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Pharmacies, the DEA vs Pain Patients

Jun 26, 2015 1:37 AM

I see a pain mngt specialist who is on an advisory board that helps create guidelines and laws that tell doctors how they are supposed to prescribe narcotics, manage patients on them, and wean patients off them if need be. He also often has had to deal with pharmacies.

The DEA has recently upgraded the schedule on the last remaining narcotics that you could get refills called in to pharmacies. Now, Vicodin, & Tramadol (& others) need new paper scripts every time you need a refill.

They have also forced companies into limiting the amount of narcotics they manufacture at all.

Add to this, Pharmacies like CVS & Walgreens have taken it upon themselves to limit the amount of narcotics they order in. They put in one order, and if they run out, they will not order any more in for patients that need them. The amount they order is arbitrary, and does not reflect the amount needed to cover their regular customers - ppl like us, chronic pain patients just trying to survive.

They have also begun giving bonuses to pharmacists and techs for NOT filling out prescriptions for narcotics.

They say this is being done to prevent abuse, but in reality all it does is screw over chronic pain sufferers. My pain mngt doctor agrees with me.

I am honestly stunned that this is legal. I feel like I should be able to sue over this, that my rights are being trampled. Are there any legal eagles on here that can maybe chime in on this travesty?

Jun 26, 2015 2:15 AM

I don't know how most of this stiff works but it seems like pharmacies blame the DEA, the DEA blames "addicts" (many of which likely have chronic pain, and gave been falsely labeled), the patients blame the docs, the docs blame the pharmacies and then there are also the drug companies and insurance companies. There's just an endless loop. The government seemed to set this up in a good way (for them?) so that patients who call out anyone on the lack of medications without being labeled addicts. There are also many policies placed on doctors so that they will have as few prescriptions as possible of narcotics and effective painkillers. The patients with chronic pain (there is a huge number) are often unable to fund a lawsuit, or be able to show up from pain or disability. We could create a petition, but all the is I've seen have been shut down and then media calls the people who create petitions addicts and then we're still stuck. I'm relying almost entirely on alternative medicines because at least I know that they're available and I won't die from not getting a prescription. But that's me. I know many people get help from meds, and this should change but I don't think it will anytime soon.

Jun 26, 2015 8:42 AM

Seriously, what a terrible time to be alive. It's as if the U.S. Believes prohibition was a success. I wish there was something we could do, but there probably isn't and it would backfire anyway. Disgusting.

I wish there was a place to share experiences about specific doctors that have neglected patients blatantly and boycott them altogether, as well as the opposite with good doctors that do the opposite. I would gladly drive 2 hours+ to know my doctor won't neglect me!!

Jun 27, 2015 9:11 AM

Opioid Prescriptions And Addictions Are On The Rise In The U.S.
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Example of different morphine tablets
Example of different morphine tablets (Photo credit: Wikipedia)

If we weren’t already convinced of the prevalence of opioid addiction in the U.S., a new study from Johns Hopkins lays out just how bad it’s gotten. The authors report that opioid prescriptions, which include OxyContin and morphine, have skyrocketed in the last decade, while pain identification and management has largely stayed the same. Opioid addiction and overdose are also creeping up. The study’s harsh reality comes at an interesting time, as the FDA has just announced its own stab at addressing the opioid problem, by urging their restriction to those who really truly seem to need round-the-clock pain management for extreme pain. What effect this will have remains to be seen, however, and some are not so convinced that it will have any.

“There is an epidemic of prescription opioid addiction and abuse in the United States,” said G. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. “We felt it was important to examine whether or not this epidemic has coincided with improved identification and treatment of pain.”

The new study looked at doctor visits from 2000 to 2010 for people seeking relief from pain that was not cancer-related. In 2000, about half of all pain visits were treated with some sort of medication – this much was about the same in 2010, which saw about 164 million office visits for pain. What did change, however, was the number of people treated with non-opioid drugs versus opioid drugs: While non-opioid painkiller prescriptions stayed at about 26-29%, opioid prescriptions almost doubled from 11% to 20% over these 10 years.

