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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Medical
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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At what point does prescription pain medication use become

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At what point does prescription pain medication use become abuse? I'm having a major disagreement with a substance abuse professional on this issue and need some expert advice to go into a hearing with.

Dr. P. Jyoti :

I am Dr. P. Jyoti, MD. I promise to use my full experience and knowledge to provide answers specific to your question. Feel free to ask me anything.

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Dr. P. Jyoti :

how long have you been taking the pain medications?

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Hello Sam,

One definition for this is - Prescription pain medicine use is considered abuse when you continue feeling the need for the medicine when your doctor says it is not needed for you. So ultimately your doctor gets to decide whether your use of the medicine is a valid use or an abuse.

THere are also some behaviors which are considered warning signs that it is going towards abuse:
  • Noticeable mood swings corresponding to availability or absence of prescription drugs
  • Changing sleep patterns
  • Increasing irritability, especially when prescriptions are unavailable
  • More frequent alcohol consumption (link)

Your doctor will watch out for these signs and tell you when to stop taking the medicines.



Hope this shows you the way forward - wish you good health and a quick recovery.

I trust my answer has helped you gain more knowledge and confidence about your problem and in knowing what to discuss with your doctor.

Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Bonus is always welcome - Thank you!

Dr.P.Jyoti, MD.

Dr. P. Jyoti and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Thank you for your answer. I just woke up and must go to work so I don't have time to chat, but I like what you said so far and will rate the answer excellent. I would like to discuss use vs. abuse in more detail when I get home tonight and tomorrow when I have a day off. I am in a dispute with a substance abuse professional assigned to me by my employer over whether I abused the drug vicodin a couple years ago and have a hearing coming up to argue the matter. I would like to be able to quote an expert at the hearing. Admittedly, what is defined as "expert" is rather subjective, but an MD who has had experience working with prescription drug abusers would qualify in my view. I am wondering if there are any so called "substance abuse professionals" or SAPs among the pantheon of Just Answer experts. What would qualify someone to be an SAP? I know my SAP has the titles CADC II and PHD after her name. Can an MD be an SAP under the definitions in the DOT Title 49 Part 40 regulations? I'll check on what those regulations have to say when I get home tonight, then carry on this discussion.

Thank you for your answers thus far. I'll click the Reply to Expert button then get back to you tonight after work.

Yes, doctors can be Substance abuse professionals, but so also can many other professions. The qualifications for transport SAP, which can be generalized are:
  • Alcohol and drug abuse counselor national level certification through the NAADAC Certification Commission (NCC) or the International Certification & Reciprocity Consortium (IC&RC). Note: State level certification does NOT meet DOT requirements.
  • Alcohol and drug abuse counselors with MAC certification through the National Board of Certified Counselors (NBCC)
  • Licensed physician (Doctor of Medicine or Osteopathy)
  • Licensed or certified psychologist
  • Licensed or certified social worker
  • Licensed or certified employee assistance professional
  • Licensed or certified Marriage and Family Therapist (MFT)
  • From

I do not think there are any SAP on JA, though there are experts in drug testing.



Hope that satisfies your query. If so, please choose a positive rating.

If you have any other queries, do ask. Wish you good health and a quick recovery. Bonus is always welcome!

Thank you.
Dr. P. Jyoti

Dr. P. Jyoti and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

I have to hurry to work as a commercial driver today and give a 9 hour bus tour of Yosemite. It sounds like you're the right guy to answer my questions on substance abuse and I look forward to continuing this discussion when I get home tonight. I usually make good tips on this tour and will happily share them with you in the form of bonuses. See you later then.

Customer: replied 3 years ago.

Glad to be able to help you.

I will wait for your response.

Customer: replied 3 years ago.

Can I arrange an interview with an MD who can make a substance abuse assessment given the exact same evidence I gave the SAP so I can get another opinion as to whether I was a substance abuser? I suppose I can find another SAP to do the assessment. Actually, an MRO would probably be best.

What do you think?

Hello Sam,

Best would be to contact a SAP near you.

Use this site to find a SAP near you:

Make an appointment and discuss your whole issue with him. If he gives a different opinion, he can then be legally quoted in your case.

Take care.

Hope that satisfies your query. If so, please choose a positive rating.

If you have any other queries, do ask. Wish you good health and a quick recovery. Bonus is always welcome!

