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No narcotic prescriptions for pain if you are a smoker

Hello everyone,

Went to my pain doctor end of June, no problem in getting my RX for Norco 7.5 for the next three months. End of September I know he will also give me three months of prescriptions, but before he issues me prescriptions for January I have to have a blood test.  He informed me of a new ruling.  If you are a smoker you will not be able to get narcotics for pain.  I've been trying to quit, even bought patches before my visit to him not knowing about new ruling.  End of December I must have blood test and if there is any nicotine in my blood, I will not be able to get RX for Norco anymore.  Also, I take .5, very low dose of generic form of valium before bedtime for leg spasms.  I have to stop with that also.  Pain doctor informed me that they (not sure who they are,, Federal, State or Hospital Alliance) believe smokers abuse narcotic prescriptions and as far as the valium goes, its in the best interest of "safety" for patients.  Has anyone else run across this new ruling? I've already started my quit smoking campaign, cheating at it at times, but with the patch have managed to go from pack a day down to cheating with one or two in a 24 hour period. Started July 5th.  Now I have to work on the two I cheat with.  I am giving myself plenty of time since nicotine is in your system for awhile even with cheating with a few puffs.  I call my cheater my perpetual cigarette in that I only take a few puffs, put it out and save same cigarette if I get really bad with cravings.  I figure it is a start. Will be going down to one cheater in a few days, then none.  Hope I am successful, have to be, or no more Norco.



  •   I've heard were some doctors are requesting it from their patients but I havent heard were it's some new regulations. I think it all depends on the doctor and how they feel about smoking

  • oh holy cow...what next...just another way to get rid of a few more patients

    the doctor wanting you to quit smoking while he has a glass of scotch  in his hand

    last year, the nurse at my pm clinic saw that I checked the box that I smoked cigars...she starts in on her “have you ever thought about quitting”  crappola.  I told her that quitting had never crossed my mind and, in fact, I had instructed my wife to cut a hole in the top of my casket so I can have a cigar sticking out of it in my mouth.  She looked at me like I was nuts, but it’s never been discussed again

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  • I also heard that this was coming about a year ago.  While it is admirable to encourage your patients to quit smoking, requiring it is wrong in my opinion.

    I started smoking off and on at 16.  We had a smoking area in our high school and that's where kids hung out to talk.  I quit at 20 when I had my daughter and did not smoke again til my divorce.  A year later my son asked me to quit so I did.

    Started again during a stressful time about five years ago.  Smoked for almost a year and decided to try Ecig to hopefully quit once and for all.  I started at 10 mg and went down every 2 weeks, (8mg,6mg,3mg,0mg) til I got to 0mg.  I found that I was just as addicted to the smoking part as I was the nicotine.  The Ecig gave me the feeling of smoking, holding it in my hand, inhaling, exhaling, seeing the vapor, etc.  After 6 months I was done and was able to put it all away and be smoke free.  I could have quit much faster but I was under no time constraints so I just took my time.  I have quit cold turkey twice and I guarantee the Ecig was the best way.  

    One reason I decided to go ahead and retire the Ecig is because when I went to the doctor in the middle of quitting I told the nurse about it (being really proud of myself) and she said she had to put me down as a smoker even if it was just ecig.  I told her I was at 3mg ready to step down to 0mg nicotine and she said even if there is no nicotine in the ecig they still report it as smoking.  I couldn't believe it!  Two weeks later I was down to 0mg nicotine and two weeks after that I just felt like I was done with it.  Still have one left but no desire to use it.  It really was a great way to quit.  It does take some upfront money to get started but nothing compared to what cigs cost.

    Anyway while I think it is a great thing to quit smoking,  no one should require you to. I almost hate to say this but......what's next???  You are overweight so you can't have your meds?  I mean really??

    I swear if you had told me 5 years ago that this is what we would be dealing with I would have thought you were crazy.  Where is common sense in all this mess?

    In closing I just have to ask this...who came up with if you smoke you will abuse meds?  I really would like to know who came up with that?


  • Skinmyheart - that's some funny stuff there!  Great way to make your point!  I haven't heard of any new requirement to quit smoking, but I don't doubt it either.  Nothing surprises me anymore when it comes to pain medication!

    Keep your head up! 

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • peanut006peanut006 MichiganPosts: 143

    I have not heard of any new regulations myself but I have heard of individual docs requiring no nicotine, no alcohol and testing for it. I've read some studies that seem to say that if you're addicted to one substance (such as nicotine) you're more prone to addictive behavior with other substances. 

    I am (unfortunately) a smoker and have been in pain management for 20 years. Without any issues. As you all said.. it's gone beyond ridiculous at this point. I understand of course not mixing alcohol and our meds but we are grown adults who have to take ua's, come into have our pills counted, are not allowed even a glass of wine with dinner, now no smoking, how long before caffeine gets added??? Smoking is obviously horrible for our health so I'm not trying to defend smoking, but it's a completely legal substance. So is alcohol (as long as it's used responsibly). How is it becoming okay in America to take away our rights and ability to live the way we see fit?? It is completely mind boggling to me that in 2018 when all adults are told that everyone has the right to live their life the way in which they choose, that the country on a whole is okay with the rights of pain patients being denied their civil rights and liberties everyday. When will it be enough???

