Some doctors and the DEA want to limit opioid/opiate prescriptions to 90 days or less

missmeyet?

missmeyet?

Bluelighter
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Hello all...I have never posted in this particular forum (Drugs in the Media) before, so I hope that I am going about this the correct way. This is a subject near and dear to my heart because it will affect me personally in a huge way as I'm sure it will many other Bluelighters. If even part of these proposals become policy it will change many of our lives in a huge way.

I am putting 3 links here (if that's not ok then someone let me know) the first of which is a link to the PROP (Physicians for Responsible Opioid Prescribing) website. This is a group led by an addictions treatment doc, Andrew Kolodny. They have submitted a petition to the DEA stating changes/new laws that they believe should be adopted which will make things even more impossible for chronic pain patients as well as many others. One of these changes is limiting opioid/opiate prescriptions (treatment with any narcotic pain medication) to no more than 90 days for chronic, non-malignant (non-cancer) pain.

It will also limit the meds that one can get to no more than 100mg of morphine per day (or the equivelant ..so if oxycodone is twice as strong as morphine then you will no longer be able to be prescribed more than 50mg of oxycodone per day! And remember, that is only for no more than 90 days!

They also wish to change hydrocodone (Lortab, Vicodin etc) to a schedule II drug, the same as oxycodone, morphine and methadone. This will make it much harder to receive a script for hydros and will no longer be able to get more than 30 days supply at a time with no refills allowed among other problems.

Also there is an article by the CDC director who basically states that prescription narcotics are the downfall of society. He states that legitimate prescription opoid/opiate users WILL become addicted, that these pain meds should only (except in rare cases) be used for cancer pain and that previous drug abusers/addicts will be screened and will not be treated with narcotics for pain. So if you have ever been treated for substance abuse or even tend to score high on a screening that says you are at high risk to abuse these meds, you can forget it.

Please read this site and see what we are up against.
Http://www.supportprop.org

The second site is for Chronic Pain Patients Against PROP. This is a site that provides information on what will really happen if these propositions are passed and become policy. This site also allows for you to sign a petition against PROP and encourages people to tell their story regarding how opioid/opiate medications have changed your life for the good (or bad). It includes those who could not function in day to day life and activities due to chronic pain if it were not for these meds being available to them.

Please visit this site and sign this petition against PROP and tell your story to preserve all of our rights to pain relief!
http://paindr.com/chronic-opioid-patients-speak-out-against-prop/

This link is to the petition that was sent to the DEA by PROP and that the DEA is happily endorsing.
http://www.citizen.org/documents/2048.pdf
 
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This is really scary, what about maintenence drugs? (methadone, bupe)

Sad thing is I could see the DEA taking this and running with it. The government should not decide your medical care, that should be between an individual and their doctor, period.
 
Hi, I encourage you to post here.

This isn't really the correct format for articles here in DiTM afaik, the guidelines are here for this forum, have a quick read -

http://www.bluelight.ru/vb/threads/196886-DiTM-GUIDELINES

But basically the articles (new threads) have to be based on a published news item.

You can basically fix your post/thread to fit in the guidelines by finding a corresponding (hopefully relatively new) news article about the topic(s) you are wanting to discuss/bring attention to. Just check through google and find some article that relates to what you are saying and then you can put in your thoughts and discussion on the topic after that. Also it's sometimes a good idea to check to see if the article has already been posted by doing a forum search of it in the 'search forum' feature up near the top right hand side. Often someone here has already posted the article and it may have discussion going on after it and it may be buried a few pages back or whatever.

I hope that makes sense, and this maybe not the way mods see it anyway, i'm just going off what 'usually' happens here and what is in the guidelines for this forum.
 
Poledriver- I appreciate your advice...I was very unsure of how I did this thread and where it would be appropriae to post it. When I first started it I had a recent NY times article to place in post but not sure how I got off track. I will go back and place it as first link and make some changes as soon as my kids are in bed tonight.

