This is a bit of a strange and difficult one

[oldanddone]

I take Tramadol for my back, which I fractured almost 3 years ago. I have really been taking these ever since then. I had noticed that I had been running out of them more quickly and putting in more repeated prescriptions but didn't look into it. The doctor phoned to say that I have had far more than needed and they won't give me another prescription. I take 6 a day. I phoned the pharmacy and they say I received 168 tablets last Friday. I have just checked and I had a box that hadn't been opened together with some other tablets. On the outside of the box it says there are 68 tablets. I have just opened the sealed box and there are 20. I have phoned the pharmacy and they don't believe me. I don't have anyone who could have taken them and anyway, the box was sealed closed. What do I do. I am seeing the pharmacist tomorrow but I only have enough to do me 4 days in total.

I spoke to the doctor about this. Although I will be physically dependent on them because they have withdrawal symptoms, I have never craved them. I only remember to take them when I start to feel the pain. The very odd occasion when I haven't felt pain I have missed a dose. People can be so judgemental.

Thanks so much. I could have come off the Tramadol but she said the kind of pain I described meant I had never pain and probably some arthritis at the site of the breakage. She thought it was better for my pain to be controlled and me still being mobile instead of me being bedridden in pain. Only people who have chronic pain can understand. I walk about most of the day with a mini hot water bottle hanging out of the back of my trousers! I definitely don't do it as a fashion statement.

As a long term user of Tramadol myself, please could you explain what you mean by addicted. How would someone like yourself know if I was addicted, what signs or symptoms would you be looking for?

I’m not having a go at you, I am just curious to know what an addiction to an opioid drug might look for so I could understand if I am an addict. I don’t think I am as I don’t take the full max dose every day, I don’t crave a tablet before one is due, I sometimes forget to take them for a few hours until my pain level increases and I am fully with it, not spaced out or sleepy.

I would appreciate your views.

I mean, someone could die, but as long as you're not getting anyone in trouble 🤦‍♀️

I think the post is indicative of how little people understand about how long term pain medication works. There was a definitive statement upthread about how no doctor would prescribe opioids on a long term basis. Which is nonsense. I have long term intractable pain due to complicated spinal issues and have been taking liquid morphine as part of a pain relief regime for about six years now. Thorough and regular reviews of medication are carried out as well as regular blood tests to check liver and kidney function. There’s no suggestion of addiction to any of the pain meds I’m on and they are all prescribed with a maximum dose which I don’t take unless pain dictates it. Long term opioid use doesn’t mean automatic addiction, as a lot of posters here are assuming, and it should be remembered that those with this type of pain still have to work and get on with every day life. Lots of judgment and lots of ignorance on this thread - many people are dependent on this type of medication, but that doesn’t mean they’re addicted.

What's the bottom of the box that had hardly anything in it like? Could it have been broken into on the underside?

Good plan to get a locked box. Don't open where anyone can see. Make sure no GoPro cameras or anything set up to 'watch' you put the combination in.

Thought I would give a quick update for anyone interested. So apparently the pharmacy are supposed to give me a week's supply at a time. They have given me the full month. Hence, if I am totally addicted and taking too many I have the perfect opportunity. It's so stupid. I have bought a locked box and only I know the combination so this shouldn't happen again. Oh, and I counted them when I got them.

So what have you put the disappearance of the tablets down to?

I also think it's really bad that some people on here are implying that addiction to pain medication is something shameful. It could happen to anyone taking pain medication because these things are addictive - more so to some than others. People can easily end up using them to self medicate their MH problems. I'm someone who got a buzz off OTC codeine the first time i was given some for period pain - I haven't taken it since, but i can see how easy it would be for someone with poor MH to start using them for pain and end up using them to self medicate their MH issues.

It is not something that people should be shamed for, they need to be supported with the addiction and MH issues. There are often people on this site with this issue and there is a lot of shame and guilt around it which can prevent people from reaching out for the help they deserve and need.

I still think you should raise the missing tablets with the pharmacy, it may be someone there is nicking tablets and they won't know if it isn't reported back to them.

I'm glad you've seen your Dr and sorted your prescription though. Being without medication you need is fucking horrible.

I don't know what some of the folk on here actually want, or think they're achieving with their accusations.

