I have been seeing pain management specialists for 14 years. I have had 4 neck surgeries and have severe nerve damage. I have been on 30 mg Oxycotin 2x daily and short acring 30 milligrams of oxycodone for breakthrough pain. Which I need all the time. Because Oxycitin can no longer be chopped up it is safe. But now becuse The short acting oxycodone is the new "party drug" the DEA is making my pain management office reduce their patients oxycodone. I was wondering if this is happening ro anyone else out there and if your offices are offering anything else to replace it because I cannot find anything tnew that helps against severe nerve pain. Why the DEA is involved in pain treatment is beyond me, but even pharmacies like CVS is saying the DEA is only allowing them to order only so many narcotics anymore. Is it just Maryland this is happening to or is a y other state going through similar issues? D
Virginia is that way too. They need a prescription that has 3 copies. Guess where the copies go-the state pharmacy board and the DEA. My pain dr just won't order much. They are all petrified. My pain dr in virginia lost his license for 2 years, and now he can do no pain management. I moved home to PA, not for that reason, but its home. Here we only need a regular prescription form. I just learned that my friend in jersey saw a sign in her pharmacy yesterday that they don't keep oxycontin in stock. That means you aren't going to be able to get your pain med on time. I've called the DEA and told them they had no right to practice medicine, it fell on deaf ears, they just said they aren't, for which they received a bs from me. The problem is we have too much pain to go to DC and make our problem known. With the millions in chronic pain in this country we could get some attention.
Only the people on the street have drugs, not the ones who need them.
This has not happened to me personally from my pain management dr, but my pharmacy told me the DEA only allows me to have two meds that are schedule 2 per month or 2 that can become habit forming. I have heard it has happened to many other patients in other states. I am in Calif and the DEA has not yet contacted my pain management dr about it that I'm aware of. In my opinion the DEA has no business in the medical field. Have you tried gabapentin or lyrica for your nerve pain? I also have nerve pain and take oxy as the gaba and lyrica does nothing for my pain nor does the oxy; however, many people claim they get much relief from either gabapentin or lyrica.
In my state, you can only be prescribed one month at a time. The insurance companies are also making sure you aren't taking it more often than it is prescribed. If you have an especially bad day or two and take an extra dose, you will run out before the month is up, and they won't let you refill it early, even if the doctor gives you a new written scrip. It's time a new delivery system was designed so those who are genuinely in need of pain meds can get them without being hassled.
Lilly, Although the FDA is a pain in the neck, they can't, don't and won't tell doctors what prescriptions they can write. Your doctor wants to stop prescribing as much pain medicine as he or she has and, like many others unfortunately, the people in your doctor's office are making up a story so they don't have to take responsibility for the decision. CVS also makes up stories about how much pain medication they're allowed to order. They may be restricted to a percentage more than their historical purchases, but they aren't being told they have to order less. And with the proper paperwork done, any pharmacy can get exceptions to their history-based allocations, but their pharmacists move around so much that no pharmacist is willing to take ownership of the ordering process at a particular store. Other pharmacies are even worse. Walmart doesn't even stock Oxycontin or Oxycodone.
They've told me ridiculous things like " we aren't allowed to carry that because there have been so many problems with that drug". A total lie. WM doesn't want to deal with taking good care of the inventory and they obviously don't trust their own employees.
The attitude among healthcare workers that everyone taking serious pain medication is a junkie and doesn't really need it is getting more prevalent and it's based on their ignorance and prejudice. The day they have a serious accident and need pain help is the day they'll sing a different tune.
Before my Primary Care referred me out due to fear over new prescribing laws, I was on 5 20mg Roxicodone a day. Now that I'm in a Pain Management Clinic, I'm only given 15mg 4 times a day and have been told numerous times that I am at the limit. By law they can't prescribe me a higher quantity nor can they raise the milligram. I have been reminded of this over and over. Is there any actual law or guidelines that claim no more than 60mgs a day? I honestly don't believe them but what do I do? Open my mouth and challenge it so I can loose my clinic?
