Is it really just because of the fentanyl situation? I know there is a huge disagreement with how the strict rules for prescribing opioids are so tight even for chronic pain patients like myself who can’t participate in life without em struggle to find a provider who is willing to prescribe us them.
New doc here; its a confusing conversation all around. In training management of controlled meds is often an elephant in the room topic with no one really wanting to address it in too much detail. That’s mostly because everyone has a different view on it as the powers that be (mostly use state board of pharmacy as guideline) are pretty vague. Most can agree that regular visits (every 3 months at least), drug screens at least yearly, and a controlled use agreement contact between provider and patient is the standard of care. Everything in between that is subject to vary. To further complicate matters medical literature on these meds consistently finds them ineffective for chronic management many disorders including back pain which is in contrast to conventional opinion. Many providers see this as reason enough to sparingly use them. Regardless, in my experience so far whether they truly work or not most patient are very reluctant to stop these medications once started.
Do the patients say they help? I can see them being reluctant if it does help. But there is always the question of if the patients are lying or not if they are still in pain.