I sent the following letter to my doctor today. I was on Oxycodone and Oxycontin — a total of 210 mg daily. Just over a month ago, my doctor suddenly told me that I was being referred to a pain clinic to justify the levels of pain meds that I’m on. The very next appointment, he reduced the Oxycodone by 33%, and has indicated that he intends to continue to reduce the dosage each month.
######### #####, D.O.
##### #####, P.A.
Dear Dr. ##### and #####,
Because of the many years of medical care you have provided to me and to ######, I felt that I would be remiss if I terminated my relationship with your practice without an explanation. I appreciate the fact that I could find a clinic that would listen to me and try to work with my numerous issues, not only medical, but financial as well. Due to recent events, however, I find that I am compelled to abandon the pursuit of treatment through the medical profession. I simply do not have any choice in the matter, because as bad as my daily pain is, I cannot and will not live the rest of my life not only in pain, but treated as a criminal or idiot child. Please do not misunderstand – your practice has never treated me this way – but the pain management clinic I was forced into does. I find the staff there to be condescending, rigid, and absolutely convinced that the best thing for me is to reduce my pain medication without regard to my pain level, medical condition, or history. In addition, I am told that if I do not consent to a number of painful and expensive tests, that I will receive no pain medication whatsoever. I have always been under the impression that, as a patient, I had the right to refuse to undergo such things, but it appears that no matter what I may think, the truth is that these pain medications that I have come to rely on to allow me to function on a daily basis are the weapons used to enforce my assent.
After having lived with excruciating pain from neuropathy for many years, and after enduring open heart surgery and hernia surgery with the associated pain uncontrolled, I have decided that, for me, I would seek to preserve the quality of my life, rather than its longevity. I don’t advocate this for anyone but myself, but I am convinced that for me this is the correct choice. I do not believe that this end is served by trying to cope with pain on a dosage of a fraction of what has been proven, through years of trial and error, to relieve my pain. And because of the onerous demands of the pain clinic, I cannot seek alternatives or supplements to relieve my pain. Because of these factors, I have decided to give up on treatment by the medical profession altogether. It appears that, despite explicit assurances to the contrary (see attached letter), there are no remaining medical professionals willing to prescribe based on their best judgement. I completely understand that no licensed medical professional wants to be singled out by the government as being “uncooperative.” I do not blame anyone for wishing to protect their lifelong investment in education and a practice. I do wish, however, that I had been simply told the truth up front. I had been told that I was being sent to a pain clinic to “justify the level of medication I’m on.” My first visit with Dr. ###### disabused me of this immediately. Dr. ###### told me that “they got rid of you because you’re on too high a dosage of opiates.” He also told me that he was going to reduce my dosage. Reducing the dosage was the goal, and there was no attempt to even assess whether that dosage might be justified. He immediately started prescribing medications that we have already tried in the past (Gabapentin, Pregabalin), which didn’t work then, and don’t work now. There isn’t even the pretense of considering anything but the new government-suggested level. These levels, as I understand them, are not meant to be absolute, are not meant to override proper medical judgement, and are not meant for long-term patients with existing opiate tolerance.
I do not know if my history is typical of someone who takes opiates, but I do know that for years now, I have never:
• Had any kind of adverse reaction;
• Failed a urine test or drug test of any kind;
• Run out of meds;
• Asked for early refills;
• Lost a script;
• Claimed that my meds were lost, or stolen, or accidentally flushed down the toilet, or dropped into a mud puddle;
• Shared my prescription with anyone;
• Had to explain to law enforcement why I had pain medication with me;
• Missed a scheduled appointment;
• Asked to increase my dosage;
• Left my prescriptions in a place where they could be intentionally or accidentally misused;
• Asked to delay or skip a drug test;
• Been irresponsible or careless in any way whatsoever.
Despite all of this, I am now supposed to believe that I’m suddenly in danger of overdosing on a medication that I have safely and responsibly taken for years, according to the medical profession’s response to what are purportedly only suggestions by the U.S. Department of Health and Human Services.
In short – if I want to live my life with pain levels that leave me functional – I’m on my own. This is why I will no longer seek medical care – because the current governmental environment doesn’t appear to allow doctors to be doctors, but rather forces them into becoming employees. I understand that medical professionals didn’t design the system. Nevertheless, I have found that this system no longer works at all for my situation. I wrote this letter of explanation out of respect for all the help you have given me in the past. I wish you the best in your continued practice.
The attached letter that I referred to is from the U.S. Department of Health and Human Services, and reads as follows: