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Interesting article

tamtamttamtam Posts: 2,749
edited 06/11/2012 - 8:46 AM in Pain Medications
I was just reading some the newest release of articles here and found this article very interesting. I am posting this link for you to make your own decision and can comment as the article describes at the bottom of it. Many of us depend on these medications so I found it interesting and a way for your voices to heard if you so choose to.



  • I have been reading about this. The basic issue is going to be more training for doctors and more education for patients- so we're going to get an earful when we get our meds.

    For the most part, I think it's a good thing. I see a lot of people getting narcotics without really understanding what they are getting into. I find that terribly sad, as the person hurt is the patient.

    The downside of course will be if PM doctors restrict narcotics even more out of a "these things are bad, I should not give them to you" mentality. I would be just as sad to see a lot of people in pain not getting treated.
  • I read this article and submitted a comment. The FDA has not approved what was presented to them, they want stricter regulations. I feel that if they had to do something, approve what was proposed but nothing further than that. I feel physicians will be very hesitant to prescribe narcotics.

    Sheesh, go after the bad guys, not us who really need pain medications.

    Big topic during my last few years of nursing was ensuring that our patients had appropriate pain control. How times quickly change. Now we're being taught to suspect that anyone seeking pain relief is a possible addict? Sad but true.

    Best to all,

  • Throughout our society we have laws to govern all kinds of things. But instead of enforcing the existing laws we make more laws. If they would go after the bad guys the problem might not go away completely but it would be miniscule.

    We had an article in the local paper about an arrest at a gas station. The owner and an attendant were arrested for selling drug paraphenalia. Like many small gas stations and convienence stores the pot pipes and rolling papers are on display. How does this happen? If the local police would make a few arrests alot of places would stop selling this stuff.

    THis is everywhere. So stop wasting money on more regulation and put it into enforcement.
  • Kris-NY said:

    THis is everywhere. So stop wasting money on more regulation and put it into enforcement.
    Hehehe... I have been saying that for my WHOLE career!!! There ARE plenty of laws in place, they just didn't let us 'enforce' many of them! Sad, huh? :(

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Mari,

    I look at the same way you do. The vast majority of patients are taken meds according to the directions and truly need them, along with the doctors prescribing the meds.

    I have long had the debate of how does prescription pain meds land on the streets and so readly available for sale. I mean these are supposed to be controlled and counted. So if you ask me the persons responsible for these issues begin with the manufactures and the controls they have in place and along the transit routes of these meds. While sure a addict will show up now and then in a medical institution but for the most part they have better luck on the streets getting the stuff. Yes there maybe a few rotten apple doctors out there over prescribing, but that is not the big picture problem. I don't like the idea of just because I use a prescription medicine I am thrown in some lump group of people or class that has behaviors. But the majority of the issues in my opinion are not coming out of your doctors office with patients going in and getting help it is on the streets. So they are going to educate all of us who are already educated on the use but it does nothing to the illegal activities that are going on out there.

    I am not sure about anyone else but the pamphelts and warnings that come with some of these meds are enough to scare a honest person to thinking maybe i will just take the pain over what could happen. But if your a drug addict more than likely you don't know what that stuff says. Keep in mind these people whom are illegal using the pills also change the forms of the pills, like crushing and sniffing them. Also my insurance pays a outside company to once every three months audit my meds to see if the meds being prescribed match the condition I have and are appropriate to be taking. Now even my step dad at 89 has the same audit but it is once a year. So I guess the true people they have the issues this law will never effect. I posted it so anyone whom wanted could follow the link and voice their opinion.
  • Tamtam you are right about the problem being with non-patients. But what I have seen is three sources of the illegal drugs.

    One is that every time you have even the most minor surgery the doctor prescribes Percocet. YOu get a bottle full of pills and I know in my home they are usually only used for 2-3 days which leaves at least half a bottle. In 20 years my husband and I have had a total of at least 7 surgeries. That's alot of extra meds. For seniors this is even worse since the doctors seem to like to keep them drugged up even more. My mom has shown me huge bottles of narcs. The usually end up in the schools because the kids swipe them from the medicine cabinet.

