Brief Answer:
Questions so that I can help advise:

Detailed Answer:
Hi XXXXXXX

I am trying to sort out your question. Who are you worried you will get in trouble with? Are you worried about your family physician being upset that you did not follow through with he pain management clinic?

Does your family dr. know that you are on Lyrica?

Is your pain control adequate without the oxycodone? Are you withdrawing from it?

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Brief Answer:
Information

Detailed Answer:
Well, there are typically a few main reasons a family doctor will refer a patient to a pain management clinic or specialist:

1. They feel the patient continues to need opiates and they know that a pain management clinic can usually legally prescribe these for longer periods of time without being investigated or reprimanded.

2. They feel that the level of knowledge for fine tuning what the patient needs to control the pain is beyond their own scope of knowledge and that pain management specialists have more training and expertise in this area.

3. There are particular procedures or medications that pain management specialists can use that the pain management specialty provides.

4. They (the family doctor) feels a patient has a substance abuse problem and needs help and alternatives to what they are using.

So your doctor is most likely coming from one of these 4 perspectives in wanting you to go to a pain management clinic.

I think you have a few choices you can consider:

1. Go back to your family doctor and tell her you know she will not be writing anymore prescriptions for oxycodone and that you would like to try Lyrica only. Tell her you would rather not go to the pain management clinic. But know, if you have been on oxycodone for awhile, you may need some help withdrawing from it because all of those opiate receptors in the body will be used to having the drug and so you will have withdrawal symptoms.

Ask her if she is willing to continue to work with you under these circumstances.

Talking it through, if she is a reasonable person, is the best way. If you don't explain your reasons, she may resent that you didn't follow through with your recommendations.

Typically family doctors are more willing to prescribe Lyrica than oxycodone.

2. Consider a consult with the pain management clinic as they are usually very good at both helping people control pain, and at helping people get off of opiates. They've been trained in both extensively whereas we in family medicine don't specialize in this area.

Does this answer your question?

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Brief Answer:
Your welcome!

Detailed Answer:
Your welcome, and I hope you and you and your doctor or doctors will be able to find a good long term plan for you that you are comfortable with.

Best regards,
Bonnie Berger-Durnbaugh, MD

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