Pills for Pokes Hall-of-Famers and Ballers...You in Here??
12 physicians sentenced to prison for $250M billing fraud Twelve Michigan- and Ohio-based physicians were sentenced March 9 to prison for their roles in a scheme to perform and bill for unnecessary procedures in exchange for opioid prescriptions. www.beckersasc.com The physicians aimed to hide their actions, perpetuated from 2007 to 2018, by working only a few hours per week, yet they were still among the highest oxycodone prescribers in Michigan, according to the Justice Department. The physicians then performed facet joint injections, which are.....
Source: Student Doctor Network - March 14, 2022 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums

Chronic abdominal pain and nausea?
I'm taking care of an outpatient patient: 60y/o woman with chronic abdominal pain with prior history of gastric bypass, appendectomy, incisional hernia repair. Her pain had been previously controlled with oxycodone 10mg a couple times a day, but recently less effective due to emesis. GI is following now, has her on Zofran, Reglan, Promethazine but the nausea is still pretty severe. Patient is cachectic and having trouble with PO intake. Utox is appropriate. I'm considering a Fentanyl patch... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - September 22, 2021 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums

Non-paying patient?
Strange circumstance but I have a patient seen at my clinic for the past few months due to widespread body pain with fibromyalgia (in hindsight also psych overlay such as h/o trauma, gastric bypass), maintained on low-dose Buprenorphine by another physician whom she's no longer seeing due to insurance changes. She was reasonable for the first few visits with continuation of Buprenorphine. However at the last visit, she requested for increase to Oxycodone 15mg for pain....and I obviously did... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - September 10, 2021 Category: Universities & Medical Training Authors: CarabinerSD Tags: Pain Medicine Source Type: forums

Why don't pharmacies fill my tylenol prescription?
Hello All, I'm an Oral and Maxillofacial Surgeon practicing in NY. My post-operative pain regimen usually entails stacking ibuprofen 400 Q4H or 600 Q4H and tylenol 500 Q4H, and a few oxycodones (4-12) for breakthrough pain. HMy oxycodone prescription tells patients to take the ibuprofen and tylenol first, wait 30 minutes, then take the oxycodone, to drive home the idea of breakthrough pain. The only other medication I'll prescribe is an antibiotic, in probably half the patients. What... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - May 17, 2021 Category: Universities & Medical Training Authors: Contach Tags: Pharmacy Source Type: forums

Belbucca initiation in opioid tolerant
I have no experience with Belbucca. Used Butrans a few times and Suboxone quite a few times when it first became available. Reading the product literature they suggest tapering opioid naive patient down to 30 MED and then dosing based upon PRE-TAPER dose of opioid. Is that really how people are doing this. I'm thinking about it in a refugee left stranded on 100mg Oxycodone/day. (Source: Student Doctor Network)
Source: Student Doctor Network - December 18, 2020 Category: Universities & Medical Training Authors: NJPAIN Tags: Pain Medicine Source Type: forums

Weird pain consult
I just got sent a consult request to take over care for a 35 yo with anxiety disorder on benzos and 150 MME's. Seems like her current pain doc's clinic had to close due to pandemic-related financial hardship. Her progress notes from her last pain doc said she's on a combination of oxycodone and buprenorphine tabs... I thought that had to be a typo, but I pulled her PDMP and yup, she's on buprenorphine and oxycodone together... What am I missing? Does this make sense to anyone? I'll probably... Weird pain consult (Source: Student Doctor Network)
Source: Student Doctor Network - October 31, 2020 Category: Universities & Medical Training Authors: William Sparrow Tags: Pain Medicine Source Type: forums

expert witnesses?
Had a patient 2.5 years ago who committed suicide on oxycodone I had prescribed. Was taking 6 5/325s of oxycodone per day for cervical and lumbar spondylosis. No history of suicidal ideation, scored 2 on the ORT, PMP always good, no early refills. Was a patient for ten years. Was getting botox for cervicogenic headache (rebound excluded) every 3 months. Seen by me (not NPs) every 3 months. UDS 1X per year and narcotic contract. Had one UDS 5 years ago that tested well below threshold of... expert witnesses? (Source: Student Doctor Network)
Source: Student Doctor Network - March 2, 2020 Category: Universities & Medical Training Authors: hawkeye2009 Tags: Pain Medicine Source Type: forums