    The second is the drug clinics that are making a fortune writing scripts for cash. There was just a huge drug bust where they were submitting to medicare for payment in the millions. These end up on the street.

    And the last is your neighbor who got hooked on the drugs he got for a sprained ankle. So now he goes to doctors for every scrape and ache because he knows most will give him something to keep him going.

    The first situation won't go away. The last is really hard too but with computerization of pharmacy records it shouldn't be too hard. It's the middle ones that are the worst. They are putting dangerous drugs on the street and costing us billions in insurance for these prescriptions. So instead of spending millions for the politicians to look like heros making new laws lets get rid of the slime. Brenda I don't know how you worked like that with your hands tied. I would have gone crazy. We the people need to take back this country and insist that laws need to be inforced.
  • Kris-So true about Drs prescribing Percocets for minor surgery. My husband had knee arthroscope surgery and total used 3 Percocets out of 80 pills! When I had shoulder arthroscopic surgery I got like 30 half Demi-percocets!

    To tell you the truth my Family Dr. was so cautious in giving me pain medications since I've had my injury and she's known me as a good friend and health professional and I get all the warnings from her each time about addiction and pain medications. I'm glad she's known me for 20 years as a patient or else I'm sure I would have a difficult time getting pain relief as none of the PM Drs I've seen ever mentioned medications to me and I've seen 3 of them.

    I don't know if stricter regulations will help but better education for Drs may help and hopefully it won't stop the people with real pain from getting help.

    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • With regard to regulations already in place... Regulations are only as good as the people willing to enforce them. I always found it somewhat "amazing" that they could catch the little old lady bringing back a pepperoni through customs but somehow managed to miss the hundreds of pounds of coke or heroin.

    For a while we had (and possibly still have) the most severe drug laws for the most minor of possession... and those seemed to be enforced a lot more than when they caught the dealers.

    So, maybe it's perception, but it sure does seem like large amounts of illegal drugs are okay and even welcome to cross our borders... just don't get caught with a single joint at home or wherever:p

    As for the bill above... it was already said a lot better than I ever could... people who are not going to abuse drugs will read every insert and make sure to take their meds no more than prescribed... and several of us will try to avoid taking even that much.
    People who think they are their own doctors or pharmacists and will take meds not prescribed for them or take them more than prescribed will continue to do so and eventually mess it up for those who don't.
  • Clandy you must be from NY. We had years under the Rockerfeller laws that put you in jail for years for a minor offense. Those laws were barbaric. And as you say a far worse crime was given a slap on the wrist.

    It seems like every state in this country has over crowded jails. When Lindsay Lohan gets out in days and other stars get out in hours what does that tell our young people?

    The sheriff of Maricopa County, AZ is a character but he has some incredible ideas. He has cut the perks that inmates get. When they ran out of cells he made tent cities. The prisoners are actually treated as criminals instead of hotel guests. Unfortunately that area is just out of control but it is nice to see someone who is making a difference and isn't afraid to make some waves.
  • I went to fill my prescription for MS Contin. I was told I was there too early. Hmmmm, I thought now these people in my small-town pharmacy are going to think I'm abusing my medications. How wrong is that for me to feel that way when I never, never, never misuse my medications.

    I then remembered that a certain "recovering" individual was in my home just a week ago visiting one of my sons. I went home and sure enough there were three pills missing, but also I always have a few leftover when I refill my scripts. Now it could be this forgetful brain took an extra pill because I couldn't remember if I took it, but having a lot of experience in substance abuse treatment, I knew intuitively where the missing pills went.

    Sadly, I'm going to have to purchase a lock box for the very rare occasion that my pills could be stolen. I also think its time for this older girly to get a pill box so I know I have taken my pills as prescribed that day lol.

