Drug War Issues
Politics & Advocacy
Under a proposed rule unveiled Wednesday, the Drug Enforcement Administation would allow doctors prescribing Schedule II drugs, such as morphine or Oxycontin, to fill prescriptions for 90 days instead of 30 days. Currently, pain patients can only get 30-day non-refillable prescriptions, requiring them to make additional visits to the doctor's office just to get a new prescription written. Doctors and patients have complained that the DEA's strict regulation of Schedule II drugs has forced doctors to limit their prescriptions, with patients going untreated as a result.
At a Wednesday press conference in Washington, DEA administrator Karen Tandy attempted to signal that the agency was hearing those concerns. "Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards," said Tandy in remarks reported by the Associated Press. "Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged."
While the number of doctors who faced federal charges over their prescribing practices is relatively small, it is increasing -- from 38 in 2003 to 67 last year. Other pain management physicians have faced state criminal charges of administrative sanctions, and pain patient and physician advocacy groups complain that the agency is interfering with and having a chilling effect on the practice of pain medicine.
The move was welcomed by the American Medical Association, with AMA board member Dr. Rebecca Patchin telling the AP it was a step toward improving the care of pain patients. "Relieving suffering while doing everything we can to prevent the abuse of controlled substances reflects appropriate patient care, a standard which is easier to achieve when a strong patient-physician relationship exists," said Dr. Patchin. "We need to provide access to pain relief for patients with legitimate needs, and the DEA proposal would help in doing this."
Others were less sanguine. "Ms. Tandy states here, as she has on many occasions, that doctors need not fear criminal prosecution as long as they practice medicine in conformity with what these drug cops think is 'appropriate,'" said Siobhan Reynolds, president of the Pain Relief Network. "If that isn't a threat, it will certainly pass for one within the thoroughly intimidated medical community."
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Comments
Cause for Hope?
I think perhaps this issue hits home for at least a few in law enforcement, as they, or their loved ones may have experienced a period of intractable pain and were unable to get sufficient medicine to deal with it; or remains in the minds of many of them as a potential if physicians refuse to prescribe for fear of prosecution. The threat of severe, prolonged pain is a powerful force.
In reply to Cause for Hope? by Anonymous (not verified)
Cause for Hope.....
I feel for those in pain, and if those in "true pain" seek the medical attention they "truely need" they do get a sufficient amount of pain medication. They in fact, seem to never have problems....30 days is a long time...you have weeks to plan ahead...and if you are in severe pain, most doctors will mail your C-II to your pharmacy.
This will only be yet another dumbass move on our great American System....long live the junkies. They are the ones that the 30-day limitation affect, they are the ones who cannot pick up the phone and make arrangemens with their doctors to have a script waiting for them, or mailed to them or to their phamacy and now, hell, let's give them 90-days....I have worked around this b.s. for 5 years now and over time have only noticed the problem worsening and it sickens me, that as the problem grows, the law is just making it easier and easier. Physicians aren't afraid, patients just aren't coming in for real pain anymore, it's the high, it's the street value. They come to the pharmacy and pay cash and then move on the next town, to the next doctor, to the next pharmacy....I'm tired of seeing these junkies get away with it. Doctors and pharmacist alike can tell who needs it and who doesn't. No wonder our country is in the shape it is in today, noone is willing to sacrifice just a little bit of an inconvience for themselves, to try and make our world a better world for the generation of little people, little people like I'm raising and care about. How instead of debt and drugs, we leave them something they can be proud of....CHANGE!!!
In reply to Cause for Hope..... by Anonymous (not verified)
You want change pal?
You have obviously NEVER felt REAL pain in your pathetic little life....So maybe if thier is a god or true justice in this B.S. world...a world made-up of truely compassionate people like yourself...
Hopefully the day will come for! The pain that 76.5 MILLION pain patients feel chaces you down! Then and ONLY THEN will you understand what it is like to suffer every single agonizing day from Chronic Intractable Pain!
Maybe, for once the ignorant (you), will get to feel the full force of what it is to be a REAL pain patient but treated like a junkie or some kind of addict when all you want is pain relief!
You wouldnt know anything about living in excruciating pain...very much the same as a Nazi would not understand what it would feel like to be a Jew starving to death in a concentration camp!
It's people like you who desperately need change...a change of your perception of life...a chance to see that even a so-called "junkie" is still a human-being and that thier addiction is a a disease!
I have lived with pain you couldnt imagine and I have been treated worse than a dog because of it, all by people like you!
