Question
As a RN, you know how pervasive and awful pain can be. My wife suffers from Chronic Myofascial pain, spine and disk degeneration, panhypopituitarism, Osteoarthritis, and a handful of similarly painful diseases and disorders.  She finally found adequate relief 4 years ago with a combination of diet, yoga, Reike, meditation and high-dose/round the clock Opioid analgesics.  She has had the same GP for 10 years and he knows only too well how disabling her diseases were before and after her current treatment plan.  At her last appointment her Dr. said he was requiring her to see a particular pain mgt. Doctor with whom he has already discussed his goal of getting her off of his "books" as she is a liability because of the meds she takes.  She doesn't want to change anything, she manages the side-effects successfully and she has not had any incidence of misuse or diversion, etc of her meds.  So, she fully expects this pain mgt. doctor to recommend drastic change and she's been advised that even seeing this other doctor or getting Rx's from him could be construed as a violation of her Dr/Patient agreement.  That same agreement says that no changes will be made unless mutually agreed on or if medical necessity warrants.  I hope I didn't say too much, I am looking for a way to make her Dr. cease and desist this attempt to push her away which will undoubtedly cause her enormous pain and stress, which I fear will damage her.  can you tell me how a patient who has the need for a certain medicine and has already received it successfully for many years can resist this kind of action?

Answer
Hi Todd,
  I found your question in our answer pool and thought I might be able to help.
I understand your concerns but I do not think that there is anyway for your wife to prevent her doctor from referring her to a pain management doctor and make him continue to prescribe her narcotic pain medicine. This is happening to a lot of people, doctors, especially GPs, are not comfortable prescribing large doses of narcotics. Perhaps your wife's doctor had received a notice from the DEA asking the doctor to justify prescribing these high doses of narcotic pain medicine to your wife. That could have made the doctor nervous enough to not want the responsibility of maintaining your wife's medicines any longer.
The pain management doctor will most likely keep your wife's treatment the same as it is now. Once a patient is stabilized on a specific treatment, pain management doctors do not usually change that treatment. At this point all your wife really needs is for a pain management doctor to maintain her current treatment.
I do not really understand what your concerns are regarding the narcotic agreement she has with her GP. He is the one sending her to the pain management doctor. Once she gets in with the pain management doctor he will then maintain her medicines, she should not be getting them from anyone else. She will probably be required to sign another narcotic agreement with the pain management doctor.

I hope this helps. If you have any questions or need additional information please don't hesitate to ask.