doc. But had to go see him and neuro 6 times total per year. My neuro agreed to write the script so I wouldn't have to pay so mu h just for refills.

My question is this... If I make appt with pain mgt doc, are what am I suppose to say? Will there be someone that lets them know about the other scripts once a new (former) doc writes a new patch script?
Posted Wed, 7 Aug 2013 in Brain and Spine
Answered by Dr. Preeti Parakh 7 hours later

On getting to know about your past history of receiving hydro scripts, your neurologist refused to write you a fentanyl patch again because both fentanyl and hydrocodone are opioid analgesics with a high abuse potential. Since misuse of prescription drugs is common, the United States government has put in place Prescription Monitoring Programs all over the country to detect illicit prescribing and dispensing of controlled substances and help legitimate users. Data from all pharmacies is electronically collected and monitored.

If you consult another doctor, it is possible that you may get away with it initially though there is always a possibility that he will subsequently come to know of your prescription history. The best option for you, in my opinion, would be to introspect if you are dependent on opioids. If so, please tell your doctor everything and ask for his help in quitting. There are medications to manage the withdrawal symptoms. There are also many options for treating migraine and you do not have to depend on opioid analgesics for the same.

Hope this has been of help. Best wishes.

Dr Preeti Parakh
Above answer was peer-reviewed by
Follow-up: Refused to prescribe fentanyl and hydrocodone. Seeing pain management doctor. What am I suppose to say? 11 hours later
I don't have a dependency, however, I have built a tolerance to them after having had 3 brain surgeries, 2c-sections, partial hysterectomy, full hysterectomy,and sinus surgery. I'm most worried about being cut off so suddenly and not having anyone monitor me. I have had severe depression and I'm just very scared of what may happen to my body as I come off the patch. It sounds like you think I should try yo go back to pain mgt doctor and tell them that neuro is no longer going to prescribe my patch. Does the pain doctor have to have my signature to look back in my past? I know I will be giving them my permission for them to have access from the date I start back with my pain mgt doctor.
Answered by Dr. Preeti Parakh 6 hours later

It is true that people become tolerant to the analgesic effects of opioids and gradually need higher dosages. It is quite understandable in your case, with your history of multiple surgeries. I do not advise stopping the patches suddenly without medical supervision. Rather than going to a new doctor, ask the neurologist, who refused to write you fentanyl patches, for help. Ask him what to do if you do not get your patch. He may then either write you a patch again or help you come off them. You can also ask him to gradually reduce the dose of the patch so that you do not have to stop suddenly.

You always have the option of going to another doctor and it is possible that he will not get to know initially. But again there is a chance that he may come to know later, and if he also refuses, you will have to find another doctor. In general, doctors are very cautious when patients ask for opioid prescriptions and with the government becoming so strict, do not wish to take any risks.

Best wishes.

Dr Preeti Parakh
Above answer was peer-reviewed by
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