I had to sign an pain management agreement with my PCP... is this normal?
Question posted by chronicpainhurts on 13 Feb 2010
Last updated on 4 May 2023
I had to sign a pain management agreement with my PCP which says that I can't get pain meds from any other Dr, even a pain mangagment specialist. I asked them, even if I get in a car accident, and they give me IV pain meds, and I am out of it, does that count and will they put me in rehab? They said "maybe, if they do not call the dr ahead of time"
Now, if I am semi-concious, can they do that? They said even if they SEND me to a pain management specialist, the PMS cannot give me pain meds... what? How the hell do I get around this one? I don't want to Dr shop, I just want the best Dr that will give me the best care, which would be a PMS... so why even go if they send me? If they won't let him do anything?
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72 Answers Page 2
TU
turner4eva
9 Dec 2012
Hi Yes its normal I signed one. It is to protect the doctor really. Basically the gist f it is use the same pharmacy (if your going away on vacation advise the dr as such and that you will need to fill it there or get a script early) no other doctors unless emergency situations like a car accident or when you cannot answer for yourself, if he/she sends you to a pain clinic then they should be working together. Try to get into one that does pain med management. Truthfully one person should handle your pain meds only. This is to prevent you from going to ER's and getting scripts or seeing other drs for the same reason. Keep in mind each time you go to the ER or see any doctor they fax a report to your PCP anyways. Its to prevent seekers. You may also have to give urine samples as well. I would call your insurance company and ask about pain management centers. You can look in your state. Mass has a bunch. Goodluck.
Some doctors at the 6 month mark want out!!! Sounds like your doctor is tough, no bedside manner. I would look for a pain management center that handles pain medication management. It would be easier for you.
Votes: +0
RH
rhinson
25 Oct 2012
I was seeing a pain management Dr and had signed a contract, then had surgery on my hand (my PM Dr knew I was having this done, the surgeon was in contact with them) went home afterward, the surgeon told me he was not sending me home without something more for pain I told him I could not accept anything he then told me and my son that he called my PM Dr and it was oked so I took the prescription and a week later went to my PM Dr for my once a month visit and was telling them about how I had more of my daily pain meds left that I had taken the lorcet which relieved the pain in my hand better ..well they dropped me (but when my other Drs called their office they were told I was not dropped they were still investigating the matter ), So no Dr wanted to give me any of meds (I was on Ms contin, Lyrica.and vicodin es prn) and for 4 months I went without any of my meds..
(found out the Surgeon did not call my PM Dr, he did not even document giving me the prescription and he used hospital scripts and the pharmacy put the Er Drs name on the bottle [ the 2 drs had same first letter for first name] I went and got paper copy of script and it had my drs {the surgeon}name I now get my meds from my PCP no pain clinic will accept me went from having 4 drs to having 1 and I do go without the pain meds (and just lay in bed because pain is so bad ) but not the lyrica {missed dose = withdrawal and it does help a lot with the pain} ... I hate this disease
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SA
sara12345
25 Oct 2012
I don't understand why you couldn't get the surgeon to write you a letter about the circumstances and that you were told that he had contacted your PM doctor. The whole thing sounds very strange. You should appeal their decision not to treat you with the American Medical Ass'n or the State Medical Board. You should not have to be without pain medication.
IN
Inactive
3 July 2013
I know this is an old question, but, the problem remains for many of us. I would certainly file a complaint with AMA, BBB, and they can tell you other places to file also. For other medical reasons, I filed a complaint and the BBB told me other places to file. I ended up sending letters to 7 organizations. I never heard from the Dr again, nor did I keep getting a bill. When its not right we NEED to speak up. Pain Dr.s seem to forget they are working FOR US!!! I was told at the 1st appt w/ pain doc that they "weed out" the drug seekers. I am told him I was looking for Pain Relief, by any means as long as it works. I, too had to sign contract, and have to submit to monthly urine tests b4 they give me rx's. Its a pain to be in pain...
SA
sara12345
3 July 2013
Good for you! You should put a separate posting on here to alert others to this strategy and how it worked for you. Your comment after mine will not cause others to see it. Thanks again.
