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I started a petition re DEA, pain meds, and us,
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leejcaroll posted:
The text and click is below. Please consider signing and passing it on. Too many of us have been victims of the DEA where our doctors are afraid to prescribe because of the government looking over their shoulder and creating more and more rules for those physicians who do pain management or treat those with chronic pain. (or any pain for that matter if they choose to write for opiods.)


we petition the obama administration to:
protect those in chronic intractable pain from the DEA and its "war on drugs."Those of us living with chronic intractable pain are finding it harder and harder to get the prescriptions for the medications that for many of us are all that is left for helping live with constant/intractable pain.
The DEA has taken its 'war" to our doctors offices and our treatments. Many physicians, afraid of the DEA, have stopped or reduced writing for opiods, which in turn has made it even more difficult for us to have the meds we need to get through the day, for some, just to be able to get out of bed in the morning.
For many it has made the difference from being able to work to going onto disability, costing more to the gov't and therefore the taxpayers.
We are petitioning to ask that our doctors decide what we need, how much and how often, and not the DEA.


https://petitions.whitehouse.gov/petition/protect-those-chronic-intractable-pain-dea-and-its-war-drugs/rqbB2zMq?utm_source=wh.gov&utm_medium=shorturl&utm_campaign=shorturl
Reply
 
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peskypain responded:
Do you mind being more specific of just exactly "how" the DEA has affected your personal PM care?

The DEA really has some basic but necessary regulations set in place. Each state has their own laws and regulations being passed that can affect pain management.

I have been in PM for over 6 years now and haven't had a single issue with my Dr. prescribing medication. Same thing with my Pharmacy. In 11 years I've never had a single issue through any of my surgeries and care.

I believe in looking at things in a very specific manner instead of just objecting to something for the "sake of it"..

Most reputable PM Drs. are not "afraid" of the DEA as they have no reason to be. They do everything on the up and up and follow protocol and keep good paperwork as well as they treat each single patient differently.

I do know that some people think that if they have pain, then they "deserve" opiates to treat that pain and that is just not the case. It's only been in the last 15 years that opiates have started being used for non cancer pain.

**The one thing that is coming down the pike which I happen to agree with is that they are requiring all non PM Drs. to take continuing education courses as well as certification if they wish to continue treating a patient for actual chronic pain (greater than 3 months which goes from acute to chronic).

This is why many non PM Drs. have been stopping prescribing controlled substances and sending those patients to see an actual PM Dr. As I said, I happen to believe in this as it should be a true specialty just like surgery or being an OB/GYN...I wouldn't go to a Podiatrist to get my spine fused!

I am certainly someone who does not agree with everything that the government does (Federal or State) but I have a problem when people use sweeping generalizations to try and get a point across.

Only people doing illegal things (Drs. or patients) should "fear" the DEA. Pain Management is not going anywhere, it's just getting more detailed.

There is better record keeping and detailed patient charts to have actual reasons to prescribe strong pain medications

There is the Prescription Monitoring Program which is good to find those who are abusing the system.

Annual or random urine tests to weed out those who are not taking their meds as prescribed.

Or random pill counts.

I just haven't found that any of these things have affected my care in a negative way.

Just one person's opinion so I will not be signing a petition that is too generic about the "DEA" in general.
 
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ctbeth responded:
Sorry leejcarol,

I read the petition and it lacks credibility.

I do not think or feel as if the DEA has taken its "war" into our doctor's offices.

MDs who are not certified in the speciality of pain management will have to become certified or refer patients who require treatment for chronic (more-than twelve weeks) to pain management doctors.

I am certain that neither my pain management MD nor my neuro-surgeon is afraid of the DEA.

I know that I am not afraid of the DEA.

Have you any facts to support your statement that,

"Many physicians, afraid of the DEA, have stopped or reduced writing for opiods,"?

You would have to survey hundreds-of thousands of MDs to get a study group with a large enough base to make any statistical margin in research.

If "many" (meaning hundreds of thousands) MDs have not confirmed that they are afraid of the DEA, then sending this petition would be lying to the President of the USA, among the most honoured and powerful men on Earth.

Have any MDs actually reported to you that they are afraid of the DEA?

If not, then how would you know that many physicians are afraid?

If they are not doing anything wrong they have nothing about which to be afraid; if we, as patients, are not doing anything wrong neither have we any reason for concern.

