Gabbapentin and Balcofen

[rock1970]

Hello all, I truly hope this message finds you well. I know the struggles and I am currently going through them. Has anyone here experienced an inappropriate taper, by a Kaiser Primary Care doctor? If so, aside from an obvious second opinion, or third opinion as it often goes, is there a process that one follows to argue the taper schedule, in hopes of slowing it down, when a doctor is not open to doing so? Basically, the doctor is telling my mom that she must stop her Gabba and Balcofen in the next 30 days? She has been dosing, per the same Doctors directive, 9 total gabba capsules per day (2700mg), for 4 years. The doctor has directed her to drop to 2 tablets, two times a day, or 1200 mg per day, immediately, for the next two weeks, then drop to 1 tablet twice per day for the last two weeks and then none per day? This seems unsafe to me, especially due to the withdraw sypmtoms she is going to experience! She is 73 with diabetes, CHF, COPD, both knees are bone on bone, and severe neuropathy, which is why she is taking the Gabba and Balcofen. She stopped the Balcofen CT, 2 weeks ago, and has not suffered anything noticeable, relative to withdraw symptoms, but I think they are masked by the Gabba. I want to have her challenge this taper directive, but I am not sure what to do. She has already spoken to her doctor, and her doctor is saying this is safe, and she experiences any withdraw symptoms, that the doctor will prescribe Effexor?????? All of this is blowing my mind, and I have genuinely scared for the wellbeing of my mom. If anyone knows what to do in this situation, please provide some insight. Thank you all in advance!

 

[Jabberwocky]

Hello all, I truly hope this message finds you well. I know the struggles and I am currently going through them. Has anyone here experienced an inappropriate taper, by a Kaiser Primary Care doctor? If so, aside from an obvious second opinion, or third opinion as it often goes, is there a process that one follows to argue the taper schedule, in hopes of slowing it down, when a doctor is not open to doing so? Basically, the doctor is telling my mom that she must stop her Gabba and Balcofen in the next 30 days? She has been dosing, per the same Doctors directive, 9 total gabba capsules per day (2700mg), for 4 years. The doctor has directed her to drop to 2 tablets, two times a day, or 1200 mg per day, immediately, for the next two weeks, then drop to 1 tablet twice per day for the last two weeks and then none per day? This seems unsafe to me, especially due to the withdraw sypmtoms she is going to experience! She is 73 with diabetes, CHF, COPD, both knees are bone on bone, and severe neuropathy, which is why she is taking the Gabba and Balcofen. She stopped the Balcofen CT, 2 weeks ago, and has not suffered anything noticeable, relative to withdraw symptoms, but I think they are masked by the Gabba. I want to have her challenge this taper directive, but I am not sure what to do. She has already spoken to her doctor, and her doctor is saying this is safe, and she experiences any withdraw symptoms, that the doctor will prescribe Effexor?????? All of this is blowing my mind, and I have genuinely scared for the wellbeing of my mom. If anyone knows what to do in this situation, please provide some insight. Thank you all in advance!

Kaiser Permanente is extremely difficult to deal with. Especially Medicare Kaiser Permanente.

You're going to have to take charge of your mother's medical care. You're going to have to have her give you a HIPAA waiver so you can discuss her care directly with the doctors and go through as many as you have to until you get the satisfaction you want.

I have had to deal with Kaiser Permanente Medicare, A lot of them are idiots.

 

[paranoid android]

That is some bullshit. Wiuthdrawal from baclofen can be dangerous and must be done slowly I would recommend that your mom get a new doctor if possible

 

[rock1970]

Thank you both! Based on what my mother has told me, I totally agree, they are idiots! Very frightening, to hear all she has told me. This doctor has been her PCP for 20 years. I figured as much, relative to getting directly involved. Thank you very much, and I will get the waiver so I may speak on her behalf, or whatever it allows me to do, to the fullest extent. Yes, I will fight for her care.

 

[brokedownpalace10]

As said, Baclofen withdrawal is dangerous. Her likely not being completely over that just further complicates that unnecessarily fast taper.

That's why I don't want to start on any gabbapentinoids although docs have prescribed them to me more than once. the new "safe and non-addicting" wonder drug turns into the next evil scourge and doctors nervously and cruelly withdraw their patients.

 

[Jabberwocky]

Thank you both! Based on what my mother has told me, I totally agree, they are idiots! Very frightening, to hear all she has told me. This doctor has been her PCP for 20 years. I figured as much, relative to getting directly involved. Thank you very much, and I will get the waiver so I may speak on her behalf, or whatever it allows me to do, to the fullest extent. Yes, I will fight for her care.

