Pain, and why you not have to suffer in California
By: Mark Norwood. Head Nurse & CEO:
MED-HELP.COM & MED-HELP.NET
In my own experiences as a patient and a nurse, I have found that too many States do not allow the use of narcotic analgesics as treatment for patients with chronic intractable pain.
Patients all over the US are suffering needlessly from doctors who are too scared to prescribe narcotic pain medication for fear of having their license revoked. Other doctors are just not properly trained in how to treat patients with the use of narcotic analgesics. Their are also those doctors from poor or third world countries who do not believe in treating patients adequately for pain. They usually come from a back grown where (in their own culture) pain is something that you just have to get used too and learn to live with. This is a Travesty!
Treatment of patients in severe or chronic pain with the use of narcotic analgesics is not only safer today with the new "hi tech" long acting narcotics, it is also more practical. Patients are far less likely to overdose with these new classes of long acting narcotics than 10 years ago when repeated dosing of short acting narcotics was the routine of the time.
I myself am tired of hearing patients tell me that their doctor has told them that they are just going to have to learn to live with the pain, (or) go in to some type of pain program. Pain Programs/Clinics Do Not use narcotic therapy as a part of their treatment plan and the worst thing is that referring doctors know this!! The use of narcotics as a part of there therapy is forbidden and other ways of controlling pain such as mind over matter as an example are the routine of choice. You can not take a patient in severe chronic intractable pain and try and tell them that they can out think it! To those doctors that use this approach I say, cut off your right finger, or better yet go out and get hit by a truck and then come back and try one of these therapies! Only then will they understand.
And to those doctors that say you are a drug seeking patient, Or he has a drug seeking personality, I say to you YES I am seeking drugs for my pain! What am I supposed to do, act like I do not really need them?
What doctors have to understand is that patients who are labeled drug seeking are just that! They are seeking to get out of pain. Studies have shown that patients suffer from chronic intractable pain, are not the typical drug addict looking for a fix! Rather they are looking for relief and to just live a normal life with some type of control over their pain.
And those doctors who do give out lets say 25 (or) 50 pills a month and have a patient sign a drug contract I say ("it just does not work that way"
If a patient is in more pain on a certain day he/she is going to need more pain medication to make it through that day. Before the patient knows it he has used up his supply, And all he gets for his/her trouble is a lecture from the doctor. PAIN CONTRACTS DO NOT WORK!!
Better yet put your patient on a longer lasting pain medication like Oxycontin or a narcotic patch like Fentanyl, and give your patient a supply of short acting pain medication for break through pain. This will not only make the patient more comfortable but less likely to ride the roller coaster of ups and downs that short acting pain medications can cause.
California NOW is one of the most recent states for adopting a law to treat patients with chronic intractable pain. The law states that doctors will not be prosecuted for treating their patients with opiate pain medications. Patients also have the right to Not under go corrective surgery (if available) to treat the patients pain, and remain on narcotic pain management if it is their wish to do so.
Doctors here in California NO longer have to fear losing their license to treat such patients. Please read the SB 402 Patients Bill of Rights!
Management Doctor of 10 years tell me in August that Kaiser would not cover my current long lasting Pain Medication and that I needed to switch to something that Kaiser would cover.
I told him that he is the boss so I would try to switch to Morphine ER from Opana ER and when would he like to have me switch?
Her told me that I needed to taper down off of the Opana because it is stronger than the Morphine.
I wasn't excited but I agreed and he said we would take it one month at a time.
I have Ankylosing spondylitis, three Degenerated Disks, I need a hip replacement because of the RA and I am barely able to walk most days without a Cain.
I am 36 years old.
Then on month 3 my primary care Doctor cut back the Opana by one tablet and also one tablet of my breakthrough meds.
I was very worried and when I started to take the mew dosages my pain went from a normal of 3 - 4 on a daily basis to a 9 -10.
I called my Pain Management Doctor and scheduled an appointment with him to discuss this new tapering schedule and when I got to his office and he came in he was looking like he had aged 10 years in the three months since I had seen him last.
Also I had been on the same dosage of Opana and Breakthrough meds for 5 years with no increases, early refills or any issues.
My Pain Management Doctor went from being my hero who gave a 24 year old man his life back and being a very compassionate doctor to a untrusting suspicious ass.
He lied right to my face about our last visit and what he had told me the reason for the tapering and I was calm and didn't get angry or say anything negative because he seems like he would tell me to go to Addiction Medicine and check myself in.
He told me at this last appointment that if I didn't like the new plan for Pain Management and my medications that I should change insurance.
That is not an option for me as I get my insurance through work and this is the only plan they offer.
I work as a IT Manager and I work 40 to 70 hours a week.
65 hours is the normal amount of hours I work 99% of the time and that's something he knows.
So not I am on month 5 and when I get my prescriptions I am afraid of how bad my pain is going to be and if my job will fire me for not being 100% and keeping my work and department running smooth and issues handled in a timely fashion.
I truly believe that Chronic Pain Patients are being lumped together with the Drug Addicts who abuse narcotic Medications.