We all have to sign the agreement due to new federal regulations and holding the physicians accountable. Thanks to the abuse of others, we all have to now be subject to pill counts at random, urinalysis at random, blood tests at random. I recently fell and broke my shoulder, ortho gave me percocet 10 mg. i had a bad reaction because of c.o.p.d. and had to turn the 10's in to get my regular script for 7.5 mg. that i have been on for 5 yrs. because of fibro. If i didn't take pain pills i couldn't function at all. I hope everyone hangs in there, we are all in the same boat, suffering because of the actions of others.
Votes: +0
MD
mdwag
5 Sep 2012
This has not happened to me, but a friend of mine told me about this. I had to know, so I ask my doctor. He informed me when people are not happy with one doctor and go to a few more. Of course each doctor will give you different kinds of medicine that they think might work. In the mean time you have got a whole drawer full of pills. Mostly they are doing it for the safety of the patient. The larger phamacies will ask you to sign this agreement so you do not get medicine that interacts with something else. It came from people that abuse the pain medication. This makes it so hard for people who need pain medicine. The best thing to do is stick to one place to get your medicine, they will help you with drug interaction.
Votes: +0
IN
Inactive
25 July 2012
chronticPainhurts, you have had so many responses in the past 2 years, don't see the point in answering, but will anyway. The DEA has come down hard on all pain prescribing doctors including PCP's. If you have chrontic pain, you would be better off with a Chrontic Pain Management doctor to presribe all of your pain meds. This would eliminate you having to have urine tests by more than one doctor. In the 2 years since you wrote your question, the DEA has gotten laws passed where if you take opiad drugs of any sort or benzo or any type of CNS depressants, you will be urine tested 2 times a year at least. This the new law. The whole idea behind this is to get prescription drugs off the streets. Ha! what a joke.
Our local news recently reported that heroin use had more than doubled in recent times because the people selling their prescriptions to pay the rent each month, have had to stop selling them so the druggies have gone back to heroin & other drugs they can get their hands on. It's really a shame for the real chrontic pain patients like you & me. I had a pain a Managenment doctor that would only prescribe methadone because they could get around all the testing they were having to do by the new laws. The part about the contract is to not only protects you, but mainly the doctors so if it isn't in your system when you are tested they can get rid of you assuming you are selling your drugs instead of taking them as prescried. My own doctor (PCP) would no longer write for the vicodin I asked him to because the pain clinic wouldn't give me anything except what I was allergic to or mentadone. He got on the phone & found a wonderful doctor to prescribe for me. I did have to take a urine test on the first visit, & one since then & it's been 15 months. With all my problems which mirrors yours, they know I am not about to sell my meds. You should your this site & use the profile to fill in all of your meds, & it will not only give you all the possible interreactions, but also will print out a sheet for you plus a wallet sized one that gives all your medical history, alleriges, meds you take, doctor & their phone numbers, addresses, & personal contacts just in case you are in an accident. My doctor have been very impressed with this info being so neatly & alphabetically organnized. I highly reccomend it to you. No one else can read this info if you have your email setting set to private. The truth is you are suppose to notify other docs that you are on pain meds before being treated. There are quite a few reasons for this also. One is the contract you signed, This is so you don't want to get overmedicated. Like if you had taken a pain ill at home & the emergency gave you a shot of something on top of it, you could stop breathing. Make sure you have a good & reachable contact listed that can verify what meds you take & how often this is very pertinet information for the doctors treating you. They can then contact your pain magement doctor & get what you are suppose to be on. It will be up to the doctor treating you in the case of surgery,but he must know your entire history & discuss your pain management with your pain doctor. I hope this clears things up a bit for you, & hope you are doing better these days. I wish you all the best. I suggest you watch a you tube vido on Jarod Polis interviewing Cheryl Reinhart of the DEA concerning whether marijuana is stronger or worse than ainmeds. It will give you a great idea of what is going on, I hope eveyone watches this video! I don't normally run people in the ground, but if this woman is who is trying to make aws on whether we have rights as patients something needs to be done about it. Please contact Mr. Jolis in the house of Reps or your own congressman on this war on drugs. We are our own advocates when it comes to our health. If we would ban together maybe we can make changes in these new laws. This woman is as dumb as rock! Plese watch. Your friend..
