Government controlling what pain management doctors prescribe

By Lori Byrnes Latest Activity October 17, 2011 at 9:10 pm Views 3,657 Replies 44 Likes 10

Lori Byrnes

I posted this for discussion on the Back Connect site also, but I wanted to get everyone's opinion, so here goes. Here in Florida, the PA in my pain management doctors office told everyone that starting next month, due to government regulations, that the amount of pain medications (oxycodone in particular) will be decreased to a maximum of 6 per day, no matter what the patient's condition. While I realize that they are fighting a drug war with the "pill mills" across the country, I don't believe that the government has the right to dictate across the board what the pain management doctors are allowed to prescribe. Where did they get their medical degrees? My doctor tailors his combinations and amounts specifically to the patient's documented injuries and length of the condition. He currently writes a maximum of 8 oxycodone per day, mixed with something long acting like MS Contin or Fentanyl patches. He does random drug tests to be sure that people are actually taking their medications and not selling them, he takes insurance (unlike the "pill mills"), and he makes sure that everyone is up to date on their tests (MRI's, etc.) The other thing I heard (and I'm not sure this is true) is that they are only going to be able to write one Schedule II narcotic (like MS Contin or morphine) and the prn medications can't be stronger than Vicodin (the weakest of the narcotics now that Darvocet was taken away). What's going to happen next, they're going to tell them they can't prescribe narcotics no matter what the condition? I would appreciate any and all opinions on this.

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  • Lori Byrnes
    Lori Byrnes November 22, 2011 at 5:44 pm   

    Just an update on the above discussion: I went to my PM doctor today, and was told by the PA that there are certain diagnoses (with failed back surgery being one of them) that allow the doctor to write the maximum dose of oxycodone at 240/mo, based on a case by case basis. I was lucky enough not to be cut, but she said that could change at any time. She also told me that since these new laws went into effect, a lot of the pharmacies will only give out 180 pills, even though the prescription is for 240. I'm lucky enough to go to a pharmacy that knows my doctor well, and knows that he's not a "pill mill", so they don't give his patients any problems, but a friend of mine went last week and had to go to 10 different pharmacies to get his prescription filled because it's the end of the year, and they were all "out". Two years ago, they met their manufacturing quota the beginning of December, and it was impossible to get that medication anywhere. This year they've met their quota earlier, not taking into account that there are new back injuries and other pain management problems occurring every day. I guess they consider this the same way they consider "cost of living increases"-NOT!!

    I hope for everyone's sake on this site that you don't have this problem in the area that you live in. As of November 1st, all pharmacies are now connected to be sure the patients aren't "doctor shopping", and people with no Florida ID or address can be prescribed to in the state of Florida. Hopefully this will help enough that they will stop this ridiculous campaign to stop the doctor's from appropriate prescribing. Good luck to all.

  • Lori Byrnes
    Lori Byrnes October 20, 2011 at 2:13 pm   

    Well, it happened. My 65 year old friend went to the doctor today, and they cut his oxycodone from 240/mo to 180/mo. A difference of two pills per day may not seem like a lot, but to those of us who are in pain 24/7, we're now counting the minutes until the 4 hours is up. It's terrible when we're only going to get worse. My fear is that people who never have before will resort to buying it off the street, which defeats the whole purpose. Next thing you know, they'll be doing away with this medication altogether, even though it works well for a lot of people.

  • 100 Acre Woods
    100 Acre Woods October 20, 2011 at 11:26 am   

    I do believe that it should be a case by case 'as needed' decision.
    This type of regulation results in people going to several different
    Drs to get the pain medicine that they need and that isn't good for
    Anyone.

  • Lori Byrnes
    Lori Byrnes October 20, 2011 at 2:08 pm   

    They're not going to be able to do that either, because now all the pharmacies have their computers connected and can tell if you're going to more than one doctor. What I'm afraid is going to happen, is that those people that need the medicine are going to resort to buying it off the street, making the drug dealers richer than they already are. Kind of defeats the purpose, wouldn't you say?