Just because you print out a coupon, doesnt mean I have to honor it!!!!
getting more and more people who wants to fill their oxycodone and adderals thru good rx coupons they print out online. Every day I have to have more and more arguments with people that we dont take good rx on their oxy!! what do I have to say to make them understand??!!! any tips? (Source: Student Doctor Network)
Source: Student Doctor Network - July 29, 2019 Category: Universities & Medical Training Authors: pencilandpen Tags: Pharmacy Source Type: forums

Oxycodone and tapentadol
Hello! Switching from 40 mg Oxycodone to tapentadol due to insuffecient effect. Does that seem reasonable or does it make more sense to increase dosage of oxycodone? I feel that the dosage of Oxycodone is fairly low. Plan was to decrease to 20 mg Oxycodone and add 150 mg Tapentadol, with the intent of tapering Oxycontin further down the line. Thanks in advance for any reply. (Source: Student Doctor Network)
Source: Student Doctor Network - July 9, 2019 Category: Universities & Medical Training Authors: LurenD Tags: Pain Medicine Source Type: forums

Chronic pain
90 year old patient with chronic low back (prior lami/fusion) and continued knee pain after TKA. I’m the 3rd PM doc she’s seen. She failed to follow up with the other PM bc she says nothing was helping. per chart review she’s been tried on multiple meds(meds all with side effects or no relief: gaba, Lyrica, cymbalta, savella, Tylenol #3, Vicodin, oxycodone) I’m hesitant to try TCA at her age and she has afibb. I tried her on Butrans but didn’t help. Compound cream slightly helpful. Starting... Chronic pain (Source: Student Doctor Network)
Source: Student Doctor Network - April 28, 2019 Category: Universities & Medical Training Authors: Bsb2015 Tags: Pain Medicine Source Type: forums

DEA Raids Arizona Naturopathic Pain Clinic
DEA raids Tempe pain management clinic, 2 arrested Authorities say two employees at a pain management clinic were arrested Thursday in a raid involving federal agents. www.abc15.com "The DEA identified the two suspects Friday as Naturopathic Medical Doctor Jelina Ip and her mother, Alane Ip. The two are accused of over-prescribing controlled substances, including oxycodone and morphine. The Ips face dozens of criminal charges including fraud schemes, illegally conducting an enterprise, illegal administration of a narcotic... DEA Raids Arizona...
Source: Student Doctor Network - April 21, 2019 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums

buprenorphine revisited
Back in March there was a brief discussion on this board about using buprenorphine off label for pain (sublingual). I know that butrans is available but it really only correlates to something like 80 mg/d of oxycodone at max doses I think. Pain Physician has a special opioid edition with an article about using off label SL buprenorphine for pain. PP 2012 15:ES59-ES66 Then there are the Dr. Heit letters where the DEA says it's OK to use bup off label for pain, but I called our local... buprenorphine revisited (Source: Student Doctor Network)
Source: Student Doctor Network - March 24, 2018 Category: Universities & Medical Training Authors: NEPain Source Type: forums

Exam Room 2: RSD following PRP
47 y.o. female book-keeper with right basilar thumb OA underwent non-image guided PRP injection 6 months ago. Felt excruciating and electrical sensation over dorsum of thumb during shot. Severe swelling at @24 hours in thumb and index finger. PCP did kenalog injection at 48 hours without improvement. Repeat kenalog injection at 2 weeks no improved. Oxycodone 15 mg QID and Lyrica initiated with little improvement. Referred to hand-surgeon who diagnoses "RSD Type 2" in right hand. Referred to... Exam Room 2: RSD following PRP (Source: Student Doctor Network)
Source: Student Doctor Network - March 22, 2018 Category: Universities & Medical Training Authors: drusso Source Type: forums

Reporting Doctors
There’s one particular cash clinic doctor in my town that absolutely needs to be reported. Previous arrests for trafficking in oxycodone, no problem here’s a prescription for 120 oxy 30. Arrested just last month for possession of cocaine? No problem let me get my prescription pad. Who can we report this to who will actually do something?! DEA diversion control website is useless, I doubt they even read what is submitted there. (Source: Student Doctor Network)
Source: Student Doctor Network - March 22, 2018 Category: Universities & Medical Training Authors: rx1983 Source Type: forums

OxyContin no longer promoted
OxyContin maker's culture change starts today: No more promoting opioids - USA TODAY OxyContin maker's culture change starts today: No more promoting opioids — USA TODAY Personally I don’t see what is so phenomenal about this, do they even need to market? Proabably more of a cost cutting measure than some kind of corporate moral decision. (Source: Student Doctor Network)
Source: Student Doctor Network - February 12, 2018 Category: Universities & Medical Training Authors: owlegrad Source Type: forums