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Prescription Monitoring Systems in the US: NarX Score

Nurse Ratched said:
Hey Roamin....I understand that drug monitoring is nationwide. All States participate. Just haven't heard of NarX is all.

The dive is a sub forum where things are discussed that have political, social and moral issues that are of value to others.
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So you simply moved this thread to a different topic forum within bluelight? One that is more appropriate to this discussion?
 
My understanding is that all patients that receive controlled substances have to use the same pharmacy every time. Unless that particular pharmacy is out of stock atm and you have to go elsewhere. But for the most part all scripts are faxed to the pharmacy on record .


It prevents Dr. shopping.
 
Nurse Ratched said:
My understanding is that all patients that receive controlled substances have to use the same pharmacy every time. Unless that particular pharmacy is out of stock atm and you have to go elsewhere. But for the most part all scripts are faxed to the pharmacy on record .


It prevents Dr. shopping.
Click to expand...
That’s true. I’ve been with the same pharmacy for years until the thing that caused me to be kicked out of it happened. They prevent me from using their pharmacy, so I go to another one, and then my NarX score goes up because I’ve now used two pharmacies instead of one. I don’t know how much the scores rise but they do because it is a parameter in the algorithm.
 
RoaminW said:
That’s true. I’ve been with the same pharmacy for years until the thing that caused me to be kicked out of it happened. They prevent me from using their pharmacy, so I go to another one, and then my NarX score goes up because I’ve now used two pharmacies instead of one. I don’t know how much the scores rise but they do because it is a parameter in the algorithm.
Click to expand...
Hmmmm. Well, that's not really fair.

But....if you used a different pharmacy and didn't notify the prescribing Dr. that you did so they have every right to hold it against you.

We now have to call and say Rite Aid is out of product and I'm heading to Walgreens. They would make a note of it and it's all good. The Dr.s and pharmacies are now in tight control of everything and are making it very difficult.
 
One of the things I thought about has to do with what I read is another parameter in the scoring system. When I was last given a prescription of Tyl IV’s, the pharmacy told me that I can either get a 7 day supply of that month long prescription and the insurance will cover it, or I could pay cash and get the whole thing. It’s relatively cheap so I just paid out of pocket for the whole thing. Another of the parameters that make scores rise is when a patient pays for a scheduled medication with cash when they have insurance. This was an okie-doke that was done to me under false pretenses. My insurance company made my score go up by only covering a 7 day amount of medication.

Looking into all of this has really opened my eyes to what is really happening to me, and why it’s happening.
 
Nurse Ratched said:
Hmmmm. Well, that's not really fair.

But....if you used a different pharmacy and didn't notify the prescribing Dr. that you did so they have every right to hold it against you.

We now have to call and say Rite Aid is out of product and I'm heading to Walgreens. They would make a note of it and it's all good. The Dr.s and pharmacies are now in tight control of everything and are making it very difficult.
Click to expand...
I notified my doctor and had him send it to the different pharmacy, but the automation of the NarX score will simply read it as using two pharmacies instead of one.
 
Yep.....because insurance only covers a controlled substance every 28-30 days many people were refilling early by paying cash and that's a big no no. Most ethical pharmacies don't let people do that. So even though they let you do it....it was still a violation. And of course you are the one that suffered because of it.
 
Nurse Ratched said:
Yep.....because insurance only covers a controlled substance every 28-30 days many people were refilling early by paying cash and that's a big no no. Most ethical pharmacies don't let people do that. So even though they let you do it....it was still a violation. And of course you are the one that suffered because of it.
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But that’s the thing. The insurance didn’t cover a months supply. They were only willing to cover 7 days of the 30 day prescription. I will have to put in for a pre authorization to get all 30 days. A months supply with cash was around $20 so I just paid that out of pocket. Now I know that doing that only made my NarX score rise. Also, I wasn’t trying to fill it early. It was a brand new prescription.
 