  • Lori Byrnes
    Lori Byrnes October 19, 2011 at 11:21 pm   

    I just want to thank everyone for your opinions. I posted this same thing on the Back Pain site and only got 2 replys-I have to say I'm amazed. I'm about to join the chronic pain site just to see what they have to say. My thoughts are that anyone who thinks this won't happen to them is sticking their heads in the sand, and the only way to turn it around is to get passionate about it. THIS IS YOUR LIVES THEY"RE MESSING WITH!!! Don't let this happen to you too.

  • Dr Gary
    Dr GaryCA October 18, 2011 at 3:24 pm   

    Hi Lori,

    I am also surprised to hear this. It seems like an arbitrary decision based on statistics, just taking the average and forcing everyone into the same mold. It may work for the majority, whatever number that is based on. But it is not going to work for everybody, and those that it doesn't work for may be miserable as a result.

    I just did some work related to pain management that involved talking to a lot of doctors. Invariably the problem of drug abuse comes up for them. The all have war stories. But they also know that the vast majority of their pain patients really need pain medication, and each one is unique in terms of their pain level and what they need to do to help them. They are under all kinds of restrictions from insurance companies and the government already. So this is kind of a case of a few bad apples doing damage to a whole lot of people with legitimate needs.

    It's a tragedy for people in need., it seems to me. I am not an expert, of course. But I if these decision-makers spent time on this Website, they would see a different side that would put their statistics to shame. Hopefully, with all of these regulations in place, they are still going to have a system in place to evaluate the exceptions.

    Gary

  • Neisee
    Neisee November 2, 2011 at 11:36 am   

    In our dreams!!! When government gets involved it is almost always the people who lose out. Been there, done that.

  • Old-n-Grey-n-Wiser
    Old-n-Grey-n-Wiser October 28, 2011 at 2:23 pm   

    You said a mouth full!
    They are under all kinds of restrictions from insurance companies and the government already. So this is kind of a case of a few bad apples doing damage to a whole lot of people with legitimate needs

    Tom

  • Lori Byrnes
    Lori Byrnes October 28, 2011 at 5:42 pm   

    I just hope they don't decide to do away with the oxycodone alltogether. I was on a stronger pain medication previously, and asked to be switched. It works well for me, I'm able to do things that I haven't been able to do in almost 4 years (unfortunately I still am unable to work), but at least I'm not in a wheelchair or spending most of my time lying in bed because it hurts too bad to get up. My pain management doc's PA said that it's going to take someone with chronic pain in the decision-making process to make a difference, even though she strongly encouraged a petition to the Governor as well as people writing to their congressmen. According to my research, Dr. Alex Cahana, the head of the University of Washington's Division of Pain Medicine is the chief proponent of the new regulations. Back in 1987, Washington State Medical Dispensary Board opposed prescribing opiates for chronic pain, and it was only stopped due to an outcry by the prescribing physicians. Statistics should show them that with the amount of chronic pain patients that are out there that this stupid, uncalled for regulation is going to ruin anyone who is supporting it's chance for re-election. There are better, more appropriate measures than taking away pain medication from patient's with legitimate problems.

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 8:24 pm   

    After working ER for so long, I totally understand the problems that doctors face with drug seekers. But if the person has documentation that shows how bad their problem is (MRI results, EMG results, etc., ) then there shouldn't be a problem. It's those "pill mills" who will hand out a script to anyone with the cash, no matter how minor their condition,that ruin it for all of us. Like I said, up until now my PM doctor has been able to taylor the prescribed medications to each patient's condition-he doesn't just hand out the same thing in the same amount to everyone. But with these new regulations, everyone is being cut across the board and he's only allowed to prescribe 180 oxycodone per month no matter what. For me and a lot of others who are at the top end of the spectum, that's 2 pills less a day, which for some people makes the difference in being able to get in and out of bed, or working and not working. I would think they would rather the people who are able to work because of being on pain meds stay able to work and not have to apply for disability, which they turn down a lot of the time anyway.

