GP labelling me a drug seeker

[ShamanYou]

I take various medications including some powerful painkillers. I had a telephone conversation recently where I asked for the quantity each month to be increased as I've been running out. I was receiving 25 doses a month and can take up to four times daily.

Doctor agreed to increase it, but I find a note relevant to the consultation saying "drug seeking behaviour". The drug is a strong opioid, stronger than morphine.

What does this label mean for my care. Any GP, / Surgery staff views really appreciated.

In total shock still, very upset and struggling.

It's the war on pain patients. No, it isn't, really, it isn't!

It's GPs making sure that they don't, through action or inaction, routinely fail patients on pain meds.

The note does not accuse or label OP as an addict, or as someone who is doing anything wrong. It is a note that OP has changed her behaviour around her prescription and, quite factually, is seeking an increased amount of drugs.

That is the first step of managing any issues before they become entrenched and harder for OP to cope with.

Many years ago I worked with a GP on a trial to reduce dependence on daily drug taking in patients such as those CovidKate describes. The stories of how they became so mentally dependent they had panic attacks just talking to me, for fear their drugs would be taken away, was heartbreaking.

@ShamanYou now you know your GP is on the ball. When you can make an appointment with them to discuss your options, make this a positive thing, not something to be angry about!

Useful responses. Not fentanyl, no. The marker has been placed, directly with the consultation I asked for a quantity increase.

I'll try and book an appointment for next week too.

My mother had a long-term dependency to benzodiazepines and other drugs through my childhood. If they were having zero effect I would stop them.

The condition I take this opioid for , the pain is excruciating and occurs in around half the month. If I had no recourse to the drug then I'd need to attend A&E for IV morphine.

Where did you find the note,

Online GP services.

I'm in the UK.

Oramorph isn't even a CD, or wasn't the last time I checked.

@ShamanYou

I'm in the UK.

Oramorph isn't even a CD, or wasn't the last time I checked.

Nope but the much less strong/effective tramadol is! Loony but true...

It is 'drug seeking behaviour' the reason might be quite legitimate but perhaps the answer for the GP and you is to find out if there is another way to control pain rather than increase meds... which can become ineffective as an individual becomes tolerant and so needs more and more....

There are a lot of individuals - I don't know the stats but a course I attended talked about the worries of prescribed medication addiction - might you be addicted? Not judging you - just wondering?

If they were having zero effect I would stop them. That's the discussion that is required. If there is an alternative, other drug, other intervention.

Even if you are certain it is always a good idea to chat with your GP and / or consultant. They can get a good idea of any behaviour / attitude changes if you are upfront with them. That could save you a lot of heartache and maybe signpost something that works better for you!

Good luck.

might you be addicted?

Absolutely not.

I was refused pain medication after a lumbar puncture and accused of being a druggy just wanting a fix from morphine. I rarely take painkillers for a headache so to have to ask for pain relief the pain must've being severe enough. The only medication I went in was ferrous fumerate for my anaemia and fluoxetine for depression from when my Dad died. Those were locked away and I had them once at the beginning of the week I was in

Perhaps ask for a consultation with your local pain management service next time you have a GP appointment?

Just out of curiosity, you log on to online GP services and see all of your medical notes? Ive never seen this app, so forgive my ignorance.

I’m sorry this must seem frustrating OP, but people on strong medication should be reviewed and assessed regularly. For their benefit.

If pain has worsened or changed, the prescriber needs to assess what might be causing that, as different treatment might be required.

Are you under a consultant for the condition? Have other options been discussed? I suspect I know what condition you suffer with and there are so many more options now to what was available when I first started suffering with it.

suspect I know what condition you suffer with

I will be very surprised if you do.

I remember you posting about this the other day, but the reason was different for you needing the drugs. You got a lot of support but didn't come back to the thread. Wasn't it a trainee GP at your practice who refused the drugs then?

