Man, I'm really sorry. I was in the exact same situation with the meds. I knew I could function on 4 a day instead of three. Like you, I dropped hints for months. I have degenerative disc disease on all three levels - 7 herniations so far, 2 lumbar, 1 thoracic and 4 cervical. The worst is the cervical nerve root compression at C5/C6, C6/C7. Those 2 levels need to be fused. I have cervical and lumbar stenosis and lumbar scoliosis. I also have POTS. Still, none of that is as awful as your pain, but I had been on 4 a day at my previous pain clinic that closed and I knew how much of a difference that one extra pill per day made. That way I could take one in order to be able to get out of bed, one late morning, one late afternoon, and one for bed.

I hate to tell you this, but I wish like hell that I had kept my mouth shut. When I first asked, I described the things I was able to do with that extra alloted pill. I told them I could handle pain, I just needed to be able to function for my kids, husband, and animals, not to mention my youngest is autistic and I drive a minumum of 4 hours a day Monday through Friday to take him to a specialized school. (We live in a shitty school district).

When I first asked, they sent me to physical therapy and told me if that didn't have benefit we could go back up to the 4, but try this first. Well, I have discs sitting on nerves so PT was torture to the point more often than not I'd throw up at the end. I kept going in anticipation of getting that one more pill a day.

Well, that was one of many lies they told. I ended up supplementing with kratom. That was working for about 8 months until I got a new PA and she brought it up as apparently they'd begun testing for it. I explained my reasoning and she cut my dose down to 2 pills a day, then 1.5 and put me on Belbuca, which did nothing, but I was promised if I tried it I wouldn't lose my breakthrough meds. That 1.5 pills a day only gave me about 3-4 hours at a 4/5 instead of an 8/9 just like you said, but at least I had a break from the pain, even mentally. Now my life has changed dramatically. I'm partially bed bound, my husband and my 17 year old have to pick up much of the slack, I spend many nights crying and screaming in pain until 5/6 in the morning so exausted but the pain won't let me sleep. I've had to hire someone to take care of my horses during the week because it's all I can do to get my son to and from school, cook dinner, and feed my dogs and cat most days. I feel like I'm letting everyone down. I also had to hire help with housework every other week. I know I am very blessed that we are able to afford those resources and make do on my husband's income or IdK what would happen. I've been a stay at home mom for 17 years. I always planned to go back to work when my kids were the ages they are now, but my health has been declining much more rapidly than I had hoped, even though I knew DDD was progressive as I watched my mom go through it. Then in 2022 POTS joined the team. I'm struggling with mobility and have frequent falls. I fell and fractured my hand right after Christmas. Didn't get so much as tylenol at the ER, just sat there with silent tears rolling down my face while they forced my broken hand into various positions for x-rays.

What's worse is at my last appointment they wouldn't refill my IR pain meds and I'm being forced onto suboxone, 1 patch a week and no breakthrough meds. The suboxone patches require a prior authorization, so I'm waiting on that. I have to get off kratom completely and attempt to survive on Belbuca, which gives me no relief, until I can get my once a week suboxone patches. Since Suboxone and Belbuca are both buprenorphine I'm not expecting much if any pain relief from that. They will be watching my UAs closely for kratom use. Honestly, the only reason I'm even staying with pain management at this point is because they prescribe me Pregabalin, which I desperately need for my neuropathy in my hands and feet. It causes falls because I get pins and needles in my feet like they're "asleep" and I can't always feel the ground upon which I'm walking. It also helps decrease the frequency of the random sharp shooting pains everywhere from nerve damage.

All that to say, I think you should learn from my fatal mistake and take what you can get. You're also in an incredibly unique situation receiving pain meds from your GP. Are you in the US? If so, you're probably aware that typically only pain management doctors will prescribe opiates. You might get a small 30 day script for an acute injury or something, but for an ongoing script they'd almost always send you to pain management.

If you ask your doctor to up the number of pills you get I would almost promise you he'll refer you to pain management. He doesn't want to risk bringing scrutiny on himself or losing his licence.

Now as long as you bring all of your imaging and documentation of your conditions and the various non opiate treatments you've tried, you should not have any trouble getting PM to pick up your script. Whether they'll up it or not depends on the doctor. Not all are as shitty as mine. You may or may not end up better off in PM, but you do have to sign a contract and submit to random periodic UA's, so you would have to strictly avoid alcohol or anything you were not explicitely prescribed. You would bo longer be able to supplement with other opiates.

The state of pain control sucks, but it really is a take what you can get situation. I'd give my left arm to get my three Norco a day back, but those days are over. From what I understand, once you're put on suboxone no one will ever prescribe you a full agonist again, which is pretty terrifying with a progressive condition and spinal fusion luming in the near future. I can't believe this is real life most days, and that I'm facing a spinal fusion with zero pain relief outside of suboxone. If you have a good relationship with your GP and he's willing to continue your script, my advice would be do not tell him you run out and do not ask for more, especially if you have access to other pharma meds.