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 35)
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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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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.

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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.

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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.

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dilaudid is hydromorphone already

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Dilaudid not dialysis metabolizes to hydromorphone

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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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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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Dialysis metabolizes to hydromorphone

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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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Here's the link to the guidelines:

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

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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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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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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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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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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 agree 100%. Nothing like this in Florida or anywhere

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This is nationwide. Australia is nice . . .

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

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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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