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Pain Medication and the DEA



  • Hello everyone I'm new here but this caught my attention so thought I'd add my 2cents.

    I have come across several people, hmmm I want to say at least 6-7 just in the past few weeks who have reported changes with in their PMs practice. Every one of these people have said the PMs have limits now on what they will prescribe.

    Now my PM told my husband & I long ago changes were coming & he felt he has little choice in the matter.
    He has mentioned he no longer could treat a patient with out hard core proof of the pain. Such as MRIs & so on...I do know not everyone has this proof. It does not exist for every pain causing ailment.

    A couple visits ago he explained there is indeed a limit to what he can prescribe. I'm not at that limit but I know others are & have to reduce the amount of meds.

    There have been a couple reasons told to patients why these changes are being made but thus far everyone has been told there will be a limit.
    I have to respect my PM enough to believe he is being honest with me.

    I have little control of my pain as it is & am scared of the future. Ive followed every rule there is & know plenty of others that do the same. I know my PM really does want to help people & this must be hard for him as well as the patients.

    I can't help but be angry at the doctors & people who have abused the PM world & medications. I see a lot of suffering in the future & its so very unfair.
    We do not let animals suffer but we are willing to let humans.
    I get injections also for my Pain but the insurance has decided to dictate when I can get those & how far apart they must be. So I don't get the full impact or relief. Seems wrong & unfair.
    I know there are other changes being made & sooner or later we will hear about them.

    I wish there was another way to go after the bad guys without punishing the good guys.

    My PM also let us know many PMs have decided to close their doors or simply not prescribe meds at all. I think we will be hearing more & I wonder if there is anything we can do to assure we will not be left to suffer.

    I so badly want to enjoy my life & have enough control to make happy memories with my family.
    Is this asking too much?

  • I don't think that the FDA realized how big it could get, making pain as much a vital sign. And that patients are so well versed with their knowledge and even in some cases demanding pain medication, the brakes are being put on hard. Some real CP patients will suffer because many Drs will [are] quit practicing in the area of CP.

    Also, even legit. PM's can be a little pushy with the ESI's and other procedures,..even if they haven't helped the patient in the past.
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  • Apparently doctors are still being contracted and notified of "pain management" changes. My new surgeon, as we went through the usual questions, one of which "Post op pain management." He told me a PCA to start, then oral medications. After discharge most likely Percocet. He then told me that per new guidelines, he can't give pain medications past 6 weeks post op. If I still have enough mechanical pain requiring schedule medications, will "have to kick you to pain management."

    In some ways I do see that as good, in others a pain in the neck (no pun intended). Treating longterm / chronic pain is not done well many times, and most doctors aren't trained specifically for chronic pain. A true PM doctor is trained for us. It just bites when the medications are working just fine, and now you have to go to another doctor...sigh. Hopefully it will all settle down soon.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I have had back pain since I was 22. When I was around 45 it became constant. I don't know exactly what happened to cause my back pain. I was in 3 physically abusive relationships, and I know I fell or was beaten many times, but I never connected the abuse with my back problems.
    Anyway, that's just a little history.
    I moved from a state where I was in pain management to another state. I have no insurance, but my husband was working full time and I cleaned houses part time. We made enough to pay for doctor appointments. He found a doctor right away, and was referred to pain management, and he has also had two back surgeries. The last one didn't help him, it put him in more pain than he was in.
    I have never had back surgery (YET), but when I went to the same doctor's office to have a primary doctor refer me to pain management, at first they said, "we don't have your medical records yet", so I contacted my former doctors and ask them again to send my records. Only one record was received from my former primary care doctor. They still wouldn't refer me to pain management, even though they had all my MRI reports, and all the information of my pain history. Finally, I talked to a lady in the doctor's office that said, "you must have your former pain management doctor call and refer you to a pain management doctor in this state." I did that, and my doctor did call and sent my records to the pain management doctor. I called after a couple of days to make an appointment and a person went to get my file, came back to the phone and said "there is a note on your file that says you are being refused as a patient." I asked why and she said she didn't know. So I told her there has to be a reason and she said call my former doctor. I called them and they said they wouldn't know of any reason the new doctor would refuse me as a patient. I e-mailed the clinic twice asking for the reason I was refused as a patient. I received an e-mail a couple of days later saying, "I have various records where it states I use marijuana, and both doctors at the clinic will not treat patients that use marijuana. I was outraged, but that doesn't even begin to explain the feeling I had. I have always truthfully check marked the usage of alcohol, marijuana, and other drugs, but I don't USE marijuana currently, nor have I used it in over 30 years. I feel humiliated for being marked as such, and there is nothing I can do about it. My husband, who goes to the same clinic, use to smoke pot, use meth, drank a lot, and he was accepted as a patient, why not me?
  • I would make an appointment to speak with the office manager or the doctor and rationally explain your need for care.
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  • joedirtjjoedirt Posts: 1
    edited 04/18/2014 - 8:39 AM
    I have had 6 back surgeries and I will have to get on disability because I can't get pain pills to kill the pain enough to go to work. The DEA has put the dr.'s on such restrictions they won't give me what I need to kill enough pain. It would be great if they would legalize pot at least I would get some pain relief. I worked for over 10 years on pain medication and was promoted and given merit raises for my accomplishments. It is ashamed I have to live off the government because of drug abusers when I have 5 scars on my back over 3" long and they think I am a drug addict. I live every day sitting horizontal because I can't walk or sit upright in a chair. Don't tell me physical therapy, eating vitamins or exercise will help because it doesn't. I have been to sports medicine and physical therapy and it don't do anything. Narcotics is the only thing that helps and vicodin to me is like taking an asprin. I have been to the best dr.'s in Houston and the best pain management dr.'s in Houston also and they see me for about 2 years after they get their money for 20 injections then they tell me they can prescribe me any more medications and can't see me anymore then what the heck am I supposed to do? I have to go find another one and go through the same thing over and over and over again. I just want pain meds and don't want to drive 60 miles every month to get them. It is not going to get better and never will!
  • dilaurodilauro ConnecticutPosts: 13,562
    The DEA has no such restriction on doctors. A doctor can prescribe as many and as high a dosage they feel justified in prescribing. That is the key word. What a patient feels they want and want a doctor believes they need can be two different answers. But dont blame the DEA.

