From middle aged backache to junkie in 15 flat

[UpInFlames]

Yeah, I was starting to think that drug use negated any ability to read for comprehension.

Anyway, the cat is the one on bupe and gabapentin. *I'm* the one with the long term Temazapam/Lorazepam habit. (used as prescribed for 8 or so years by former shrink) that my current pdoc is trying to figure out how to get me free of without putting me though hell or exacerbating my mental and physical issues. So far, I gripe about taking the stuff and she shakes her head and writes the RXs and made me promise not to try to quit on my own.

My purpose in writing this was to warn about the new WI database and how hosed it is, and also to comiserate with those on replacement therapy who are "flagged" and how they are treated by the medical profession.

My biggest concern is that some poor person is going to be injured or post-surgical and be denied proper pain relief. In my case, I got my pain relief (which isn't working for shit. Back is beyond tramadol this time) and I have the dispensing pharmacy willing to speak with doctors to verify that the bupe RX with refills isn't for me.

But, if you fill a RX for controlled substances in WI, your name goes in this database. The dispensing pharmacy inputs the information. Technically, only medical personnel and pharmacists have access to the database, but law enforcement does as well.

Just something to be aware of if you are filling scripts from multiple doctors, are on maintenance, are filling scripts early, etc. In a state that uses a database, all that info is out there and IMO, it's not all that secure.

Regards,
UIF

 

[JM357]

As far as your question about how addicts get treated when it comes to pain: I have been off and on subs and methadone since 2005 or so. I also have fractured my back 4 times (fortunately didn't sever the nerve, still hurts like hell though- the reason for so many incidences of fracture is powerlifting and wrestling (I now can't anymore...)) and have 3 discs that are degenerating, dessicated, and sliding. It is not impossible to get on pain management if you see the right doc (the AMA does say addicts are supposed to have their pain treated appropriately even if it requires opioids) BUT you likely will see many first that give no help; then when you do find a doc that is willing to help at all (I've had docs, where after I came in and was completely honest didn't even look at my x-rays and MRIs and wasn't willing to do anything- not even any non-narcotic treatment) they will have an addict sign a contract agreeing to random pill counts and monitored urines. Also, some will actually prescribe LESS or the same even though the addict likely has a tolerance or will develop one more quickly, due to their fears (last time I got pain meds years ago was 10mgs of methadone 3 times a day after being on 24mgs of bupe a day (after making me wait 4 days of just taking nothing and being in WDs) it didn't even get rid of the WDs completely). Also, they likely will not prescribe anything for breakthrough pain like they would with others (it seems like when they do give an addict pain management it is also just about always methadone from what I've seen- if the patient has no history of heart problems in many cases this maybe isn't always a bad idea as methadone doesn't have the quick hitting effects of say oxys on an empty stomach, and it does seem to work fairly well for long-term pain management but does very little for breakthrough pain).

Then forget being able to get anything any time soon with a history of addiction unless there is like severe and easily visible trauma or surgery (and I've heard horror stories about them giving such low doses the person was screaming in pain even in those cases). No way I would just go to a regular doctor and get anything other than NSAIDs (I actually have been prescribed tramadol easily in the past but IMHO it is a very poor painkiller at least for someone with a tolerance). The only docs who SOMETIMES will help an addict are anestheologists/PM specialists.

I'm currently having problems with this and think it may work out very bad in terms of pain and not taking opioids on my own. I do fortunately have family in my corner (who have no history of sub. abuse and are well respected, etc.) who want to help me with this, but in the end that doesn't mean much. My addiction specialist claims that while a few doctors are biased against addicts the biggest issue is actually the DEA prosecuting doctors for simply practicing medicine.

 

[JM357]

Just to clarify: I know "you" as in OP are not an addict. When I used "you" I was just using it in the sense of what happens if "you" ARE an addict, at least in my experience (there are always some exceptions: there was a doc around here who got in trouble because they were prescribing opioids to addicts under the premise WDs are painful and therefore they were treating pain- if this was allowed I think it would pretty much solve the opioid problem (they have had a lot of success in lowering property crime and increasing quality of life for addicts and their families in places they have tried for example HAT (heroin assisted therapy, as has been tried experimentally in Switzerland and some other European countries).

