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) (Top voted first)

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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Vernon or Anyone- Do you know of ANY legitimate providers in or within 100 miles of Knoxville? My provider was recently indicted in the now defunct Broadway Health of Maryville money laundering scam which occurred in 2009-2010. I thought I had done my due diligence when I decided to use Serenity Health in Alcoa. I asked the principle provider if there was any reason she would not be around a year from now. Of course she said no. I am a legitimate & compliant patient who wants to.do the "right thing" & it seems almost impossible. I would appreciate help & guidance. I am at my wits end & need a provider who accepts self pay patients & doesn't charge an arm & a leg for services. Thanks

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Hello, Grace! How are you doing? I'm very sorry about what happened to you, that's horrible.

I wish I knew of a doctor there, but unfortunately, I don't. I'm in the Pacific Northwest, so quite a ways away.

Can anyone recommend a good doctor in that area that can help Grace? Pretty please?!?

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I am going through the same thing in the state of Oregon. I don't know if it is a law here, but it is creating havoc with my mental health as well as with my chronic pain from two back surgeries that haven't done much. Have you learned anything more about if it is a state or federal law? I am thinking about moving from Oregon and I am scared to death that I might have to leave the country....hi my name is Samantha I am Eileen's daughter I just walked in and she explained to me about your post I sure hope this post finds you well I am really worried about my mom and any help you can give us would be really appreicted I'm am just at a loss when it comes to giving her any advice because I really need more knowledge to be sure because this is my mom whom my god I love dearly our prayers are with you thank you sincerely Samantha

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Chris, I think I know which group you are talking about. Thanks for your post.

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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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Posters;

Rereading this before the end of my life occurs. Many of you know my background and I want ya'll to realize this is not just 120 mg. it is a morphine equivalent. Do not think that adding up milligrams on various opioids will give you a total it will not. For example 50 mg. of Demerol IV is about the same as 3 to 5 mg. Morphine IV. A conversion chart is used for many of our long acting medications are released at a different rate.

For over five years I was seen by Dr. Famous in California the best there is alive at this time; my best died was with him 10 plus years and he was on top as well. Only rare cases are seen of suicidal level pain and mine has embedded in my memory or in my brain which shows on lab values moving me to Central Pain Syndrome. I am also an ultra rapid opioid metabolizer as shown on P450 testing. I was dumped along with 30 other out of state pain patients and now 10 months later only because I put aside a percentage monthly which he had us do am I alive barely and now am at the end.

Odumma is subsidizing incentives as it stands for physicians to stop treatment of chronic illness. Your state may have further limitations. This will pass but when it does many of us will be dead.

I hope the best for all of you. if you still have a doctor do not let go. stay with him right now. do not offend or drop the doctor. The reason the FDA recommendation occurred is due to high overdoses with death NOT by legitimate pain patients who need this medication. Due to those who sell their pain medication for extra income, who leave it around where people can take it in short TO PEOPLE IT IS NOT PRESCRIBED and again we are punished by the government operating under killer Odumma and too little will be too late.

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Addicting? Who cares? We all have to take them the rest of our lives anyway! Ive been taking oxy for six years and my personal dose, although not what Im prescribed, has not risen the entire time. Its still the same. Read BiPolar and The Opiate Cure by doctor Robert Cochran, his patients asked for more and more and he gave it to them. It got to where it reached what worked and the increases stopped and stabilized and they didnt ask for more increases. Pain patients if left on their own will ask for more until adequate relief is got, then they are able to stick with that. They wont tell you that cause they give it to you in such small increases to create addiction but relief doesnt come. Doctors by fear of addiction are creating addicts by teasing them with small amounts. I say start moderate to high and if the patient is too sleepy then lower it, other wise this mess will continue. Do you really believe that many folks are overdosing on their prescription pain meds. NO! Other folks are on meds they stole or obtained illegally. Patients are dying by committing suicide on opioids cause they are sick of being played by this corrupt system. We should be able to consume cannabis or drink poppy tea or whatever works best for us. We are not all the same.

