Pain Management Community

Hi Moonlite,

I'm not even going to get into it, but we, with chronic pain syndromes, who have been taking opioid medication, are in for some rough times.

MDs are no longer allowed to prescribe more-than the morphine equivalent of 180 mg/day for non cancer chronic pain.

I have been treated for failed fusion syndrome (I have cervical and lumbar fusions)for over five years.

Now, my MD wants me to withdraw off of all my meds and take a one-month, "drug holiday".

After I am suffering for one month with no pain meds, the rationale is that I
'll be prescribed between 60-80% less morphine.

Our MDs no longer can prescribe the meds that we need.

My prediction is that there will be mass suicide, illegal drugs traffic will increase as persons who need meds to function will find other ways to get them.

Many persons are still in the workforce because opioid meds provide the comfort to enable them to work. They will become disabled to work.

This is crazy, and the same MDs who offered us the meds to help us are now treating us like addicts.

I am considering moving to the Netherlands where herion is legal.

You are quite right: unethical and uncivilized.

CTBeth,

Unfortunately I totally agree with you about suicide and illegal drug traffic, which is so sad. I don't understand what is happening, that they think chronic pain patients do not deserve to have our pain managed so we can have fairly comfortable lives.

I have a tough time as it is on my meds. I have already told my family when the day comes that my meds are taken away I will try but I will not live in constant relentless pain. I just won't do it.
Unfortunately the people that have abused the system have ruined it for the people that truly need their medications. And the government has stepped in and now we are not going to get the medical help we need.

It is becoming a very sad world when the people suffering can not get the proper meds to give them relief.

I usually get the most relief from the morphine in the first couple of months. After that, its suffer. Mt P.M. Dr. works with the V.A., and he is very good, but has to follow guidelines. He cannot change my meds over for six months to a year. Then, its wean off one, then start the new. The wean period just about kills me. Then, i have to hope the new meds will be sufficient? And it takes time to build up to enough to help.

I am not hearing this, about taking people off of opioids? This must be in the civillian world, i guess? I can't go to a regular Dr., unless its an emergency.

Good luck, everyone!
Dennis

My long-time doc at Kaiser Permanente will no longer prescribe opiods for chronic pain, which is the company's new policy.

It is cruel, barbaric, illogical, and based in fear that the DOCTOR will suffer if they are audited.

They don't want to be responsible for creating an addict. So now, all people with Chronic Pain are treated as potential addicts. Its a catch-22. If you develop tolerance and need a higher dose..well, you're an addict!

I also agree that this policy will lead to suicides and more black market use.

People can not live in unrelieved pain!!!

ATTN: Anyone who would like to speak to me PRIVATELY about this topic, I would ask to email me.

I have some thoughts and idea that I do not feel comfortable posting in an open forum.

Please identify yourself as "FROM WEB MD" in the subject of your email.

I would welcome an intelligent and lively discussion, and even syllogism, as I welcome thoughts that do not agree with mine: that is how we learn.

My email:

BethHuntington@live.com

At some point, we, persons with known and objectively-diagnosed pain syndromes or diseases, MUST, at some point, involve ourselves in litigation.

The sooner we mobilize- the better!

I await a full inbox.

Love,

Beth

Hi CTBeth,
I have been inn Chronic pain for over 25 yrs.!Only been on strong meds for about12 yrs.!I say only...Actually thats a long time and I wish I did'nt have to take them but my pain level is at an 8 alot of the time!
I don't understand at all about what you all are talking about!My Dr. hasn't said anythign or have my pharmasists,this is really scarey!
What is the reason for this big change????Is it going to be Law???WHY!!!!!
PLease help me understand !!
I will be praying for all of us,all we can do is give it to God !
Thanks,77grace

Hello Grace,

JoMully, moonlite and I have written about our experiences of late.

Perhaps you'll be of better fortune and not have these restrictions imposed upon you.

I would think that your MD would explain his/ her practice's restrictions as it relates to your medication(s).

I don't think any of us wants to take them; we take them because we need them to function.

I hope you'll have a nice holiday tomorrow.

I think it was the 37 Doctors who petitioned the FDA, and the Affordable Care Act. (heath care) witch I belive in part is to get the ones who really need pain meds. and weed out the ones who abuse them. because people are dying. plus the money it will save. my Doc. gave me a blood test (i think to check my levels
and for no other stuff in my system) and the next time urine
test everybody needs to be on the straight & straight
Dan

Moonlite: The reason you are not getting the same relief is because chronic pain can become worse and more difficult to manage when you're taken off the medication that is providing relief"026 or if you're unable to obtain proper care to start with. The same thing happened to me when Medicare D first started to cover my medications. By the time we appealed my and i got back on the orginal dose it didn't work as well. As a result my doctor had to increase the dose. They didn't fight the increase thankfully.
There were a few things I read in the replies that I would like to comment on.
CTbeth: I just discussed this issue with my doctor. MD's are allowed to prescribe pain medications over the morphine equivalent of 180 mg/day. Even primary care doctors can write prescription for over this strength. They may not want to write them"026but if they are licensed they are allowed.