Votes: +0
HE
HeadStarter
25 July 2012
Hey Mary... just adding my two cents worth here to this very old post. In the State of Connecticut, we are tested 3 times a year now. That started this year.
The Other "Mary"
IN
Inactive
25 July 2012
I know, each state has their own laws on this pain stuff too. Be glad you don't live in Florida or the state of Washington. My brother moved from AZ to WA a few months ago, & they will only prescribe to anyone any drug that equals to 100mg of morphine a day under any circumstances. It's a state law. They took my borthers pain meds away from him & started him on 10mg of MS contin. He was in the hospital within 2 days. Now he is 71 years old. WTH? He was prescribed 30mg of oxycodone every 4 hours with 15mg for breakthru pain, in AZ. Can you imagine the withdrawal he went thru? It's just not right! I really believe he was given too much in AZ, but to just say NO! That's not right to do to a person with chrontic pain & old age to boot. His health is very very bad. Can't even walk. It breaks my heart... Mary
HE
HeadStarter
25 July 2012
I know Mary... I do not understand how a medical professional can look a patient in the face and just say, "NO"... no more... no weaning... just go help yourself or whatever else they have to do because this isn't right. One sister lives in Florida so I can appreciate the "H" of it all... The other sister lives in Georgia... about the same situation there. It is a CRIME in itself the direction this country is headed... we ain't so free any more either.
The Other "M"
IN
Inactive
26 July 2012
Mary, have you seen the you tube video from last week with Rep. Jarod Polis interviewing the DEA head person fighting all this? You wouldn't believe it!
HE
HeadStarter
26 July 2012
No I haven't, Mary but I sure will go there and give a listen! Thank you.
In your Pain Management Contract it should say somewhere that if for some reason you need pain meds from another doctor, that you have to contact your PCP within 24 hours or risk dismissal. I broke a tooth & had to have gum surgery. I called my PCP's office & let them know & there was no problem at all.
Votes: +0
BU
butterflylynn
23 May 2012
Chronic Pain hurts, Yes this is Normal that you have to sign a PCP pain management contract. Due to all of the illegal Pain Clinics that have been busted this is something that was passed. Thank you again to those Junkies... As far as the emergency requirements... All of the contracts have that phrase in there. But I know from My Pain Management Dr. that is very high on the Board of Pain management. Any emergencies where you are sent to a hospital can give you pain medications without contacting your Pain dr.
I had a wreck & pain meds were administered in the ambulance & emergency room & hospital. My Pain mngmnt Dr. was notified by the hospital once I was admitted. At the Hospitals they have actually a "Pain Management specialist" that approve & report to the Pain Dr. & are required by law to report what medications were given to you. So do not worry about not getting pain medication in an emergency I have been through all of that Several times in a year also I have had foot surgery were my Podiatrist contacted my Pain management Dr. & they agreed to give me another pain medication to take along with my Opiate medication. Your pain Dr. receives documentation periodically & they review this documentation. IF they see that you have been going to various Dr.s & receiving alot of "additional" pain medication then they have the right to cancel your PCP. Another thing that the PCP does is that it requires the doctor to have you take Random Drug testing. If they find that you have other drugs "illegal or prescribed" they can cancel your contract. If the test shows you have "legal" pain meds in your system they would then go into the report they receive to see if that medication was prescribed by another Dr. If it was prescribed by another Dr. & the information shows that you did & it was prescribed under a "normal" dosage amount you will still have your PCP contract still valid.
