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 3)

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.

REPLY

REPORT

Dilaudid not dialysis metabolizes to hydromorphone

REPLY

Was this helpful? 1

dilaudid is hydromorphone already

REPLY

Was this helpful? 2

Jenny, I too live in TN and no it's not a law. It is recommended to not exceed four pulls a day of anything, though trying to stay at or below 120mgs a day. Now that I am doing my best to comply, my thyroid is shot, I stay in PAWS (post acute withdrawal) and of course as the multiple conditions worsen so does the pain. I just started Levothyroxine for my thyroid and that decreases the effectiveness of oxycodone which, increase thyroid levels so I sat scrap the thyroid medicine and increase opiates by two per day and I achieve homeostasis! Back in the day opiated were prescribed for thyroid and other endocrine/adrenal and hormonal conditions which includes the notorious fibromyalgia which they say is not relieved by opiates. Nonsense! They finally concurred last year that opiates do indeed help fibro and neuropathic pain; at twice the regular dose. Sure it does! We knew that! That's why back in the day it was prescribed for, and this is the technical medical term: things pertaining to women. That would include fatigue, menstrual cramps, pms, fibro and everything else we tell the doc why we need them. What the powers that be seen to have forgotten is that we are the first generation not having free access to them and all this so called bi-polar and addiction is no more than chemical pica which means out bodies are lacking the opiate nutrients our brains need.

REPLY

Was this helpful? 3

Dude I looked it up per your link. I don't know if you are attempting to show how smart u are or how stupid. That sir is an insurance guideline and even it doesn't limit you to 120med. It simply says the 120med guideline calls for a closer look.. I have called Dea myself and they also say there is no such law. It is indeed a pain in the ass, due to people like u adding to it calling it a federal law, there is not such law. Let me repeat a insurance guideline isn't law. We as pain suffers have to band together and fight the discrimination against us. We have to fight ignorance such as yours. Please don't post something unless u read and understand. Thank u.

REPLY

Was this helpful? 5

I've heard rumors of this law but to be honest I don't know if its true or not. I do know that the majority of doctors in practice belong to certain groups for example most Dr's that practice as primary care physicians belong to the Primary Care Doctors of America Association or something like that. There are national groups and state groups. These associations that like I said most all doctors belong to, put out "guidelines" that are to be followed by the doctors that are part of their group. These guidelines are based on all the national, state, and other research that is done. When Dr's receive these "guidelines" they are pushed to follow them as per their obligation to society, their patients, and their colleagues. Guidelines are issued on all areas of practice not just medications. If a doctor chooses not to follow the guidelines the legal risk is fairly low due to the fact that they're only guidelines issued by groups, not laws issued by government. But, due to social acceptance and fear of not knowing, Dr's for the most part do all they can to follow the guidelines. There are also policies that are set by certain medical groups that must be followed if the Dr is part of it and under their authority. For example my ortho Dr works for and is part of an ortho association. Based on their policy my ortho Dr cannot prescribe any controlled substance for chronic or continued pain after post surgical period. If he were to do so he'd be risking losing his current job, office, surgical room, and everything that currently gives him the ability to be a surgeon. He would not however be at risk for losing his license because you have to go against law to risk that. Not just against guidelines or policy. This is just my understanding and interpretation of things. I hope this is helpful. If any of this is wrong or misguided my apologies.

REPLY

Was this helpful? 0

I have been researching Tennessee law.... right now it's only affecting tenncare but will affect others if they are not stopped. Reading and talking to Doctor's what my last post states is very true. They changed definition of the term addict. You can find it at Tn.gov website, sadly it's like they are all working together against us right now.. letter from tenncare just came..making patients aware of the 2 specific u/a coverages. State requires 3 or more. And will not let doctors roll cost... 2 if they pre scribe more they get audited by the DEA and who ever else. They can't go to jail but they are threatening there licences.. my Dr has been trying to fight it but can't loose licence first. I was unfortunately let go from a senority purge at work. Figures this would happen now when I need to function. I have held job in this pain for 13 years. I am not ready to go on disability yet and don't have to be if my pain can be managed.. I know I will loose my ability to walk it does scare me. Buy not ready to give up until that happens. I was told I was going to be in a wheel chair 15 years ago. I started bartending to stay on my feet last job was sit down which was not as good for me buy with heath deterioration don't know of I could go back to restaurants. Sick of people making us pay for others bad habits.. I have news junkies will always and have always been around. Are they counting those numbers? How bout counting ones that give up do to thus bs? They took laudanum in cough syrup form back in day right at the local grocery market.... hypocritical jerks. Sorry for rant I am stubborn! Care to much for people to see this bs.