 

[UpInFlames]

Providing clean, tested heroin to addicts, AND providing safe, monitored places to use, would save a LOT of lives. When i lived in Germany in the 80's, they were experimenting with that very thing. They found that in addition to saving lives, it did cut way down on property crime.

I lost a nephew in 99 to an opioid OD. My late husband was on Fentanyl and Dilaudid (Patch, lollipop and tablets) for severe pain related to the illness that killed him.

Nephew was an addict. At a family gathering, he stole a quantity of husband's meds and was found dead with a needle in his arm a day later. Toxicology showed that he died of a fentanyl and dilaudid OD as well as having other drugs in his system.

Had we had cheaply available, clean heroin, and a safe place for him to use it, Nephew, who stole the drugs because he was dopesick and didn't have the money to buy enough heroin to get well, might still be alive, and who knows? He might even be on subs or methadone and a contributing member of society.

Nephew was only 22 when he died, and my husband blamed himself for his death because he had only "child-proofed" his meds as opposed to really securing them. He bought a locking safe for them after the fact, but that, of course, didn't bring nephew back.

I was with BIL when he found nephew. I drove BIL over to the apartment when he didn't show up for breakfast and wasn't answering his phone.

It was prohibition that killed Tony, prohibition that is killing addicts every day and night, and only regulated availability and "injection rooms" that will save lives

In my state, we can't even manage to pass a law making Narcan available OTC, and RX it is so expensive that many people can't afford it.

 

[JM357]

I actually do think there are some signs that make me slightly hopeful things will change (part of me is afraid they will get worse though- especially when it comes to pain treatment):
- Police in my home town (born and grew up there) now have a program where anyone arrested for personal possession will not be criminally charged if they get treatment. (what kind of treatment I don't know, and not everyone is ready to get clean, etc. but still it is a step in the right direction and I never thought it would be the police dept. that would take such a step).
- Opioid addiction has become a big topic among politicians, and at least when it comes to addicts not in a "get tough" sort of way- but actually talking about more methadone clinics and lifting the cap on suboxone docs.
- A general shift away from trying to stigmatize addicts (Massachusetts is starting a "StigMAless State" program or called something similar to that (I know they use MA as in the state's abbreviation in the word stigMA)
- The general public hearing again and again on the news that it is a disease and not a personality flaw
etc. Again I don't think it is perfect and they still don't seem to get that they can't make drugs disappear (the whole state databases like you mentioned, doctor's being prosecuted for treating pain patients (my doc wanted to give me a medical marijuana card but admitted he is afraid of the feds still)) but at least they are starting to change the general thinking on it a little. For the first time I think that MAYBE just MAYBE I will see this drug war end or significantly change in my lifetime- still a long way to go, and it isn't going to help me today, next month, or probably even the net few years. But I am starting to think there may be hope...

 

[LilikoiMoon]

(Grr..my post disappeared)

I went to rehab in 2010, states and miles away and they filled a Suboxone RX through CVS. I was unaware of this, as I assumed all their RXs were coming from in house. When I got home I never had another bupe rx filled.

Fast forward to a few months later, extremely painful surgery that included stage IV tendonitis and another repair from a severed finger....I mosey on down to the pharmacy with my 5mg oxycodone rx and the pharmacist says "They'll be no oxycodone for you today because you had a rx filled for suboxone a few months ago". There was no changing their mind, and I was flagged. This all happened in 2010 and after a year, the bupe rx disappeared and the flag.

CVS made my life hell for that year.

OP your rx monitoring program is new, so expect the worst, seriously. And if you ever start out with bupe rx on file, it'll be worse because when you really need pain meds/scheduled with bupe on file, they'll look at you as a drug seeker. They don't care if it's your cat, you're not gonna get any pain meds. And never get "red flagged" which is what could happen if you keep bitchin over the rx you have now...they'll label you with "drug seeking behavior".

Get to know the new laws, seriously. Alot of people don't take the time to read them and that could be a matter of pain relief or spending several years in prison for rx.

Good luck!

P.S. It's been several years since my state started this program and it runs alot smoother now. The first year or two, oh hell!

