It's a tricky balance. Doctors need to monitor their patients to ensure there's no wrongdoing, while patients with a legitimate need want to ensure a continuing supply of meds. Some physicians ask the patient to sign a contract, which may include things like having pills counted at each visit, keeping with the same doctor to avoid "doctor shopping," and regularly turning up in person. For an explanation of this practice, see Health.com's interview with leading pain expert, Russell K. Portenoy, MD.
Doctors need to increase their awareness
Andrea Cooper, 52, of Phoenix, Md., who suffers from fibromyalgia and spinal degeneration, has felt the stigma of narcotic use. "The last pain specialist I had, I just hated it. There were signs up all over the office about rules and limitations. All about being suspicious of the patients. Not the way medicine ought to be practiced. I found it insulting."
If a physician, for whatever reason, is uncomfortable writing prescriptions for opioidswhether it's a new prescription or a refillpatients can ask for a referral to a pain specialist. Pain specialists can also be located through online directories below.
- The American Board of Pain Medicine lists doctors who are board-certified pain specialists.
- The American Academy of Pain Medicine lists medical doctors who regularly work with pain, and may or may not be board-certified pain specialists.
- The American Academy of Pain Management lists health-care providers who regularly treat pain, though they may not be board-certified pain specialists or medical doctors.