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 31)
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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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125

Joey,

Under Odumma established pain patients after the first year when once monthly visits are required must be seen every 3 months and are to take 3 months of scripts with them and write "not to be filled until" they are not post dated.

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124

Pharmacist,

They have shut down most of Houston, and the list grows daily of physicians who try to do chronic pain in Texas without pain clinic certification.

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123

Joey,

Anywhere in the country works. I'm in dire need due to my complexity and P450 even with my credentials I am at the point of having to end my life soon as it stands I had almost enough medication saved for this physician had us keep a percentage probably due to this type crap to taper me to a state where I am housebound. I cannot function and continue living at this rate.

If I cut again my renals will shut down, you would think my peers in Texas would care but the FDA suggestion has too much outcome.

For the pharmacist perhaps you know someone in Texas who can help me if you've kept up on my posts. I had Dr. Famous in California after my Houston doc of 10 years died. I am complex. He dropped 30 of us out of state due to new California regulations.

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122

Once again....I said that the DEA uses local guidelines, which they invent at will because each regional office makes up their own rules - not laws, but guidelines of practice. There is no FEDERAL regulation regarding maximum amount of controlled substances of ANY type and ANY agency using that as an excuse for investigation is lying...that said, it does not mean that they will not investigate, nor that the physician or pharmacist will refuse the prescription, patient or otherwise. The point being, it is not a "LAW" but a guideline which are unpublished, subject to interpretation and in all cases non-binding. Unless it is part of the CFR, or part of the pharmacy regulations, it is not a LAW - it is a practice that you still will not be able to get around.

EVEN when the FDA makes labeling requirements and warnings - it does NOT prevent a physician from doing otherwise and ALL "guidelines" are just that, guidelines - not laws.

Arguing otherwise simply shows that you have not had a course in DEA and pharmacy law - and are confused about rules, regulations, guidelines and laws - and the state and federal agencies which make such - different from individual DEA offices, FDA inspectors, pharmacies, physicians and insurance companies.

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121

The DEA and State boards of Pharmacy do NOT issue guidelines in these matters. When it comes to what you call guidelines I and every MD , DO and district attorney in the country calls "Regulation with the Force of Law". There's are underlying enabling statute(s) and the penalties are the same as for criminal offenses and ethical violations. (The basic difference: a judge can't suspend a doc's license except as part of plea deal. The DEA or state board? They suspend or revoke in a New York Minute upon the presentation of valid, substantiated charges.)

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120

DrJoeyMDPhD, no hard feelings. I have RA and nerve damage in my hands and sometimes typing is more difficult than at other times. My mind knows what to type but my fingers don't always coorperate.

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119

BL - The original poster said that they were told it was a REGULATION. I did NOT say this.... in fact I said the opposite. It is a guideline....a rule, which different DEA offices can choose or choose not to decide to pressure docs to comply with their ideas. Many doctors, many pharmacies will say it is a Law to get the patient off their backs. It shuts most patients up and makes them go away as they are powerless to argue. Once again, read my comments and see clearly I said it was NOT a law.

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118

Regarding Houston...I personally know people from my old neighborhood who make their living by going to pain doctors every single day of the week - I know of 12 individuals who pick up homeless people to take as "patients" to pill docs every day....and who did so every day of LAST WEEK....your information about the pill docs being shut down is simply wrong and frankly delusional. They have been tightened and there are a few hundred less but there are still hundreds there - and hundreds of pharmacies filling prescriptions. As for Montana....it was by comparison as an opposite to Houston.

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117

Thanks, Spyz

Never heard of that procedure. I will check it out on Utube as you suggested! I will also ask about the other drug yoy mentioned if I am ever able to get into a PM doc.

Thanks.

Sylvie

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116

Thanks, Spyz

Never heard of that procedure. I will check it out on Utube as you suggested! Thanks.

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115

Thanks for the link. I've done this a few times myself, so I don't have to look it up. My shrink and old friend has done the same. I WILL NOT ask him to lie and put the ADD/ADHD or Narcolepsy codes on on my Ritalin scripts. (Ritalin boosts my Prozac and Effexor's efficacy; I'm a tough guy to treat,) Thanks for the correction. You understand how that first post sounded, I hope. No hard feelings!

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114

I've been trying, but we can't find anyone taking new patients, even from me. I know you have all your docs and your creds are away more impressive than mine, but NYS is like the Sahara when it comes to treating real pain. My CII scripts for opiates are filled in my hospital's pharmacy and they don't look too closely at MY Rxs. I'm going to do a county-by-county search with the help of the NYS Medical Association next.

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113

DrJoeyMDPhD , my apologies. I meant to write that a dr can write up to 3 30 day prescriptions for a Schedule II med without seeing the patient. That would last a patient 90 days. Federal law states that a dr must see a patient at Least once every 90 days if they are taking Schedule II meds for chronic pain.

VALID PRESCRIPTION REQUIREMENTS-(See-Issuance of Multiple Prescriptions for Schedule II Controlled Substances)
http:/­/­www.deadiversion.usdoj.gov/­pubs/­manuals/­pharm2/­pharm_content.htm

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112

Joey,

If you know a pain specialist I am in dire need I have all records and came from the top specialist in America.

You never got back to me on this I will get on a plane to save my life whats up with all that?

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111

Unfortunately, my friend, state [pharmacy rules and regs have been he;d to have "the Force of Law". I didn't believe it at first either, but as a onetime "Expert Witness," I have friends in overalls DA's offices and they got me an "on paper" binding legal opinion. Unfortunately, we don't get to VOTE for the people who put theses "rues and regs" in place.

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110

Chris,

They can ship it out to the lab in Tennessee that does the LE, sports figures and not only get extended knowledge but a fixed report.

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109

Pharmacist?

If you knew Houston or Montana you'd know Houston is cleaned up years ago before this crap and Montana is one of the driest states in America and harder on those in pain.

Now those on pumps (which I was considering due to this life threatening crisis for me) because physicians are not making enough money doing refills need I say more between paying physicians incentives to let chronic cases die, this is all Odumma.

This is not about the poor either its about prejudice!!

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108

Posters,

As most know my background I need not repeat. MEDCO has been doing this prior to change that was put into effect under the shady auspices of Odummacare. Try it, you'll see it happen. Physicians warn you directly not to call back and use one pharmacy for a reason--they are overwhelmed by the power given pharmacists.

My rare case is being chicken s***ted on by so called physicians who although 120 mg. equivalent is NOT law are too ball (less) to stand up have heard of several other rare patients as myself being left to die.

When the tides turn in a few years we will be dead, you easy guys who need a few pills will get by, not those like me.

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107

Calling people in true pain that are pleading for help whiners and complainers is unfortunately very shallow minded. I have not broken to that point yet however pain that in unbearable 24/7 can wear a person's patients and until you have walked in thier shoes tread lightly on manner of speaking. Also the ones in true pain barely complain. The ones that may not need possibly do.. everyone is individual and only people that are caught breaking any kind of law should be treated like we are being treated now. All of us should not be treated like criminals for having pain we would rather not have. Also the meds have been around how is it that only now after 100 years is it just now dangerously adictive? Sounds like hype to drive price and contol. And impliment death panels on the poor.

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106

MellexRx, 120 Morphine/Morphine Equivalent Daily is the FDA Guidelines, this is Not law. Although most drs are going by it. And unfortunately many drs chose to lie to their patients and tell them that things they do are because of new laws instead of because it is what in their professional judgement is best. Although with the way some chronic pain patients whine and complain I don't really blame the drs.

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