RoaminW said:
But that’s the thing. The insurance didn’t cover a months supply. They were only willing to cover 7 days of the 30 day prescription. I will have to put in for a pre authorization to get all 30 days. A months supply with cash was around $20 so I just paid that out of pocket. Now I know that doing that only made my NarX score rise. Also, I wasn’t trying to fill it early. It was a brand new prescription.
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Okay, I get ya. Yeah, in the last 5 years or so ( and even before that ) filling controlled substances has been a real pain in the ass for a lot of people. Jumping through way too many hoops just to get their meds.
 
Wow, thanks for this information, pretty eye opening. I have never had many prescriptions... at times I've had gabapentin, and I have clonidine... but also suboxone now. So I'm sure that puts my score pretty high. I also have a specialty medication for psoriatic arthritis which is a biologic agent that modifies my immune system in one very targeted pathway and prevents my joints from slowly fusing together.

I'm very grateful to not be a chronic pain patient, or long-term benzo-prescribed patient, right now.
 
Xorkoth said:
Wow, thanks for this information, pretty eye opening. I have never had many prescriptions... at times I've had gabapentin, and I have clonidine... but also suboxone now. So I'm sure that puts my score pretty high. I also have a specialty medication for psoriatic arthritis which is a biologic agent that modifies my immune system in one very targeted pathway and prevents my joints from slowly fusing together.

I'm very grateful to not be a chronic pain patient, or long-term benzo-prescribed patient, right now.
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One of the questions I have is how Buprenorphine affects scores. It used to be a strictly tapering off med, but I think it is prescribed for analgesic reasons now, too.
 
It is, in some cases, yes. It's prescribed in far lower doses (like 0.3mg) for pain management.
 
RoaminW said:
One of the questions I have is how Buprenorphine affects scores. It used to be a strictly tapering off med, but I think it is prescribed for analgesic reasons now, too.
Click to expand...
I am a chronic pain patient who was abruptly cut off MS Contin, which I have taken for 15-16 years, and put on Buprenorphine for chronic pain management.
I just started the Buprenorphine treatment end of November.
It is working pretty well for chronic pain, but I must use 16-24 mg every 8 hours.
(I wonder if just the change in pain medication is what has helped )
It doesn’t last 24 hours for me.
Neither for withdrawal or for chronic pain.

I noticed that when I went to my pharmacy this last time, they have a big sign up saying
”We do not carry Phenergan (promethazine) with Codeine”

My doctor told me that the medical system is making huge changes and no one who is on opiates/opioids or benzodiazepines monthly will be able to fill their prescriptions anymore.
So, I had to switch to suboxone (Subutex for me due to headaches from suboxone)

I feel we are definitely being put into some kind of China like system of credit scores.
Something that is ILLEGAL according to our CONSTITUTIONAL RIGHTS!
Our Constitution just seems to be going out the window!

Everyone who went along with the FORCED experimental COVID injections (that neither protect you or anyone else from COVID)
has helped the communists bring in this system!
NEVER has there been a situation where an experimental injection of God knows what, has been forced upon the population of The World!
It has now been shown that more people have died or been disabled due to the experimental poison vaccine than from Covid.
Seems like we would know if we were in a pandemic. Bodies would be everywhere but I didn’t see that.

We have reached a point in time where government is targeting us all!
WE MUST SPEAK OUT and STAND AGAINST This UNCONSTITUTIONAL and INHUMANE “System” that is being forced upon us!
No one has been able to explain why this is happening or even the details.
Look at what the O.P is saying- he looked into it and was LIED to about it from pharmacist etc....
They cannot even explain it!

Not to mention that our government is saying we will be having food scarcity, rolling electricity blackouts, moving from fossil fuel with NO alternatives given! Monetary system moving to digital currency, Etc. etc....

It really looks like they want to depopulate us all!
Not to mention torture us to death by cutting off medication!
They are doing Genocide and quite honestly are hoping people like me, will just commit suicide.
I am sure many have, being cut off medications they need and have never abused!