So do we place the text of the article in the actually post then speak about the article or just a link to the actual article? Let me know andi appreciate your help.
Thanks
 
^ Yeah. Just post the article then a link as SD said and then start posting your thoughts and others will too. This is a topic that alot of people will wont to know about and comment on i'm pretty sure.

No worries.
 
Do-gooder, out-of touch with reality, I know better than you, save me from myself, ivory tower living scum!

90 days?! SO what if I develop a dependence? You can function with a physical opiate addiction a hell of a lot better than you can function with severe chronic pain!

These guys seem to "think" they're some pretty big names in medicine!....It seems like the douchiness is centered in Seattle! The big U-dub big-wigs!...The other suck-ass, brown nosers just signed it for future job considerations! Thank God there's at least a lot of heroin on the streets there. God forbid you draw the shit-stick and get one of these delusional ego-maniacs as your pain management doc!

Yeah, you're in excruciating pain, but we're gonna just cut you off after 90 days no matter what...It's for your own good! I know better than you....Those sleepless nights and your inability to function, that's all in your head! Here's a Yoga gift certificate for my daughter's yoga studio!
 
Okay not to sound like a huge drama queen and I know every one has a hard life etc etc. But its not enough that I was almost killed 4 years ago from a person who fell asleep behind the wheel without car insurance. So I lost my job after fighting back from a coma and every damn bone in my body being broken. BUT even though I have metal plates in my head and rods and screws in my back and neck I just happen to life in a state that ranks almost 50th in judges allowing disbality benefits so I have this hard assed judge that denied me my big whopping 900 bucks/mo in disability...even though I have 3 CP Dr's saying I am in constant pain and not even able to get out of bed most days. So that is not enough now I have to really worry that my methadone will get cut off after 90 days and being on it 4 years since my wreck. great. Maybe I will just jump off a fuckin bridge because life to me right now is so not worth living if I had to then deal with withdrawel let alone the Chronic pain fuckin forget it.
 
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Here's another quick question...when I put the news article in like talked about...can I leave the links to PROP site and the site for opponents of this bullshit PROP so that if they wish they can go directly to them and see where to sign a petition against these proposals and post their story about how opiates have helped them to actually live?
 
^It's really good stuff, what you're trying to bring to light....I don't personally see how it's any less valid than some of the pieces people post linked to half-ass bloggers on here, but I didn't read the posting guidelines to this forum....

I don't think this particular petition has been discussed even indirectly....I think it makes for a great discussion. Maybe it should be moved to CEP though.....
 
ganeal said:
Okay not to sound like a huge drama queen and I know every one has a hard life etc etc. But its not enough that I was almost killed 4 years ago from a person who fell asleep behind the wheel without car insurance. So I lost my job after fighting back from a coma and every damn bone in my body being broken. BUT even though I have metal plates in my head and rods and screws in my back and neck I just happen to life in a state that ranks almost 50th in judges allowing disbality benefits so I have this hard assed judge that denied me my big whopping 900 bucks/mo in disability...even though I have 3 CP Dr's saying I am in constant pain and not even able to get out of bed most days. So that is not enough now I have to really worry that my methadone will get cut off after 90 days and being on it 4 years since my wreck. great. Maybe I will just jump off a fuckin bridge because life to me right now is so not worth living if I had to then deal with withdrawel let alone the Chronic pain fuckin forget it.
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I don't think you sound like a drama queen. I know how badly I hurt and I haven't been through the sam things that you have. Just the thought of this bullshit is depressing. I can't imagine how desperate I will be if they take away my meds, the little I get now. At least I can function part of the time. Do they think that after knowing there is relief available and having experienced a little taste of it that if they take that away that I won't do whatever I have to to not be miserable every second of every day?