As Peskypain, said, my MD is not afraid of the DEA; he has no reason to be afraid.

The prescription monitoring system not only identifies abusers, but also makes it safer for all of our providers to know what other meds that we are taking, lest an MD prescribe a med that may be contra-indicated with other meds that we regularly take.

Might I suggest that you, or the person/ group who has written the petition, state your concerns in a more factual manner?

Remember, you are planning on sending this document to the President of the United States of America!

As it reads, the author seems angry, but is not specific about what the anger is about: Is the DEA is effecting your ability to get proper care and treatment? If so: How?

Remember high school English class:
Who?
What?
When?
Where?
How?

Address these issues in a cohesive and orderly manner and state ONLY facts.

Regarding disability: I am qualified and receive some of my income from my long-term disability insurance. I have part of my medical expenses covered by Medicare Disability.

I have paid, and do still, pay for my insurance and have paid into the Social Security fund for many years.

I cost neither the government nor the taxpayers anything.

Your statement statement, that we who are disabled are a financial burden to society (gov't and private individuals aka "taxpayers"), to me, is more disturbing than any concern I may have about the DEA doing its job of protecting MDs and persons who abuse their opiates.

In the long-term, having competent MDs and compliant patients will make it easier for those who are not abusing meds to be treated.

It will also make the MD's job of treating persons who really require this level of analgesia more efficient.

If the abusers are not wasting time and resources, we legitimate patients will, ultimately, receive better medical care.

The President of the United States is not going to take seriously a document alleging that a government agency is at war with him/ her, but is presented as an opinion with no factual base.

Perhaps best for you to just wait it out a while and see what unfolds. If you are dead set on sending this, please consider examining the document critically and separating fact from opinion.

You may also consider, once the document is cleaned up, communicating with a representative on a state level (State Representative or State, not Federal Senator) rather than President Obama.
[br /
 
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annette030 replied to peskypain's response:
I agree with you, Pesky.

I doubt this petition will get enough signatures to pass along anyway. The numbers are against them.

I don't feel any threat from the DEA anyhow. I have never even met a doctor who said he was afraid of the DEA. As an RN for forty years I have not felt any of this.

Take care, Annette
 
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leejcaroll replied to annette030's response:
This is a reply to all 3. Their are only so many words permitted to start the petition. They will not permit a treatise.
My PM doctor told me to go to my FMD who could write just as easily as he could for the opiate I take. (I have been a chronic pain patient for over 30 years)
I just had a doctor in the same practice with the one who is writing for me who wrote for exactly what I need, not one extra pill for the times when I have to do more and therefore make the ain worse and may need to take an extra pill. He toldme he was writing only for that (20 pills less then his colleague) because he had concerns about the government looking over his shoulder.
I have read and heard many other stories of patients whose doctors have said they are leaving pm because the government is setting the rules for how they may treat theiur patients. This is not so with say diabetes or cancer or any other disorders (and chronic pain is the result of specific disorders (for themajority of patients such as rheumatiod
arthristi, trigeminal neuralgia, CRPS, MS, and so on.
What I read from these replies is anger and disbelief about the level of pain many in chronic pain experience.
Doctors are training/getting training to treat us. The DEA is a group of bureaucrats who have no business joining the doctor and poatient in the examining room.
I appreciate your responses and of course you make a choice as to whether to sign or not.
I am glad that none of you have had to experience the doctor saying well the government is making me do it this way.
(I will give you another example. The rules were changed as to how often one had to go to the office for refill rescriptiions. I used to get mine 1ce a year. Luckily for me I only have to go now 2 x a year but some have to go in once a month so they can get a new prescriptiion. Their pain makes it exceedingly difficult for them to get around and now they are forced to go to the doctor when they did not have to before the DEA enacted rules as to how the doctor treated them, i.e. how often he had to see them. If they have private insurance, your premiums go up to help pay for the extra visits. If they get state assistance you pay more to cover their care.)
(My pain is primarily eye at this point so I have not spell checked or edited so please excuse any errors)
 
