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.

OP also says she is taking other drugs with the tramadol, so it’s entirely possible to miss occasionally and not notice if other painkillers are in use. With painkillers there is a maximum daily dose, which may not always be necessary if pain doesn’t dictate it.

OP says she didn’t receive the hundred tablets. Only a box labelled 68 tablets, which actually contained 20. So less than four days supply.

so it’s entirely possible to miss occasionally

@Rosscameasdoody again, “possible” doing a lot of heavy lifting in this sentence.

The most likely answer here is OP is misusing her prescription, deliberately or negligently and “helpful” posters are facilitating addiction related drug seeking behaviours.

Nurses in hospital have been known to steal things like diazepam and other controlled drugs, it is possible there could be tampering by pharmacy employee or a relative of OP. Either that or OP is the culprit themselves.

Yes absolutely this. Try to reduce the amount you take until your next prescription pick up, and then open the box in front of the pharmacist.

I have spinal stenosis and have severe pain. I use high dose Fentanyl skin patches and Oxynorm, these are obviously controlled drugs so kept in the safe at the pharmacy. When I collect I always make a point of checking in the bag in front of the pharmacist, just in case.

Also I would like to point out that there is a huge difference between addiction and dependency. The OP is dependant, and most certainly not addicted in the way people have suggested.

On yourself?

If you are absolutely sure it's not someone in your house taking the tablets surreptitiously, and the pharmacy have been dispensing the wrong amount, then you need to raise this with the pharmacist. It could well be someone at the pharmacy with an addiction, although I would imagine it's extremely difficult to steal controlled drugs for one's own use.

I work in a hospital and controlled drugs are checked out of the cupboard with a registered nurse and a second qualified medication checker, and at no point is one person left alone with the drug. The patient has to be witnessed taking it before the MAR can be signed.

A strict eye is also kept on other non-controlled drugs like benzodiazepines, sleeping tablets and codeine based pain relief. I'm sure there are rogue nurses who help themselves to those, but I'd like to think they are in a minority.

@Rosscameasdoody I don't move in circles where people discuss their "stashes" of illegal drugs, I just use the English language according to the every day use of words. I must lead a sheltered life.

I also have not accused the OP of being addicted to or abusing her prescribed medication.

Don't you have better things to do than pick fights with strangers on the internet over vocabulary?

My GP prescribes more than that for me and has done for four years, it’s not unusual if carefully monitored. Without it I would be in a wheelchair.

If you live with constant pain when walking or doing everyday things then high levels of medication are necessary.

I agree with your comments about proper supervision.

I have explained the checks I have with my medication by my GP and also from the Pharmacy which reassures me that I am being monitored carefully. I always go to the same pharmacy although it is not always the same pharmacist but the counter staff know me very well! My health centre is very busy and there seems to be a high turnover of doctors but even so, they seem to be on the ball regarding repeat prescriptions.

I've only read the OP posts so sorry if I'm repeating what someone else has said, but a while ago there was a bit of a scandal when doctors were prescribing a strong sleeping tablet and they were going missing from the medication bags - could this be a similar situation? Check what's in the bag before you leave the pharmacy OP, and get DH or DS to do the same if they go for you.

Ignore the people diagnosing your addiction. I have a friend who has to take these and she certainly doesn't do it for fun. However you must report this to the pharmacy, in writing, and to your doctors. Someone is clearly not checking properly at the pharmacy and they are being sold off.

Is there any new staff at the pharmacy? I wonder if either, the process for when there is an outstanding quantity ( probably a full box ) to be collected later - you'd which expect if 100 tablets are missing; or someone at the pharmacy has not handed over a whole box deliberately

168 is 28 days supply at 6 tablets per day. I'm guessing if that's what was prescribed, they would dispense a complete box of 100 plus the odd 68. Which suggests that the 100 tablets have gone missing somewhere along the line.

Exactly so. So many posters missing this.

And by the same token I would say that the posters ignoring the potential for someone at the pharmacy to be at fault - whether deliberately or otherwise - are ‘helpful’ in facilitating these drugs in finding their way to be sold on the streets. And having been prescribed a cocktail of similar painkillers for the past two years, I can attest to the fact that if other painkillers are in the mix, where a maximum dose of a particular drug is prescribed there will be times when it’s not necessary to adhere to that if pain doesn’t dictate it. One of my painkillers is liquid morphine. If other painkillers I’ve taken are dealing with the pain, I don’t take it if I don’t need it. Why would I ?

The Pharmacy could simply have made a mistake. They do.
Once I was issued with beta blockers at double the dosage I was taking. When I returned them to the pharmacy, they were horrified & very apologetic.
Unfortunately, your situation is much more tricky.
All you can do is show the package and stick calmly to the facts. Again and again if necessary.
Good luck sorting it out. It's horrible to be in such pain

It's a bit of an odd prescription for back pain from a fracture anyway tbh. I would've expected Naproxenor Diclofenac or similar NSAID. Not an opiate.

OP what a load of accusatory comments when you are preparing to endure back pain. Sorry about that. And good on you that you're finding a silver lining.

To me the facts you state point to something going wrong at the pharmacy, whether by design or not. I guess the best you can do is reconstruct as far as possible what you got vs. what you should have got and speak yo GP and pharmacy. Not sure in which order.

Hope you find a good resolution.

As a one-off what happens if you say you lost them? Some of mine went missing at a hotel, Mine are not addictive IDT but they do have a street value.

Pharmacies can and do make mistakes. I know someone that got a 0 added to the dosage and it ruined their health long-term.

Diclofenac is no longer prescribed by GPs for long term pain - wish it was, as Naproxen is nowhere near as effective for me.

And the OP is most likely taking NSAIDs and the Tramadol - I'm taking Naproxen and co-codamol together for my back, which is just about enough to keep me working. You can't assume that any fracture is the same as any other fracture either, and with backs you are looking at discs, impingement on the nerves etc as well as bony changes such as arthritis.

Yes it is, I'm on it and have been for months. Probably going to have it for a while as its neurological pain and there is no cure for the condition. GP hasn't been reluctant in the least to prescribe it, he suggested it. Comes as suppository rather than pills but I don't care, as long as it works.

I'm just suggesting that opiates are possibly not the most effective choice over NSAIDS anti inflammatory effects and that her GP might recommend changing it anyway.

My pain is primarily nerve related although it does cause some secondary muscle pain. I've had tramadol for it in the past but it wasn't that effective.

I have a diclofenac stash in the bathroom cupboard, I can't recall why I was prescribed them, possibly post surgery once.

I've sciatic pain, some days excruciating. My GP prescribed gabapentin two years ago. He said recently when I asked for an alternative that it was pointless because all drugs cease to work after a while. So gabapentin and ibuprofen when necessary, which mucks up my stomach so I try to avoid it, I took two at lunchtime by mid afternoon was digging out the nexium.

No-one takes these drugs because they're addicted but just to function to some degree.

You really need to pursue this with the pharmacy and insist they investigate, it's quite a serious issue - either it's an accident in which case needs to be flagged and rectified otherwise something much more serious could happen, or it's deliberate and is theft. Whether you want to continue taking the tablets or not, this is not OK and needs reporting.

It sounds like you're addicted to painkillers and are trying to get info from mumsnetters in the know on how to bypass the system. You really need to speak to the GP about weaning down the tramadol and finding alternative ways to manage your pain. Big hugs xxx