I went through all the other things to try to get relief prior to being put on pain meds 7 years ago, therapy of all types, exercise, a hundred or more injections, burning of my nerves so those pain pathways never exist, every other non-narcotic med that there was to try, psych consultations etc. Some provided a little relief, most provided none. Finally I was placed on Oxycontin and fo the first time in years I had the ability to function without it being a constant, exhausting trial. I could enjoy life again for the first time in years because I waited a long time, tried to be strong before I sought help. Then I had the misfortune of relocating across the country to a new state and got to start the experience the whole thing over again.

Life is so short. I want to enjoy my children and the time I have. I only get one go around and I want it to count. I don't want everyday to be such a struggle. Take the small amount of relief I get away and what's the point? Look at everything I will miss out on. I want to live my life! trust me, the doctors and people that are for this have never experienced what you and I have. I know life isn't fair but why make things so much harder than the have to be?
 
Just speaking from my experience I was so anti-drug during my high school and college years....sure I drank like a fish but then the day I got hurt and realized how valuable those drugs were to me my outlook has changed completely . Dr's who refuse to rx opiates to cpp should have to suffer just one day how it feels to hurt and Drs who cut their patients off when they have been on opiates should have to suffer through one day of cold turkey opiate withdrawel. I bet we would have a whole lot of more sympathetic Dr's out there. Now the DEA and other Lawmakers I don't know what to say about them...some are good some don't give a shit and never will because they are the elite and can always get 'thier' drugs no matter what.
 
BlueHues said:
^It's really good stuff, what you're trying to bring to light....I don't personally see how it's any less valid than some of the pieces people post linked to half-ass bloggers on here, but I didn't read the posting guidelines to this forum....

I don't think this particular petition has been discussed even indirectly....I think it makes for a great discussion. Maybe it should be moved to CEP though.....
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I appreciate your comments. As I said before, this is an issue that is important to me personally and everyone should be aware of it.

I did a search here on BL before I posted this thread to be sure and did not come across anything. As far as it being moved, I am open to this as I wasn't really sure where it would call home. I did notice that occasionally a thread here would be based on an article that I wouldn't consider a necessarily reliable source...I just don't want to break any rules.

Its very important to me that people know that this is happening because it will change people's lives immensly. Even for those who are not prescription drug users/abusers, this is just another step towards more government control. Not that I am truly anti-government, but I think for law enforcement to make the decisions on how doctors can or cannot treat their patients' medical issues is ridiculous. And as said in an earlier post, just another case of them saying that they know what is best for us and must save us from our stupid selves (and our docs).

In a time where everyone wishes to work on legalization of (some) illicit drugs, I think a first step is to prevent the DEA from prohibiting our already legal medications.

Please, oh please, just have one of these proponents of PROP come walk in my shoes for a day!
 
This is a pretty good thread, I think. In the future you'll know to adhere to the format in the guidelines, but this is good stuff I think.

I don't see how this has anything to do with methadone maintenance. The emphasis is chronic pain. The methadone culture in the US is so entrenched that I don't think it'll ever be messed with.
 
23536 said:
This is a pretty good thread, I think. In the future you'll know to adhere to the format in the guidelines, but this is good stuff I think.

I don't see how this has anything to do with methadone maintenance. The emphasis is chronic pain. The methadone culture in the US is so entrenched that I don't think it'll ever be messed with.
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Someone in an above post mentioned methadone maintenance therapy but I haven't really seen a lot of fuss about it from this group. I agree, I don't think there will be a lot of change in regards to it. I mean, they don't want anyone using what they don't want them using, but if it is endorsed and will keep you from using the others I can't imagine them doing away with it except for use of treatment of pain.
 
I doubt this will happen, although it would be a HUGE step in the wrong direction if it did.

Edit - I'm willing to bet my life that there's way too many politicians, doctors, cops, judges, lawyers and others who are presently addicted to prescription opioids (and who have way too much power combined, and they're not suffering from cancer) - they'll make sure opioid prescriptions never become as strictly monitored as PROP is suggesting. Not even close. Why do you think that the bill regarding the mandatory testing of government officials for controlled substances was promptly thrown out almost quicker than it was drafted? The real reason - not the privacy bullshit. The government and its sectors are no better than your average junkie when it comes to drug use. They may do a better job of hiding it, but considering the difference of resources as opposed to a homeless, panhandling addict, it's easy to see why.
 