Why is he taking her off the gabapentin?

 

[Jabberwocky]

Thank you both! Based on what my mother has told me, I totally agree, they are idiots! Very frightening, to hear all she has told me. This doctor has been her PCP for 20 years. I figured as much, relative to getting directly involved. Thank you very much, and I will get the waiver so I may speak on her behalf, or whatever it allows me to do, to the fullest extent. Yes, I will fight for her care.

You have to get a durable medical power of attorney as well. There are simple forms that you can use from the internet, you and your mother just go to a notary public with a witness. That way you can actually make medical decisions for her.

Just make it revocable so that if she wants to remove you she can do it easily.

 

[rock1970]

Why is he taking her off the gabapentin?

She said it was due to some CDC changes with pain medications. I have not heard about any CDC changes. I truly believe it stems from an episode in November of last year. She went on vacation and forgot her gabbapentin. A day or two later, she felt horrible. She thought she had a bacterial infection, as the sypmtoms were similar. She contacted her doctor, who in turn prescribed an antibiotic. I however, told my mom it could be from missing the gabbapentin doses. When we arrived home she immediately took her dosage of gabbapentin, and sure enough, started to feel way better in short order, and over the "infection" in a few hours! She was in withdraw is all it was. She contacted her doctor to inform her that she was feeling back to normal, after taking her gabba. She told the doctor that she must be dependent on them now, after all of the years of taking them. A few weeks later, she received a letter indicating that changes are going to be made due to the CDC, stepping up regulations for Pain management medications. She called to inquire about what the changes are going to be, and the doctor said they were going to taper her off of her balcofen and Gabba. My mom expected that it would be over a period of time, as I told her that a safe taper takes months, if not years in some cases and often a maintenance dose may be forever. The next time the doctor refilled the meds, the balcofen was done, and the gabba dosing was changed to what I think I indicated above. This is not a safe taper, to me, which is why I am getting involved. Thank you for your aid.

 

[JackARoe]

I would create a holy hell of complaining. Here is an instance where the squeaky wheel gets the grease. Not sure on Balcofen but my doc told me gabapentin is widely prescribed. Phone call after phone call may be necessary. If you do that they will probably just keep your mom on. I do not see CDC changes so I am willing to bet this is one person at medicare that made a decision. That is all. And you can reverse that. Threaten if you have too. This reaks of trying to save a few pennies at a person's expense.

 

[Jabberwocky]

She said it was due to some CDC changes with pain medications. I have not heard about any CDC changes. I truly believe it stems from an episode in November of last year. She went on vacation and forgot her gabbapentin. A day or two later, she felt horrible. She thought she had a bacterial infection, as the sypmtoms were similar. She contacted her doctor, who in turn prescribed an antibiotic. I however, told my mom it could be from missing the gabbapentin doses. When we arrived home she immediately took her dosage of gabbapentin, and sure enough, started to feel way better in short order, and over the "infection" in a few hours! She was in withdraw is all it was. She contacted her doctor to inform her that she was feeling back to normal, after taking her gabba. She told the doctor that she must be dependent on them now, after all of the years of taking them. A few weeks later, she received a letter indicating that changes are going to be made due to the CDC, stepping up regulations for Pain management medications. She called to inquire about what the changes are going to be, and the doctor said they were going to taper her off of her balcofen and Gabba. My mom expected that it would be over a period of time, as I told her that a safe taper takes months, if not years in some cases and often a maintenance dose may be forever. The next time the doctor refilled the meds, the balcofen was done, and the gabba dosing was changed to what I think I indicated above. This is not a safe taper, to me, which is why I am getting involved. Thank you for your aid.

The CDC doesn't make regulations for pain medication. States and the DEA do.

The CDC can only report adverse events.

Perhaps the state that you live in scheduled gabapentin. Some states have scheduled it.

 

[brokedownpalace10]

She said it was due to some CDC changes with pain medications. I have not heard about any CDC changes. I truly believe it stems from an episode in November of last year. She went on vacation and forgot her gabbapentin. A day or two later, she felt horrible. She thought she had a bacterial infection, as the sypmtoms were similar. She contacted her doctor, who in turn prescribed an antibiotic. I however, told my mom it could be from missing the gabbapentin doses. When we arrived home she immediately took her dosage of gabbapentin, and sure enough, started to feel way better in short order, and over the "infection" in a few hours! She was in withdraw is all it was. She contacted her doctor to inform her that she was feeling back to normal, after taking her gabba. She told the doctor that she must be dependent on them now, after all of the years of taking them. A few weeks later, she received a letter indicating that changes are going to be made due to the CDC, stepping up regulations for Pain management medications. She called to inquire about what the changes are going to be, and the doctor said they were going to taper her off of her balcofen and Gabba. My mom expected that it would be over a period of time, as I told her that a safe taper takes months, if not years in some cases and often a maintenance dose may be forever. The next time the doctor refilled the meds, the balcofen was done, and the gabba dosing was changed to what I think I indicated above. This is not a safe taper, to me, which is why I am getting involved. Thank you for your aid.