All trust has been lost in the medical system and government systems for myself!
You all should be more concerned with this shit!
I am older, many of you younger people are going to be screwed!
 
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Xorkoth said:
It is, in some cases, yes. It's prescribed in far lower doses (like 0.3mg) for pain management.
Click to expand...
I just got changed from 90 mg morphine a month to Suboxone-Subutex and it is taking ALOT more than 0.3 mg for pain management.

I am sure they have marked me down as an addict also.
Even though I was a perfect pain patient.
Perfect record of never refilling early!
For 15-16 years!

My chronic pain has been well documented also. Through MRI and other tests.
I had Acute Liver Failure from Tylenol right after car accident because I could not obtain opiates/ opioids for pain relief!

They have made things too hard!

I guess that is why so many have had to turn to street drugs and have died from fentanyl!
You do not see them trying to get fentanyl off the streets!
No! In fact, our government is the biggest drug dealers out there!
Almost seems like they are trying to kill us!
 
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Painful One said:
I am a chronic pain patient who was abruptly cut off MS Contin, which I have taken for 15-16 years, and put on Buprenorphine for chronic pain management.
I just started the Buprenorphine treatment end of November.
It is working pretty well for chronic pain, but I must use 16-24 mg every 8 hours.
(I wonder if just the change in pain medication is what has helped )
It doesn’t last 24 hours for me.
Neither for withdrawal or for chronic pain.

I noticed that when I went to my pharmacy this last time, they have a big sign up saying
”We do not carry Phenergan (promethazine) with Codeine”

My doctor told me that the medical system is making huge changes and no one who is on opiates/opioids or benzodiazepines monthly will be able to fill their prescriptions anymore.
So, I had to switch to suboxone (Subutex for me due to headaches from suboxone)

I feel we are definitely being put into some kind of China like system of credit scores.
Something that is ILLEGAL according to our CONSTITUTIONAL RIGHTS!
Our Constitution just seems to be going out the window!

Everyone who went along with the FORCED experimental COVID injections (that neither protect you or anyone else from COVID)
has helped the communists bring in this system!
NEVER has there been a situation where an experimental injection of God knows what, has been forced upon the population of The World!
It has now been shown that more people have died or been disabled due to the experimental poison vaccine than from Covid.
Seems like we would know if we were in a pandemic. Bodies would be everywhere but I didn’t see that.

We have reached a point in time where government is targeting us all!
WE MUST SPEAK OUT and STAND AGAINST This UNCONSTITUTIONAL and INHUMANE “System” that is being forced upon us!
No one has been able to explain why this is happening or even the details.
Look at what the O.P is saying- he looked into it and was LIED to about it from pharmacist etc....
They cannot even explain it!

Not to mention that our government is saying we will be having food scarcity, rolling electricity blackouts, moving from fossil fuel with NO alternatives given! Monetary system moving to digital currency, Etc. etc....

It really looks like they want to depopulate us all!
Not to mention torture us to death by cutting off medication!
They are doing Genocide and quite honestly are hoping people like me, will just commit suicide.
I am sure many have, being cut off medications they need and have never abused!

All trust has been lost in the medical system and government systems for myself!
You all should be more concerned with this shit!
I am older, many of you younger people are going to be screwed!
Click to expand...
I, too, have had chronic pain in the past. Since both lumbar surgeries, 2014 & 2017, I only have intermittent inflammations but when I have one, it is god damn painful! I chose to quit taking the hard stuff in 2007. I found a Dr to prescribe Subutex for me to taper. I finished tapering in 1.5 years. Then in 2014, after months of powerful pain meds, I switched and tapered with Sub again in 1.5 years. Same thing in 2017. The doctors eyes always got wide and with an expression of amazement every time I told him I didn’t need it anymore. I think it’s been approved for pain mitigation since 2017, but not certain. Apparently, LOTS of folks never try to taper off. Of course with your ongoing chronic pain, you’ll likely be taking it from now on. All I know is that Sub constipates the hell out of me. I never took the amount you take, so with 8mg per day, then tapering, and still having god awful constipation, I hope it doesn’t do that to you. It used to feel like I was trying to push a dinner plate out.