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it will also limit the meds that one can get to no more than 100mg of morphine per day (or the equivelant ..so if oxycodone is twice as strong as morphine then you will no longer be able to be prescribed more than 50mg of oxycodone per day! And remember, that is only for no more than 90 days!
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what.the.fuck
 
Here is the relevant NY Times opinion piece by Dr. Kolodny of PROP.

"Doctors have contributed to an epidemic of overdose deaths and addiction by overprescribing opioids. We didn’t do this out of malicious intent. For most of us, it was a desire to treat pain more compassionately that led to overprescribing. To bring this public health crisis under control, doctors must prescribe more cautiously.

In response to an industry-funded campaign, sales for opioids increased exponentially. Doctors were taught that unrealistic fear of addiction was resulting in needless suffering and that opioids would provide long-term relief of chronic pain. Doctors were misinformed."

http://www.nytimes.com/roomfordebat...tion-drug-abuse/opioids-are-rarely-the-answer

The comments are overwhelmingly opposed to Dr. Kolodny. It is also interesting to note that Dr. Kolodny is a psychiatrist and that there are no pain specialists on the board of PROP.
 
Hobble said:
Here is the relevant NY Times opinion piece by Dr. Kolodny of PROP.

"Doctors have contributed to an epidemic of overdose deaths and addiction by overprescribing opioids. We didn’t do this out of malicious intent. For most of us, it was a desire to treat pain more compassionately that led to overprescribing. To bring this public health crisis under control, doctors must prescribe more cautiously.

In response to an industry-funded campaign, sales for opioids increased exponentially. Doctors were taught that unrealistic fear of addiction was resulting in needless suffering and that opioids would provide long-term relief of chronic pain. Doctors were misinformed."

http://www.nytimes.com/roomfordebat...tion-drug-abuse/opioids-are-rarely-the-answer

The comments are overwhelmingly opposed to Dr. Kolodny. It is also interesting to note that Dr. Kolodny is a psychiatrist and that there are no pain specialists on the board of PROP.
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Correct, this is one of the recent articles and the one that I had mentioned from the NY Times. (thanks for posting it!). He is not a pain specialist but considers himself a addictions treatment specialist.

Please take a look at the website of the opposing group that is having people against these proposed changes in regards to limiting pain meds prescribing and if possible and if you feel strongly about it, sign their petition and post your own story about how opiates/opioids have helped you or changed your life.

The link is in the original post.
 
Just another few important points that I was thinking about regarding PROP (the ones that are for all these changes that are going to affect people who use prescription narcotics-opiates/opioids).
One of the things that was stated in the petition and that Kolodny keeps harping on is that there is no evidence that the use of narcotics for non-cancer/non-malignant pain long term is actually beneficial to the chronic pain patient. The reason there is no good evidence that it works is because there has been no long term studies done on treatment of chronic pain patients who are not cancer patients who are on opiates/opioids.
He is being misleading IMO because its not like it has been studied and found that this is the case, there are just no studies to show that it is effective. How hard would it be to go through a few thousand long term opiate/opioid using chronic pain patients medical records and see how many have had improved quality of life and what the long term effects have been on them medically and in regards to "addiction"?

Also some other thoughts and facts that need to be pointed out-
-By changing hydrocodone to a schedule II drug it will make it even more difficult for rural patients and people in underserved (by doctors, PAs/ARNPs etc) areas. Many of these areas only have access mostly to providers other than docs such as physician assistants and nurse practitioners. If it were to be a schedule II drug in most place the PAs and nurse practitioners are not allowed by law to prescribe schedule II drugs. And there are A LOT of underserved, poorer rural areas in the US.

