ZocdocAnswersWhy won't the nurse practitioner rx a breakthrough pain medication?

Question

Why won't the nurse practitioner rx a breakthrough pain medication?

The nurse practitioner that rx's my 75mcg Fentanyl patches refuses to rx a breakthrough medication. I haven't asked for one until around 6-8 months ago due to episodes of severely increased pain. I've undergone every procedure they've suggested, tried everything from physical therapy-yoga-OTC meds. I don't drink/do drugs/smoke, have never violated my pain contract, and simply don't understand. Should I find a new center or should I talk with the Dr. in charge?

Answer

Thanks for your question. It is unfortunately somewhat common for patients to have questions and feel that they are being treated improperly when they work with a physician who limits their pain prescriptions. This is obviously a difficult situation for both the patients and the providers who treat them. On one hand, the patient is the only one who can truly feel the pain and understand what they are feeling. It is the patient who has to suffer, and it is the patient who is in the position of weakness. The prescribing provider is in a different situation, and it is his or her job to "first do no harm." While this sometimes means taking away pain through medications, at other times it means NOT prescribing medications that may affect the ability of a person to function and return to optimal health. Obviously, both sides of this discussion have a different perspective and a different objective, and it is only possible to reach an optimal health outcome through conversation and dialogue. While it may be appropriate for you to reach out to your physician in charge, it is also good to discuss these concerns with the NP. Please speak with your doctor.

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