Can I ask what is causing your chronic pain?
I’ll be 51 in Jan. What is your age around, if you don’t mind me asking?
 
RoaminW said:
I, too, have had chronic pain in the past. Since both lumbar surgeries, 2014 & 2017, I only have intermittent inflammations but when I have one, it is god damn painful! I chose to quit taking the hard stuff in 2007. I found a Dr to prescribe Subutex for me to taper. I finished tapering in 1.5 years. Then in 2014, after months of powerful pain meds, I switched and tapered with Sub again in 1.5 years. Same thing in 2017. The doctors eyes always got wide and with an expression of amazement every time I told him I didn’t need it anymore. I think it’s been approved for pain mitigation since 2017, but not certain. Apparently, LOTS of folks never try to taper off. Of course with your ongoing chronic pain, you’ll likely be taking it from now on. All I know is that Sub constipates the hell out of me. I never took the amount you take, so with 8mg per day, then tapering, and still having god awful constipation, I hope it doesn’t do that to you. It used to feel like I was trying to push a dinner plate out.

Can I ask what is causing your chronic pain?
I’ll be 51 in Jan. What is your age around, if you don’t mind me asking?
Click to expand...
Sure.
I was hit from behind on the freeway by a huge truck going 80 mph. While I was at a full stop, last In line for a traffic jam.
The guy in the truck came over the hill to find everyone stopped and tried to slam on his brakes but rammed into me.
I thought I was dead for sure, even had my life reviewed at high speed in front of my eyes.
I thought that truck would pick up my little Ford Mustang and throw it forward...killing others.
So, I locked my legs up, one on the break, and one on the clutch.

It was a crushing blow and threw me hard against my dashboard and back into my chair, hitting my head so hard that I had complete amnesia for awhile.
Traumatic brain injury shows up on MRI, as well as my tailbone got broken off and lodged on my sciatic nerve.
Doctors told me I would have been better off if I had broken my back and my neck.
Told me to go to pain management.

Easier said than done. You cannot just call up and make an appointment for pain management.
That caused me to take Tylenol like crazy. I couldn’t keep track of time and kept taking them.
I thought hours had passed when it had only been 15 minutes really.
I overdosed myself on Tylenol accidentally and had liver failure!

I barely survived that and got to a doctor who put me on MS Contin. I refused the opiates for “break through” pain.
I have tried to get by with the very least amount of opioids that I could.
I remember how strange it was to just be able to eat, sleep, not have massive migraine headaches all the time and think straight was like.

I did good for all the years taking the MS Contin (15-16 years)
Now, I got cut off MS Contin and put on Subutex and I am a sweaty, non functioning mess.
I haven’t slept through the night once since the change.
I am requiring 16-24 mg Subutex every 8 hours.
I am not sure if this is a good change or not,
Apparently, this Subutex (Suboxone) is like 15 times stronger than morphine.

I do feel less lower back pain and left leg pain.
That might be due to just a change In Opioid medications.
I have heard many pain patients say to rotate between opiate medications for best relief.
No doctor would do that though.

Now, All I can get is Suboxone/ Subutex, due to doctors cutting patients off.
Even when chronic pain is established and can be seen in tests.

This May drive me to suicide.
Quite frankly.
I need to be able to eat, sleep, not be screaming- moaning in pain all the time, functional on some level.
I am currently sweating out pounds of fluid all day long.
Otherwise, my life is just hell.

PS- yeah, it is constipating, so was MS Contin. It is about the same. I can control that with stool softeners.
But yes...it is no fun.
Better than nit being able to eat at all though.

PS: about the same age as you 52 here.
 
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I ran into shit with my states system and was forced to seek treatment one state over. I travel there three times a week for work but its still such bullshit. American health care is terrible. Its a broken mess that mostly about money. The funniest thing is many doctors act so arrogant still.. idk why.. its revolting and hilarious at the same time.