  • snwbird
    snwbird October 18, 2011 at 8:24 am   

    I agree with each and everyone of you. This is so ridiculous! I too would like to know what "brillant" politician came up with this idea and where did they get they're medical degree (if they even have a medical degree)? I like the rest of you have suffered for many years with horrible pain and have just found the pain specialist that I've needed for so long and to have it taken away from me b/c of a bunch of politicians and pharmacists that think they know my pain better than a licensed, practicing doctor who has had many years of school and experience is just ludicrous! There are those of us who are legitimatly in in severe crippling pain and need these medications and aren't abusing them and there's always some body who wants to take it away. So does this mean that if they do go ahead with this and take away our medications or limit them to the extent that they do no good and we can't function because of our pain is the government going to make it easier for us to get approved for disability benefits? And now I'm just talking about my situation if I get limited on my pain meds. I will no longer be physically able to work that's why I finally found a pain specialist doctor to treat my conditions b/c I was starting to miss so much work that I was in jeopardy of losing a job that I've been working for 18 yrs. I literally could not stand to sit in a chair for over 2 hrs. without being in so much pain that I was in tears. Yes, I would get up and walk around the room/office, but that didn't really give me any relief, my pain got to the extent that if I tensed up over the slightest thing my pain would set in and that was it, I could not get any relief without going to the ER and getting a demerol shot, tell me which is worse, being on a pain medication regiment that takes care of my pain or becoming addicted to a narcotic pain killer that has to be injected such as demerol and also wasting the time of the ER doctor's and nurses by taking up precious time that they should be using to treat true Emergencies such as car accident victims, heart attacks or people having strokes which to me are true emergencies? I could go on and on, but I'll stop here b/c I'm sure everyone gets my message loud and clear. But please if you do find out who the idiot was that came up with this in Florida let us know. I'm sure if Florida goes to doing this then other states will follow suit which is scary.

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 9:34 pm   

    That's exactly why I can't work anymore, even with the meds. My back hurts so bad after just 30 minutes of sitting that it's aching down both legs and my feet and left leg go numb. My previous pain management doctor prescribed me a high dose of narcotics that got me out of a wheelchair and walking again, but he was shut down by the DEA three years ago for "overprescribing". Since then, it was 5 different doctors (a different one each month) in the same clinic until I got so fed up I found the one I have now, who is a jewel. His PA was telling everyone last month that they were going to be cut, and she said, "if you can, just take half a pill". What good is that going to do when we all continue to get worse instead of better, on top of developing a tolerance to the lower doses after being on them for years?

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 10:47 am   

    Well, since our idiot Governor is Rick Scott, I'd have to say that he has had to approve it. I can tell you this-no one in Florida will vote him back to a second term in office just because of this stupid thing.

  • 0ld car
    0ld car October 18, 2011 at 7:47 am   

    i understand the reason. But people with this arthritis like R A or O A really needs something for the pain, just to get them through the day or night.

  • chroniccyn
    chroniccyn October 19, 2011 at 2:03 am   

    Too much interference. FDA is too slow to put good things on the market that can help and then they take what works off CRAZY. Anyone know how we can fight this????

  • Lakota Twofeathers
    Lakota Twofeathers October 23, 2011 at 5:26 pm   

    We The People of America can stand up together and take our country back and give it back to the people to be ran by the people for the people and the Goverment can sit in the corner and reflect on the damage they have caused to the people and still causing.( God Bless America)

  • Neisee
    Neisee November 2, 2011 at 11:43 am   

    This sounds like a great idea Lakota. Our problem is getting EVERYONE to stand together. Many seem to have forgotten that it is the suppose a government For the people, By the people. We ( many ) have come to think the government is ALMIGHTY and we just have to take what they dish.

