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Their petition is very serious given that many are academic addictionologists and emergency room docs that see only the failures and never the successes with opioid use and some are academic pain physicians that have written in the medical literature about their concerns over opioid use. Effectively, for the sake of harm reduction, the petition would eliminate opioids for chronic non-malignant pain. They try to mitigate this effect by saying physicians are free to prescribe "off label" however given the current regulatory environment, it is very unlikely physicians would risk their license prescribing "off label" for opioid narcotics and less likely that insurers would pay for "off label" usage. Effectively these physicians are trying to use a back door approach to eliminate opioid narcotics for chronic pain. The petition may be found by doing a google search on "Physicians for Responsible Opioid Prescribing FDA Petition" and there are also links available for FDA comment. In your response to the FDA it is suggested you be brief, talk about how opioids are improving your function and giving pain reduction (compared to no opioids) and avoid long discussions about your pain history.
The academic institutions for these physicians are also listed in the original document and you may write the president of their universities protesting these doctor's positions that would bring untold suffering to millions if their petition were granted, and you may wish to contact your US Senators and Representatives to help thwart this radical petition.
http://www.regulations.gov/#!documentDetail;D=FDA-2012-P-0818-0001?
Overall I wasn't too concerned since only 37 physicians signed the petition. What I do worry about is those elected officials who have the power to pass legislation. For example: ?Congresswoman Mary Bono Mack?
WE have a say in who represents US.
Also, an article that I found comforting (on Pain Topics Updates website) ?includes the following statement: "The petitioners"019 proposal is a blunt instrument solution based on the faulty premise that this problem will be solved if we only restrict the supply of opioid analgesics to a sufficient degree. "
This article also?has links to?3 studies cited by the PROP petitioners. ?They have been thoroughly critiqued ?in previous Pain-Topics UPDATES.?
If you don't have time to read the whole article, scroll down to: "Statements of Scientific Basis for Petition". There the author, Bob Twillman PhD, addresses those specifics points PROP bring about and critiques each one.?
Here's the link:
?http://updates.pain-topics.org/2012/08/group-petitions-fda-to-change-opioid.html?m=1
Final thought: If there haven't been any valid double-blind studies on the?long-term safety and efficacy of opioids (as the petitioners say) then it cannot be determined that long term use for chronic non-cancer pain is absolutely harmful. They negate their claim by pointing out the LACK of quality research.?
THE ARTICLE BY TILLMAN:
http://updates.pain-topics.org/2012/08/group-petitions-fda-to-change-opioid.html?m=1
SORRY FOLKS!
Blessings to All, fibrofran
In 4 days it may be too late. It's amazing how proper use of opiads can give a person a chance at a quality of life. It still takes a lot of mental and physical work.
I'm in physical therapy 3 times a week working out. My therapyst has a PHD (Masters) in physical therapy. She told me it is likely noting will ever temper my pain except for some amount of opiads. Working out makes me stronger and makes me feel better. I've lost ten pounds and have gained core strentgh. Withouth the pain meds I wouldn't be able to push myself to continue PT.
I ran in to an ex police sargeant today. He works at a sporting goods store and I was looking at some toys. We'd talked a few years ago and he told me about his fusions. He's been shot in the line of duty twice, later he has spine surgery. He could not beleive the amount of pain the spine surgery cuased...much more than the bullet wounds.I told I'd had more hardware installed sinc we last spoke and now I am completely fused from T4-L3. I was smiling and standing pretty straight. He said, "doesn't it bother you!" I told him it hurts like hell every second, but I'm OK.
Healthcare reform my ass!!! We need to let our highly trained doctors do their jobs and cut the insurance companies and legislatures off at the knees. No room for hypocrites.Let those that want to help us have free reigns on how to help us. Some oversite will be needed, but writing each prescription just so the DEA wont take their license is crap! They desrve better and they deserve our support.
Off-label prescribing is perfectly appropriate. It just means that drug companies can't advertise the treatment as proven safe and effective.
TRS1960- Hinting at a desire to physically attack the petition's authors suggests that you need much more help than just treatment for pain.
here's what I have found - I live on the boarder of KS/MO on the MO side. However, my Physiatrist is in KS and since I don't have prescription insurance I have to pay out of pocket. So I go to the small independent pharmacies where they can cut me deals on my meds.
Ok - so I was getting my meds in KS and there had been a couple of pharmacies I went to (one was farther away and other was a little closer) - so last month when I went to said pharmacy he said he could fill all my meds EXCEPT my roxycodone - seems he was RED FLAGGED - which meant by FDA standards and the pharmaceutical company the pharmacies (3 in KS so far) had exceeded the amount that is supposed to be dispensed. At this time I was forced to get these filled at full price at a pharmacy chain.
Once I got home I called 2 independent pharmacies in MO and found they had no problems and the one close to me stated they would have the meds there when I come in. I even gave them the name of the pharmacy in KS just in case they wanted to verify - which they did and have agreed to give me the same price (grateful for that!)
just thought i would let you all know what I have learned -
What Anon_973 described above is happening more and more often. Some pharmacies are simply opting out of selling opioids.
I'd rather see the FDA place some controls on drug company advertising than have laws passed by politicians that get between patients and doctors.
The reason ER docs have an axe to grind is that they see only overdoses of meds and drug seekers- not the millions that use controlled substances appropriately. Addiction specialists treat addiction, and usually not chronic pain. Their emphasis in their training is to eradicate opioids since these are "bad" drugs. Administrators would love to see opioids go away since they no longer have to pay for them...
If a day comes where access is totally lost and only people on the verge of death will be able to get opioids- it will be their fault for helping drug companies push opioids on everyone- that's what's causing this mess.
Opioids should be saved for chronic pain patients who really need them instead of being doled out like candy.
The PROP petition is a move in the right direction.
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