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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Medical
Satisfied Customers: 2771
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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I am currentlly taking 4 tylenol 4's daily, as well as 300

Customer Question

I am currentlly taking 4 tylenol 4's daily, as well as 300 mg wellbutrin daily. I was not aware of the seizure issue, but the painkillers do not seem to work as well. I have tried suggesting an equivalent dose of morphine until I finish physio and taper off the pain meds, but it is hard enough getting codeine fro a doctor. They are VERY wary of prescribing anything else as it is triplicate, and thus tracked by the college of physicians. Any suggestions?
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: I have always had lumbar and thoracic scoliosis but it had been tolerable. At one point I had a doctor who trusted me enough to give me 15 mg MS contin bid until I was able to stop
it completely
JA: Anything else in your medical history you think the doctor should know?
Customer: Well.... I have tried this befire and i beat it. But I also have a history of drug abuse, and bipoar. BTW I never misuse my Xanax or anything like that.
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 4 months ago.
Category: Medical
Customer: replied 4 months ago.
I guess my question is when is it medically acceptable for a family doctor to pull out their triplicate pad (which is actually very difficult in Canada), knowing this is temporary, and I have treated this issue sucessfully before. No codeine, no nothing. Just physio excercise and massage. I did gt into a fairly serious car collision, and that is what started this again. Yes I have had drug problems befire, but with cocaine, fentanyl pills (which nearly killed me) but I have never abused benzos, morphine, T4, dexedrine, vyvannse, or whatever was prescribed bymy doctor or psychiatrist.I used the morphine to be able to live life and want to go to physio and fix this issuem instead of waking up like an oldman when i;m 34.
Expert:  Dr. Muneeb Ali replied 4 months ago.


Im very sorry to hear about your pain. Now regardless of your past history of drug abuse, your pain should be managed nonetheless but i can understand why the doctors are reluctant to prescribe anything stronger. But you should definitely on a stronger painkiller to control the pain, a solution would be to start the codiene or even another opioid for a very short duration of time and withdraw it quickly while adding another drug like ibuprofen or naproxen to the regimen or even ketorolac which a newer NSAID.

Well in regards ***** ***** question, it is appropiate for a doctor to prescribe pain meds when you are in pain which is NOT responding to anything else. He might be reluctant to do so considering your past history but that does not mean that you need to stay in pain. A temporary prescription is warranted here, for a week even. If your doctor is reluctant to even do that then it would be appropiate to ask for referral to a pain management specialist who will be able to better understand your situation. But i believe your pain should be resolved, even if it means starting you on a short course of opioids. Infact the best option would be the opioids for immediate relief and he can then refer you to a pain management specialist who devise a plan of management for your pain without the use of opioids in the long term.

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