My husband felt an abscessed tooth coming on and made an appointment with our dentist (which took a week). Over that week and on the day of the appointment, the pain was not bad and easily controlled with ibuprofen. When the dentist inquired about the pain level, my husband told him this. He was given an antibiotic and another appointment in 2 weeks. That night, the tooth started to really swell and cause significantly increased pain. By late morning the next day (a Saturday), my husband called the emergency line to ask if he could get a prescription for Tylenol with codeine (he can’t tolerate anything stronger or he’ll spend days puking his guts out). He was informed that it is illegal to prescribe medication without seeing the patient. Obviously, if you have never seen a particular doctor or have not seen them in a long time, you can’t expect a prescription, especially for any type of pain medication. He was seen THE DAY BEFORE and declined receiving a pain med at that time. That cannot possibly hold true in this situation can it? This is in Michigan in case it is a state by state thing. If it is true, while I think it is crap, fine. However, if it was basically a lie because they didn’t want to for whatever reason, the whole family is finding a new dentist. Thanks!!
He I Florida any controlled drug requires an in person appointment. I’m a chronic pain patient and I’ve been prescribed drugs like morphine every single month for over ten years. Yet I have to see my doctor every month in person to get a refill. Thanks DEA.
He made a mistake in declining the medication the day before. He could have taken the prescription and not filled it-- albeit, I don’t think Tylenol 3 is very expensive. Let this be a lesson, and take medication when it’s offered.
I live in a different state, and I have had doctors call in prescriptions a day or two after seeing me, after test results have come in, mainly antibiotics-- strep tests, for example. But that is not a separate thing, and antibiotics are not as tightly controlled as narcotics.
I think your doctor is acting within the bounds of the regulations, and nothing is wrong. I would not go looking for a new dentist.
My husband has chronic pain, and the rules just changed a year or so ago. He has to go in and then get a paper prescription for his meds. They can’t be called in.
So, as RivkahChaya said, never refuse a pain medicine prescription.
Another one chiming in to say that you should always accept the pain meds when offered. You don’t have to take them, but it’s a lot easier than begging for them later (and it’s nice to have them on hand).
As for the nausea, a dentist might not be as well versed in this, but you can try asking for a script for Zofran (ondansetron) as well. They’ll help with that. I got a few when I had one of my kidney stones and then asked my neurologist for a script for them to help when I have migraines. If I take a pain killer for whatever reason, sometimes I’ll take one of those as well.
Zofran is not a controlled substance or anything like that. Assuming they’re familiar with it, they shouldn’t give you a hard time about it…unless they’re on the fence about giving you the Percocets or T3s and use you not tolerating them that well as a reason to not give you anything, but that’s another story.
But, like I said, a dentist might not be familiar enough with Zofran to prescribe it.
FWIW, I live in MI and I’ve not had a problem phoning in my request for renewal of my painkiller prescription. It’s for Tramadol, which is a Schedule IV controlled substance. Of course, I don’t make a habit of that but my doc is more than an hr away and occasionally I will not be able to get in to see him prior to my scrips running out.
I would. Being within the bounds of the regulations is the bare minimum. This is a doctor who knew he’d seen the patient the day before and knew his patient was in pain. He has no reason to believe this is an attempt to get drugs out of him. If there was a way to provide the medication, he should do so.
The only way such a claim should be made is in the context of setting up another appointment so that he can then prescribe the medication. Not as an excuse to leave a patient in pain.
I only can see this as him trying to teach the guy a lesson. And that’s bullshit.
Not clear from the OP if he actually talked to the doctor (or dentist?) when he called that emergency line. More likely, unless OP tells us otherwise, I suppose he got an answering service, and it was that answering service that told him that. And, if so, no telling if that answering service actually relayed the message to the doctor in any emergency-like hurry.
ETA: So, if that’s correct, OP doesn’t necessarily need to find a new dentist (he may have had the same thing happen no matter what dentist he saw), but he needs to do some serious ass-kicking about the answering service – if that’s how it happened.
Medical advice is best suited to IMHO.
Colibri
General Questions Moderator
My dentist has fussed about prescribing Rx-only antibacterial mouthwash. (Presumably more industrial strength than over-the-counter Scope or Listerine.) He says that they[sup][who?][/sup] keep and eye on such things and give him flak if they think he’s prescribing too much.
(ETA: Possibly, “they” might not mean the DEA in this case, but perhaps simply the medical plan that covers my prescriptions.)
Ask the dentist BEFORE having any work done if he will prescribe pain medicine for you and which type! If the dentist will not say or says something like it depends, go to another dentist!
Note due to these new restrictions, some dentists are no longer allowed to prescribe pain medicine (due to “over prescribing” in the past). They of course will not tell you this in advance - tell you to take aspirin after they are done with you!
Also NO OTHER DOCTOR can prescribe pain medicine for the work someone else did! (I was told.) Has to be the original dentist. And of course they are not available on weekends. Furthermore you need a printed piece of paper - they can’t call it in.
Luckily I have had all my teeth removed, so I no longer have to put up with this nonsense. But when I was having teeth trouble, I told one dentist that I needed pain medicine just to deal with the “pain in the a$$” of getting pain medicine these days!
And you can thank all the druggies for this. They totally exaggerate their pain, then I go in and say “it hurts” - they tell me to take aspirin. (When I say it hurts, it REALLY hurts!)
Druggies gonna be druggies. I blame the DEA for all the overboard restrictions and paranoia.
Yep. Time to abandon the “war on drugs” because it only punishes the innocent. The WHO is called for an end to it. Didn’t we learn this during Prohibition? We must be stupid.
Many MD’s, let alone DDS’s will NOT prescribe narcotics.
Until a year or so ago, there was a back door drug - Vicodin and Perco (something) had hydrocodone ( a Sch II opioid) and a non-controlled drug (Vicodin used acetaminophen). It was a Sch III - it could be written by anybody and did not require the high-security 'script form, could be called/faxed in, and could be re-filled.
It is now on Sch II and subject to the same controls as morphine, hydromorphone, etc.
On the plus side, it is now possible to get straight hydrocodone in the US. Didn’t used to be able to.
Sch II:
Requires a special, high security form which is filled out in triplicate. It used to require the prescribing MD’s thumb print.
This form must be picked up in person and taken to the pharmacy.
The pills must be counted TWICE. The pharmacy must be able to account for every pill they get.
The 'script cannot be re-filled or renewed - a new piece of triplicate paper is required every month.
My MD allows me to go 3 months with a face-to-face. The advantage of being old and boring.
There are many, many MD’s (Hi, QtM!) who will not prescribe opioids for anything less than cancer (no “non-malignant” opioids.
Not only are opioids the only drugs which deal with pain for me, but I also have kidney failure - which means NO NSAIDS for me.
Well of course they did - have you ever seen the movie “Tommy”?
How close are you to Canada? My understanding is that Tylenol with codeine is otc there.
And where did I ever say that? :dubious:
I write a lot of opioid scripts for significant acute pain. Even for heroin addicts.
I write a lot of opioid scripts for malignant pain (which is NOT restricted to cancer pain). Even for heroin addicts.
I very infrequently write opioid scripts for chronic, non-malignant pain. Which is a far cry from what you are stating my practices are. But opioids are not appropriate for the majority of my patients who experience chronic non-malignant pain, so they don’t get them. Opioids are relatively contra-indicated for patients with a significant history of substance abuse and/or untreated depression. Which means over 70% of my patients shouldn’t have them for their chronic non-malignant pain.
There’s a LOT of other misinformation in this thread too. These issues have been well-discussed and the misinformation addressed in other recent opioid threads.