This new FDA Guideline is his reason for this new treatment plan and I don't think that legitimate pain patients should have to suffer in silence because of the FDA and DEAs ignorance.
It is cruel and torture to cut off patients who have done nothing wrong to have to go through this. Well thank you for writing this blog.
We just need to get attention from others to joint and post their comments. Thanks again and good luck and god bless.
Good morning to Y'all! I guess my question to Rhyenn & the previous Nurses' post is... How do we get the attention of The DEA., The FDA., & anyone else whom are the one's making the rules for All of US who know what we are talking about?? We have all posted our issues, cries for help & yet it doesn't do anything because THEY MAKE THE LAWS! We know the pain we are in! We know that there certainly are the trouble makers! BUT, What about us? What can we do? Does ANYONE have the answer to that?? PLEASE, let me know what to do! Where to go! or Anything else I can join in, because Something has to Give!! Thank y'all so very much, periwinkle
periwinkle52, the info rhyenn posted at the beginning is Not Correct. Look up California Laws governing Physicians and you will see what I mean. Physicians in Calif are more concerned now about treating chronic pain patients that they have ever been before. Almost all drs who treat chronic pain have their patients sign Pain Contracts. Physicians still lose their medical license.
I'm not sure what state thekraftyone is in, but it seems that their Physician is afraid to treat chronic pain patients.
The politicians are the ones who began this back in the 1990's, it's just taken a while for them to get anything accomplished like they wanted. The ones that abuse and misuse pain meds and their families are the ones that put the pressure on the politicians. These laws won't be changed in the next 20-30 yrs, if ever. How many times have restrictions been reversed when they deal with something like this ? Never. The media has also played a huge part in this because drug abuse has ratings, especially when people die. Not being treated properly or at all for chronic pain does not directly result in death, although it is can be a contributing factor in many deaths, so it doesn't get the ratings the media wants.
You said that the "new FDA guideline is the reason..."
What is the new guideline to which you allude?
You also state that pain patients suffer due to the "FDA and DEA's ignorance" and that pain patients are forced to " suffer in silence".
Of what, do you think, are these federal agencies "ignorant"?
How, may I ask, have these same agencies forced you to silence? Americans have rights to free speech and never have to suffer in silence.
Last, regarding your situation, it sounds as if your problem is with your insurance company or policy and has nothing at all to do with the two federal agencies that you state have infringed upon your right, of all American citizens, to free speech.
Insurance companies are privately help organizations, not federal agencies, btw.
You contact your district representative, your state senator.
Become educated on how our government works and familiar with the topics that are to be, and being addressed, the dates and times that legislature has sessions, and where your elected officials stand on the issues that matter to you.
As a non-Native American citizen, I am shocked and stunned to read Periwinkle's post.
We are living in the greatest nation on earth. We mustn't sit on put hands as the Romans did. SPQR,
I graduated from nursing school in 1970, and the scheduled drug list was old news then. I do agree with your closing comments though. EVERYONE should read the websites for any laws or regulations the have any questions about.
Yes! I agree 100 %! And yes! The previous nurses' post was way off! One has to wonder if he or she is a nurse @ all! At any rate, it is going to have to be batted back into the Politician's laps for any hope of any of this to change. And THAT is a very scary thing! Thanks for your reply, periwinkle
O.K.! Well, apparently you HAVE NOT lived here long enough! I know, quite well, the process of which my Government works! WHAT you don't know nor understand, is that it would the sum of The United States Army, Navy, Marines, & Air Force in numbers, that is, to be behind me to get the attention of anybody! You have to do EVERYTHING by the legal steps, But, you Must have plenty of people to back you or your cause will be lost before you make it to your very own State Representative! Thank you so much for your very motivated reply, periwinkle p.s., I would hardly say that The Romans, "sat on their hands!" pps, Why the anonymous reply??
thekraftyone, look up the laws in your state that govern Pain Clinics/Pain Management and also other physicians who write pain meds. Look up what the Federal Laws are. Unfortunately, just because your dr tell you something does not mean it is true.
Someone asked how do we get the attention of our politicians. The news media, is the answer. How many stories have you seen and read about chronic severe pain patients not being treated for their pain in the media ? And how many stories have you seen and read about people who misuse and abuse pain meds ? The news media is interested in ratings and so are politicians. There were bills introduced in Congress in the 1990's to reschedule hydrocodone combination products, but they didn't get anywhere. It wasn't until the media was filled with stories of abuse and misuse the past few yrs that anything was done to change the law.
Those that don't have any problems getting their pain meds don't see that there is a problem. But, it will affect them eventually. Drs retire and they can recommend another dr treat a patient the same way, but that doesn't mean another dr will. Maybe when those who believe they will always have access to their pain meds aren't able to get them or able to get them in the quanity they have been use to, they will speak out.
With politicians like Senator Charles Grassley demanding to know what states are doing to high prescribers of pain meds and certain other meds who prescribe to Medicaid and Medicare patients, pain patients not receiving adequate pain relief or any pain relief will grow. It takes a huge amount of time effort to get a politicians attention and to keep it. But, when people can't work or do the activities of daily living because of lack of pain management meds, maybe then they can find the time.
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