Someone who states that tablets have gone missing, they haven't taken them, theres a chance they were not given the number expected/written on the box in the first place...

a/might be lying
b/might be telling the truth.

How should the person telling the truth do so, in a way that avoids them being accused of lying?

Given it is more than possible that tablets were miscounted, mis-dispensed or indeed stolen, why the immediate leap to the assumption OP (or anyone in a similar situation) is lying?

Also addiction to pain medication is much less common if you're still suffering from that pain. It's far more likely where conditions improve, and the dose is not scaled back accordingly.

This is what the pain management team at my local hospital told me, as I wasn't using the pain medications I had (tramadol, oramorph) correctly, for fear of addiction (I was waiting til I was in absolute agony before taking them!)

I have fluctuating pain, managed with buprenorphine patches, and other meds as and when required. Funnily enough, despite long term use (months in some cases) of those situational meds, I am not addicted, I do not crave the drugs.

I would still get distressed if I ran out of/lost/did not have those meds, because 1/ I'll be in pain (awful nerve pain, muscular pain and joint pain) and 2/ whilst coming off them is only noticeable due to increased pain, getting back ON some of them causes severe nausea that lasts for days/weeks.

I forgot to change my patch for a week recently. As a result on sticking the next patch on, I spent 2 solid weeks on the verge of vomiting (despite ondansetron regularly). If you haven't experienced that, you really haven't a fucking clue!

Thanks for this. I do not crave the tablets either. I did cut them right back because I thought they were going to stop giving them to me. I pain was awful, a horrible nerve like pain. I don't want to experience that again. You wonder what is better, someone who is taking pain medication as prescribed and managing to function ok or someone who is signed off sick and in agony. Some people have no clue. And, if I had taken them myself, why would I bother posting on her for advice?

That's a very good point ! If you'd taken the lot then what would have been the point of the post !

Get an urgent GP appointment and check inside the boxes when still in the chemists (assuming you collect them)

My chemist or GP, they're blaming each other. Screwed up again this month. Doubled up on one lot of eye drops, forgot the most important eye drops. Gave me yet again a nasal spray I tried over a year ago and made me feel very sick. I never ordered it again, took it off repeat on the pharmacy computer ordering system.

I phoned them immediately stressing that I had run out of the important eye drops on Friday and need them urgently. My eyes are playing up.

Next month when I order online I'm going to screen shot the order.

I don't know who's to blame but, two months running really isn't funny.

It is very odd, the utter faith some have in the prescription ordering/GP/pharmacy system..

I have had - box of patches with two missing per whats written on the box.
Dosette box with meds missing, meds in the wrong slot (couldn't figure out for weeks why I was falling asleep in the day, then checked and a night time med was in the morning slot)...
Incorrect dose of something I have once a week.
Being supplied 28 of something I take once a day, but the prescription is for a month, and most months are of course not 28 days... that took weeks to resolve that if they wanted me to have a new lot 30 or 31 days after the last lot, they'd need to send that many pills!
Failing to remove an old med from the dosette box but adding in the new med that is contra-indicated. Fortunately I spotted that straight away.
Supplying me with six months of something I was supposed to have monthly.

This is across three different pharmacies in my town and two different GP practices too (and I can't move again there are no more!)

I can only assume these people have never had handfuls of drugs every day that they'll take for life.

They have employed a practice pharmacist in my GP surgery to deal with medication reviews and repeat prescriptions. The number of mistakes and omissions has increased a lot since then, with essential drugs being crossed off the repeat list, dosages altered and some being massively over supplied.
The other issue is that once the pharmacist has decided what you can or cannot have, the prescription is printed, but it then has to languish in a GP's in tray for anything up to a couple of weeks. It just makes everything more stressful.

This has happened at ours as well. I used to take co-codamol but stopped it when I was prescribed Tramadol. One month I inadvertently ticked it on the repeat prescription App. They sent me a month's supply along with the Tramadol. I didn't need it and didn't want it but I could have gone to town. I have been really stupid not checking everything but I am doing this now.

You do need to report it officially to the pharmacy though OP. Imagine if this is happening to other people, and each person is thinking ‘well anyway I had an appointment with my gp and I feel better now so no harm done’ and the pharmacy employee is………who knows?

Please report it.