  • Lori Byrnes
    Lori Byrnes October 19, 2011 at 11:18 pm   

    The only thing I can suggest is to flood your congressman with letters of complaint about governmental interference. Threaten them where they live by telling them you'll never vote for someone who could do something so blatantly ignorant. The only other thing I can suggest is a class action lawsuit. There are a lot of people out there on legitimate pain medications, and if everyone got together and signed a petition against it, maybe a lawyer would take the case and get this thing turned around before it happens all over the country.

  • Neisee
    Neisee November 2, 2011 at 11:48 am   

    This is exactly what needs to be done. EVERYONE needs to write their congressman about ALL the governmental interference. Find all the people you can in your area with any sort of pain issue, go to the capital and march in there to present your complaint.

  • robertoj
    robertoj October 18, 2011 at 12:50 am   

    The abuse of prescription medications is the reason that they pass these laws. It illustrates the simplistic knee jerk type of solution that they adopt to appear as if they are solving problems. The real answers generally lie in solutions involving actions in which they have no appetite to address. That it results in actual human suffering is never a consideration.

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 10:44 am   

    Boy are you ever on the money. They can't find any other way to get it under control, so they're just going to let the "real" patients suffer. I understand about the problems with abuse of medications, but they need to do the things like catch the people who go to more than one doctor. Those doctors like mine who follow the rules shouldn't be told what they can prescribe to whom. I understand not treating patients from out of state-some of the "pill mills" in Florid had people driving in vans all the way from Kentucky and Ohio every month with cash in hand to get their drugs. Now that's a regulation I can get behind.

  • MickifromKY
    MickifromKY October 20, 2011 at 8:18 pm   

    I sat on the jury of a young man who had been trafficking pills from Florida to Kentucky; had him on video talking about how many pills he would get at a time (480). He was a persistant felon too. I wanted to give him a stiff sentence but I was overruled. He was given 10 years but probated after 2 years with time already served counted in. Several on the jury felt sorry for him because he had a tragic childhood and was so young. I didn't feel sorry for him. On the video he was high as a kite with his infant son right there beside him. After that a woman in my town was coming back from Florida after a drug run and OD'd in her car on the interstate. There needs to be some sort of collaboration between KY and FL to stop these pill mills but not effect the lives of those who truly need pain medication. Punishing all for the sins of others does not work. The innocent alway suffer and the guilty find ways around the rules.

  • Lori Byrnes
    Lori Byrnes October 23, 2011 at 6:31 pm   

    Fortunately, one of the "good" things the government did was to stop the pill mills in Florida from prescribing to out of state patients. Now you have to have a Florida residence and driver's license or ID to even be seen. Not that they won't find a way around that one too. We were having VANS full of people from Kentucky and Ohio coming to the doctors in Florida every month to get their fixes. I had a hard childhood also, but if I was doing that, I wouldn't expect to get let off easily. Just think of all the people who may have died from the pills he was selling.

  • robertoj
    robertoj October 18, 2011 at 3:50 pm   

    If they went to a universal care health system it would be easier to monitor. Plus they could flag any medications that may cause interaction problems. The pharmaceutical industry would not be happy with the lost income.

  • snwbird
    snwbird October 19, 2011 at 11:44 am   

    I don't believe in universal health care, because if you look at countries that have it such as Germany it doesn't work for everyone. If you get too old they just want to let you die than give you decent medical care, read the whole deal on that (I know it's a lot to read, but worth it) and you will see that. Also it will not do away with the abusers. What needs to be done is the laws that are already on the books need to be used and the "drug seekers" need to be dealt with as far as the laws allow. You don't do mass punishment because there are some who just want the drugs to get a high, it's not right to punish those of us who truely need the medications to function. If you read my previous post you'll understand more of what I'm talking about.