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lorigibs40734 responded:
I understand your frustration. A friend of mine let me know that the DEA plans to recommend to put Vicodin on Schedule II drug list. I don't use this drug, and don't know any who do, but I left a comment on the government page (http://www.regulations.gov search for FDA-2012-N-0548) all the same.
I am very frustrated as one of KY legislators Greg Stumbo is making it more difficult to get the help a pain patient needs here in Kentucky. What I've went through the past two months is proof of that. But anyway, he says that statistics show a great decrease in the pain pills being prescribed. He says nothing of the crime rate that has increased since then though. I read an article on the net about how Southern Ohio, and Northern KY police officers are seeing people who have Never been in trouble before seeing the inside of police stations. People being put off their medication are turning to Meth, or heroin... It would seem to me that our politicians would want to go after the ILLEGAL drug trade and stay the heck out of our doctors' offices and our lives. And while Mr. Stumbo says that there is a decrease in pain pills being prescribed, meth and heroin dealers are getting richer. Bless his heart. (Southern sarcasm)

Lori

 
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ctbeth replied to leejcaroll's response:
First,
Thanks for writing again. I kind-of didn't think that you would since the three of us were not supportive of your idea.

Re: "The DEA is a group of bureaucrats who have no business joining the doctor and patient in the examining room".

The Drug Enforcement Agency is a federal law enforcement agency under the United States Dept of Justice, tasked with combating drug smuggling and use within the USA.

Not only is the DEA the lead agency for domestic enforcement of the Controlled Substance Act sharing concurrent jurisdiction with the FBI and Immigrant Customs Enforcement (ICE).

DEA is a federal bureau, thus your use of the term "bureaucrat", is correct.

When an individual requires medicines that fall under the Controlled Substance Schedule, the DEA is automatically involved in a passive or active manner.

While, as you write,

"..no business joining the doctor and patient in the examining room.",

may be true, they do, however do have business,"joining the doctor and patient", at the prescription-writing desk.

Although persons experiencing the level of pain that requires opiate treatment are not whom the DEA is targeting, there certainly is significant criminal activity within this function and, it is incontrovertibly so that much of the illegal Scheduled drug prescriptions do end up, "on the street".

The goal of DEA controls is to ensure that these "controlled substances" are readily available for medical use, while preventing their distribution for illicit sale and recreational use.

Sadly, many persons who are prescribed Scheduled substances do not need them and do sell them. It is this activity that is problematic- NOT our activity.

In attempt to curb the traffic of scheduled substances from the MDs to the street, the DEA has set forth some guidelines which may make it more-difficult for persons involved in criminal activity.

I, also, have to pick up my prescription in person once a month. I live about an hour's drive from my PM, and it is a bit of a bother, but if this is what must be done to curb illegal drug use, then I'm fine with it. I do not drive much and this is an inconvenience, but if my being inconvenienced saves but one life, it's the least that I can do.

Same thing with random urine screens and pill counts.

These mandates are not punitive actions; they have an important goal- saving lives.

Now, and idea: The second letter you posted is much-more appropriate. It tells of your actual experience.

Perhaps you could make an appointment with your state or district rep and discuss your concerns with an elected representative at the state level.

Please rest assured that the government is NOT setting the rules on how they (MDs) may treat their patients.

You can, also, search the DEA guidelines.
That would probably be a good place to begin.

Again, I am pleased that you returned to address us again!

Please stick around. I like you,

CTB
 
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ctbeth replied to lorigibs40734's response:
Hi Lori!

I'm always happy to "see" you.

How was the MD visit?

below is my email:

bethhuntington@live.com

if you'd like to talk privately.

I so hope that you have good news to share with us!

<3,

CTB
 
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lorigibs40734 replied to ctbeth's response:
Hi Beth! I posted an update on the pain management thread just now. I'll record your email for future reference. I have to get off here now cause my hands are killing me.. carpal tunnel sucks sideways LOL

Lori
 
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ctbeth replied to ctbeth's response:
Below is the agenda for the up-coming FDA agenda for the 24-25 Jan 2013 meeting:

Agenda: On January 24 and 25, 2013, the committee will discuss the public health benefits and risks, including the potential for abuse, of drugs containing hydrocodone either combined with other analgesics or as an antitussive. The Department of Health and Human Services received a request from the Drug Enforcement Administration for a scientific and medical evaluation and scheduling recommendation for these products in response to continued reports of misuse, abuse, and addiction related to these products. The committee will also discuss the impact of rescheduling these hydrocodone products from Schedule III to Schedule II.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I see no reason for concern.
 
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annette030 replied to lorigibs40734's response:
I assume by "meth" you mean methamphetamine, not methadone? Why would anyone in pain use methamphetamine? Heroin I understand but not methamphetamine.

