I'm getting fucking frustrated by docs in general. They are generally clueless about pain management.
The ACTUAL pain management specialist doc I saw, ALL he did, was repeatedly emphasize that opioids produce tolerance and tell me that he didn't like scripting them for about `15 minutes, then tell me my appointment is over, and he will talk to my GP.
He never did. And my GP? he is a decent, compassionate guy, and a very senior doctor in the trafford catchment PCT area.
But fucks sake...he first suggested switching me from oxycontin to buprenorphine patches, saying that he thought precipitated withdrawal (bupe is a partial agonist at Mu-ORs) would be unlikely at the dose he had in mind.
If that WAS true, it would be completely and fucking totally useless for both analgesia AND preventing withdrawal from oxy during any switch over.
I shot that idea down right away, so he gave me a few fentanyl patches. Unfortunately he is clueless enough not to know how to adjust dosing of fent for longterm opioid dependent patients. Sure, it has a reputation for being fuckoff potent stuff...but he tried starting me on 12mcg/hour patches.
When I'm on a dose of oxy that would require at the VERY minimum, some 150-200mcg/hour