Where as before you could keep refills on file for pain meds, you now have to see a doctor every month to get a new script.

 

[UpInFlames]

I lived in a small town in Northern WI when the law passed that chronically used narcotics had to be prescribed by a pain mgmt specialist.

At that time, there was only one PM clinic in town, with 1 doctor and 2 NPs. They were booked solid 8 mos out. This pushed a lot of people who were using oxy or hydrocodone for relief of chronic pain right onto heroin, despite WI's draconian drug laws.

I'm not sure of the exact specifics of the new law, but it seems that regular physicians are able to prescribe 2 RXs of narcotics and then must shunt the pt off to pain mgmt.

I know that when I got my tramadol RXs from her, each was for 20 days. Admittedly, I was offered a "menu" of painkillers and chose tramadol because it doesn't make me so high that I'm incapacitated.

At the same time, public opinion in a lot of areas here is changing in favor of treating addicts rather than jailing them. OTOH, with the laws regarding chronic painkiller RXs, even pain mgmt docs are very leery of RXing meds and tend to insist on spinal injections and the like, basically requiring pts to jump through the hoop of a potentially dangerous and often useless treatment before they can get pain meds.

 

[Bliindsided]

Actually, he was referring to himself but trying to avoid self incrimination, it's actually painfully obvious.. cats don't get prescribed bupe, fuckin' moron.

Yes. this person prescribed sub-doses of bupe. You're a great example of a horrible human being with no room for believing anything but what you already think you know. animals get pretty much teh same drugs as humans.... in fact my german Sheppard gets more abusable drugs than i do. do this website a favor and cease to exist on here because youre not helping anyone.

cats get bupe. just google it christ.

 

[UpInFlames]

Thanks, @Blindsided. I had German Shepherds for many years. Best dogs on the planet.

Bupe has been used in vet practice for many, many years. I actually thought it was just an animal med until a friend who's daughter was a heroin addict told me that her daughter had been put on it.

My cat is also on gabapentin along with the bupe. Anyone want to tell me that cats don't get prescribed THAT? (His gaba is chicken-flavored)

There are even special pharmacies that specialize in making up (human) meds for animals. My cat's meds are made up by one of those pharmacies. My vet calls in the RXs, just as your doctor would send a RX for you into your pharmacy.

The big issue right now is that the way the records are set up in the database, there is no comments field where the filling pharmacy can add information, such as the RX being for an animal, or a child for that matter.

Blindsided, your information is very concerning. We've had the rule where you have to pick up a fresh RX each month for class I and II controlled substances for about 2 years.

The database just came on line a few months ago, and I suspect you are right and it's going to be a nightmare until they get the kinks worked out of it.

Meanwhile, I guess I'm just dependent on TPTB reading the name of the pharmacy, which clearly indicates it is for animals, and reading the dosage of bupe prescribed.

Given that the doc-in-the-box doc didn't bother, it doesn't bode well at all.

 

[JM357]

(Grr..my post disappeared)

I went to rehab in 2010, states and miles away and they filled a Suboxone RX through CVS. I was unaware of this, as I assumed all their RXs were coming from in house. When I got home I never had another bupe rx filled.

Fast forward to a few months later, extremely painful surgery that included stage IV tendonitis and another repair from a severed finger....I mosey on down to the pharmacy with my 5mg oxycodone rx and the pharmacist says "They'll be no oxycodone for you today because you had a rx filled for suboxone a few months ago". There was no changing their mind, and I was flagged. This all happened in 2010 and after a year, the bupe rx disappeared and the flag.

CVS made my life hell for that year.

OP your rx monitoring program is new, so expect the worst, seriously. And if you ever start out with bupe rx on file, it'll be worse because when you really need pain meds/scheduled with bupe on file, they'll look at you as a drug seeker. They don't care if it's your cat, you're not gonna get any pain meds. And never get "red flagged" which is what could happen if you keep bitchin over the rx you have now...they'll label you with "drug seeking behavior".

Get to know the new laws, seriously. Alot of people don't take the time to read them and that could be a matter of pain relief or spending several years in prison for rx.

Good luck!

P.S. It's been several years since my state started this program and it runs alot smoother now. The first year or two, oh hell!