This whole idea that they can't I think began with problems that happened in Washington State"026and this state's response. To help primary care doctors they came up with a system to provide guidance for primary care physicians when providing care for pain management. The recommendation are that dosing over 120 morphine equivalents per day should not be given unless a pain specialist was consulted. The problem has been that (and this is a view based on observations) "026 is insurance company's in other states have decide to interpret this as primary care doctors can't write over this strength at all"026so they deny coverage.

JoMully: Now you may already know this"026 I wasn't sure if you were being sarcastic or not. Anyway, tolerance and addition are two different things. Individuals with chronic pain do not have the same reaction as someone not in pain taking these drugs. These drugs act on a different part of the brain"026and provides us pain relief. For someone not in pain they act on the part of the brain that is associated with pleasure"026 hence the reason they get "high". We are being penalized because of the ignorance and misplaced fears out there concerning opiates"026which are in many cases safer than some newer"026but non-narcotic drugs. And what others may or may not do with them.
77grace: It sounds like you have a good doctor. I wouldn't worry. Like I said any doctor with a license can prescribe these medications. Now they may choose not to for reasons that have nothing to do with what's best for their patients. And some pharmacies have chosen not to carry some of the stronger drugs in large amounts"026again for reasons that have nothing to do with patient care. But there are lots that do"026and will continue to carry them.

Now I'm not saying we don't have major problems. We do. There are not nearly enough qualified pain specialists who will do what is best for their patients"026as opposed to what is easier and makes them more money (like injections). Between the politics and the lack of understanding about pain and pain meds among the public "026things are not good. And it is worse for some than others.
The only way this disease is going to treated how it should"026 based on what is best for each patient"026 and not on the "politics of the moment", the misplaced fears of the public, or what a "third party" may or may not do with the same type of medication we take. Before we are ever going to get the medical community (including medical schools) to give this horrendous disease the attention that it warrants"026 before they will provide the same attention that they provide to any other medical conditions/diseases that impact such a large part of the population"026 before anything is going to change we have to come together as a group and demand it. And we would have a strong voice considering 48 million Americans suffer with nonmalignant chronic pain. If you're interested in doing just this contact me here or at cpal@chronicpainadvocacyleague.com
Lorraine

I just notice that where I used three dots between words it got pprinted as "026 ... sorry about that. anyway
Lorraine

Hi Lorraine,

The PA at my MD's office told me 180 mg/day; in her note, she wrote the figure as 200 mg/day.

Thanks

After three disastrous disc herniations and four failed spine surgeries, I was ready to stop working at age 42. Then Fentanyl Transdermal gave me nine years of bliss, during which my career flourished. Of course, we all become victims of tolerance over many years. Eventually, at age 51, I had to stop working. About a year later, I decided to stop the Fentanyl and try Kadian (long-acting morphine). It was a disaster. My pain, on the 0-10 scale went from 6.5 with Fentanyl to 9.5 with morphine (10 is reserved for the pain of burning alive).
Many times we think that we're in so much pain that it's worth trying almost anything new. In my experience, and I've tried virtually every medication and treatment through two comprehensive pain management programs, change can deliver some very bad results. I realized that despite being tolerant to Fentanyl, no other medication was remotely as efficacious, including morphine.
I also learned that when we max out on the most powerful drug combinations, mind-body alternative treatments are often the best option. For example, I can reduce my pain by at least 20% with biofeedback. Distraction is also a powerful tool. With me, it's writing. And THC can significantly reduce chronic pain. The side effects are minimal. Try whatever you can. But beware of ditching one decent medication for the promise of another one. The result is often very disappointing. Then, you must beg to go back on your prior drug, which really offered some decent relief. I fact, in today's addiction-adverse society, you might never again get to go back to that original drug that helped a great deal. So, the nest time you want to dump your current medication for the promise of something new, make sure that you'll be able to go back to the original drug if the new one fails.

Any MD can write scrips for pain medications (any strength) That doesn't mean all should though. Now I'm assuming you're refering to your primary care doctor and not a pain speclist ... so it may be that your MD has chosen to limit the amount to what's in the guidelines since he or she is not a pain specilist. He or she could though. unless there is something else going on that I'm sure of.

My MD is a pain management specialist.

What made you assume that I was referring to a Primary Care MD? Just wondering.

You can click on my name or little pic to read a brief synopsis of my history. Much is left out; it's a skeleton of my past five years of life.

I have been with this practice for nearly five years and have had no med problems. I have no history of recreational drug use or abuse, if that is the,"something else going on", to which you refer.

I do not want to repeat myself and the people who are "regulars" on the site know my multi-trauma history and some-of my upsettingly-long surgical history.

I am also a middle-aged Registered Nurse and am quite knowledgeable of my pain issues and pain medications.

Please read my, "about me", before making any further assumptions about me, okay.