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 9:27 pm   

    Hopefully the pharmaceutical industry will fight this stupid regulation, since they have deep pockets and are going to be losing income. I know that two years ago in December, none of the pharmacies in Florida were able to get oxycodone because the pharmaceutical companies were only allowed to produce so many pills each year. My husband had to get his prescription changed to a totally different medication that didnt really work, and he went through withdrawals from the oxycodone. His new doctor sticks strictly with the long acting morphine and then the immediate release morphine for breakthrough pain.

  • robertoj
    robertoj October 19, 2011 at 1:58 am   

    Every body is different and if something works there may not be a viable replacement. I am sorry he has to go through it. I just hope they can fix the system so it makes sense.

  • marieanne
    marieanne October 18, 2011 at 12:12 am   

    This is bad, but I can see where this probably is coming from. This I
    believe is the result of situations like Michael Jackson. But these people
    have many options, & resources, so they will continue to get them- &
    thus the people (like us) will pay the price, in pain, for this new
    "regulation". Senseless! This WILL NOT control the illegal drug trade!
    To me this is much like the gun trade, those criminals that want them
    will get them. What will they think of next?! I wonder who started
    this mess, from the top? Thanks for the post. Hugs, marieanne

  • snwbird
    snwbird October 19, 2011 at 11:54 am   

    Did you realize that propafol isn't on the medication schedule? It doesn't have any controls put on it which I blame the FDA for that. That drug should never be let out of a clinic or hospital setting, the doctor was having it mailed to him. In my opinion the doctor killed Michael b/c he knew he was addicted to the medication and he left him alone in the room with the drug and needles so that Michael could easily access it and give it to himself if he wanted to. To me that is pure negligence on the doctors part. I agree Marianne that people with the money that Michael had can buy any doctor or drug they want and that is what happened in his case. The doctor is negligent also in the fact that the hipocratic oath states that he will do no harm and with the doctor knowing Michael had a drug addiction he did harm by allowing him to influence the doctor to give Michael the drugs. Wrong, Wrong, Wrong in my book. That doctor should NEVER be able to practice medicine again anywhere he let money influence his judgment and has no ethics when it comes to practicing medicine again I say punish the person/persons that break the laws, don't punish the people and doctors who act responsibly and don't abuse the drugs that they have to have to function a half way decent life.

  • Lori Byrnes
    Lori Byrnes October 19, 2011 at 11:12 pm   

    The use of propafol in the hospital is to keep patient's on ventilators sedated so much that they don't pull out their ventilator tubes!! It's also used as anesthesia to put people to sleep for procedures like endoscopies or colonoscopies, and the patients have to be put on heart monitors and oxygen monitors, in case their breathing slows or stops, as in the case of Michael Jackson. I've given doses of the same medications that the stupid doctor gave, but never without a crash cart at the bedside and the patient being on a continuous monitor. Same with the Versed that he gave him. That's to sedate people, and causes amnesia to the events-it's used a lot of times in patients with broken arms that need to have their bones realigned before being casted and patients who have dislocated hips and shoulders. It's NOT a sleeping medication. The thing that gets me is that if he was suffering from that type of insomnia, he had to either have mania from manic-depression, or he was doing cocaine or methamphetamines. I hope they lock that doctor up and throw the key away.

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 12:20 am   

    They are so determined to shut down the "pill mills" (which I'm all in favor for), that they started with saying that doctors in Florida were not allowed to treat patients from out of state, which doesn't allow for emergeny situations like a death in the family and you're out of state when you run out of your prescription (that happened to me in Ohio at my dad's funeral in 2003). Then, they connected all the pharmacy computers so that doctor hopping (which is illegal), would be immediately caught. That I don't have a problem with either. But when someone with no medical training comes up with the bright idea of telling the doctors how to practice medicine, that I have a real problem with. I don't know which idiot first had the idea, but I'm going to research it and try to find out. Just thinking about how bad some of us are-what about people with bone cancer? Are they going to tell hospice that they're not allowed to give them enough to make them comfortable while they're dying in excrutiating pain?