So basically you do not have alot to worry about if you are taking your medication correctly & not getting additional medication from various other doctors you will be fine. Plus the most important thing is that you Do Not take any type of additional Drug legal or illegal than prescribed. Because if you end up having a drug test come back "dirty" then they can cancel your PCP contract for good. Which means that you will be Banned & Flagged from getting ANY Narcotic pain medication from Any Dr. forever. I might also Point out that you are allowed to take over the counter medication like Advil or something like that. They are monitoring for Narcotics & illegal drugs plus once you due the drug test if it shows that you do not have the Narcotic drug that your Pain Dr. prescribed to you in your system they can also cancel your PCP contract as that would tell them that YOU were Not the one taking the Narcotics that were prescribed to YOU that you were probably selling them. So just take your narcotic medication as directed and you should be fine. Kathy
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12
123becku
23 May 2012
The government uses these as well as the doctor to make sure you are using the correct combination of drugs. Last week my doctor changed all my prescriptions because he discovered significant interactions between all my drugs but one.
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OC
oceanman
2 March 2012
Like everyone said here it is normal.
About the car accident or any other emergency ( I have been through this already) don't worry about getting pain meds from them, if you can tell them the last time you took pain meds. An emergency situation DOES NOT COUNT. Take them, It is not a problem, you just can't comtinue getting it from the emergency situation once they have treated you. I would tell the Dr you signed the aggreement with that you got the meds from another Dr & why he will understand. Just can't continue like I said getting more from the EM situation. You would then let your Dr take over the situation once you are released from the hospital or what ever.
Also I would not advise finding a pain management Dr they do not like giving pain meds & you will really be suffering! It is very hard to get pain meds from a pain management specialist. Stay with the Dr you have now. I have been fighting this for 11 years now. I have 11 diseases & bad pain with 4 of them. I can't have any more surgeries, i have had 12 in the past ten years & my body will not heal any more. I have to live on pain meds & it is terrible but that is the way it is for me. I have had appointments with 22 pain specialist Drs & they tell me I need rehab, but they will not read all of my records there are to many of them. So they have no idea what I live with. The Dr I am seeing now understands pain meds are my only option left to function anymore. If I said anything wrong here I hope someone will correct me & please stay with this group to get more help ! Good luck !
Votes: +0
LO
lorimarlin1
14 Sep 2011
I too was asked to sign this contract, 2 years ago, however my doctor had stated in our visit she didnt want my case so while she went into her office I put the UNsigned contrat ona counter and left. For thoose 2 years she continued to refill all my meds including the pain. Though a month or so ago she cancled all my scripts because she states i didnt comply with the contract(i didnt sign) However I was at the hospital in the beggining of the year and I had strep i almost died, the doctor offered a shot of dialauded I refused, a month later back with a really bad asthma atteck, I was givin albuterol which is also controlled, in reading some of the post Im assuming that she was notifyed by them however the day i returned home from the ER I called to let her know what they had givin and if she wanted to see me, she didnt. I to was givin a U.A.
they state in Tri age that i was positive for Oxycodone, Im allergic is in my chart, as far as I see it the doctors are just not wanting to give controlled meds, they seem to boot all that are on these Not weining but straight abrupt removal. You dont have to in an emergency call and ask permission, however if you are able I suggest you let the doc know when your able as they may take this before the contract board and they actually have the final say, you will recive a registared letter. Im not agreeing at all with this method as im in a situation simaliar, but I feel this if a doctor or pharmisist can be U.A. at anytime they are positive they have made a contract with the state board, however no with drawl no boot they get rehab and a second chance while we get. so best as a few say carry a card with you so u arent in this boat im rowing...
Votes: +0
JO
JocelynMelum
2 July 2011
Okay, I understand the reason why the government is trying to regulate the narcotics. My sister-in-law went to a pain clinic and was given so much pain medication that she accidently overdosed and died.
This is my issue, I need pain medication and can see why people go to pain clinics.
Four and a half years ago I had what my mother called a nervous breakdown. I couldn't cope with some crappy emotional issues and circumstances in my life, and my mind couldn't take anymore. I contemplated suicide and then made the biggest mistake of my life. I drove myself to the hospital and asked for help.
Two days later, as I sat in the psyc ward drugged with Ativan, I was convinced by the psyciatrist that I was a drug addict. It just so happened that I was also in a great deal of pain while I was "mentally crashing" and was prescribed opiates to deal with the pain.
