2014 New Pain Medication Laws Dictating To Doctors That They Cannot Prescribe Anything Equivalent 120 Mg Of Morphine Or Higher A Day Per Patient (Page 2)

I was told Friday by my Pain Management Doctor at my monthly appointment that the DEA was implementing a new law dictating to doctors on how much pain medication they could prescribe per patient per day. It could be equal to no more than 120 mg of Morphine per day per patient and they had to comply within 3 months for all of their patients. I am trying to find out as much information on this as possible. I don't know if my Pain Management Doctor is stating fact or if he is just running scared and if he is stating fact, I don't know if this is federal or state (Alabama) mandated. I spoke directly with the Southeastern division of the DEA in Atlanta this morning and they are not aware of any law of this nature coming into effect and I also contacted another pain clinic locally that has never heard of it either. So I have been trying to reach my Pain Management Clinic and get a copy of the law itself so I will know if it's federal or state and if it is an actual law or just a state regulation and if it's even true but so far no one has called me back so I thought I'd try my luck here and see if anyone has heard of this. This really has me bothered. It looks like either way, true or not, to get adequate pain care I am at least going to have to move out of state if not the entire country. I will ask my questions about that in a different post. But if this is in any way true, and it seems my pain doctor is going to be going by these guidelines whether it is or is not true, it is going to cut my pain meds by almost half. I am on 120 mg of Oxycodone and 8 mg of Dilaudid per day which I was told equals 212 mg of Morphine per day. And before someone decides to tell me that I don't need that much pain medication, I will go ahead and say to you, you don't know me, you don't know what conditions I have that cause me Daily Severe Chronic Pain and other Daily Severe Pain to warrant that much medication, you don't know my tolerance for pain meds, I do NOT take any pain medication to feel high, I ONLY take pain medication to relieve some of the pain as what I am on doesn't even relieve all of my pain, I do NOT drink, I do NOT do street drugs, I see my doctor every 28 days just as I am supposed to, I take my medication as prescribed and the way I am supposed to take it except when I had extreme oral surgery a month ago and I did have to break up my tablets for about a week but they were put on my tongue and NOT up my nose and they were IR tablets so I was fine doing that as I had checked with my pharmacist prior, and you don't feel what I feel or see me lying in bed 24/7 crying from the pain because it is so excruciating and unrelenting so please before anyone starts telling me that I don't need that much pain medicine just stop now before you even start. Those of you that have to live with daily pain will surely understand where I am coming from being this defensive as I'm sure you know you are treated as a drug addict by most doctors even. Thanks in advance for any help with my question.

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You're right, Bart, it isn't a law. I think what the commenter is thinking about is the LAW which changed the schedule status of the drug Hydrocodone from schedule III to schedule II which is a major big deal in that Dr's now have to write a script every 30 days, no more refills or calling the pharmacy. That in itself changed the scope of opioid prescribing for anyone taking the drug for chronic pain.

The second letter I saw was about morphine. The first 2/3 of the letter described new thoughts on the drug. It suggested that 80mg of morphine had been set as "trigger point" signifying the Dr should stop and reassess the Patient. It suggested more than 80mg of morphine was found to be non therapeutic blah blah blah. Then finally, in the last paragraph it did state the Dr should use her discretion in managing those patients on higher doses.

No it didn't change any laws regarding Morphine doses but it implied heavily that prescribing as much as or over 80 mg Morphine was frowned upon heavily. It may as well have been a law because it scared the CRAP out of my Dr. I'd been on extended release morphine for more than 22 years. I was taking waaay more than 80mg. I think I was taking 300 mg split into 2 doses which was immediately cut in half. I WAS given Vicoden or Lortab to take, only if needed, between the two doses of morphine. Also I was told to expect an even greater cut in my dosage the following month. I was a complete wreck. The month after that I taken completely off the morphine and put on 40 mg Oxycontin. One, twice per day plus Lortab for breakthru pain. I've never been so sick in my life. I'd been a patient of this dr for nearly 10 years. During the appts, his nurse would sit near him and not look me in the eye. I was afraid to try to talk during the appt, scared I'd start crying and not be able to stop.

I'd had a great job I loved and had to take a medical leave of absence. Couldn't take proper care of myself or my home. The last time I saw that dr was March, 2014. He left the state. I was referred to another pain specialist where I was made to feel like a criminal, drug addict. He would not prescribe ANY narcotic pain medicine though I was given a u/a before every appt. He sent me for physical therapy, which I did. What I said "no" to was the repeated tries to send me to "their" Psychiatrist. I have a psychiatrist I've seen for 15 years, my insurance won't pay for me to see 2 psychiatrists and finally I don't need two psychiatrists! I finally told that a**hole from hell where to stick it.