  • acebass
    acebass October 17, 2011 at 10:25 pm   

    This is just plain dumb! It'll drive people to pill mills or mail order outfits. Since when are politicians qualified to practice medicine?

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 12:13 am   

    My point exactly. I'm sure they'll screw this up just like they've screwed everyhing else up. To me, it's just like going to the pharmacy with a prescription and having the pharmacist say that they "won't fill this because you shouldn't be taking that many". If a qualified doctor prescribes it, who are they to refuse to fill it?

  • marieanne
    marieanne October 18, 2011 at 12:22 am   

    I agree, this is crazy! So, basically all the Docs don't know what their doing, right?! Hugs, marieanne

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 12:32 am   

    I guess that's what some of the pharmacists think. I even had one lie to my face and tell me that they don't carry oxycodone, when I know for a fact that a good friend of mine that goes to the same doctor gets his prescription for the same thing filled there. The different is, that he's 65 and looks his age, and I'm 49 and have been told that I look younger than that. Like I've said before, people get prejudiced just by looking at you, knowing nothing about what's going on inside of you.

  • marieanne
    marieanne October 18, 2011 at 12:36 am   

    So, this problem seems to come from the Pharmacists also? This is
    really getting crazy! Hugs, marieanne

  • Lori Byrnes
    Lori Byrnes October 18, 2011 at 9:23 pm   

    A lot of the pharmacies in the area, especially Walgreens, will refuse to fill prescriptions if they think the doctor wrote for too high of an amount (in their opinion). In my opinion, if they want to be in charge they should be a doctor, not a pharmacist.

  • kittenpurr1
    kittenpurr1 October 17, 2011 at 9:19 pm   

    I and many pharmacies, and the medical profession thinks they are wrong for taking Darvocet/ Darvon off. There's a lawyer fighting to get the medication put back on the market, b/c some people aren't adjusting well to the other medications. I think it is wrong, they are trying to control everything, from paid TV to medication. So, if they get it where they want it, some people can't even view the news. I think the FDA is so wrong in so many things they do, they will give out a med, with so many black box warnings, and then take one off the shelf, that has been on the market for over 50 years.

  • sandypops
    sandypops October 18, 2011 at 11:12 pm   

    If Darvocet/Darvon was on the market now, I would surely give them a try bc the meds I take now are a joke. I have no relief of my pain. It's depressing.

  • Lori Byrnes
    Lori Byrnes October 19, 2011 at 11:14 pm   

    Honey, if the meds you're taking don't work, chances are that the Darvocet wouldn't work either, because it's the weakest of the narcotics. If you're NOT taking narcotics, there's a chance they may have worked for you. I know after I hurt my back they tried to give them to me, and I might as well have taken a Tylenol.

  • marieanne
    marieanne October 18, 2011 at 12:17 am   

    kittenpurr1, why did they take these off the market? Just curious-
    was there a danger in using them, or what? I used to take these, &
    they worked good, I never had any trouble with them. Thanks &
    Hugs, marieanne

  • kittenpurr1
    kittenpurr1 October 19, 2011 at 2:24 am   

    Someone had a reaction- like a heart attack, so after 50 something years, they remove them. There's a lawyer fighting to bring them back, I signed the petition on line. It's still in the books and has a docket number for people to sign, I think. I get notices about it. All medications can cause reactions, and the black box one's should be looked at, some of the arthritis medication is not very healthy either.

  • chroniccyn
    chroniccyn October 19, 2011 at 3:03 am   

    I agree that medications can have bad reactions-but we have the option to decide what we think works best for us. Wish FDA was better at what they do. There is a website to get notice of changes, reactions package changes etc. Helpful sometimes

  • kittenpurr1
    kittenpurr1 October 19, 2011 at 3:37 am   

    I get the FDA changes on medications, and I get the notifications on meds that I have signed petitions on. I agree, we know our bodies, and we know what works.

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