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"Fentanyl Crisis"

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Many U.S. states have implemented restrictions on opioid prescribing, but these regulations often include specific exemptions for patients in end-of-life care, hospice, nursing homes, or those with cancer-related pain. These exemptions acknowledge the unique needs of these patient populations for effective pain management. However, the specifics of the exemptions can vary from state to state.

The Centers for Disease Control and Prevention (CDC) released guidelines for prescribing opioids for chronic pain in 2016 and updated them in 2022. It's crucial to understand that these guidelines specifically state they are not intended to apply to patients receiving active cancer treatment, palliative care, or end-of-life care.
Despite these exemptions, unintended consequences of stricter opioid regulations have been reported, making it potentially more challenging for patients in these exempt categories to access necessary pain medication.

The Drug Enforcement Administration (DEA) has also implemented regulations regarding controlled substances, including allowing for the faxing of prescriptions for Schedule II opioids for hospice patients. However, proposed DEA rules regarding telemedicine prescribing of controlled substances have sparked concerns that they could create additional burdens for hospice physicians and patients, potentially impacting access to medications.
While many states recognize the importance of exemptions for end-of-life care, hospice, cancer pain, and nursing home patients, the nuances of these regulations can be complex, and ongoing efforts are needed to ensure appropriate access to pain relief for these vulnerable populations.

Someone in hospice (USA) being limited to 60mme or 90mme is illegal. Even if there are logistics at play such as bradycardia, health insurance limits opioid coverage without a PA & the patient is unable to get a PA for some reason. @pcplease -- You are right, forget getting on the phone and calling someone about it. Put on your best fighting shoes and go face to face to the end boss at the hospital, practice, etc. The pain and discomfort treatment does not have to stop at opiates/opioids, there are all kinds of good medications suited for hospice -- Inapsine, Ativan, Promethazine, Vistaril PAM, Clonidine, Z-drugs to name a few. If I am going to die, lets make it my final cruise.
 
Unfortunately not unheard of, but sometimes can be fixed by going "up the prescribing ladder" to a superior (or the board) at a hospital. The risk of becoming an addict is pretty explicitly NOT to be considered when dealing with end-of-life care.

That said, besides methadone which would surely work, Suboxone might provide more stability than 60mg of oxy/hydro.

I wish people at the end of their lives could get whatever their hearts desire for pain meds
 
Is paying $0.008 per Mallinckrodt Oxycodone Hydrochloride 30mg still considered high score..?


Whoa!
They say the bigger the headache, the bigger the pill, baby
Call me the big pill
Dr Funkenstein
The disco fiend with the monster sound
The cool ghoul with the bump transplant

Hip bone connected to my thigh bone
My thigh bone connected to my leg bone
My leg bone connected to my ankle bone
I get so hung up on bones
Dr Funkenstein here
Preoccupied and dedicated
To the preservation of the motion of hips

We love to funk you, Funkenstein
Your funk is the best (talk!)
Take my body, give it the mind
To funk with the rest (kiss me on my ego)
Hit me with the one and then
If you like, hit me again
We love to Funk-a-stein (ohhh, over!)

Dr. Funkenstein, King of the Funk, yeah!
Swift lippin', ego trippin' and body snatchin'
I'll blow your mind
Comin' to you directly from the Mothership
Pulling up the last leg (ah, ah, ah)
Of the P.Funk
Well, alright

Microbiologically Speaking When I start
curnN' burnN' and turnN'
It will make your atoms move so fast
Expanding your molecules to a friction fire
BurnN' on your neutron causing you to scream
Hit me in the proton Baby

 
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It was hard to make it past one sentence.

All good, I’ll just chalk it up to them “ailments” of yours 🤣

Wasn’t talkin to you nah but looks like you’re pressed so maybe the shoe fits I dunno

Deep breaths. You’ll be alright either way bud. Promise
 
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