So be very carefull what you wish for pal...you want change, you might just get it! In the form of a crippling, dibilitating, invisible pain disorder...I used to say I wouldnt wish my pain on anyone...but how else are you idiots going to learn?
25tolife
In reply to Cause for Hope..... by Anonymous (not verified)
C II refills
I can see you are truly concerned with all of healthcare's many varialbes. As you have the great thought process at work to call those in cancer pain, post surgical,and non cancer pain, "junkies" and "long love the junkies".
I was run over by an eight thousand pound truck from my left
shoulder across my chest through my left hip shattering all bones lungs, internal organs, and their processes.
While I recieve pain management medication and have done so for 10 years I would not spit into the wind if I were you.
I never dreamed or planned that I would become totally disabled and the single parent of four children, but here I am.
Before you judge anyone especially those with bonafide medical problems you should attempt to walk in their shoes!
There is an old saying : "There but for the grace of God go I".
In reply to Cause for Hope..... by Anonymous (not verified)
Please...
You're self-righteousness is going to cause you more nosebleeds from keeping it so high in the air.
In reply to Cause for Hope..... by Anonymous (not verified)
For those junkies?
For the little ones? What if one of your little ones grow up, God forbid, with a problem that causes so much pain they can't stand it and they are not allowed any medication to help them? There has been problems for years abd years with drugs. Just because things have evolved to where junkies as well as people in pain can go to the same doctor does not mean that everyone is looking for a high. Unfortunately, I have been in severe pain for years. For the first few years I refused any help from my doctor. I literally had to set my clock twenty minutes early to be able to get my children up for school, because thats how long it took me to just get out of the bed because of the pain. Finally I decided I NEEDED HELP and agreed to try some pain meds. This has certainly changed over the years. Now a lot of doctors have found ways to make monry off of this situation and end up hurting the patient, while the others look at everybody as a junkie and thats how you are treated thses days. If yiou had been through just a little of what I.ve been through with failed spinal surgeries etc. you might be of a different mind. You're PC's won't hardly write tyelonol anymore so you're sent to pain clinics who do expensive procedures on your back that may or may not help but if you don't let them they won't write your meds. What about the rest of your body that hurts constantly from arthrithis, etc? Live in my shoes for one day and I promise you will change your mind.
RX FOR PAIN
It has never ceased to amaze me how those on each side of this argument are separated by the thin line in the sand that I call "holy shit, this really hurts!" Once they experience true unrelieved pain, either personally or vicariously, they are quick to jump to the enemy side, never to question "the right to be pain free" again. I have been a legal dispenser of class 2 narcotics for many years, always seeing things from the paitients viewpoint, and yet, I was always made to feel as if I had inferior morals and a poor attitude. About 5 years ago I was hit with physical problems that caused me to experience the "holy shit, this really hurts!" type of pain. At first the doctors were quick to prescribe class 2 narcotics while they were "fixing" me. Then they were done, and I had to be better. The only problem was that I felt worse then I did before they worked their magic. I was left a semi-invalid for another 2 years because the surgeon would not admit that he had used the wrong size hip replacement. Within a year, he had given up his practice to do hair transplants. No lawyers would take my case because of the close knit group of professionals that predominate in the Maryland area. Even surgeons who told me that I had been given the shaft(actually it was the wrong size shaft!), would not agree to testify. In the mean time, I was suffering and going down the "chronic pain drain". This is where the situation became problematic because ,like I said, I was a dispenser of class 2 drugs. Get the picture? I am in mortal pain with narcotics all around me! This story does not end happily but if anyone wants to know the conclusion, send money to produce the movie.
DocA
In reply to RX FOR PAIN by Anonymous (not verified)
RX FOR PAIN
I too have always been very sympathetic to patients need for pain medication. As an ER M.D. I see lots of suffering. I have been chastised by nurses who often refuse to administer the ordered drug saying I could administer them. As soon as I do that then I am whispered about "loudly"
as possibly being an addict because of this practice. The physicians I work with often give nothing but NSAIDS even for fractures. Occasionally giving Toradal for a hip fracture. I have always regarded these people as never having been in pain. Boy when they have pain it really changes their thinking. I have Lupus, My mother has Bechet's, add several more dx's for both and I personally know what being in chronic pain is. I no longer practice in the ER because of pain and fatigue but am continually told that patients with Lupus aren't treated with pain meds! Or my mother's rheumatologist told her he didn't prescribe Vicodin when she asked for a few to take on vacation if her pain became severe. Oh but prednisone with
dire effects is handed out frequently. Or the usual course with chronic pain is that you will be treated during the acute surgical phase or perhaps for one or two years and then told either that you should be better now or that you've become an addict and they can't see you anymore. Yet I read the memo's sent out by several states telling doctors under treat pain (big surprise) and to be more liberal. Then I read about prosecutions of doctors but they are usually doing something illegal. I have found as you have that if you do what is right for the patient an keep reasonable records you will stay out of trouble. this only applies if you're not in chronic pain. It ruins you're health, quality of life and negatively affects all your relationships. You represent the old saying NO GOOD DEED GOES UNPUNISHED. I only wish I had an answer for you.