The class of drugs is dangerous in part because they are so highly addictive, and the mortality rate from their use is rising. “By 2008,” wrote the Hopkins team, “the annual number of fatal drug poisonings surpassed those of motor vehicle deaths and overdose deaths attributable to prescription drugs exceeded those of cocaine and heroin combined.”

The irony is that the treatment of pain hasn’t improved much. And other drugs like acetaminophen and ibuprofen, which have far fewer safety concerns, seem to be flat or even dropping slightly, which, the authors say, “suggests that efforts to improve the identification and treatment of pain have backfired, due to an over-reliance on prescription opioids that have caused incredible morbidity and mortality among patients young and old alike.”

The solution to the problem is not clear, though the FDA has tried to address it. Last week, the FDA urged doctors to limit the use of the drugs in part by restricting prescriptions to those who have severe, rather than moderate, pain all the time, and in whom no other alternatives are possible. “The goal here was to make every patient taking extended-release and long-acting opioids to have a conversation about whether these products are helping them,” said Douglas Throckmorton, an FDA deputy director. “I hope this encourages physicians and patients to be more thoughtful and more careful as they use these medications.” The FDA also moved for drug companies to conduct studies to better understand risk over the long term, and investigation into how tolerance to the drugs may develop.

Though the new guidelines may have some effect, at least at calling out the problem once more for the medical community, it’s not clear how much it will really penetrate the current model of pain care. As The New York Times points out, the refusal of the FDA to require a cap on the length of the prescription still leaves it fairly open-ended, and “drug makers free to imply in their advertising that long-term use and high doses are acceptable.” Others, like New York City’s health commissioner Thomas Farley have lamented the FDA’s failure to take more aggressive measures at fixing the problem.

Perhaps the recommendations will help patients themselves be aware of the risks – of addiction, overdose, and death – before accepting prescription for the drugs from their doctors. But mostly, the future of opioid use is still unclear, and it may not change in tangible ways any time soon. “These regulatory changes may help prescribers and patients to better appreciate the risks of these therapies,” says Hopkins’ Matthew Daubresse. “Despite this, the ultimate impact of the FDA’s labeling change has yet to be seen.”

Jun 27, 2015 12:09 PM

I see a pain management Dr. And we have undergo pill counts, urin test's ( to make sure were not selling them) and we have to sign a contract to have all of our medications filled at a certain pharmacy. They pull my medications list from the pharmacy too.

Jun 27, 2015 12:59 PM

Me, too. I was more than happy to do those in agreement for actual treatment, but that's not even enough. This is all political nonsense and blatant discrimination. If you are very old, or have cancer, everyone agrees you deserve treatment and there are multitudes of articles about helping patients understand the positives of using opioid therapy, for it is, for whatever it's worth, the most effective pain reliever available. Like I've said before, this is the beginning of another prohibition. It's likely to force people in pain toward either suicide, suffering, or a more developed black market.

Jun 27, 2015 6:19 PM

Wow oh wow StarryNight. I am so damned tired of this crap it's not funny. Maybe instead of looking at the statistics, they should actually look at THE PEOPLE whose lives are unlivable without pain relief. I'm sick to death of always hearing about the drug addiction problem. WHAT ABOUT US?? What about the millions of ppl who through no fault of their own need these medications to just get out of bed in the morning. No one ever talks about us. No one talks about the incurable medical conditions that we have that cause us terrible pain, both physically and mentally. No one shows our struggles. No one cares how we are treated. We have legit disabilities but we are still somehow lumped into the same category as drug seeking addicts. WE ARE NOT THE SAME.

I almost punched my tv when I heard about the new Jennifer Aniston movie where her character who has chronic pain turns into an addict and now all the media is showering this movie and her with praise and all I can think of is how this stupid movie is going to spread more ignorance about ppl who have chronic pain.