Where as before you could keep refills on file for pain meds, you now have to see a doctor every month to get a new script.

What the hell is with these pharmacies? I can see saying "we know you have a history of addiction, so we are going to call your doctor and make sure this script is legit," but to say "you have a history of addiction, so we will not fill this" - what is wrong with them, I could find the link where the AMA says that while doctors should be careful and examine other possibilities for managing pain in addicts, sometimes addicts do need opioids (and that NOT prescribing them in some cases can be worse because it leads people to relapse by self-medicating). I actually am starting to feel like I have been very lucky b/c even though I have been prescribed subs (and even went to the same pharmacy where I had had subs filled the month before (actually probably a couple weeks) and had an RX for methadone filled (well my father went and had it filled because at that point it had been three days since the last sub and I didn't feel like going to have it filled) I've never been denied a script (actually my wife was denied oxycodone though and she has never had an addiction, a script for subs, been to detox, etc. but she was pregnant at the time (but had had gallbladder surgery); even though the docs said that our child would be at more risk from the stress of the pain than from one bottle of 30 percs the pharmacist decided they would not fill the script- so she went to another pharmacy where they filled it). I may end up having back surgery though and this scares the shit out of me- that I might get out of the hospital and they will deny the script for pain meds (it has been years since I was prescribed anything other than tramadol- so that could be a difference). Or that I will be prescribed something for my back (they have talked about methadone), so I won't even have subs anymore, and then they will deny my rx so I will end up going into withdrawals and end up relapsing.

I'm almost certain I am flagged (been on subs, methadone clinic, detoxes, prison, etc.)- but I thought a flag was a caution against prescribing, not an absolute.

Did they at least give you your rx back so you could try to have it filled elsewhere (this is what happened when my wife was denied for being pregnant)? Or if they took it did you call the doctor and tell them what happened so you could get another?

Honestly, if a pharmacy took an rx from me refused to fill it, refused to give it back, and caused me to be sick I would consider filing a lawsuit for pain and suffering from not having the medication I needed. Part of me would feel bad- I've heard for the most part that it isn't pharmacists DON'T want to fill it (they make money off selling prescriptions after all) it is that they are afraid the DEA is trying to bust them. It would probably depend on wither they gave it back or not (I've never had them take an rx- I have gone in to have something filled and it ended up being a couple days early and they wrote that note on the rx, but they did give it back). I highly doubt you'd win but even having a lawsuit filed against is a pain in the ass. And I'm not someone who is for filling lawsuits against medical people, it would have to be something where they overstepped and put someone in danger- like some of these pharmacies refusing rx's; not like a mistake- everyone makes mistakes and you can't expect doctors to be perfect.

 

[UpInFlames]

I had a problem getting the doctor sorted out, but once I got her to understand that the bupe was for a pet, she wrote the script.

I took it to my usual pharmacy and asked the pharmacist to look at the database and read the record to me. He caught that it was from Pet Apothecary right away, and sort of shook his head and laughed about a RX for .1mg of bupe every 12 hours.

He filled the RXs for tramadol and robaxin without any problem at all.

The only hitch in all of this was with the doctor flipping out on me.

Now my big concern is that the tramadol isn't touching my back and I'm afraid to ask my regular doctor for something stronger for fear of being thought to be a "drug-seeker".

I've spent a week barely able to walk or sleep and it's getting a bit old.

 

[manboychef]

I had a problem getting the doctor sorted out, but once I got her to understand that the bupe was for a pet, she wrote the script.

I took it to my usual pharmacy and asked the pharmacist to look at the database and read the record to me. He caught that it was from Pet Apothecary right away, and sort of shook his head and laughed about a RX for .1mg of bupe every 12 hours.

He filled the RXs for tramadol and robaxin without any problem at all.

The only hitch in all of this was with the doctor flipping out on me.

Now my big concern is that the tramadol isn't touching my back and I'm afraid to ask my regular doctor for something stronger for fear of being thought to be a "drug-seeker".

I've spent a week barely able to walk or sleep and it's getting a bit old.