Pain Meds
I am a pain management patient and where I live I must travel 2 days to see a doctor to get the medication that I need, It really is so unreal that the "powers that be" would rather we pain patients to suffer the rest of our lives rather than have a normal pain free (so to speak) day. But then we in America have no civil liberities anymore. It's really a damn shame.
Xaliax
Back pain
Its so hard for me to get medication for my back pain. i cant sleep at night and i cry sometimes because it is killing me, but most doctors dont like giving out pain medication, and all my x rays show that my pain must be terrible. sometimes i want to die because i cant deal with this pain 24 hours a day, i wish someone could help me. [email protected]
Refills on Scedule II Narcotics woud be a blessing.
I have suffered with intractable low back pain for almost 9 years. I thank god that I was able to find a compasionate reliable doctor (there are a few out there). I have been on a stable dose of narcotics now for 4 years with only a small increase of break through medication during the period. My problem is financial. I am forced to go back every month for a refill on 1 of the three medications because of the schedule 2 restrictions on refills.
Living below the poverty level makes it almost a miracle when I come up with the $115.00 every month (thank god for Mom). The change to getting refills on this medication would not only relieve some of the financial burden 66%, it would help relieve the stress involved knowing that I must borrow this money every month.
Please make this law as soon as possible, the relief would be greatly appreciated not only by myself, but by millions of low income patients all around the country.
[email protected]
chronic pain and addiction
after being diagnosed w/ fibromyalgia my pcp feels the need to constantly remind of the dangers of addiction.
i understand what what the word means obviously, however i feel it should be my choice whether or not the risks outway the benifits. if you are given the choice to regain some of your
mobility and some degree of pain relief through the administration of an fda approved substance and being labled
an addict, its obvious that anyones opinion as to whether or not this decision constitutes addiction is highly subjective.
i wonder if doctors suffering chronic pain hesitate in self medicating, i highly doubt it.
so now what do we have here, is it because we as patients are
less educated and to arrive at the assumption that because of
that education they are in a better position to deal with the possibilty of addiction then we are.
High level of pain
I have been diagnosed with some pretty severe conditions and will require pain medication for quite some time. My dilemma has been the doctor being afraid to prescribe a higher milligram of the medication I have been taking because the medicine is no longer giving me the pain relief that it once did. I am being looked at as an addict! How sad is this! I can clearly read the pharmacy leaflet that states if this medication is no longer working speak to your physician. Well I have done that now I feel guilty when my medication is about to run out and I have to schedule another appointment and go back so many times, it might look as though I am having some sort of a problem but that is not the case. We should be allowed to be pain free in this day and age. Why must I go to the doctor so often to be out of pain. With the level of pain I am afraid to not have my medication and be in agony. When are they going to pass this law so the doctor doesn't feel as though she is under a microscope, and get me out from under the microscope also? This law would be a blessing.
Cost is partly passed on to Medicare
Those extra unnecessary doctor visits to get refills, in many cases get billed off to Medicare. Medicare pays out more while the patient consumes physician time for something that should have been scheduled for three month review. Money wasted at a time we can't afford it.