Enough is enough! I'm sick of talking about addicts. Not everyone gets addicted to opiates. And addiction IS NOT THE SAME AS TOLERANCE. So many ppl don't understand this. I just want to scream this at doctors, pharmacists, techs, the government.

We are citizens too. We have the right to live pain free. I'm so unbelievably frustrated. 👿

Jun 27, 2015 6:34 PM

MiriP, omg a petition is seriously on its way that wants to limit narcotics to chronic pain sufferers to only a 90 day period - and that's it? Am I reading this correctly? So it would effectively ban Extended Release medications?

I don't even know what to say or even where to start on this other then to say I hope the ppl who created this petition and the ppl who signed it know they are going to Hell for being evil and having no empathy or compassion.

Jun 28, 2015 1:18 AM

I agree with AmieLaBlanc.... You couldn't have said it any better!!! What about US.... The focus is always on the folks out there who are abusing the system and their medications. Doctor shopping, selling medications, and causing it to be more and more difficult for those of us who need these medications to get through the day with some resemblance to being a human being. I find it very sad that they are more focused on these law breakers than the people who just want and need someone to help them get out of pain. There is NOT any one of us on these medications that WANT to have to take them!!! Believe me, if there was another way of getting rid of my pain, please tell me what it is... Promise me that it will work... Until then, I have no choice but to take these narcotics to help me get through the day.

Jun 28, 2015 3:22 AM

I have been labeled a drug seeker, so I'm likely an "addict" in statistics, even though I don't take any narcotics or opiates.
I feel offended that the media (and government) is willing to call me out when I'm in pain.
I remember when I had to so seeing my doc as she had accused my dad of assisting my drug seeking.
Yes, I wanted pain relief.
I'd tried ibuprofen, Tylenol, Gallium, alcohol (legally, my dad looked up the law and if he's home and making sure I don't do anything dangerous it's fine), gabapentin, Benadryl, salt, inhalers, etc.
I was teaching migraines from tooth pain and Tylenol 3 (Codeine is a narcotic) was the only thing that helped, and lessened the hallucinations, migraines, and crippling pain that caused my teachers to send me home several times in the first month of my freshman year.
I ended up hiding outside during Thanksgiving, sighing against the garage door. I had a long train of thought...

"Just your average drug seeker.
Asking the doc for alternatives to my narcotics.
Just your average drug seeker.
Knowing there is a drug house down the street and wondering if they might actually help me, unlike my doctor.
Just your average drug seeker.
14 and hiding my tears from my family.
Just your average drug seeker.
Wishing I could walk without wondering if I'll die.
Just your average drug seeker.
Wishing for a real cure.
Just your average drug seeker.
Hating the floating feeling so familiar, dreading the "high" of the pain and narcotics."

It eventually felt like a song, lost in tears and pain and fear. I was suposed to be strong, hide behind a smile so my cousins won't worry. There are 4 of them, all boys. They are 2, 5, 8, and 10 years old. They have never seen chronic pain. I've seen it all my life, but only recently experienced the tough chronic pain. My first "10" on the pain scale suddenly became a "2".

I have heard some people my age talk about drugs. Sometimes they will describe a high as if it's a miracle. That "high" sums me up on bad pain days. The floating feeling. Being unable to focus. Stumbling down the hallway. Bumping into people in the hallways like we are playing bumper calls. I just don't understand wanting to feel like that.

Yet, I'm probably part of the addict population, at least according to any statistic I look at.

Maybe all the pain patients can band together in a petition against the other one? Narcotics haven't done much for me, but I also believe that anyone with pain should have the opportunity to try various medication, even if I mostly take over the counter, alternative meds, or teas.

