Hello all, I’ve been on pain meds for many years for several ailments and started using the VA in 2015 and the PCM I was assigned established all of my prescriptions including my pain meds. Last month went I requested a refill online through secure messaging my new provider (this is my 4th) told me that that the VA no longer offers narcotic or opioid chronic pain management and a taper is mandated. Now my main issue with this is I’ve never met and or have I ever been examined by the ARNP that I’m assigned to, we have no medical doctor at my facility. According to numerous articles and literature on VA websites the following must occur: prior to any changes in therapy a caregiver needs to discuss the risks of continued use along with possible benefits. Additionally there needs to be an established plan to consider dose reduction and to consult with specialists, or to consider alternative pain management strategies when considering an opioid taper. A physician needs to monitor conditions that may warrant additional evaluation and arrange follow-up care when indicated. The caregiver needs to ensure that screening and treatment is offered for conditions that can complicate pain management before initiating opioid taper since numerous factors go into the speed of taper selected, suggests only 5 to 20% every 4 weeks depending on dose, duration and any risk factors of medical conditions. Now my dose was cut by 66%, from 84 tablets to 28 tablets. I have been communicating thru the secure messaging and the clinic has responded with letters. My issue is what the hell am I suppose to do? The clinic refuses to make me an appointment to discuss this and said I can only make one for my annual…all the correspondence ends with I can seek an out of the VA provider who would accede to my wishes…My wish is that I didn’t have so much pain that I cry several times a week, I can’t sleep because the pain wakes me up and I’ve been getting by with a very low dosage, along with ibuprofen, joint gel, heat and ice. What can we do???