I just stay away as much as possible.
 
Painful One said:
Sure.
I was hit from behind on the freeway by a huge truck going 80 mph. While I was at a full stop, last In line for a traffic jam.
The guy in the truck came over the hill to find everyone stopped and tried to slam on his brakes but rammed into me.
I thought I was dead for sure, even had my life reviewed at high speed in front of my eyes.
I thought that truck would pick up my little Ford Mustang and throw it forward...killing others.
So, I locked my legs up, one on the break, and one on the clutch.

It was a crushing blow and threw me hard against my dashboard and back into my chair, hitting my head so hard that I had complete amnesia for awhile.
Traumatic brain injury shows up on MRI, as well as my tailbone got broken off and lodged on my sciatic nerve.
Doctors told me I would have been better off if I had broken my back and my neck.
Told me to go to pain management.

Easier said than done. You cannot just call up and make an appointment for pain management.
That caused me to take Tylenol like crazy. I couldn’t keep track of time and kept taking them.
I thought hours had passed when it had only been 15 minutes really.
I overdosed myself on Tylenol accidentally and had liver failure!

I barely survived that and got to a doctor who put me on MS Contin. I refused the opiates for “break through” pain.
I have tried to get by with the very least amount of opioids that I could.
I remember how strange it was to just be able to eat, sleep, not have massive migraine headaches all the time and think straight was like.

I did good for all the years taking the MS Contin (15-16 years)
Now, I got cut off MS Contin and put on Subutex and I am a sweaty, non functioning mess.
I haven’t slept through the night once since the change.
I am requiring 16-24 mg Subutex every 8 hours.
I am not sure if this is a good change or not,
Apparently, this Subutex (Suboxone) is like 15 times stronger than morphine.

I do feel less lower back pain and left leg pain.
That might be due to just a change In Opioid medications.
I have heard many pain patients say to rotate between opiate medications for best relief.
No doctor would do that though.

Now, All I can get is Suboxone/ Subutex, due to doctors cutting patients off.
Even when chronic pain is established and can be seen in tests.

This May drive me to suicide.
Quite frankly.
I need to be able to eat, sleep, not be screaming- moaning in pain all the time, functional on some level.
I am currently sweating out pounds of fluid all day long.
Otherwise, my life is just hell.

PS- yeah, it is constipating, so was MS Contin. It is about the same. I can control that with stool softeners.
But yes...it is no fun.
Better than nit being able to eat at all though.

PS: about the same age as you 52 here.
Click to expand...
I’ve come up with an idea that would help people like you or I but I don’t think it would ever happen. I think some sort of certification of our problems would be a good idea. Something like a state promulgated system where a patient with certain maladies can present themself to a tribunal of sorts and that tribunal can make a determination as to the legitimacy of painful conditions whereby that person could go to a doctor and present their situation as being legit which would then allow a treating doctor to rest more assured that the medicine isn’t being diverted, etc.

It sounds like to me that you will live with intractable pain for the rest of your life. It should be perfectly fine for a person to live with taking narcotic pain medications. Even if it turns into a dependency problem, the fact would be that your life would be higher quality with a dependency thing as opposed to not treating it and try to live without it.

Not sure where you live, but I think if you were in Texas you’d be able to at least get better treatment than you are getting now. It’s been my experience, since getting tough on prescribed pain meds, that pain doctors prefer to have a monthly, repetitive chronic pain patient as opposed to someone who needs it intermittently like me. I’m not sure why it’s that way but that’s the feeling I get. As if 24/7/365 patients need it more than a person that has episodes several times a year. It’s like of course you need it, but since I don’t need it every single month, I’m less deserving of it when I do need it.

Also, if you’ve been using an orthopedic surgeon, I’d recommend a neurosurgeon. I think they have an edge over bone doctors. They seem to be able to better stop the nervous system signals from getting to the brain in the first place.
 
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