How would you feel if you didn’t have a full pack of the meds for when the pain starts? Addiction is not really the issue but the fear of not having the medication at hand when you need it can be horrendous.
I suffered with endometriosis, the pain is crippling, even opioids are of limited use. My miracle cure was Mirena coil, but after 4 yrs the hormone level starts to drop and I start to experience pain I am begging my GP to replace it. I suppose I am addicted to Mirena coils.
Chronic pain is a very different beast to acute pain. I would be looking for a referral to see if there are alternative ways of preventing your pain rather than just treating it.

Yes, I remember your other post ShamanYou.

Hope that you're okay.

I honestly don't think that the GP is 'labelling' you. They're identifying a type of behaviour - drug seeking - that can indicate a dependency, which they do not want to facilitate.

Or that the current level of pain relief isn't adequate for someone and needs to be reviewed, which is also the right course of action.

Those medical notes can read very bluntly, but they're only intended as a shorthand not a judgement.

HTH.

This thread and the other thread are two separate issues.

To answer you question, it means that your care is being taken seriously and within NICE guidelines.

I have similar on my notes because I call and ask for diazepam occasionally I get 8 around every 6 months and use them for muscle spasms related to a condition I have. It just let's the doctor I get next know I've asked for them so next time I do they can be made aware by the flag popping up on my record and check I'm not changing how much I use them.

It's much better than years ago when they didn't both much I was well on my way to being hooked on cocodamol without anyone realising it me included. I fell pregnant so stopped them because the pregnancy helped ease the pain (they think by the increase in some hormones) at that point I realised they had become a habit since I wasn't in pain but they thought I need my meds came to me several times a day. Luckily I was still not dependant and had a good reason to not take them so managed to stop an addiction before it started. I still take them but I'm very aware how you can fall down that rabbit hole so I mostly use alternative therapy, diet and exercise to manage it.

I hope you can find other ways to manage but if there are none it's a good thing they are taking care of you by making sure your not taking to much.

Judging from your tone, the wording of a few things here and the fact you admit to having two threads regarding getting paint medication but say it's about separate issues suggest that you may, without realising, be becoming dependant on this medication. This isn't a dig at you or a criticism. Other posters have explained very well how these medications work and how quickly we develop a tolerance - people don't even realise it's happening. As someone who has had every conversation going with people who need to order prescriptions early or want the Doctor to issue extra medication (I'm in admin, not clinical) you do tend to notice the pattern emerging and I think you would benefit from asking for a referral to Pain Management Team. They can look at long term management with you, not just medication, and try and support you with your pain management in daily life.

People are getting addicted to strong meds - you are likely addicted now.
The GP does need to flag so that of you come back seeking more, quickly, they remember that and you may need help to deal with addiction.
The problem with pain meds is they work, and then your body tolerates them, and you need stronger ones... but we're at the point that there is nothing stronger than Oxy on a day ot day basis and they are highly additive. IS there anyway you can cut down on meds, manage pain on other ways? Not easy I know for chronic pain, the temptation, naturally, is to take the temporary relief at the cost of our general health

Do you need to take the medication 4 times a day for at least half the month or is it that the pain builds, so you go from 1 or 2 a day up to 4 a day for X number of days, then the pain subsides and you go back to managing on 1 or 2 a day again ? 25 doses doesn't sound sufficent to cover either scenario so I can easily understand you running out.

Have you been seen by a pain clinic ?

I wouldn't worry about the 'drug seeking behaviour' note, I would be more concerned about speaking to a Doctor and getting the best pain management regime you can.

Even if you’re not physically addicted unfortunately you can also become mentally addicted.

This is an entirely normal flag. It is very common nowadays for patients to see multiple GPs in one practice, or other clinical care providers in other settings. It is also increasingly common for patients to move GP practices more often. It simply identifies something, which for you and your needs, may be entirely benign and nothing will result from it that will affect your access to medication. But, in combination with other factors which may or may not occur either in the near or distant future, it may need to be addressed.

It is precisely the opposite of what you are worried about, not at all personal to you, but a necessary tick in one particular box.

The concern is that by the time as patient is addicted, they won't know it. They won't remember, or care about the pattern of behaviour which led them to that point. Again, all combined with many other risk factors.