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Pain management laws, 2013 is it realistic?
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stoogle posted:
I suffer several different issues that equal chronic pain. Mainly my lower back has several bulged discs-degenerative disease-arthritis and I suffer sciatica as well. I am 48 years old and have been taking Percocet since I was 18. My General Practitioner told me he no longer will prescribe opiates and I need to see a pain management Doctor for that. I went to the Pain Management Doctor yesterday and was quite taken back! I have been taking 60 mgs of Percocet's a day along with Subutex to help me from NOT running out of Percocet's. The 60 mgs of Percocet keeps me going so I can move and function-without it pain is unbearable and I can barely move. The new Dr asked me if I take street drugs. I told him I occasionally will puff a joint if it is offered and I'm in pain, it helps. This new Doctor said, "Well-take this as a warning- In Maryland it is illegal and we will be doing random drug tests. If you show positive- we will drop you and you will have a hard time getting opiates anywhere. We will also see if you are not taking your meds- If that's the case we will assume you are selling them, we can now tell how many pills you have taken, so if you are short a few, you better have those few to show us upon request. If you can't show us the actual drug there could be the case of us dropping you or worse problems. Three of my patients are currently in jail." I felt like I was treated as a drug addict in a police station instead of a patient needing help to manage his pain" Then He took away my Subutex and lowered my Percocet amount from taking 6 , 10 mg a day, to taking 3, 10 mg a day along with 2, 5 mg Percocet's. He added a steroid, a muscle relaxant/ sleeping aid (Soma) and ordered me a cream for an anti-inflammatory. I go back in in 15 days. I am to bring all receipts to show I bought the drugs he prescribed. The last time I was tested for drugs was for a job. I quit smoking weed for 30 days and also took a product foe detox called ready clean. I STILL failed the test and showed as a heavy thc user. Now I am to see my new Doc in 15 days for a drug test? I think that this is crazy and I also feel this breaches my privacy. Doc also told me that soon, Percocet's will be no more in the industry and other things will replace it- less addictive. I want to call the doctor and tell him I will test positive for thc in 15 days-I already told him I smoked the other day. I should have told him for 3/4 of my life I have been smoking! Should I call him? 15 days will NOT clear my system enough to rid the thc stored in my blood and or urine! I can NOT risk losing my pain doctor and meds! Is this true about ending Percocet's? Is my privacy breached? My goal s to take action to help pain with no surgery and to get OFF narcotics. Massage works- will Medicare pay for that? After reading other posts, I feel that the doctors are more interested in protecting themselves from "the pain of a law suit" for over prescribing, than the fact they are taking away too much to fast from their patients- leaving us in more physical pain. Sure, I'll sign your contract assuring I will only use you as my Dr for pain meds- I feel that is enough, the rest? Way too much! HELP! Thanks!

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Do you think a Pain Medicine Doctor has the right to randomly drug test their patients, drop the patient if they use marijuana in a non-legal state and black list them, preventing them from getting any more pain meds...even though the patient has been diagnosed with chronic pain?
  • Yes
  • No
  • At least provide a warning and give them 30 days to detox
  • At least provide a warning and give them 60 days to detox
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blessedladyptl responded:
If Medical Marijuana is not legal in your state, or even if it is and you can't prove that you're prescribed it or if the pain dr doesn't agree with it, you're running the risk of not being able to be treated for your chronic pain. And like it or not, Marijuana is still against Federal Law. I know they aren't cracking down in states where it has been legalized. But, smoking marijuana could cost someone their housing, if they are on federal housing assistance, their disability if the receive SSA disability, it is still against Federal Law and Federal Law supercedes State Law, if Federal is more stringent.

From the drs perspective, if you are taking illegal drugs, then you are a risk. By smoking marijuana, you engage in illegal drug activity and that is a huge red flag to any dr that is treating a patient for pain. The risk of you selling your meds goes up along with you taking other meds that weren't prescribed to you as well as other illegal meds. And people who engage in illegal drug activity show they can't be trusted because they are already breaking the law. Also many of the people that have died while taking pain meds, also smoked marijuana. Marijuana is a central nervous system depressant and the more you have in your body, the bigger the risk you may stop breathing. You won't be able to find a dr who will allow you to smoke marijuana and have them treat you with the same meds, if at all.


And I wouldn't count on the marijuana being out of your system after only 15 days, but it depends on the tox screen. You need to make a choice, either your pain meds or the marijuana, if it's not already too late.
 
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Anon_2912 responded:
Do they have the "right" yes. Just as easily as they can say "I don't want you as a patient".

Not saying I agree with it morally....
 
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blessedladyptl responded:
What are you referring to when you say "Pain Management Laws, 2013 is it realistic ?" I don't know of any laws that are new regarding the topic of your post. Even if you lived in a state that had legalized Marijuana for recreational use, that in no way means any dr would continue to treat you with pain meds if you tested positive.
 
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annette030 replied to blessedladyptl's response:
Remember that using marijuana is still a federal crime, regardless what relaxation of state laws has taken place.

Take care, Annette
 
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dfromspencer responded:
Mary Jane for medical use, YES, just for smoking, NO!


No, I do not think a doctor of any kind, should be allowed to drug test you, unless its court ordered!!! Otherwise, I do believe it fringes on your right to privacy! What a person does behind closed doors, should be left behind those doors!!! Even if it might kill them, it is still your own private choice, no one elses!!!


Privacy means PRIVATE!!! Anything else is just wrong!!!


This is just my opinion! I know someone in Colo. that is prescribed med. pot, he does not have to disclose that to his P.M.D.! That is not even in his contract!


One day, and I hope its soon, everyone will be able to have the choice to smoke pot, or not! Just as it should be!!! And our greedy government, will get billions and billions of tax dollars!!!