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  • peanut006, well said and I second what you have said also.  When is enough enough?!?!?

  • Well the one issue is the cost on health care.  I know my mother would have live a much longer life and would have been in much better health though out her life if she did not smoke 2 packs a day. In today's world medical care is so expensive so rarely does the person who get lung problems pay for all their healthcare. The bottom line is people's addictions to food, alcohol, drugs and horrible habits cost use all. However  you cannot force people to quit when they are not ready to. In fact, by pushing people all it does is make people move away from the help they need and then they wait much longer to see a doctor when their condition symptoms get worse because of fear of what a doctor will say until a condition gets so advanced it becomes a health crisis and can cost hundred of thousands of dollars.  Basically what is happening to chronic pain patients and just being cut from their medications  there is a very good chance if a chronic pain patient cannot get help from a doctor for there pain then they will find what they need on  the street after they tried other options that don't work and that helps no one. Almost everyone who OD on opiates have other drugs in their system. If they used just pills then they have usually drank alcohol with those pills or used seditives. 75% of the opiate deaths have illegal  drugs in their system.

  • I definitely have heard of individual docs not wanting to give meds if you smoke. I guess they figure addictive to one thing means you'll be addictive to another substance. As far as the valium goes, that is a benzo and it can be deadly when mixed with pain meds. I too had to give up my valium (for anxiety) in order to get my pain meds.

    I finally gave up on all of this crap and quit my pain meds last December. It was the hardest thing ever! I did find though, that once I was off a few weeks, they really weren't helping me. I'm not saying they don't help some people, just not me at that point. It had been 6 solid years. Anyway, fast forward to this past May and I had surgery, then another surgery in June (fusion) and an infection so more surgery for that... Well, back on the pain meds I am... Ugh. Once I get through this healing process I'm getting off again. I'm fearful whoever "they" are will take them away anyway. 

  • And here we go again. While I agree that smoking is a  nasty habit and extremely bad for your health so are many other things. What's next? How about no pain meds till you surrender your drivers license? This is just complete and total BS and these types of things just beg for some smart attorney to come along and file a class action suit on behalf of all chronic pain patients! Sad, but it needs to happen. Doctors need to know that some of these so called "guidelines" are just that; guidelines and not something set in stone. Some of these actions in my mind border on malpractice and honestly it is time to fight back. Picture a TV commercial " Are you a chronic pain patient who has been denied relief from your suffering because your doctor is a wuss?"  Contact so and so..... Sorry folks but this needs to happen and has already begun although on a individual scale.  Hopefully an attorney will read this who just also happens to be a pain patient and take the bull by the horns.....And if anyone is aware of these types of things happening, then share the info.  I know that last week a federal judge in the Carolinas was supposed to rule on a case involving the VA. The case did go to trial (non jury) but I have not heard the outcome yet..   Pretty sad when you even have to consider something like this..

  • I agree with the above.  I smoked for 25 years; quit 23 years ago, but have been chewing Nicorette ever since!  The drs have always said, oh that's good, chewing Nicorette instead of smoking!  It's very expensive and very addictive.  By the way, when my pain clinic tested everyone for alcohol, the Nicorette made the test come out Positive - It was 8:30 in the morning, plus, I had quit drinking completely several years ago.  They kept telling me they were going to cut me off my pain meds immediately due to the test.  I kept arguing and offering to get a blood test.  Finally, one of the drs at the pain clinic said Nicorette definitely alters the results!  

    If they cut you off now, I guess you wouldn't be allowed to chew Nicorette either.  I quit getting pain meds over a year ago, because they now insisted I get injections, which I elected not to get after researching it plus drs previously telling me inj would not help me much.

    I'm all for doing everything to keep young people from starting to smoke and/or drink.  Look at all the steps they're taking to get people off opioids!  They could surely put the time and money into everything in their power to STOP alcohol and cigs below age 21!  Instead they have commercials aimed at people younger than 21 - Look at all the new alcohol drink flavors being advertised - oranje crush, grape, vanilla flavored scotch, etc etc - who else would that be geared towards??

    What if they started to make all drs and nurses quit smoking?  The attitudes in the ERs, etc would surely change!!  What about a data base that lists all smokers, and where they purchase their cigarettes?  Make them sign a contract to only buy them from Walgreens, etc. Big Government is telling us what to do more and more!  When they first made everyone smoke outside, I was a smoker and said they should also outlaw candy machines, etc. There were so many self righteous overweight people screaming about 2nd hand smoke!

    What if the CDC limited the amount of nicotine allowed in our bodies?  Made us get tested every month before we could purchase cigarettes?  What about a medical diagnosis for nicotine addiction - NUD Nicotine Use Disorder - Make Ins and Medicare cover the cost of rehab for NUDs!

    I can't believe we're standing by letting them get away with this!  If they would test underage college kids for alcohol in their system, riots would break out.  But of course with CPPs, we're just not able to protest the way we once used to.

    If they test CPPs for nicotine, they should test everyone for nicotine!  I think the protests would begin.  The general public that are not CPPs believe all the hype about opioids for legit pain patients.  How about limiting the amount of Fast Food you can purchase?  Or No Fast Food under the age of 5 ??  It would save lives.  

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