Question Why do some doctors are not able to prescribe pain meds?

[uncfnp]

Per DEA rules, if they can prescribe Tramadol they can prescribe Hydrocodone unless the institution they work for does allow it, and I would find that hard to believe. If they are Interventional Cardiologist, it is possible that they don’t typically prescribe medicines and so have not bothered with a DEA license. I would presume that there’s an anesthesiologist present for the procedures and any controlled substance given for the procedure may be through their license. But of course this is all just speculation.

Federal and state governments are making it more and more difficult to prescribe narcotics so beyond the ability to prescribe schedule Ii some practices/providers elect not to.

 

[Mrs. B]

So it is being normalized that society gives free narcotics and needles to addicts but not those having painful medical procedures?

 

[uncfnp]

So it is being normalized that society gives free narcotics and needles to addicts but not those having painful medical procedures?

Some reluctance from providers in office practice is understandable. When I started working at a relatively new urgent care office (many uncounted years ago ) we would get obvious drug seekers. Finally word spread that we didn’t prescribe routine narcotics, even if you provided MRI results of your back pain, and those visits dropped off dramatically.

But that’s not the case here. In North Carolina providers are limited on the amount of pills prescribed for acute pain but we are certain not restricted from providing some initial treatment.

 

[Mrs. B]

It seems to me that licensed clinicians should be able to say no if they use their clinical judgement instead of punishing “everyone” due to the drug seekers. It seems they, as a group, have chosen to take the path of least resistance. Where have we seen that before?

If I knew a practice would not prescribe for a procedure I’d go find another practitioner that advocated for their individual patient.

 

[Duke Dive Medicine]

One of my cardiologists worked on my bad leg again today, cleaned out a couple of arteries that he did not finish three weeks ago. Seems the work was great, but the pain was tremendous! I awoke in recovery with my favorite nurse holding the hole in an artery until it'd clog, I guess, me whining and moaning, but nothing either of us could do but live through the agony. I survived thru recovery, wondering why she didn't get me a pain pill, lunch, and a recovery nap - waking to pain in my foot. I called the 24 hour number to request a Hydrocodone script, but was told this doc is not licensed to write those. I have to wonder why a doctor who is licensed to create Hydrocodone pain is not allowed to write the needed script...?!

Fortunately, I saved 5 pills from a couple of years ago in case of emergency need, 20 Tramadol, and 20 Apap/Codiene. There are good reasons why I shouldn't, but I'm glad I did. I am not allowed to take aspirin or ibuprofen now, and I have pain.

I don't want to change heart doctors, but I need an answer to this lack. It's not like I can take my own pain meds into angiograms. I might tho.

Don, are you sure this was a cardiologist? This is more the territory of vascular interventional radiology which is a separate specialty. In my mind a larger question than the pain itself is where it was coming from. Going by what you said it could be reperfusion injury which means that the tissue downstream of those arterial obstructions was significantly hypoperfused. I don't work directly with VIR but it would not surprise me to learn that they don't routinely prescribe narcotics post-procedure. How is the pain now, and how is the circulation?

Best regards,
DDM

 

[DandyDon]

Don, are you sure this was a cardiologist?

Yes, sir. He is listed as Specialty: Cardiovascular Disease (Cardiology

I don't work directly with VIR but it would not surprise me to learn that they don't routinely prescribe narcotics post-procedure.

He has promised to take measures to prevent pain, and I did not insist on details.

How is the pain now, and how is the circulation?

It was okay after a few minutes of horror. There was some residual pain, but one leftover hydrocodone pill I had fixed that. I'm glad that I did not turn it in.

 

[Duke Dive Medicine]

Yes, sir. He is listed at Specialty: Cardiovascular Disease (Cardiology

He has promised to take measures to prevent pain, and I did not insist on details.

It was okay after a few minutes of horror. There was some residual pain, but one leftover hydrocodone pill I had fixed that. I'm glad that I did not turn it in.

Ok that's making sense. Some interventional cardiologists are cross-trained. Glad it wasn't for long, it could have just been your foot waking up after having been chronically underperfused. In cases like that where you're still in the post-procedure phase they may choose IV meds vs. oral and they would not prescribe oral narcotics.

Best regards,
DDM