The DEA started it and a group of doctors looking for free trips and to get their name put on studies promoted it.
I can give you an interesting scenario of one of these doctors without using his name or state. If you are interested in how this craziness got started.
The CDC now has guidelines they must follow.
Go to their website and look up "use of opioids"
Here is a section to get you started :
Checklist for prescribing opioids for chronic painFor primary care providers treating adults (18+) with chronic pain ≥ 3 months, excluding cancer, palliative, and end-of-life careCHECKLISTWhen CONSIDERING long-term opioid therapySet realistic goals for pain and function based on diagnosis (eg, walk around the block).Check that non-opioid therapies tried and optimized.Discuss benefits and risks (eg, addiction, overdose) with patient.Evaluate risk of harm or misuse.• Discuss risk factors with patient.• Check prescription drug monitoring program (PDMP) data.• Check urine drug screen.Set criteria for stopping or continuing opioids.Assess baseline pain and function (eg, PEG scale).Schedule initial reassessment within 1– 4 weeks.Prescribe short-acting opioids using lowest dosage on product labeling; match duration to scheduled reassessment.If RENEWING without patient visitCheck that return visit is scheduled ≤ 3 months from last visit.When REASSESSING at return visitContinue opioids only after confirming clinically meaningful improvements in pain and function without significant risks or harm.Assess pain and function (eg, PEG); compare results to baseline.Evaluate risk of harm or misuse:• Observe patient for signs of over-sedation or overdose risk.– If yes: Taper dose.• Check PDMP.• Check for opioid use disorder if indicated (eg, difficulty controlling use).– If yes: Refer for treatment.Check that non-opioid therapies optimized.Determine whether to continue, adjust, taper, or stop opioids.Calculate opioid dosage morphine milligram ***equivalent (MME).• If ≥ 50 MME /day total (≥ 50 mg hydrocodone; ≥ 33 mg oxycodone),increase frequency of follow-up; consider offering naloxone.• Avoid ≥ 90 MME /day total (≥ 90 mg hydrocodone; ≥ 60 mg oxycodone),or carefully justify; consider specialist referral.Schedule reassessment at regular intervals (≤ 3 months).REFERENCEEVIDENCE ABOUT OPIOID THERAPY• Benefits of long-term opioid therapy for chronic pain not well supported by evidence. • Short-term benefits small to moderate for pain; inconsistent for function.• Insufficient evidence for long-term benefits in low back pain, headache, and fibromyalgia.NON-OPIOID THERAPIESUse alone or combined with opioids, as indicated:• Non-opioid medications (eg, NSAIDs, TCAs, SNRIs, anti-convulsants).• Physical treatments (eg, exercise therapy, weight loss).• Behavioral treatment (eg, CBT).• Procedures (eg, intra-articular corticosteroids).EVALUATING RISK OF HARM OR MISUSEKnown risk factors include:• Illegal drug use; prescription drug use for nonmedical reasons.• History of substance use disorder or overdose.• Mental health conditions (eg, depression, anxiety).• Sleep-disordered breathing.• Concurrent benzodiazepine use.Urine drug testing: Check to confirm presence of prescribed substances and for undisclosed prescription drug or illicit substance use.Prescription drug monitoring program (PDMP): Check for opioids or benzodiazepines from other sources.ASSESSING PAIN & FUNCTION USING PEG SCALEPEG score = average 3 individual question scores(30% improvement from baseline is clinically meaningful)Q1: What number from 0– 10 best describes your pain in the past week?0 = “no pain”, 10 = “worst you can imagine”Q2: What number from 0– 10 describes how, during the past week, pain has interfered with your enjoyment of life?0 = “not at all”, 10 = “complete interference”Q3: What number from 0– 10 describes how, during the past week, pain has interfered with your general activity?0 = “not at all”, 10 = “complete interference”TO LEARN MOREWWW.CDC.GOV / DRUGOVERDOSE / PRESCRIBING / GUIDELINEU.S. Department of Health and Human Services Centers for DiseaseControl and PreventionMarch 2016
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