Be honest with your doctor. Let the bastard know that you tried it and it isn't working. If he tries to just give you an NSAID prescription, just say you'll go over to the dollar store and buy them since they are cheaper and thanks for wasting my time. Hopefully noone firebombs your windows after you close tonight....jk. But really just be honest. One thing about being in a captalist healthcare system is that you vote with your money. If you don't like the way the doctor is treating you, go somewhere else and write a letter to the review board in your state explaining exactly what experiences you had with this doctor and why you felt the need to go to a different one.

On another note, I have an excellent pharmacist. I am prescribed xanax and temazepam. If I am not going to be able to make it down there when my scripts are due and its way early he will still let me fill them. Not to mention he looks out for deals on medications...he was actually a doctor in nigeria and became a pharmacist when he came to the states, so he knows the meds very well. He ended up finding a replacement for spiriva which saved my grandmother like 125 dollars a month for her COPD. (He called the doctor and suggested that he prescribe that to her, and the doctor researched it and changed the prescription.)

Basically what I am saying is there are good doctors and good pharmacists out there just as there are good people out there...however there are sadistic, holier than thou people out there as well. Pass this type of person your medical well being, or how pain impacts your daily life and you have the perfect storm for a severe departure from the Hippocratic oath.

 

[EnlightenedOne1]

I'm confused, why would they give a cat or any feline would take subs? I thought the drug was just designed for human consumption; but I'm not a vet or medical professional.

I've owned cats all of my life and I would NEVER give them an opiate based painkiller or even subs.

I'm moving this to other drugs but we do not write in terms like "My pet cat", SWIM, etc. here so you may have to clarify your topic and post.

I thought the same thing until I got both of my cat's declawed and was handed a small liquid dropper of 1mg Bupe. My cats were constipated and lethargic all week.

 

[JM357]

Be honest with your doctor. Let the bastard know that you tried it and it isn't working. If he tries to just give you an NSAID prescription, just say you'll go over to the dollar store and buy them since they are cheaper and thanks for wasting my time. Hopefully noone firebombs your windows after you close tonight....jk. But really just be honest. One thing about being in a captalist healthcare system is that you vote with your money. If you don't like the way the doctor is treating you, go somewhere else and write a letter to the review board in your state explaining exactly what experiences you had with this doctor and why you felt the need to go to a different one.

On another note, I have an excellent pharmacist. I am prescribed xanax and temazepam. If I am not going to be able to make it down there when my scripts are due and its way early he will still let me fill them. Not to mention he looks out for deals on medications...he was actually a doctor in nigeria and became a pharmacist when he came to the states, so he knows the meds very well. He ended up finding a replacement for spiriva which saved my grandmother like 125 dollars a month for her COPD. (He called the doctor and suggested that he prescribe that to her, and the doctor researched it and changed the prescription.)

Basically what I am saying is there are good doctors and good pharmacists out there just as there are good people out there...however there are sadistic, holier than thou people out there as well. Pass this type of person your medical well being, or how pain impacts your daily life and you have the perfect storm for a severe departure from the Hippocratic oath.

Yeah, also I think we always tend to think that doctors and pharmacists are always to blame when things go our way, but often it may be they are afraid of law enforcement even though they may be sympathetic to us. Like as I said I have a history of addiction but also a bad back and anxiety- my addiction specialist who prescribes me bupe wanted to get me a medical marijuana card. When I went in one visit he said he would look into it- that he would like me to have the medical card; at the next he completely honestly told me that he was afraid of being arrested by the feds, that since I was over the border it wouldn't cover me in my state anyways (and the state I live in now is EXTREMELY restrictive on who gets medical marijuana- basically pretty much cancer patients on chemo and maybe like MS or severe seizure disorders that aren't responding to other meds etc.), and that he would consider drug tests positive for marijuana negative (he also doesn't really care about very occassional use of low doses of benzos- like he said literally take kpins at like 0.25-0.5 at a time and wait to make sure I'm not having any problems with interactions and if they came up ocassionally he would disregard that as well). So basically he has said to me "it sucks, I know you need more help but am afraid of the DEA who has made doctors a huge target in recent years. I think this is also the case with pharmacists most often- think about it, they make money of dispensing scripts (and pharmacists have also been targeted).