REPLY

Was this helpful? 0

I also know that certain pharmacies follow this guideline. For example I had just seen my Dr. And received scripts one of which was for oxymorphone 10mg ir four times daily as needed... My regular pharmacy was out of stock so I looked everywhere. I eventually verified by phone that a city market pharmacy had them in stock so of coarse I took my rx there to get it filled. After driving way out of my way to get there, going in to drop it off and waiting 45mins, I expected to be picking up my medication. To my disappointment it was unable to be filled. I asked why and was told they were not allowed to fill rx exceeding 120mg morphine or equivalent due to new guidelines. I was perplexed as to why they would even carry medications that bases on the manufacture recommended dose and usual Dr prescribing dose would by far exceed this guideline and also how I would be able to fill my rx if it exceeded what a pharmacy was allowed to distribute. It was explained to me that this was only a policy that was adopted by city market and not all individual pharmacies. As to why they would even have the meds in stock then I didn't get a straight answer. So I do know that. Hope this helps.

REPLY

Was this helpful? 0

If it was a federal law , it would be enforced everywhere. That pharmacy did not want to fill it for you and gave a reason. All this about limits etc are all suggestions or ideas. No law. The only major law passed recently about this was hydrocodone now being schedule 2. I live in Florida and the pharmacies are real strict and most do not like to add new patients with pain meds. I have seen many turned away at some pharmacies. That is not a law , just a corporate decision. Same with the other morphine suggestions. No new federal law

REPLY

Was this helpful? 2

That's exactly what I was trying to emphasise on. The majority of health care providers, Dr's pharmacies, etc. Treat and abide by guidelines as if they were law. Patients like myself with extensive and exceptional issues that are very atypical and require treatment based on my specific needs and not what most Dr's are used to doing and are directed to do have a very difficult time finding and getting the treatment we needand deserve because providers aren't willing to treat me (us) or they aren't willing to go against guidelines.

REPLY

Was this helpful? 2

Florida was the capital of pill mills till the government got involved. In two years 98% have been. Loses. All prescriptions are entered into a statewide database and Dr shopping is stopped as well. In Fl pharmacists are given a certain limit to how many opiates they can sell. I have been at a number of pharmacies where patients are turned away and they have no alternative. My subutex is easy to fill (thank god) but my other med is a schedule 2 and I had to go to quite a few places to get that filled. It's always about money or being as inconvenient as possible. There is a new problem attracting too little attention in Florida is the fact that all these addicts who are now without Drs and are in withdrawal, are all switching from rx opiates to other illicit substances. The amount of OD's has skyrocketed in the state. It's getting bad and I am greatful to be on Subutex and wish many more would try it for their addiction. They didn't think this one out. Not one cent towards rehabs or anything to help the addicts

REPLY

Was this helpful? 0

I still can't figure out why doctors and nurse practitioners who only have a few years of 'book learning' or prescribing experience would not take into consideration things that folks who survived the 70's had to say regarding our/their opiate tolerances

REPLY

Was this helpful? 1

Spyz, a lot has been learned about opiates and how they affect someone since the 70's. The drs are responsible if the patient dies due to him over prescribing, not if the patient isn't treated adequately for their pain.

REPLY

Was this helpful? 0

Still does not help, no matter how much book learning they get. There is no chart or formula that will solve this. Unfortunately the only concern is money and that's it. I said it before: do you think the insurance companies care about people? They only advertise buckling your seatbelt to save them money, not our health. Same with these insurance committee's and doctors groups, they do not care one bit.

REPLY

Was this helpful? 2

The pharmacist could start a whole new thread on its own. I have always been respectful but know bs when it is presented. I was stuck at one pharmacy for a time due to it being the only place that had my medication in stock consistently. It is scary how quickly things changed. That you even need to be a patient for a pharmacy especially now a days with the computer systems in place is one way of not allowing the free market work its B.S. When I first started taking medicine I was nieve to the stigma in place and in shock at treatment given. However, the first 6 months they were real nice.. soon as it changed I went somewhere else. Then I got stuck when Noone carried my medicine and that is when I learned what was truly going on. The pharmacy has 48 hour grace period as listed in the DEA rules I found on website for ANY meds. The Dr. Is only allowed to write a 30 day.. and the lies and excuses they come up with is amazing to me. They make me run out of medicine completely 31 days all the time. Swinging finger on calendar I ask them why I am not allowed to take my meds on day I am prescribed since they run me out first. Had one melt down after I came in with DEA rules and admit it was company policy told him I did not like being lied to about things and to fill it! However I have not been told they won't fill over 120mg that Is not the pharmacist say or place.. besides due to privacy writes they don't have our diagnosis on file..... how dare we be allowed to walk if we are in pain. A friend of mine just had her meds changed, she uses a different pharmacy and those jerks (she has been same place 10 years) had nerve to tell her that they wouldn't fill due to fact that medicine being changed considered her a new patient and they were not accepting new... that floored me! I thought it was bad enough where I was. This is a issue that needs to be fought as well. The solution of this all is bs.