I've had to start completely over, going to a specialist for my syndrome. Repeating all the painful diagnostics, examinations & procedures I went thru years ago. I've signed petitions for DEA reform blah blah blah. So, no, there's no law, other than the new scheduling for Hydrocodone which has caused far reaching catastrophes for thousands of American people.....

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Keikee..... I feel you .....my doctor of almost 9 years who has been wonderful to me just quit prescribing. I was on over a 1000 morphine equivalents. It completely changed my life and freed me from being a prisoner of my body. I haven't found a new doctor and have less than two weeks of medication left. It's awful feeling like I've been sentenced to hell on earth for a crime I didn't commit. All the doctors I have contacted said that they do think I need the medication and they do want to help me but every single one has cited fear of the DEA and the State Board. After years of trying to find employment, I was on top and of the world to have done so.....and then I found out I'd lose my medication. Without it basic living is almost impossible....not to mention work. I'm so sorry you are going through this.

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Here is what they did.. They did not restrict pain meds to 120 however they played this trick that will be implemented starting in October 2016 for tn..if you are prescribed 120mg the state mandates 3-6 mandated URINE SPECIFIC... (different than normal) over 650.. the insurance company went behind them.. starting this month you will receive letters however they put suboxone info so you dont read further and insurance companies will only pay for 2. The catch is the doctor at that point is not allowed to ask you to pay for additional diagnostics. The state is mandating and if you already met the limit for the year you can not be prescribed until the following year and stupid governors did not read and were sold like they were saving money by limiting needless diagnostics and no dr is going to pay out of pocket for all the extra evaluations for all his patients.. and they are too ignorant to tell the difference between long acting and short acting meds so they lumped total together. so either state needs to lower its mandate or insurance co needs to cover what state is before October and dr's started early so they could taper since if you already have over 2 URINE SPECIFIC in October they cant see you for a year. Since they are going to back date that and not start new in October to see how many can be kicked out to save lots of money... be prepared and they count all drs that you see so if another neurologist does a diagnostic it can count against the year total..

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AMEN!!! I have been unceremoniously dumped into completely "cattle herding" PM clinic with a "Doctor" who literally said to my face he does not CARE what my tests say or health concerns are; neither is he interested in corresponding w/referring GP. - I was cut from 100 Oxy-CR daily to 60 Oxy-CR/day - NOW changed DOWN AGAIN to MS15 ER 3x/day ... after being PROMISED 30mg 3x/day by Dr's P.A as we changed from Oxy to Morph Sulph - even knowing as they do that ANY Oxy is 1.5x stronger than ANY Morph Sulph dosage ... BUT I'm not stopping yet!!!

Either change Dr AGAIN with referral from GP- OR - write another set of letters to NIH.gov + DEA.gov + FDA as well as FL DBPR - not to mention the VERY cutesy, bouncy & seemingly VERY healthy smug Ms Pam Bondi and Rick Scott, -- Florida's AG and Gov respectively. They care more about their rep than they doe about those of us living in hell on earth ea day! I feel U'r frustrations... I live in FLORIDA... birthplace of this CRAP... and her name is PAMELA BONDI- ATTORNEY GENERAL OF STATE OF FL... And I live in MISERY Day 2 Day ... on my sofa... BTW DONT depend on SS Disabiity they are STINGY - START w/ an attorney FIRST or denial will be all U hear.. I have been trying since 2009!!

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This is so utterly wrong. All of America would be in an uproar if this pertained to any population OTHER than pain management patients!

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I do still need a dr in Knox, TN area so would appreciate any suggestions you have.

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Morphine is metabolized to hydromorphone. Doc knows that . . .

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I urge all to log onto petition2congress.com and lodge a complaint. Also complain to Jim Arnold of DEA repeatedly to start with. Litigation, picketing, they started it and we'll finish it!

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This is nationwide. Australia is nice . . .