I did everything they told me to do and detoxed from the opiates. It was the worst thing I have ever gone through. Three weeks after I stopped and went through the sleepless nights, great agitation, nausea, sweats (horrible), and pain, I ended up having a migraine headache that lasted for more than a week. I thought I had some kind of brain tumor. It was like an ice cream headache times 1000.
So after all of that, I learned how to deal with pain in a couple of different ways. I used over the counter medication and learned how to meditate.
Now my pain has returned with a vengence. I can't move on some days. I have a herniated disc in my lower back and I have chronic kidney stones (one or two every 4-6 weeks).
Do you think I ever get any pain medication that actually works on these issues? ABSOLUTELY NOT! If I even mention that I am in pain or would like some pain medication, I am accused of drug seeking. I don't even want to go to the doctor anymore. I am judged constantly.
There are days that I would like to just shove a kidney stone up my doctor's penis and into his kidney so he can feel how painful they are when they aren't moving down and out (he admitted that he never had a kidney stone). I have a child, and would rather have ten more children than deal with the large stones I pass. (That includes raising them through the pre-teen years!)
I take Neurontin for the fibromyalgia and auto-immune inflammatory disease I have. It works for that, but doesn't touch the back and stone pain.
The lawyers for Kaiser have put so many restrictions on the doctors about pain medications, that I don't think that Kaiser will ever help me with my pain more than what they are doing with the Neurontin.
I like Kaiser other than this issue. I don't want to change my insurance, but if I can't get help to manage my pain, I will have to go to an insurance where I can see a doctor that doesn't have the information about my supposed addiction.
If anyone has a suggestion on what to do, I would appreciate it very much.
Votes: +0
IN
Inactive
9 June 2011
This is a new Federal Regulation that any doctor prescribing pain medication must have special training in the field of pain control.The patient will sign a contract not to receive pain medication of any kind from any other doctor without signing another contract. The patient will also submit to random urine tests as determined by said doctor. Like it or not this is how the drug addicts today have made it for anyone in pain. Whenever my husband is hospitalized they call his pain mangement doctor before prescribing any meds. He had to have a chest tube put in with no meds the first time because his pain doc was in surgery & could not be reached. He has so many problems that now he, & all his docs are on first name basis, so it is no longer too much of a problem. The FDA thinks this will slow the selling of people on pain meds to drug dealers. It probably will to some extent.
I contend they will have to find a way to help these low income people eat since they can no longer sell their meds & buy food. Hooray for our Government. Once again in our business! Maybe these people take their meds as directed they won't have an appetite & we will solve the obesity problem too! Kill 2 birds with one stone so of to speak! To answer your question, yes you will have to sign a contract to have only one physician for your pain meds if even in an accident so carry his name around your neck or some where visible, & be ready for those random urine checks as they will be done. My family doc gave me one for xanax so I just had the script changed to my pain doc. They wanted me to pee 20 minutes apart. Finally decided they could use the others test results. Good luck to you, don't get discouraged, keep the faith & watch for whom you vote for...
Votes: +1
CH
charlesboggs
8 June 2011
Unfortunately there does not seem to be a standardized form for doctors to use. They (and their lawyers)pick and choose what they want in their form from the basic idea that only one doctor is allowed to prescribe opiods. Requiring urine tests or blood tests to see if you are abusing drugs is not generally required, but is becoming more common place. My family physician treated me for fibromyalgia for years because we could not find anyone else that knew how to treat it. Last year the state drug enforcement agency and medical board audited her records and said she had been issueing to many opiods. They suspended her license to practice, but allowed her to go on "probation" if she paid a hefty fine. She does not issue prescriptions for opiods any more. We tried to find a doctor who could help with the pain, contacted over 40, none of them wanted new patients or patients already on pain meds.