    What is the dosage that you doctor is writing you script for and for what medication? Having to take enough pills to kill the pain just to go to work is wrong. You could be setting yourself up for something much worse. First, if you are stating you need that many much pain medication to kill the pain, then how about how much you are impaired at the same time?
    You coudnt possible perform at 100% with a lot of narcotics in your system, that just doesnt work.

    If you have to find another doctor and another doctor just to get your scripts written, you are again setting yourself up for being labeled a drug seeker. There are enough national data bases that doctors and pharmacists can search just to see how many doctors or pharmacists a person has used.

    I would instead spend your time working with doctors to figure out an action plan that can give you some pain relief so that you can manage your pain. There are many different actions a person can take to manage pain. Prescript drugs just play a small role.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • Been on and off for many years since my back to back auto accidents in 1989. I can tell you first hand the pain meds and muscle relaxers were prescribed more readily then, than today. I never once abused them. IMHO, 99% of people suffering pain don't sell them because the meds are more important than money.
    I have had several conversations with doctors I trust over the last ten years and they all said the same. The DEA keeps logs of who prescribes what, how often, and to whom. The dr. has to be carefull they don't exceed a certain amount, or they are in the dea's scope. You have to produce a drivers license that is recorded now for controlled substances to get a script filled. The doctors are skittish on prescribing pain meds now, no matter how long you've been a patient. I was never on anything heavy-duty, [ vicodin, talwin, robaxin] That's about it.

    Now, surprise surprise, medicare requires 65 and older a special request from the Dr. because of age. Are they crazy? Do they not get the concept that pain gets worse as you get older? [ Trust me]

    So the govt. does have control.
    I don't think any of this is offensive, I just think there is no reason someone should suffer without meds if they need them.

    One thing I have learned over the years, if you do too many, they become ineffective, so you have to manage your meds.
    I would bet there are deserving people who resort to black market, unfortunately.
  • In the past, when I've discussed my pain journey with friends more often than not I've been asked 'Why won't your doctor give you more or stronger pain medications?'. I think it's part of our culture to believe that narcotic pills take any pain away. It seems to be one of the hardest hurdles to get over for many. When I first arrived in the USA I had a tooth filling that needed replacing. I was given an injection & a small pain med prescription. In England the only time I'd even received even an injection was for an extraction. I completely understand why people get so frustrated & think they're being treated poorly when a doctor refuses to prescribe narcotics for back pain.

    The first time I took Hydrocodone I was 'Comfortably Numb' to say the least so why not give me more & more to battle increased pain? You live & learn. I now know that there is no quantity of narcotic that will completely relieve my chronic pain (if I want to be conscious) but that knowledge is part of the journey. Maybe some doctors assume that this is common knowledge & doesn't have to be explained fully? Maybe narcotic medications have become so culturally ingrained that patients don't want to hear it? I take narcotics daily & they do help me to function but although my spine damage & pain has increased I'm actually taking a lot less than I have in the past. Higher quantities & doses do not help more, it just turned me into a depressed zombie with an incredibly high tolerance!

    I have read so many angry posts from people feeling offended & neglected because they've been told to practice physical therapy, relaxation & meditation, heat & cold etc. as if these modalities equal cruel dismissal of their feelings. I can honestly say that these therapies are as important in my treatment as narcotic medications. If I had to choose between muscle & nerve meds or narcotics it would be incredibly hard. One does not work without the other for me.

    For a doctor to continue or increase narcotics they have to weigh the risks with the benefits. If you state that your current prescriptions do not help with your pain why would the doctor increase the dose? If you're not getting any relief & your standard of living isnt improved it's not worth the risks. If a patient is unwilling to develop their own 'blend' & they refuse other therapies they are setting themselves up for failure. Chronic spine pain takes teamwork between you & your specialists.

    I know this sounds really harsh. I'm not addressing those that are doing everything they can but still need medicinal help. There are members on this site that I believe should of been offered the chance to try narcotic therapy & it's wrong that they weren't but that's individual cases. I just think the days of saying 'nothing else works' & being allowed to live on narcotics have gone. If adding pain meds to an extensive pain management regime allows a patient a better quality of life then & only then should prescriptions be written. Doctors are learning from past mistakes & modern studies. That's a good thing for patients.
    Osteoarthritis & DDD.
  • epidural3eepidural3 Posts: 10
    edited 04/19/2014 - 6:05 AM

    I totally agree, it takes a combination of therapies, whatever they may be. Finding that sweet spot is not always easy, that's why we read these great forums.

    Meds alone are not always the answer, however there are some chronic sufferers that cannot tolerate PT or excercise, especially without pain meds.

    I think pain threshold has to be considered as well. I cannot speak for anyone else, but it seems the older I get the lower my threshold becomes.

    To Jon:
    You are fortunate. All I stated in previous post is true. As far as medicare goes, my drug plan denied my script for Robaxin because of medicare guidelines [ over age of 65] My Dr. has to submit more paperwork to get it approved. Also, the hospital pharmacy I go to informed me it is the law that requires ID. Once it is on record you do not have to produce it repeatedly. State Laws in CA. may be different than laws in Pa. , but Medicare is the same.
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