Her doctor was told that it was a wonder drug, "safe and non-addicting". Now that addiction is becoming well documented, and hearing your mom was addicted, he's nervously taking her, and likely others, off it. I've seen it over and over.

What sucks is that docs can and will blame the patient for their malpractice, which is what it is. "They're exhibiting drug seeking behaviour" like "certain sensitive individuals" can. Pfizer made their money on this one and they will do it on the next "safe and non-addicting" drug if they can.

This is why recreational marijuana needs to be federally legal. Medical users don't need to be subjected to Big Pharma's and doctor's BS.

To be clear, there's nothing wrong with being addicted to something if the addiction is preferable to the condition. Is a person addicted to high blood pressure medicine?

 

[Keif' Richards]

Hey @rock1970

I was going through the posts, I couldn't help but notice how you spelled "Gabbapentin". It was at that point, I knew we had a greenhorn on our hands and these are some of my favorite folks to help answer. No true addict or degenerate like myself or other BL'ers would ever sin so badly as to misspell the names of our drugs, but I'm digressing.

I too have had experience with managing medication for family members and dealing with doctors in basically identical circumstances to yours. It's a real bitch, so pat yourself on the back for being there for her. My gran was on Benzodiazepines and that was basically her issue, although she's been on Gabapentinoids before as well. She had had multiple instances of not being able to control her consumption, typically running out 5 days early or whatever, nothing crazy, but enough to screw her over. I would have understood making a plan to withdraw the medication, but gradually, over a few months at least. They took her completely off the Lorazepam (Ativan) she had been taking for a decade in two weeks.

As I said, many of us are seasoned drug addicts and we've seen some shit. My grandmother is not a seasoned drug addict. Watching her experience Benzodiazepine withdrawal, while having dementia, while recovering from knee surgery at 85 years old made me sad, angry and hopeless. I felt it was totally inappropriate to put her through that, but sadly, once the doctor has initiated this sort of thing, it is extremely difficult to get them to change.

For them to change, would mean them doing an about face and admitting that they were wrong, which is unlikely regardless of how crazy things get for your ward. Going to get "a second opinion" will almost certainly lead to backlash from that provider, entrenching the idea that this person is an addict. This will only make the situation more difficult.

It really kills me to say this, but you have an uphill battle here. As @shugenja was saying, get everything prepared so that you can speak for this person and be an equal part of the treatment plan. Next, we can help you figure out exactly what to say and how to say it, but in the end, the argument will always be that this taper is too fast and that the suffering involved will cross ethical lines. For the record, I do believe that it will be a difficult withdrawal. Gabapentinoids can be pretty rough.

For now, play the game within the established channels. See if you can make any kind of headway in getting the taper reduced to a more suitable speed. Ideally, this would be over 3 months at least. I see no clinical value in taking someone off of a medication in two weeks over 3 months. It just contributes to suffering needlessly, but doctors in this country are not exactly known for their medical ethics or dedication to the wellbeing of their patients. There are some good ones, sure, but as a society, we are basically abused by doctors who take their marching orders from the pharmaceutical companies. When doctors get scared, I believe they do the rapid taper as a way of saying "see, I'm tough on addiction. I'm not gonna tolerate it in my practice" even though they were the ones who planted the seed and nurtured it to full-bloom.

If you are unable to work within the established channels, things will be difficult, but not impossible. I would recommend actually experiencing the taper and if it is too extreme, which it likely will be, have your ward present at the ED with her extreme withdrawal symptoms. Let them see her writhe, cry and sweat in the hospital for an hour or two. I know this sounds really cold, but that's what you need to do. Don't mess around. Don't go to the ED until things are bad. This will just arouse suspicion and potnetially end any chance of receiving better care.

We're here to help you and let us know if you have any questions.

 

[rock1970]

Thank you so very much. Great information and very in synch with what I have thought, but so very good to hear, outside of spelling lol, that I was not too far off. I'm very scared for my mom, due to so many others ailments, as such, I will certainly be diligent in going through the proper channels, as your take on potential backlash is very likely here, and I do not want to blow it, even though I'm frustrated. Thank you again, and I will update here when I can.