Just can't feed the over grown piggy bank (Government) enough!!!


D.
LIVE LONG-LOVE WELL!!!
 
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blessedladyptl replied to dfromspencer's response:
If someone wants to kill themselves, I also believe that's their business, just say home alone to do it. And if someone wants o beak the law, that's their right. But, if you're prescribed meds by a dr and you decide to do these things, then that may call the dr into question that prescribes meds. It is behavior like this that has caused all the problems pain patients are having now with being able to be treated properly.
 
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stoogle replied to blessedladyptl's response:
THAT RINGS 100% TRUTH- SCREW THE THC! THAT CAN EASILY BE STOPPED- I JUST HOPE DOC KNOWS iIAM 6'4" 340 LBS AND IT WILL TAKE OVER 30 DAYS FOR THE THC TO RID MY FAT CELLS- AND LORD KNOWS I AM 100 LBS OVERWEIGHT!
 
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stoogle replied to Anon_2912's response:
True
 
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stoogle replied to blessedladyptl's response:
3rd comment I read- Very clear now- Thanks!
 
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stoogle replied to dfromspencer's response:
You were the 1 out of four comments so far that said YES it is a Privacy issue! I will easily let go of pot- point is Privacy- all 4 posts on this thread THANKS
 
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stoogle replied to blessedladyptl's response:
I agree
 
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cweinbl responded:
Sorry to hear about your problems. I'm not sure where to begin.


Millions of people use marijuana for chronic pain. Each year, more and more states make it legal with an Rx. It is truly a godsend for many of us with chronic pain. You should know that there is a legal way to use THC in an illegal state. It's a drug called Marinol (Elan Pharmaceuticals). The drug was designed to treat the nausea and weight loss associated with chemotherapy. It requires only a prescription and approval from your health insurance carrier.


Do you have a long and/or trusting relationship with an internist or family doctor? If so, you might ask that doc to handle all of your medications, including your Oxycodone, Soma and possibly also Marinol. In fact, having one physician control all of your medications can reduce the risk of serious side effects from medications that should never be used together.


Are you aware that using a long-acting pain medication is more efficacious for chronic pain patients than using a short-acting drug? I'm talking about Kadian, Oxycontin, Fentanyl Transdermal, etc. Most are effective for at least 12-24 hours. Fentanyl Transdermal claims to be effective for 72 hours, although most patients claim it losses efficacy after 48 hours. Still, that's a long time during which you have no ups and downs associated with short-acting drugs. You can then use the short-acting pain medication (Hydrocodone, Oxycodone, etc.) for breakthrough pain.


There are also off-label medications that can reduce chronic pain. For example, if you have referent pain (pain that radiates down an arm, leg or elsewhere) from a compressed nerve, anti-seizure medications (Lyrica, Neurontin, etc.) can help.


It's an axiom that chronic pain patients will virtually all benefit from using an anti-depressant. No... not for depression. The active ingredients of most anti-depressant medications inhibit the reuptake of serotonin in the bloodstream. Serotonin is one of the body's natural pain-fighting chemicals, binding with pain receptors in the brain.


Finally, I agree with you that many physicians today are more motivated by fear of going on an FDA list than by helping patients manage chronic pain. Very sad, but true. Now, we've also got the government trying to reduce the amount of pain medications we can receive because of a so-called "epidemic" of addiction and overdoses." In reality, less than 3% of all chronic pain patients develop an addiction (if you remove patients with a prior addiction disorder from that group, the addiction rate drops to under 1%. I'd be happy to share university and government research that reveals these percentages. Most physicians know that this so-called "epidemic" does not exist. But they remain afraid of the DEA. In ever-larger numbers, these selfish physicians are deciding to stop prescribing any opioids, leaving their chronic pain patients in agony and undertreated. Ironically, when this occurs, many patients turn to alcohol and illegal drugs to self-treat their chronic pain and many of them later develop an addiction. But the cause of that addiction is the complete selfish disregard among physicians for treating their patient's pain. The thought is sickening.


Those of us who have found a physician willing to prescribe whatever we require for chronic pain are most fortunate. I hope that you will eventually find such a compassionate physician.


Best of luck!


P.S. THC from inhaled or ingested marijuana is not water-soluble in the body. So, it remains within our cells for months. That's why you flunked your drug test after going 30 days without it. In reality, it takes up to 4-5 months for THC to completely clear the system sufficiently to produce a negative drug test. I'll bet a lot of people would find that information valuable.
cweinbl
csw2@bex.net
 
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stoogle replied to cweinbl's response:
Currently- to make me even look MORE like a "Golden Boy" in the eyes of the ever so cautious medical world- I am on Medicaid- I KNOW they will not pay for thc tablets- lol
All I ask for is a plan- that won't crush my nerves any further in my spine - that works so I can get the hell off opiates- If Oxycodone is it- fine- but the interrogation was stupid
 
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blessedladyptl replied to stoogle's response:
Being on Medicaid, may not be to your advantage, depending on where you live and the reasons you're on Medicaid. Although most drs don't bother to look at the reason someone is on Medicaid because they just lump everyone together.

For many they view those on Medicaid in a negative light. Also, you may not be aware of this, but Senator Charles Grassley has put Medicaid patients that are rxed pain meds and certain other meds in the class as those that abuse the meds. He has also pressured states to go after high prescribers of these meds. So if your dr has a choice between rxing certain pain meds to Medicaid patients or those with private insurance, he will Not choose Medicaid patients.

Grassley Probes High Volume Medicaid Prescribers-
http://www.medpagetoday.com/PublicHealthPolicy/Medicaid/30857

Grassley Probes Prescription Drug Abuse In Medicaid, Medicare-
http://www.grassley.senate.gov/news/Article.cfm?customel_dataPageID_1502=39902


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