A quick history:
-Migraines that were unusually resistant to standard treatments until the age of 18
-At 18 my neurologist increases my Valporic Acid dose to 4000mg/day
-ER neglected to perform any tests except for a spinal tap (no bacteria, just the worst headache of my life)
-Spinal tap pain is supposed to subside, but I am discharged with constant head pain and simply don't feel right
-I see a psychiatrist to address my mental status's acute change
-It turns out I have a traumatic brain injury - probably from ammonia build-up in the brain
-I had to wait 8 months to recover to a level in which treatment could be considered medically safe
-My psychiatrist decides that my chance of full recover is slim and saturates every major neurotransmitter with a questionable cocktail of amphetamines, benzodiazepines, and SSRI's
-I sort of feel human again, but the head pain never went away.
-Pity scripts from my primary doc for hydrocodone - 15mg is minimum effective dosage, no side effects
-Bounced from neurologist to neurologist (not the one that fried my brain), retrying every treatment combo
-After standard migraine treatments fail, I flunked out on the off-label ones, and then even experimental mayo-clinic treatments failed.
-I'm nearing 20, pain management finally comes through
And it was fantastic. I didn't know that 8 hours of sleep was even possible in my condition - but the 12hr ER Opana 10mg definitely agree with me. My pain management doc implied without explicitly stating that he would discharge me if I didn't attempt the last treatment on the list: Botox. After only one month, I was surprised he agreed to give me break-through meds so I would at least have something after the 24 needle injection. Botox didn't agree with me and those 10 pills lasted exactly as long as I was legally allowed to take them. My doc understands that I'm not a great candidate for break-through meds and just prescribes 2 15mg Opana ER per day. This works wonderfully until the the third series of shots came up (6 months of pain management, no perceivable tolerance). He decides I need to taper off the Opana until I'm off all my pain meds for 3 months. I reasonably panicked, since I was finally about to move out and start getting on with my life. He offers to refer me to any pain management doctor I want for a second opinion - so if they say that my 15mg dose is reasonable, he will continue to prescribe it. He says it's to avoid Florida's legal repercussions and seems really guilty. The problem is two-fold: I can't afford to pay for these consultant fees and even if I go through this three month "drug holiday", I probably couldn't get back on the Opana unless I had a cancer diagnosis.
Is it even legal to taper-down a stable patient who's quality of life suddenly became somewhat normal again? I've looked for legal loopholes and will offer him the documents at the next appointment for him to peruse if it truly is a legal complication that he needs justification for. I suppose it's more shock than anything else, considering how well we were doing and the suddenness of it all. I'm down to half of my normal dose per day (fast taper) and I'm already in agony on the bad days. I want to keep as many days where the pain is just in the back of my mind as possible, so any advice is welcome. Thank you for any help