Question
my wife was seeing a pain management dr. for severe back pain.He first tried steroid shots in the back Three times with no success,he then eventually talked her into surgery, saying it was a must and only option left, after the surgery the doctor prescribed her hydromorphone for pain for about 8 mns. she was in canstant pain but he said it would eventually get better,he then sent her back to her p.m.d and over the next 7 mns. the pain didnt go away and he switched her to opana e.r. for about 6 mns. and said come back in a month and we'll try something else,when she returned he asked her to take a urine sample to check levels,she agreed and told him she had last taken the medication a couple days ago and was trying to limit takeing the medication to days she was in severe pain, cause of the constant drowsiness, she got a letter from him two weeks later saying he was no longer going to help her with pain because there was nothing in her system, she is now in terrible pain and haveing withdrawl from the medication,unable to work,take care of our kids,and been bedridden for 4 days, she then was refered to another P.M.D and he gave her shots that she already had and said he wont prescribe for the pain because he didnt want to get in the middle of it,i think this is cruelty and neglect she is constantly in tears,what should she do,hope to hear from u soon,thanks

Answer
I am not really clear on what the doctor was looking for when he got a urine specimen. If it had been longer than two days after taking the medication it may not show up in her system, because opiate drugs only last 48 hours in our systems.  However, I do feel that the surgery, whatever kind of surgery it was, seemed to be pushed on her. I'm sure when she first consulted the pain doctor she had to sign a contract; this being said, you need to go back to the contract and read it over carefully. Patients have their own responsibilities, but so do doctors. If you consult a lawyer you would want to take this to the lawyer to look over. It may be that the doctor is not living up to his side of the contract. However, I'm sure he'll find a loophole to protect himself. That is how non-ethical doctors are. They always seem to be protected.

Right now I'm more concerned about her withdrawal symptoms than  the legal issues. Could you possibly take her to the ER along with several bottles of empty prescriptions and simply tell the ER docs that she was "cut off" and is in withdrawal. No compassionate physician should let a patient go without medication to the point where they are in withdrawal.

Another option is to locate a Methadone Treatment Clinic in your city and have her sign up there for a short term of treatment. These are lifesavers for people who have been dropped from their pain doctors. Yes, Methadone clinics were first opened for heroin addicts, but nowadays there are very few heroin addicts; most of the clients in these clinics are coming off oxycontin, Vicodin, hydrocodone, etc. All drugs from doctors! You will see mostly middle-class people, like you and me in these clinics- not derelicts on heroin. This is just an idea. Just look in the Yellow Pages for a methadone program or "drug treatment program". Most large cities have at least 1-2. There aren't a lot of questions asked; the patient is simply examined by a doctor and put on a methadone dose. They have to go every day, but if your wife's goal is to just get off the drugs the doctor gave her, and avoid the withdrawals she wouldn't need to be a patient at this clinic long. I am not trying to "sell" methadone clinics, but I've seen them save many a person in the throes of withdrawal. They are completely nonjudgmental, too. The cost is usually 10-11 dollars/day, small price if it gets rid of the withdrawals.

To address the legal issues, I urge you to examine the contract from the pain clinic. Then, when you decide the time is right you can take it, along with all pertinent records, to the attorney. He/she will then decide if you have a case. However, to be honest, these doctors really "cover their tracks" to avoid this type of thing. Still, it is well worth seeing where you and your wife stand legally. She may have rights that I, as a nurse are not aware of.

I hope I've offered some suggestions you can use. Wish I could help more. I get angry when I see patients dropped from medications that they are dependent on. It just isn't right.

Please let me know how things turn out. I really want to know.