Jun 28, 2015 9:42 AM

I am sorry your doctor won't help you out, my 12 year old daughter also suffers from chronic migraines and and like me she is allergic to all triptain medications that they normally use to help aide in migraines. We both are taking amitripaline and topramate to try and prevent one but it doesn't always work, and when my daughters migraines come back, she is much like you she tries to hide her tears from the migraine pain and it doesn't always work for her but this momma knows what chronic pain and migraines look like on a person having suffered with them for a very long time and narcotic medicine can cause a rebound migraine it is worse then the first. I have back problems and see a pain doctor and medication he gave me doesn't always work

Jun 28, 2015 10:13 AM

(Sorry butter fingers on my phone) the pain medications that they gave me doesn't always work and I left to fight the pain all day while trying to get my mom duties done. Its hard and I have to take a ton of breaks and a lot of the times I feel like I'm letting my kids down because I can't do what most parent's do with their children. But i agree ,something has to be done about people like us with chronic pain who need the meds and the only bringing to light about the drug seekers and drug addictions! Heck I'm probably labeled an addicted or drug seeker since I see a pain doctor! Most of are. Every time I go refill my pain medications I get a funny look! It didn't help that the pharmacy that I love to use got hit by the DEA because a pharmacist was filling fake scripts for hydrocodone and xanxe(spelling). So they took away their right to fill medications that are classified as controlled substance. So I have to drive Half hour or more to get my medications filled. I hate taking the medication because of the way it makes me feel and the fact it makes me sleepy sometimes in the middle of the day, by the time I sleep off my medication its time to go to bed again and it takes away time with the family. The petition is one way to get positive attention on this but what are other ways our story's could be herd?

Jun 28, 2015 6:42 PM

Ferretbandit, just a thought has your parents thought to get you into a neurologist? I know you mentioned seeing a dentist for your tooth, but was wondering if your parents thought to get you into a neurologist. They could help with the kind of medications I mentioned earlier (triptains) the ones I'm allergic to. But they do well for my friends migraines. It would be good idea to get an MRI or cat scan done of your head as well. Hope all is good with you today and will continue to pray for you.

Jun 29, 2015 3:17 PM

I've seen 3 neurologists so far, they recently gave me something for headaches, but I'm looking up side effects and everything that's in the pills first. I haven't had any scans done, but I'll ask at my next appointment. I'm doing much better with headaches right now, had a bad flare one last night but it's pretty much gone.

Jul 13, 2015 9:44 PM

Please Do NOT post things arguing that statistically we are all basically addicts. I get that line enough from the ER when I need help with an overwhelming migraine or chronic pancreatitis. I take urine tests, etc... I follow all regulations, laws, and went through an intensive chronic pain management course and continue with a pain specializing team. I am NOT an addict. I have true pain and I follow my pain management plan which includes non narcotic elements like acupuncture and biofeedback as well. I do not need to be made to feel like a criminal, second class, or suicidal from agony because of others prejudices.

Jul 13, 2015 10:19 PM

are you referencing me? I know I talk about being treated like an addict. So far as statistics go, if you read what definition researchers have for "addicts", it can man anyone who is not elderly, or have cancer and who is prescribed opioids. There are some researchers who have multiple definitions, and who ask certain questions, which is helpful when comparing percentages in statistics.

Jul 14, 2015 1:18 AM

No Ferret, not you. StarryNight. Should've been clearer, but was upset. I liked what you had to say and the points you have made. And yes I'm aware the word ends up with multiple meanings, uses, and connotations. I think that is why I just don't like it thrown around so much. It gets misunderstood and there's so much force behind it.

Aug 24, 2015 9:17 AM

Ferret did you see the recent news article about the release of a new form of basically oxyconton I think, but made specially for children and teens safety in mind. It would be prescribed to chronic pain patients that are children and teens. I thought it was a step in the right direction, but who knows how hard it is to get an rx for it.

Aug 24, 2015 11:46 AM

No, I didn't see that article. It sounds interesting though.

Aug 24, 2015 12:23 PM

I heard about it. I think the doses are 5-10 mg maximum. Hopefully you can get some better pain relief now. 🙏🌼

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