REPLY

Was this helpful? 1

LOL Due to hyper metabolism of oxycodone with phenytoin I was taking 450-600mgs a day of oxy, I asked for six a day so I wouldn't run out (this was before we knew how the phenytoin affected oxy) the NP said, "but if I give you one more you could die or get addicted!" That's when I had to bust her nut and tell her I'm already taking about 15 more per day. People are NOT overdosing! They are committing suicide! Now that I'm compliant with phenytoin gone and my dose dropping,not a day goes by that it's not considered! Really is this how I would have felt the past five years on just four a day? This is not living and is already a slow dragged out death. One doctor asked me why would I intentionally take 6 a day and run out? I told her I would rather have three great weeks and one sucky week, than every week suck! And now it does! I'm having to quit school and do nothing but lay on the sofa crying and honey that's no quality of life! Put me back on phenytoin, let my metabolism go up and let take 15, 30mgs oxy a day again! My body was in perfect homeostasis and now it's falling apart. To those of us who have proven there is no detriment at a higher dose, give it to us! We have to pay cash anyway cause ins doesn't pay.

REPLY

Was this helpful? 0

John you are so right! And pain doctor only have a few extra hours in a class with a test to take. One that I and other pain patients have taken. There are a ton of medical sites that have the Risk Mitigation test, the SCOPES, and more and it's all outdated addiction bs. Addiction is chemical pica, meaning our bodies don't make enough of that substance to begin with. They don't take into consideration EDS either. Too bad Colorado so far. Ohh I hate pot and quit for a reason but it work for pain

REPLY

Was this helpful? 0

I think this sounds like the Washington STATE Law. There is currently no Federal LAW with regard to dosing. The Washington Guidelines have wreaked havoc for pain patients despite Washington State celebrating their success. They DO at least provide a pathway (though it's very much discouraged) for patients needing higher doses. The CDC GUIDELINES (won't have the force of law but will be a stifling nonetheless) in their original form called for doses less than 90 morphine equivalents (preferably 50) for primary care providers. Patients (and physician/nurse groups) worked very hard and CDC SAYS it heard us (but then again this whole thing was very shady to begin with so I don't trust them at all) and that revisions are being made. I'm hopeful but I'll believe it when I see it.

REPLY

Was this helpful? 0

Posters,

As a professional nurse and published researcher with over 400 intractable pain disorders, and who will die without a new physician in days it is FDA a regulation they are ADVISING and all physicians due to the DEA witch hunts are compliant. I had the top specialist in America let's call him Dr. Famous in California and he let go 30 out of state patients over 10 months ago. I am seeking a physician in Texas, Louisiana or Alabama. Any good ideas? I have ultra rapid opioiod metabolization and was on $25,000 a month of Duragesic and Oxy liquid (pills do not work for this DNA).

Unfortunately we are all being thrown under the bus. I suggest if you like most pain patients start putting away medication start working downward.

Editor's note: We do not verify the credentials of our users and nothing stated in our forums is intended to be taken as medical advice.

REPLY

Was this helpful? 1

In addition to what I just wrote Odumma is behind this.

Insurance companies have NO SAY (nada) on what these huge pharmaceutical companies make money wise kicking off to multiple federal agencies--the real profit is there people and us needing opioids works for them and they have more control.

Because the FDA did something to protect all the OD DEATHS which 99.9% are people NOT PRESCRIBED using our medications (physicians who are pill mills and pain patients selling or leaving drugs around are the culprit) we are all at risk of death.

REPLY

Was this helpful? 0

Anne , the FDA regulates prescription drugs not the CDC. It will be interesting to see how this plays out. On the other hand since these Recommendations/Guidelines are not actually law it will be up to each individual dr to decide how they want to prescribe for their patients.

REPLY

Was this helpful? 0

My family doctor is no longer able to prescribe my pain medication, and has referred me to a pain management doctor that...

21 REPLIES

I live in central new jersey, and lost my dr. of 10 years. I did 5 years in physical therapy for some issues. I am now f...

54 REPLIES

I have a bulging disc and go to Kelsey Seybold as part of my insurance plan. I took ultram or ultracet for 18 years when...

2 REPLIES

I just moved to Ocean County NJ from North Carolina....I have had 2 failed back surgeries and 1 failed neck surgery and ...

1 REPLY

I. need a pain dr that will prescribe pain medication without insurance. I had been going to a pain dr for 6 years becau...

5 REPLIES

many years ago i had a very bad car accident. i was in traction and did physical theraphy for a year. i had severe neck ...

9 REPLIES

Looking for a doctor to prescribe me Vicodin & or any narcotics near flint mi 48458 have meridian insurance ## I hav...

3 REPLIES

I've been suffering from chronic back pain for years due to fractured vertebrae's a compressed disc and a hernia...

15 REPLIES

Hi there, I have spinal stenosis, 2 herniated discs, and five tears in different discs, don't want surgery, looking ...

11 REPLIES

I need a Doctor that will prescribe adderall or other ADHD medications in Portland, OR. I had a script before I moved he...

10 REPLIES