I couldn't agree with you more babes! It's totally irresponsible to adopt a one-size-fits-all (or rather one size MUST fit all) approach.
And for that matter, for greasy pole-climbing political slime to think they can play doctor. They aren't, and they have no qualifications in that area, nor reason to give a flying fuck about patients.
I just hope while such laws are in force, as many politicunts end up with some horrific, agonizing, lifelong, but non-terminal disease. So they have to suffer horribly for the duration of their naturally allotted, filthy existence. It's disgusting. And those responsible, it would be nature's laugh at them if they themselves had to be the ones who suffer the consequences, only to be told 'sorry you are in screaming agony and will be for the next 70-80 years, But this tiny scrap of morphine is all you can have, legally, but we have decided, based on your encouragement that 5mg oral morphine is all you can have. Per week.
If I were a doctor, and had a politician in the US as a patient, thats what I'd do. No matter if I was treating them for a mosquito bite, or for a dental abscess the size of a grapefruit. I'd just leave them to scream, after reminding them it was their choice, and their own policy.
Isn't the cap something like 60mg in 'morphine equivalents'?
Because that is minuscule, especially if someone is in really serious pain. Orally, morphine has a BA of between 20%-25%, maybe 30% if one is fortunate enough to have just the right liver enzyme mutations. 60mg orally, without a tolerance of any degree, might make someone with a common cold feel a little less miserably. IV, it'd have some hope, with a little tolerance, but not much. Someone who is a chronic pain patient, which obviously these slimy little demagogic masturbators have not taken into account in the slightest degree, can quickly rise above that just to stay in one piece.
I'm a chronic pain patient, knee joint damage, bilateral trochanteric bursitis to top it off, nerve damage in one leg, and, thanks to some fucking bastards messing around with things in my lab, I got blasted in the eye with a mixture of lithium amide, sodamide, alkoxides, caustic soda and ammonia and ammonium phosphate, searing, steaming hot, in a jet from a container forceful enough to knock the goggles up from my eyes, allowing that boiling, noxious corrosive mixture to blast me in the left eye, as well as covering me all over the forehead, left cheek, front of the top of my head, my throat, and all over my upper torso.
and I'm on (prescribed) 100mg morphine twice daily, and even taking cimetidine with it (which after I explained what it could do, in blocking certain CYP-P450 series isoenzymes, my GP agreed to script me in order for it to look less suspicious on his part giving the opioid rx) I HAVE to shoot it. If I took it orally it wouldn't even stop withdrawal. Also scripted 80mg oxycodone a day. All the same, I'm still forced either to add 6-AcO-dihydromorphine, IM or if I can find a vein, IV (its another strong opioid, prepared from dihydrocodeine) when I can get enough DHC together from 7.5mg OTC pills, or else buy black market methadone and H. Or convert the morphine to dipropionylmorphine (the propionate ester analog of heroin, only more euphoric by a long shot, at least as potent again compared to H as heroin is to morphine, probably more, and with a duration of action more than double the duration of H, maybe 15-18 hours per dose, give or take).
And doctors, at least, GPs don't tend to know shit about pain management other than acute short term pain in nontolerant patients. I had one GP offer me fentanyl patches, and she was absolutely astonished (I was on oxy alone, at the time), that I was back the next day, begging for a return to the previous regime because it was leaving me in withdrawal, both because of insufficient dose of fent, and because she had neglected to include in the new script, a single dose per patch-changeover of a strong, instant-release opioid with good oral BA. Hell I had to explain to her what bioavailability WAS, and how it differs by route of intake of a drug, differs from drug to drug, and differs according to the enzymatic profile of a patient with many drugs, she barely believed me when I told her that there are people for which codeine does not provide any benefit whatsoever, no matter how much they take, and that for a normal person, 500mg or so is as much as can be made use of, she believed me, as at the time, I had no script for, and wasn't ASKING for a script for codeine, so had zero possible self interest in giving her false information, but was gobsmacked, when I told her that, plus that it affected tramadol, in a worse way (given the noradrenergic/serotonergic effects of the un-desmethylated parent drug) and affected dihydrocodeine, but that DHC has some inherent MOR agonism, but not a huge amount.
(didn't even know what I meant by 'MOR agonist' or 'CYP-P450 isoenzyme' before I told her!)
Although it worked out to my advantage in the end. I got put back on the oxycontin, which that week, I had been due for on the monday, collected the script for my allotment of OC80s, went in about the pain on the tuesday, given the fentanyl patches, then the next day, asked for my OC script to be returned, expecting that the next due date I'd get it. Only she gave me another whole script, just two days after. Didn't ask for the fent patches back either
I don't much like fentanyl, I find it bland, too cold and clinical, but throwing it in with an oxy shot, it at least kicked things up a notch. So I got left with a full extra script of the oxy to just get shitfaced with
Just what IS the limit anyway, as 'prescribed' by those dirty bastards?
Here in the UK at least AFAIK GPs don't have a set cap like that or be jailed. But I need far more than a few measly 'morphine equivalents', and pharmacies WILL dispense what they are told to dispense, here, it is up to the GP, and the pharmacists, they don't act as doctor-police. The doctor tells them what to do, the pharmacist's place is to comply. End of.
Which is the way it ought to be. GP tells them what to do, they do it. Patient or their representative goes away.