-Almost all users of narcotic opioid and opiate meds for long term, including chronic pain patients will become physically dependent on the med. This is not the same thing as abusing them or being "addicted" to them. There are many other non narcotic drugs that treat other illness (even diabetes, hypertension etc) that people will become dependent and tolerant of requiring higher doses and withdrawal symptoms upon discontinuation. And thats not even talking about mental health/psychiatric drugs! Most of them have effects like this also. Many other classes of drugs kill people also, especially when someone takes them not as prescribed.

-Kolodny states that research of patient records show that most patients that are on narcotic pain meds for at least 90 days are almost always still on them 5 years later! Ok, so what? Does he really think that chronic pain will just get better after a round of pain meds for 90 days?? Is that how this is supposed to work? No one said it cures chronic pain, just makes life more livable. A lot of illnesses are for a lifetime such as diabetes, high cholesterol, high blood pressure, COPD and the list goes on and on.

-Are they basing the opinion that long term treatment of chonic pain with opiates/opioids is not helpful on the fact that they just believe its not or have they actually asked patients? Because on every article I have read and then looked at the comments portion, almost everyone states that these meds have had a positive influence in their lives.

-Who are these people/docs to say that they know what is best for me and others? They are telling us that it is better to just suffer for the rest of our lives and have a miserable existence and poor quality of life than to take a chance on being a productive, happier person because we MIGHT OD or become addicted or dependent? Well guess what asshole, I will take that chance.

-I also wonder,is it no longer going to be a "patient right" (you know those signs you see in the hospitals/ERs/acute care walk in clinics) to have pain treated adequately?

-I feel for cancer victims. But what gives them more right to pain relief than a chronic pain patient? Because they are going to be dead within a limited amount of time and the docs wont have to worry about the liability for very long? Many illnesses that cause chronic pain have been shown to be just as painful and the chronic pain patient must suffer for even longer, a lifetime which could be 10, 20, even 50 years or more?If you arent dying then you are just S.O.L??? Un-freakin-believable!!!

-I think what it is going to come down to is that most docs really dont care if patients take pain meds as long as they dont have to be the one responsible for prescribing it to them. This goes back to the war on drugs and the fact that the government is intimidating docs into doing as they say. If a doc is prescribing what the DEA sees as too much, he will be investigated and risk losing his license and livelihood and everything that he has worked for for so many years. I would have a hard time risking that for my patients.

-Kolodny (main talking dude of PROP) says oh trust me, these guidelines that say opiate/opioids must be labeled from now on that they are only for severe pain, no longer for moderate to severe pain. This is just a guideline guys, you can still prescribe them for moderate pain if you must, just do it as an off-label use. Look jackass, not all of us make money like docs do and have YOU ever tried to get insurance to pay for a med that is prescribed for and off label use? Not going to happen. Besides, who the hell can say that 2 people who have the same condition experience the same amount of pain? So X condition causes moderate pain so you no longer can get narcotic pain meds. One of the biggest arguments that proponents of PROP and the changes have is that pain is not something you can see or know how bad it is, it is purely subjective, not objective. Well buddy, that argument works both ways. How the hell do you know that I dont have SEVERE pain from this disorder? Just because your medical books say it usually causes moderate pain doesnt mean that is the case for everyone.

On top of all of this, it is already so hard to find a doc that is willing to prescribe narcotics for long term pain. Do you think that if pain meds are labeled as only for severe pain that you are ever going to find a doc that will prescribe it for moderate pain? Absolutely not. When the DEA comes a knocking and checking records and that doc is the odd man out, they are going to say "Hey doc, you are not prescribing in a way that is considered standard medical practices (this isnt the way that you are supposed to and most other docs wouldnt do this) therefore it is investigation, close down the practice and jail time for you buddy!

I saw a comment a guy had made that said basically, you know its kinda funny, I can make the decision on whether or not to pull the plug on myself and make other end of life choices say if for example i were to be in a coma, but I'm not allowed to make a decision on whether or not I am willing to take pain meds or suffer a lifetime of miserable existence?
:?
 
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