First of all, my name is Tim and I am 30 years old. I have had an issue with my back, head, and left leg for the better part of a decade. I was diagnosed with an annular tear L4-L5 and sciatica w/o radiculopathy in 2005 by a spine specialist. Had countless eipdurals w/fluoroscopy, MRIs, nerve block injections, discography w/ CT, x-rays, trigger-point injections, etc. Also, had surgery for fractured left eye orbital required reconstruct and three permanent titanium plates to be put in skull in 2006. Been under psychiatrist care since 1999 for anxiety and some depression. SOOO...starting in 2003 I was on 40-80mg hyrdrocodone daily for my back until the diagnosis in 2005. From then I was on 20mg oxycontin 3/day and 120 percoset 10 for breakthrough, then referred to pain management where I kept the same protocal but was upped to the 40mg oxycontin and briefly tried morphine time release w/oxy for breakthrough and since my pain management was working with my psychiatrist who also is licensed to rx suboxone, briefly tried switching from morphine to subs and really didnt tell much of a difference between the two, but after losing my insurance, went back to the morphine (cheaper) and subsequently switched to roxicodone 30mg 5-6 daily. This went on until May of 2008 when I left the pain management of my own will to try and function w/o any pain meds and taper off of the xanax as well. Ultimately I had the plan of joining the Navy and in August signed into the DEP program to ship out early 2009. At this point, my psych had me on tapering xanax and suboxone as the only opiate. I was able to finish my taper about a week before I flew out to Chicago at which point I was on no medication at all. This lasted 10 days and I was then medically separated to return home from the NAVY. (NOTE: I never mentioned back problems to the Navy in fear of ineligibility) Immediately I went back to my psych and was put on 8mg 2/day suboxone and xanax 1mg 4/day (only take usually 2-3/day) and adderall 20mg for school. Since getting back early May, I enrolled for 6hours in summer school which I completed with a 3.5 G.P.A. for the semester (I am a senior BTW). I saw a GP about my back pain as I felt it needed some attention as it had gotten aggravated while at boot camp. They RX'd tramadol, toradol, lyrica, and phenergan and referred me to pain management. I saw PM last monday and was charged $260 for first visit, $100 for the urinalysis, and Rx'd a two week supply of 5mg 8/day of oxycodone and flexeril. I told the PM doc I had just gotten off of the suboxone at 16mg/day and tramadol did nothing and toradol while great, was not a long term option as my stomach was killing me (history diagnosis of ulcer and GERD after endoscopy w/esophagus dialation), hence the reason for the phenergan. Now, I am one week from seeing the PM doc again for my two week follow up and another $90/office visit, not to mention another $100 if they give me another urinalysis plus my two week meds cost $140 and I initially had another x-ray done which I still don't know how much that will be in charges. So, basically because I have no insurance at the moment I am broke and on unemployment and now to my question ultimately - is it normal for me to feel very undertreated for my pain i.e. not as much relief as I was getting from the suboxone w/tramadol and toradol or even suboxone ALONE, than now with only my 40mg/day of oxycodone. I told the PM I used to take 30mg oxycodone 5-6/day and she said that was a year ago and I had no tolerance...and made no mention of the suboxone I was taking at 16mg/day up until that appt. Well, am I crazy or does not the buprenorphine (an opiate) in suboxone also have pain killing and tolerance to opiate properties??? I feel like I am in more pain now under the care and extreme high cost of PM who is telling me to take 40mg/day of oxy and 2 flexerils (cannot take NSAIDS), as well as having to pay a $100/per for urinalyses and x-rays which are useless to show an annular tear as I understand it, plus having visits every 2 weeks??? I think they also want to do another nerve conduction which I have already had (but its this PM docs specialty so...) at who knows what cost... Basically this is a lot of history that all comes down to the simple fact that I KNOW I have a tolerance to pain medications and I am pretty sure it has to be from the SUBOXONE I was taking since transistioning from the 30mg/5-6 a day of roxicodone in may of 08, but with a short break during my time (10 days) at the Navy, then resuming the suboxone upon return. But somehow the doc thinks I can just start over at 240 5mg capsules of oxy /month (40mg/day) and no NSAIDS and be alright until my tolerance builds up. I don't want to say anything in fear of looking like a drug-seeker or addict, but I am not comfortable, still in pain, broke, and frustrated...and I have NO idea what my next move should be...get a refill on the suboxone and say goodbye to the PM doc, see my family doc (who I know will treat chronic pain, but said could not rx a narcotic while receiving suboxone) and explain to him my situation (only $55/visit), or see the PM doc next Monday and pay another $200 to just hope I can somehow get my meds upped to a level that will allow me to hopefully get a part-time job while I finish school (probably as a waitor as the hours only fit with school, but that requires lifting/twisting/stuff that aggrivates my back)...because I have 5 weeks of unemployment left and thats it. I am hoping for financial aid from school but its never a definite so...IM so frustrated...I went thru agony coming off of suboxone to be able to take regular pain meds that might work better for me, just to pay over a thousand dollars and get 40mg/oxy day that gives less relief than I had before..is suboxone really that good of a painkiller (but at $7/pill who can afford it w/o insurance) or is this DR just not smart enough to realize that I obviously have a tolerance from the 16mg/day suboxone and that taking 40mg/day of the last other med I took for pain when I last took it at 150-180mg/day (OXY) is not going to cut it, OR am I subconciously focusing on the psin (it IS always there) and just wanting an excuse to take more medication daily?? PLEASE anyone with replies , especially DRs please give me some feedback, I need to do something within the next week and am very sensitive to having any DR view me as a drug-seeker and am even more sensitive after being sent home medically from boot camp...my parents are not very supportive since then so I basically have to pay everything for the first time in my life off of a weekly unemployment check and hopefully school financial aid. Again please any comments and suggestions, please. -Tim