pain and more pain
Many people suffer from any kind of pain, i'm one of them, i have back pain becouse i work with heavy stuff, i know there are many like me,and the problem is the money for the drugs, Where to find cheap drugs ?? why prescription ?? well i want to give you an advice one find a doctor friend, two surgery, tree use drugs, the easy is the number 3 i give you a link where i go, a place that work for me, where they help me www.trustedprescriptionsonline.com, or go to your doctor and see the real problem, hope i help you
thank you
doctors only protect themselves
I suffer fro several rupture disks in my lower back and also diagnosed with complex regional pain symdrome but I don't like to take opiatesbecause it makes me constipated, I rather use norco but the problem is the time isn't long enough. I'm prescribed 8 per day but when I have alot to do it's just not strong enough or last the time needed is there any thing out there that can help the doctor has given me tapentadol but because its a relatively new drug insurance won't cover it.I' hoping that this new law passes because I only get 12 free trips per year and have to use them all up with pain mangement and what about my heart physical therapy, and the other tests they run on me. cant take public transportation because it's to far and I can't walk for short periods and no wheel chair because I livve in a two story.The DEA needs to find better ways to works this out along with the cannabis situation. I live in ca where it's almost legal but because I signed a pain contract I can't use it or I'll be kick out of the system,wish I could find a cannabis friendly doctor that can prescribe my pain meds and don't mind when the pain gets to bad that I smoke cannabis I live in san diego Ca. if anyone has any info on this please fre free to drop me a line [email protected] , and thank you for letting me vent with you guys
Damage done by doctors
I was in a pain management for three years here in "Good ole KY." That doctor gave me adequate pain meds and for the first time I wasn't looked at like a junkie. Problem is he had an agenda that I didn't know about. Give you more meds, after a year or so, start billing you for more and more. Four hundred above what I always paid each visit the second year, which I paid by paying extra each visit, without question. Third year immediately started out with nearly seven hundred dollars they said I still owed. Questioning the book keeper, she said each month, don't worry it's stuff thats pending with you're insurance, you don't owe anything." Wrong answer. In October I went for my monthly visit, traveling over three hours was not only expensive but extremely had on my arthritis riddled body, and when I got there they said my chart was locked by the book keeper and I had to pay almost a thousand dollars, it had grown that quickly, to see the doctor. I have always paid my bills somehow, but this I had no earthly way of paying. I always worked ten to twelve hours a day before I got so sick I couldn't hardly walk. I didn't want to talk to the book keeper, I waited for the doctor to walk through to talk to him. They both came together and the book keeper tried to say she'd told me already I needed to pay some on this bill. I told the doc she was a liar "to her face" they decided together that I could see him this time but she would give me my balance that would have to be paid. It was a little over two hundred dollars she penned it on an invoice. By the time I got back the next month it had risen to two hundred fifty five, plus what I always had to pay. There went my kids Christmas I'd been saving. Thinking it was over I stupidly went back in November, after calling my ins. only to find out that every bill sent to them had been paid, and my chart was locked again. I was told I had to pay another two hundred and fifty five dollars plus the extra to see the doc. I told them I didn't have that much money and asked where the charges were coming from since my ins. just told me they'd paid all bills. I was litterally ran off. No meds, no explanation, nothing. I've since found out they've done a lot of patients that same way. Here's my problem, I had no one that would help me through the process of coming off the meds he had me on. I would not wish what I've gone through on any human being. I have lupus, RA, a brain tumor, have had spinal surgeries from degenerative disk disease, I've actually died twice, and still no one would help me. I changed PC's because they didn't even want to send referrals to another pain clinic. This doctor said she would help me but I had to see a behavorial psych before she could, new law in KY. This idiot suggested that maybe I didn't even need the meds, to keep me off of them for several months and then see if I was in real pain. Had to have someone take me two hours one way for that brillant analysis. I've had neuro-surgeons ask me how I could stand the pain I live in every day, and this nut thought I didn't really need it. Now "miss I will help you", wont lift one finger and I was referred to another idiot in a pain clinic who gave me tramadol. When I went back and told him I couldn't take it because I had an allergic reaction he got mad and gave me Butran patch. After five days I ended up in the hospital with this patch. I have asthma and have had severe pneumonia which landed me on a ventilator for five weeks and I thought I was dyeing. The hospital thought I was having a heart attack and admitted me doing breathing treatments and stress test etc. It wasn't my hearyt turns out it was that patch so the hospital called and made me an appointment a few days later with my new nut. I went in and explained what had happened and he got ragging mad and told me not to aggravate him. Here I am still in this mess looking for a "REAL" doctor and I don't know where there are any in KY. If they would help, they are to afraid to, only the con artists are left, and there are plenty of them here. I need help but am beginning to think there is no such thing here anymore. If you knew what I have gone through, dealing with the pain as well as having no meds and withdrawals from what the first con had me on, you'd be crying out for help. What is wrong with taking medicine for pain? I have never used illegal drugs, I don't drink, I've never sold or purchased meds from others. Why am I suddenly a suspected junkie because I've "been in a pain clinic" so now I'm labeled? Where is the legal system when patients are treated like this? Oh and the first pain clinic, I've since gotten a bill for less than half of what they were trying to make me pay. Funny right?
Damage done by doctor's
If you would like to know who this first con artist with a white coat is, e-mail me at [email protected]
Nobody should be done this way.
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