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I agree 100%. Nothing like this in Florida or anywhere

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Bart.....there supposedly is no such law but, in Minnesota, the doctors are cutting people down and off meds left and right using this 120mg Morphine Equivalent as a reason!!!! It does not matter why the person is on the meds! This is pure bs and this is not going to resolve a drug war. If nothing else, it will create more criminals than you have ever seen!!!!! NO ONE has the right.....and I mean NO ONE.....to tell someone else that they are on too much pain medication. Everyones tolerance is different.....you don't have to be on narcs for years to have a low pain and high narc tolerance. People who are saying this kind of crap know nothing about human physiology! Pain....especially long term, chronic pain can cause strokes and heart attacks. Of course I am talking about pain that is not controlled to some degree. The DEA, FDA, Government, etc has no business in the relationship of a doctor and their patient. Of course, if the doctor has someone on a ridiculous amount of medications that are proven lethal or dangerous...then, by alll means....BUT, to tell a doctor they cannot treat their patients pain? Total BS!!!!! I have worked in healthcare for almost 30 years and I remember when a doctor was able to treat his/her patient as they saw they needed.....that doesn't exist anymore. Even the dam medical insurance companies are dictating what and how much a doctor can prescribe.Some how and some way we need to fight "city hall." I believe in pain control!!!!!!

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I live in Tennessee and this is happening here starting this month as well... I have done research since my last post and please forgive any auto correct errors since I am using my cell to respond. Here is what I found out so far.. and it's in multiple but all equally important steps. To state the obvious they don't know the difference between long acting and short acting meds so to lump together is quote frankly going to cut me by 3/4 and sadly was just getting to true functional level go figure =(.

1st. Dr's can write however if they do they get audited and threaten to take away licence if they don't like the answers of why we are prescribed. So it says they won't be fined or get put in jail. They will just make them not have licence which threatens their job..

2. They are starting with only some insurances and of course medicaid is first. The people like me that just lost job and needed insurance for my many issues M.S/fibermyligia/slipped L5 disc/post tibular tendonitis both ankles and many other issues.. Poor working class people with jobs that have kids and seniors that are not on medicare yet.

They were sneaky. First they ate using Medical definitions in new law that have been proven incorrect 15 years ago. They also are using outdated treatment terminology to make it fit agenda. They do not have the true definition of addiction listed in law so they are confusing it. It has been proven that people like us are not addicted to these meds they are like Tylenol to use because we use them only to function in work take care of kids and not be bed ridden.

3 The state health department is mandating 3 to 6 URI E specific tests a year. (Very different then the ones you take every time you go in these get sent to lab and cost $650 or more a piece.

4. The insurance company will only pay for 2. I asked if I could pay out of pocket for 3rd and was told he was not allowed to take my payment in cash.

So if insurance company only pays for 2 and state mandates 3 or more. And only if you are taking 120 milligrams Morphine equivalent they are not allowed to see you until next fiscal year since state mandates more he or she can not write without being audited.

I AM VERY AFRAID!

they also stopped covering my adderall that finally controlled the Fatigue that comes with my disease. Not allowed to take that with any opioid!!!

I HAVE HAD THIS THIS PAIN SINCE 1996. I did not start taking meds till pain was so bad I couldn't get up without crying and had 2 toddlers under 4 to take care of. Also I was having panic attacks my pain I was trying to ignore was internalizing once pain controlled those stopped. I don't want to be bed ridden . Why should I have to be because of the true addicts that abuse anything they get hands on and have nothing to do with people like us that are lawful and always have been.

When you break your arm they give you something, it however goes away and you forget pain.

I wanna know if someone beats their legs with a baseball bat till black and blue. And then keeps hitting them every 5 minutes 24 hours a day 7 days a week. Then tell them we have meds that will help you but to bad.. Instead you need to be bed ridden instead of a productive member of society.

Does anyone reading that does not have pain volunteer? Have to do it for 6 months minimum to understand. Make your choice remain in bed or take something and Live Life?

I talked to many M.S patients that are bed ridden..I am not yet.. the only difference they were not given pain meds to function legs hurt to bad to want to keep walking and their muscles became to weak..

I KEEP MOVING BUT ONCE YOU MAKE IT TO PAINFUL TO DO SO YOU WILL MAKE ME BED RIDDEN YEARS BEFORE I NEED TO BE.

NOT SATISFIED? GOT TO LISTEN TO HYPE OVER THE TRUE ADDICTS THAT HAVE BEEN AROUND SINCE BEGINNING OF TIME?..

BACK IN THE DAY THEY USED COKE. THEN THEY SWITCHED TO OPIATES.. THOSE WERE TRULY ADDICTIVE..SO THEY FINALLY MADE A BREAK THROUGH MEDICALLY AND MADE PERCODAN WHICH IS WHAT IS NOW CALLED PERCOCET IT'S NOT NEW!!! GROW UP PEOPLE PLEASE AND READ YOUR HISTORY!!!