  • Marianne I'm with you. I'm 45 but with all these meds I can't remember if I took my meds. So I think it is time to get a pill holder for the days worth.

    See you at CVS :)
  • My fear in all of this is the government having more say as to what, how much and for how long a physician can prescribe certain medicines. When our physicians no longer have free reign to prescribe on an individual basis, I can see the problem actually escalating versus improving. When government forces a person to "self medicate" because they can't get adequate assistance from their physician the problem will become even greater.

    Let medical professionals "be" medical professionals, otherwise you may as well start handing out ration cards for any type of pain relief medication.

  • But think of it, if they CAN manage more capably, then we as the non-criminal users of the drug benefit, because we have a known path to availability.

    I believe the stricter standard is going to make some doctors not able to prescribe the Schedule II and higher meds. That is why you see so much effort to make more meds that are difficult to use illicitly.

    It's going to mean increased training, more restricted availability (no more of that 80 pills after surgery- for goodness sake, your husband wouldn't, but a lot of people would sell those on the black market if they are poor enough).

    There is going to be a required patient training as well, so no more "drive by narcotics window" or so they say.

    I don't know, it all looked like stuff that should already be in place. None of it was unreasonable. None of it was aimed at people like us. It was all aimed at bad doctors and bad patients. I think those with board certified pain management doctors are not going to notice a difference. Those who get meds from PCPs might, I don't know. I just don't think you'll be able to prescribe this stuff just because you have an MD anymore. But of course beyond that it lost me.
  • Coming from the government angle, I can tell you that it's more than likely that the only people that will be badly affected by something like you suggest are the ones that are following the law. Dishonest people will always find a way... because there always Is a way, if you don't mind being a liar or cheat.

    As for meds... being the lil nerd that I am, I can tell you that there are plenty of people logging your meds.

    Notice, I said logging, not tracking. However, once it needs tracking, all of the information is right there. Whether your script comes online, over the phone, or in person... if you pay cash, credit, insurance, MA... it's all tracked and the info is all there... waiting for when someone wants it. Depending on where you are, it may already Be tracked (in NY, MA makes available the 50 most requested scripts paid for by MA.... do you think your own insurance company and/or workmens' comp board aren't doing the same?)

    This data can be tracked by zip code, by pharmacy, by doctor, etc. So, if that's all they want, it's already out there.

    One thing bothered me in the statement above... having "come up" in a poor area and knowing several folks now in that bracket... being poor enough doesn't make you do criminial things... just being dishonest is enough to cover that type of behaavior...and I've met plenty of monied folks that don't have the morals of a loose alley cat that sell their drugs or were willing to. I know it probably wasn't meant that way... but I still felt the need to respond to it as it looks reallly icky.
  • I think need is what makes you sell the drugs. But need comes in lots of flavors. It can be a middle class mommy who is addicted to shopping who realized that she can get oxys from her doc and sell them to friends. I knew one woman who was feeding her brothers habit - what love there. Need can be addiction to other meds. It can also be the need to pay mom's nursing home bill this month.

    The saddest need of all is the need for a social network. I know one man who got into selling joints in high school. It made him not popular but accepted. Now in his mid 40s he is still supplying his "friends". It is his only social contact because he could never keep a girlfriend and his parents are gone now. Welcome to America.

  • I grew up poor too, but there is poor, and there is desperation.

    People do a lot of things out of desperation that they'd never do otherwise.

    Trust me, it wasn't meant to be a "poor people have no ethics" type of comment. It is actually kind of the opposite. It is that the most ethical person can find themselves faced with difficult decisions, like hungry children, and make decisions they never thought possible.
  • You know the funny thing I see here, as looks like you all know more than I do or something. I mean first off if I needed money, which of course I do, haven't had a income in a year and half. But I wouldn't know the first thing about selling my meds if i needed to. I don't know anyone whom is involved in illegal activity or would I associate with those types of individuals. So if you know those kind of people around you, I suggest you remove them from your life. I would have to begin thinking like a criminal to figure out whom and how I could sell them. It is not like I am going to walk over to my neighbors and say "hey I need some money would you like to buy my prescriptions". The police would be at my house faster than you can say Police. So I am going to say you have to know people who participate in illegal activities to begin with. Not the kind of people i choose to align myself with in life.

