CONCORD — A Portsmouth doctor has been reprimanded and fined by the New Hampshire Board of Medicine after he cut back a chronic pain patient’s prescription opioid painkillers — and
I don’t understand this. Maybe the taper was too quick but I felt like he took appropriate measures even warning local authorities and primary care provider. I really don’t know what he was supposed to do? What am I missing?
I actually have one patient just like this that I inherited and when I tried to go down to 90MME. She’s a senior citizen and she suffered a lot had a terrible quality of life and was saying that life’s not worth living if she’s in such bad pain.
After several combative visits it’s because of this case I became worried that I’d get in trouble like this doc so I bumped her back to oxy 30 BID + Norco 7.5 qid added Celebrex and lyrica and she’s actually doing quite well on this regimen.
I saw her today and she had markedly more energy was more jovial. I’m still uncomfortable that she is on 120MME but I documented my reasoning and made a stipulation with her that she is required to go to a psychiatrist for evaluation and to help treat any underlying psychiatric disorder. I provided her resources on opioid induced hyperalgesia as well as resources suggesting that opioids don’t have any benefit for fibromyalgia.
Every other patient in my clinic is on a max of 90MME but because of this case I let her slide a bit but I am very strict about her seeking a comprehensive approach to her pain. I feel like I’m damned if I do damned if I don’t :-/ .
I know another doc here that has a strict NO OPIOID policy. If they are on any opioid he’ll just slap on a fentanyl patch for 72 hrs and then dc all opioids and give them no more refills.
I’m wondering if I should just do that and have a strict no opioid policy.
I’d like to hear people’s opinions on this and if it’s ethical to do that especially if you’re inheriting patients and didn’t start them on it on the first place.
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