SO NOW WHAT'S THE NEXT STEP TO BATTLE THIS BREACH OF OUR PATIENT RIGHTS? YES WE DO HAVE RIGHTS. THEY WROTE A BILL TO KEEP US OUT OF PAIN. HOW IS THIS NOT BREACHING THAT?

RANT OVER. PLEASE WE NEED HELP WITH OUT BEING TREATED LIKE THIS.. STRESS IS WORSE THAN ANYTHING ON PEOPLE TRYING TO FIGHT THE DISEASE THEY DID NOT ASK FOR. AND MAKING US SWALLOW TONS OF TYLENOL THAT IS KILLING MY LIVER TO CALM QUIVERING PAIN IS GOING TO COST MORE IN LONG RUN TO TREAT LIVE CANCER. IT'S HEALTHIER TO GIVE US WHAT WE NEED AND WE TAKE LESS THEN THE GOBS OF TYLENOL THAT DONT WORK BUT YOU ARE HOPEFUL AND TRY ANYTHING.

I AM SCARED FOR SOME PEOPLE THAT ARE WORSE OFF THAN ME. THAT MAY NOT BE AS.STRONG WILLED. SOME PEOPLE CAN'T TAKE PAIN AND THEY MAY WONDER WHAT'S THE POINT?

THAT IS BLOOD ON THE OVER REACH OMG GOVERNMENT'S HANDS IF YOU ASK ME...

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Jenny, I'm not finished reading your post but I'm stopping at the part about not being allowed to take Adderall & narcotics. Is that per the insurance Co, the Dr or the new rules set by the DEA? I'm really not a hateful person at all but I can honestly say I think the DEA and our government in general are the most evil, power hungry, arrogant, freaks from hell. Ok, I'm going back to your post.

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Keikee,
So far it is the insurance company denial of coverage right now and in the PA it specifically states if opiods prescribed or over 80mg if over 20 will be turned down even though I have conditions they say are covered still in appeal process but been denied twice.

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Yes it is a federal law, you can look it up on the Internet. I will try to find you the link and what it states is that 120 mg morphine is the maximum dose for non-terminally ill patients, it also states that you can go to a pain management doctor to qualify for a higher dosage. there's also a table for the different dosages and if you are on a 120 mg morphine equivalent or higher that you may fall into the category of drug seeker and that you are supposed to be psych eval and that you are to be given drug panels up to eight times a year, but is that I will find you the link and try to figure out how to post it. it was issued and put into effect October 2014 and it is a federal guideline, and I do believe it was Medicaid or Medicare. they put the four pills a day 120 pills a month into affect for any combination of short acting opiate. so to get around that at least here in Colorado doctors just upped the dose so same dose less pills and I think that may have something to do with the 120 mg that the feds came out with about 6 months later. but again 120 mg of morphine equivalent is the federal guidelines as of October 2014 and there is also a table or you can look up on the Internet for the morphine equivalent of all opiates short and long acting. you can get more than 120 mg if you go to a pain management specialist and they are willing to prescribe it but that's the only way I know of. And just realize that they are putting their license on the line to go above the 120 mg.

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Here's the link to the guidelines:

ghc.org/all-sites/guidelines/chronicOpioid.pdf

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That previous attachment was a insurance companies website with their thoughts. I am on adderral and subutex. Nothing in the horizon to change any of that in Florida or most of the country. There might be suggestions but no strict law taking away your valid medications.

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Dialysis metabolizes to hydromorphone

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Great response . Its a shame that a bunch of people with no real experience are dictating the treatment of ALL patients.
I live in Florida and the situation was awful a few years ago. We were the capital of pill mills and about 50-100 people were dying of OD every day. It was destroying florida. So the state decided to do something about it. The DA got the pill mills shut down . There are 98% gone now. There is also a statewide opiate register and ever prescription was put in the computer. Its a law now and that has destroyed the doctor shoppers and has helped get a handle on the problems. The state of FL recognized the advantages of subutex/suboxone and it was not attacked like the state of TN.

Thank God that craziness of that attachment / link is NOT a DEA paper. Its a bunch of bullying Doctors and insurance people that DO NOT care for patients and just want to save money. Is like when the insurance company started to get people to wear seat belts. Do you think they were doing to help save peoples lives etc? NO , it was just to save money they were paying out on claims.

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What the insurance companies do/say and what the actual Laws are aren't always the same. You need to do research at the DEA website and with your state statues regarding the prescribing of Schedule II meds. If you can't find it in the Laws, then it isn't a law. Unfortunately, drs, pharmacist and insurance compaines lie.

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