    The odd thing is I don't think anyone who is desperate to feed their children would have those meds in their position to begin with because that would mean they had the money to pay for the doctors or pay for the prescriptions to begin with. We have plenty of state programs to have food put on the tables if you qualify. While it may not be steaks it is enough to pay for nutritional meals for a family. So someone who has limited means of income if they have those in their position for legitimate use I bet they aren't letting go of them. How many low income members do we have here looking for ways to get assistant paying for the meds or take a lesser effective one for purposes of price.

    The only meds I have been given post surgery is what you would need to make to the post-op appointment. Which is usually two weeks following surgery. So I don't know anything about some huge bottle of pills going out. Following a surgery for a fracture ankle to put a steel plate in it and having to weight bear on it immediately following surgery the script was for 30 pills. Trust me I did some serious rationing on those pills. Trust me that is the worst post surgery pain i have ever felt every time i need to get up. Would break out in cold sweats from the pain. Even this last surgery on my spine we did enough to get me to the follow-up appointment. Now i have had in the past meds left over from a surgery and i get rid of them. But I get rid of all things I don't need any longer. That is a behavior in itself if you keep something like that you don't need but in case you need it in the future. That is actual mis use of the meds. Meaning your using them for something they weren't intended for and your self medicating. If you have a new or different injury and you keep left over meds and use them then you need to see a doctor for the issue, if it takes a prescription med.
  • Yes, I do know what it is like to be surrounded by that type of people, or to know that type of people.

    And poor people do get medical care- here the poorest of the poor get Medi-Cal, a subsidized program. It's only the working poor who are out of luck. So if you have an extra few pain pills, and your friend has a friend who sells them, that could be a few hundred bucks! That might be rent!

    But these days I'm a middle-aged housewife in the suburbs. I get worried about people stealing my meds, but never would think about selling them. This life is so much easier than the other, one can really never imagine unless they've lived both.

  • My PM Dr. will reassess my need for a change in narcotics the end of my 6th epidural Oct. 7. Change from Oxycontin to Fentanyl patch. Oxycontin is now going to be regulated where I live and while going to the pharmacy today there's a big sign outside Oxycontin is now a special order medication. I know Fentanyl patch is harder to abuse I guess for drug seekers so glad the PM Dr. is recommending it to my Family Dr. who gives my meds. She doesn't want to give me Fentanyl patch without the PM Drs approval but was even cautious ordering Oxy for me. I don't mind the strict regulations and hopefully will stop the addicts from getting it. They said there will be over 200,000 people seeking withdrawal help because of strict regulations here.
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I have not heard that! I've been on the patches before anbd they did do well for my pain, however I was slways sleepy,. Then my hubby watched an episode of Dr. G...the autopsy doctor and found that the patient had died of a fentanyl overdose...not meaning to...but the patch was defective. So, now my hubby will never let that be an option again. It's too bad, b/c it was such steady pain control and I hardly used break thru meds at all.

    My 2nd favorite med for non abuse is kadian. I told my doctor that if he ever suspected the patient to have abuse issues (but have real, legitament pain), that Kadian is great for not being able to abuse.

    I've been on ms contin before a couple times with not good pain controll...so I've ended up back on oxycontin, I have heard they are making the covering of the pill harder to crush or chew though, so that is a step in the right direction. Oxy just happens to really do well for my pain...I just hate being associated with the biggest abusable drug there is. Well, I've read all the responses to the article and haven't even read the article yet! So, off to read the article that has sparked this conversation!

    Have a good weekend to all!!
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