Thank you.
Dr. P. Jyoti
Dr. P. Jyoti and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

That was an excellent tip on the SAP-list. Now we are making progress. I called the first SAP on the list and she was quite accommodating at first, telling me her fee - $375 - for an assessment. I asked if my medical insurance - Blue Cross Blue Shield - would cover it since it is a medical issue? She did not know so I'll call to find out.

When I told her I was looking for a second opinion from an SAP since I absolutely disagreed with that SAP this new SAP said they do not want to get involved.

So I am making progress in fits and starts thanks to JA but still finding this area of medicine and law to be a strange one where it's not only difficult to get legal representation but difficult to get information from lawyers, apparently because it is just not an area lawyers like to dwell, relative to other areas of alleged malpractice or personal injury anyway. I am getting most of my good advice from the MDs with JA, which is still progress in this great research project of mine. So thank you, XXXXX XXXXX am still learning my way around JA. I'm thinking of beaking away from my usual drug-testing questions and ask why my refrigerator keeps freezing lettuce and produce in the non-freezer dept. just to see what happens.

One thing I would like to ask is regarding bonuses:

I am a tour bus driver so I know how nice it is to get a gratuity at the end of a long bus trip, thus validating the value my passengers place on my ability after their lives have been in my surgically repaired hands driving on cliffs through dangerous bear, lion, and squirrel country. The price of the ticket is high enough to begin with.

Bonuses are the same as tips for JA experts and I'm starting to feel guilty not hitting that button after an answer, especially since I get so many tips in my job I feel I did something wrong if I don't get a tip, kind of like a food server at a restaurant.

Do JA experts feel the same way if they don't get a bonus? Does a "big bonuser" customer get better service in the future than a low or no-bonuser? I'm usually a big tipper, for working class, when I'm out on the town or getting serviced. My girlfriend or domestic partner (DM) is a total control freek and took my credit cards away from my control. I had to beg her to let me get a subscription to JA. I told her I wanted to start giving bonuses like a normal person and she is refusing. Can she do this legally or medically? She thinks my credit card will get stolen on JA and charged beyond it's multi-hundred dollar limit along with my identity. After what the JA experts now know about my issues, no one wants to go that near my identity.

My question is two-fold: Does a track record of leaving bonuses affect in any way the quality of future correspondence? Is there a relationship psychologist that can counsel regarding dominance mitigation?

Not at all, dont worry, not leaving bonuses is not at all going to affect your future questions. There is no track of how much bonuses you have been giving.

What does make a difference though is the positive ratings or accepts vs the number of questions asked. When it is positive or over, it means the customer accepts most of the answers and has multiple accepts too. For example, your profile now shows, 17 positive ratings/13 questions. So it means you make multiple accepts, and that is sure to get you a lot of attention from the experts who would like to go the extra mile for a good customer.

Bonuses help on the individual level and in the individual question - the expert feels gratified that the customer has left him/her a bonus.

But I must also say that even with a poor rate of accepts, we on JA would still try our level best to do the best that we can for our customers.

I am happy that you have found the JA service satisfactory. Do come back with your questions on any subject at all.

Thank you.

Dr. P. Jyoti and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Thank you again for your great service and ability to read my lengthy posts. I mentioned I am trying to get our workplace drug testing policy as DOT compliant as humanly possible and not finding any lawyers willing to delve very far into this apparently unpopular legal area. I've been having great luck with the MDs giving advice on the more medical side of drug testing and drug use - abuse, as evidenced when I scroll back over all my sometimes redundant questions from various angles in review and see I eventually get the kind of answer I can rest my case on.

That tip you gave me with the SAPLIST site was the Mother Lode as the fellow who compiled the list and runs the program called me on the phone last night. After an extended discussion of our workplace drug testing issues I think he might be the foremost authority on drug testing in the workplace on the planet with about 30 years in the business. So I will likely retain his services to get our program about as DOT and FMCSA compliant as possible where humans are involved. Today he will email me a preliminary plan and I'll let you know how it goes. Thanks again for the referral to his site.

Now I just have to get my financial controller freek girlfriend who took custody of my credit cards to loosen up a bonus for you. If I do good for my passengers on the bus tour this weekend I'll pay some forward and bypass my girlfriend entirely. Thanks again DP!

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