We finally found a pain management doctor who does not believe in fibromyalgia so he has taken me off all meds related to it. I also had to sign a form saying I would not get meds for pain from any other doctor. My life has been h..ll since then and still no answers. I ride a lot with our local law enforcement as a chaplain. One day at lunch we sat behind a building watching a pain management doctors "clinic" and watched a parade of mainly young people go in and out. 4 got into a car with expired out of state license tags. When we stopped them 3 of them were dividing up oxycodone 15 mm tablets into 10 units and putting them in small envelopes. The doctor had given them to the young people from her "clinic".There is a real problem with this abuse... doctors are caught in the middle for the most part... and patients that are supposed to be protected from abuse end up being the ones who suffer. The DEA has put pressure on law enforcement to catch drug abusers. For all major drugs busts the Federal government gets half of the value and the local law enforcement agency gets half. Our local police department just got 2 million dollars from a drug bust. Before that they were running short on their budget because taxes are down due to the economy. All set up because a group abuses drugs. It is almost like prohabition.
Votes: +0
MA
MACE1010
10 May 2011
Mine had me do the same thing last time I was there, mine also said I have to take a pee drug test everytime I go there to make sure I am not getting any other meds somewhere else. I am not liking this very much.
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CH
ChronicICPain
9 May 2011
Hi everyone, please help... I have visited this site for a couple of days now and just took the time to read all the questions and comments. I am a chronic Interstitial Cystitis patient, which means I have open open ulcers inside my bladder, which causes lots of bleeding from inside the bladder, chronic pain, bladder spasms and genital pain that shoots down my leg.. I let the urologist do the bladder scope and he says my case is one of the worse. here aernt many treatments for IC,and no cure, and the small amounts of treatments have failed.( he wants to try another new drug in 2 weeks) There is no cure for this, and my Urologist has told me last week he wanted to refer me out to a Pain Management Specialist. I have no idea what to expect. I am a little unsure, but I am so tired of the pain issues. The urologist had me on 5/500mg of Tylox, the bottle says take 1 or 2 tablets every 4 hours as needed.
He gave me 35 tabs, which I had to take 2 to get any releif at all. needless to say, they didnt last too long. I hate calling his office for prescriptions and feel ashamed. I cry in my bed at nights and sleep on the toilet a lot. I ran out of meds after 10 days he wrote me the script. after taking 8 tabs in a day they didnt last very long at all... I am just waiting to hear from the pain management Dr for an appointment Today I was in so much pain, I resorted to going to the emergency clinic to get enough meds to get me through until I could get to my Uroligost tommorrow. The Dr there was so rude, didnt listen to me, and prescribed me an antibiotic because there was blood in my urine. I tried to explain IC to her but she insisted it was an infection. I then asked her for enough pills to last until I called my Urologist tommorrow, but she was so nasty and asked me how long it had been since I had a pain pill. She then gave me a dirty look, and gave me some 5/500 mg Hydrocodone after she checked my urine for drugs I presume. (She said, ' well let me check if I can give you something" so I dont know what that meant) she went to check something. I had been crying while waiting in the waiting room, and was comepletely humiliated and ashamed that I was in pain and treated like a liar by her. My question is also, should I call my urologist and let him know I went to the emergency room,got a few weak pills, and the antibiotic situation and ask for another script until I get in to see the pain management doctor? After today I am completely depressed and ashamed I have pain problems. I feel desperate for releif Also, what happens when I am referred by the irologist to the pain management doctor? He wanted to call to make the appointment for me, after they sent my urologyrecords to the pain management doctor. I read I have to sign some papers and let them check the pharmacies for any red flags? Will the urologist work with the PMD? ( the urologist seems to know this doctor so he should be used to getting patients from him, dont you think?) Thanks for being here..any help is appreciated. ChronicICPain
Votes: +1
BR
brenda fain
22 May 2011
i don't know if u got many comments since u asked a question on someones else question page but hopefully i can help some i hope!pain sucks i know !but u have got to get it together and get into pm doc they will help with ur pain!and yes u most likely will have to sign a contract with them!but if they r meeting your pain needs u don't need to get pain meds any where else!
sorry i just saw this was posted a year agao!well i hope things turned out well for u!