There is a huge geographical part of prescribing drugs, I lived in one state and had never heard of hydrocodone (the opiate in Vicoden) there. Tylenol with codeine was used for moderate, acute pain. I moved to the state next to my home state and Vicoden was the drug used for acute pain, always. The same was true of meds used for nausea, etc.

I am a retired/disabled RN, I also have chronic pain.

Take care, Annette
 
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ctbeth replied to annette030's response:
Hey Night Owl,

Where did you see Meth?

Vicodin is pretty widely used in the New England, and I've not heard much of anyone being prescribed Tylenol #2 or #3 in a long time.

I wonder why that is- that meds come and go in popularity.

I had never heard of Norco until I read it on this site. I've not ever heard of Norco here, as an RN or a patient.

For N & V, compazine is the popular drug in this part of the nation. How about in Calif?

Don't we ever sleep, LOL?
 
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annette030 replied to leejcaroll's response:
I do not know where you live, or what rules your doctor uses. or whether you must go in twice a year due to the insurance you have or the type of meds you are on.

It is my experience that different doctor's practices do things differently. My doctor prefers to see me in person every 3 months, and gives me separate RXs for Schedule II drugs, for each month that I do not see her. She writes on them when I may fill them. She has done things differently depending on where and for whom she was working. I have been seeing her for over 15 years now. I am fine with seeing her every three months. I am on strong drugs, why shouldn't she assess me in person?

Ever since I have been an RN, 40 years, Schedule II drugs required a separate paper RX each month, no calls on the phone for refills, they were clearly marked "No refills". Schedule III drugs like Vicodin could be refilled for up to six months only, then you had to have a paper RX from the doctor. When exactly were the rules changed? What pain meds do you get 2X a year?

I totally agree that the DEA does not belong in the examination room. It just has not happened to me.

Take care, Annette
 
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leejcaroll replied to ctbeth's response:
Thanks CTB.
The problem is when they report on the "epidemic" they do not break down how much is from illicit use and how mich from licit.
The number of people who try and con their docs I would surnise is fairly low. I think your take that it is "many" s off the mark. MOst docs can figure out who is needing of opiods and who is not.
My doctor never had me sign a pain contract but I have seen them in his office.
No other medical condition assumes felonious behavior, agreeing to random urine testing, etc.
Pain patients rarely become addicted although they may devekop a physical dependency.
If a patient has an addiction issue then it does make sense to require the sampling given their history, which is still a medical issue.
If I am diabetic a conract is not required. An insulin dependent diabetic does not sign an agreement that if they run out of insulin, if they lose a dose or need to take extra during the montht they are unable to get more to get through the month. Someone with diagnosed chronic pain should also be able to not worry if they lose a pill or run out because they did too much and needed extra meds.
There is media coverage to docs who prescribe, say, vicodin, for pain that is not to the level to require an opiod but that is the exception, not the rule.
For many pain patients, going often is more then an inconvenience. I do not know how many people you have talked with who have as en example CRPS, For many just being able to get out of bed in the morning is a major acheivement.
I was virtually housebound from my trigeminal neuralgia for many years. The DEA was not invoved at that point (and I have been prescribed methadone, morphine, even tincture of opium).I was gven codeine with refill for the year.
Having to go out to the doctor every month would have cause me great pain and been very problematic.
I write a blog. Aside from character, or word, restriction, I find in the blog that my writing has to be short winded or I have gotten replies" too much too read". Petitions are not the place for long expositions.
As long as the DEA makes the rules, how many refills can be written for, then they are in the room with me and my doc.
It is a good idea about talking to the state rep, as well as federal.
Thanks for your reply. I like you too. ((*_*))
 
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leejcaroll replied to annette030's response:
I am codeine #4. My pain management doc told me, "I'm sorry but because the DEA changed the rules on how you can write, how many refills, you must now come in tp see me 2x a year."
My case is somewhat different. It never changes. I have had all the surgery there is to be had, or can be done on me, IN fact I am with an experimental brain implant now (13th in world to have it)
Many pain conditions do change, assessment is necessary but to go from every 3 months to every month because of DEA rule changes is unfair to many of the patients fro whom this travel to and fro is very difficult and pain provoking.
I was amazed when this last doc said he was concerned about how many he wrote for, 90 instead of 120 to give me some wiggle room, not for my health but for government looking over his shoulder.
you too. Carol


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