We do have to be sympathetic to some degree- they are people with families who are relying on their profession. My cousin had a psych doc that prescribed her her benzos and subs who she really liked- one day the dea busted her and immediately shut down her office. The psych doc ended up comitting suicide and it turns out that it had already been decided that she had not been praticing innapropriately and that the feds were no longer going to pursue the case. When a doc gets hit by the DEA (and it really has become pretty common- when I got out of prison I called the sub doc I had before going in and he told me he wished he could help me but the feds had shut them down- the DEA uses the most conservative 5-10% of docs there are out there to decide who to pursue and as expert witnesses in court) the doc is immediately suspended as far as prescribing goes (there goes all their patients) and it will take them 1-2 years to get it back even if they are cleared and by then tremendous damage has already been done.

 

[UpInFlames]

I had a really good pharmacist when I lived up north. He saved my bacon a couple of times by picking up on drug interactions that my doctors missed when prescribing.

I haven't been down here long enough to establish a good relationship with a pharmacist, and frankly, I don't know if it's gonna happen.

Enlightened 1, I won't get on the declawing soapbox here as it has no place in the current conversation, but yes, opioids used in animals have all the charming side effects they do in humans.

Thomas has an RX for a laxative if he needs it, and the bupe even makes him nod sometimes. It doesn't seem to make him itch, which I suppose is something.

His bottle of bupe even says, "Do not discontinue except under advice of licensed veterinarian.", so withdrawals would also be an issue, I assume.

It's also horribly expensive, as is the gabapentin, but the two meds keep him comfortable.

 

[UpInFlames]

There isn't a problem with my regular doctor. The problem was with a doctor at an urgent care clinic that I saw because my regular doctor was out of town.

My personal doctor won't give me any trouble about the bupe once I explain it to her. In fact, she'll probably get a good laugh out of it. So far, she's been very reasonable about prescribing various meds, as is my psychiatrist, who is associated with the same clinic.

I think part of the issue is the drug laws in WI, and part of the issue locally, is that the Milwaukee area is a real heroin and pill hotbed that they are constantly "cracking down on" to no avail.

The crackdown on RX pills drove a lot of legitimate users onto heroin who initially were just seeking pain relief. We have a lot of new-ish heroin users in my age group (50s) and older in this area, as well as a lot of highschool age users.

It may sound horrible, but I'm glad that my husband died in 02, as he was able to access good pain management during his illness. I suspect that today he would've been left to suffer much more pain than he did then, when there was no concern about a terminally ill patient becoming addicted, and the primary goal was to keep him comfortable and give him quality of life for as long as possible.

I guess thats what bothers me more than anything else. The sheer cruelty of so many of our drug laws.

 

[UpInFlames]

Well, the first of the birds came home to roost. I saw my shrink today. She increased my lorazepam to 1mg 3x daily as needed from 1mg 2x daily as needed.

She also had me sign a "controlled substance contract" which states that I will not get controlled substances from doctors outside that practice and/or will notify them if I do so. I also had to agree to random pill counts and urinalyses. Though she prescribes my benzos, this also applies to any other controlled substances.

The contract also states that if I run out or lose meds, or they are stolen, they will not be replaced early, and I acknowledge that I may suffer withdrawal in those cases.

Charming. I also stopped by the main clinic front desk and made an appointment to see my primary care physician Friday for my back to get a referral to physical therapy.

Then, when I went to the pharmacy to fill all the prescriptions from my pdoc, the pharmacist called my pdoc on the lorazepam RX to verify that it was legit, I guess due to the increased dosage.

Got all the stuff filled without a problem, though I guess I'll have to start taking the full dosage of the loraz as I don't always take it all if i don't need it on a given day. The pdoc said the UAs are to check both that I'm taking my meds as opposed to selling them, and that I'm not taking more than prescribed.

Nothing like feeling like a criminal. This is a county subsidized behavioral health clinic that treats substance abuse as well, so I guess they are stricter in general. I certainly never had to go through any of this up North. The contract also said that if I come in intoxicated or my UA shows use of unprescribed controlled substances, that my meds will be cut off.

Best I make sure my blood sugar is up to snuff (I'm diabetic) when I go in for appts.