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BL, there is currently no formal guideline in effect through the FDA or otherwise that establishes a dosing threshold NATIONWIDE. Several states, starting with Washington have implemented them though. Some are guidelines, others are binding and require a specialist consult or other measures be implemented if the threshold (which varies but range from mid double digits to around 120mg (sorry on my phone don't have the table in front of me right now) is exceeded. These have really been devastating for patients. The PROP Petition to the FDA asked for a labeling change that would have involved the 120mg figure. Thankfully Jeff Fudin, PharmD established PROMPT to counter PROP's efforts and the petition failed (except for minor changes like "pain severe enough to warrant around the clock treatment" as opposed to "moderate to severe pain". After failing with the FDA, PROP joined with the CDC in efforts to establish guidelines that would actually be worse for patients in some respects than the original PROP Petition. HB 2029 was signed into law last week and a provision requiring the VA adopt CDC's guidelines once finalized was included. WE DESPERATELY NEED PATIENTS TO GO TO THE LINK INCLUDED (or google "comment on CDC opioid guidelines"if the link is scrubbed or not allowed) AND COMMENT ON CDC's PROPOSED GUIDELINES BY JANUARY 13, 2016. I truly feel like I'm fighting to keep my life because of this. CDC says they guidelines are voluntary and aimed at primary care, but in this current climate of fear, they will be devastating for legitimate patients, especially those who truly benefit from higher doses due to metabolic defects.

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I get a lot of feedback from my late, beloved Mom's elderly (80s) friends complaining about the adverse effects of methadone. Those in assisted living with licensed preribed on board were the easiest to deal with. I don't flaunt my creds unless I have to, and these ladies are more comfortable on Dialudid, and some of the newer narcotic products, such as Opana. I wrote an opinion as if I were asked to do so and recommended a therapy change. It's always easy to mention "psychological adverse effects" for an experienced shrink with an 80 year old patient, IT'S NEVER ONE SIZE FITS ALL. I never charge. My Mom would want me to do this; I know that for sure.

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I am in NC and I was told about the same, I was told up to 200mg per day,per person, but another doctor, says he knows nothing of this laws (this doctor doesn't do my pain medication ) just to let everyone know my God this is the worst thing I have ever went through I feel like I am defending my self all the time ( I am not a drug addicted) just in PAIN, If you do find answers please post need to know.

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Jenny-I have been on Endo Patient Assistance over 4 years until last month got letter they have DROPPED THE PROGRAM! No explanation why, plus only for Opana products nothing else. Hmmmmm. sounds too fishy that DEA has been there??!! Or at least scared them etc. All 17 years of patient assistance programs I have been involved with I NEVER heard of a pain med program just being dropped like this. I am in process of switching back to Oxycontin with Purdue Patient Assistance Program which was with over 10 yea & never any probs. Except they cert letter me would no longer accept my pain dr. scripts so needed to change drs. but couldn't find new dr. so I went to Opana er & the Endo Program which just quit. IDK if Purdue stops too I can afford since ins. not pay & cannot afford $10- $15 per pill. Exalgo was $45!!!!. No one can pay that!
Pain relief to us all......
Chris,FL

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Joe992d , The FDA Guidelines are 120 mg Morphine Daily. The American Pain Society had 200 mg Morphine Daily but that came out before the FDA Guidelines did. The drs that are prescribing 200 mg Morphine Daily won't be doing it for much longer.

Jenny, that i a standard reply that you received. Politicians don't read their correspondance. They have an aid that reads it and then if the aid that reads it thinks the politicians needs to see it they will forward it to them.

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Always wishful,

Here is what I got, however I have not had a chance to respond back yet.

February 22, 2016

Dear Mrs. *******

Thank you for contacting me to express concern for the treatment of patients who suffer from chronic pain. I appreciate your views, which help inform and guide me in Congress.

As a physician with more than 30 years of experience, I believe that every patient must be treated with respect—individuals with chronic pain included. While we face a growing epidemic of prescription drug abuse, that does not change the fact that some patients need these pharmaceuticals to improve their quality of life.

Please rest assured that I will closely monitor developments related to this issue.

If there is anything I can do to be of assistance, or if you would like to receive my e-newsletter, please visit roe.house.gov. Again, I thank you for your opinions and look forward to serving you. Please do not hesitate to contact my office in the future.

Sincerely,

David P. Roe
Member of Congress

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I feel your pain! Pun intended.... I have been on pain meds for 25 years. I am a 60 year old professional and now consider alternatives. No wonder the H rate is skyrocketing. I would sign a petition or donate to the cause. I too have never abused the drugs.

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Chris,
I wish you the Very Best.! KICK ASS IN FLORIDA!! That IS the State where it all began...I know because I lived there a total of 50 yrs. I temporarily moved to N.C. and soon, must decide where I want to live the Remainder of My Pain filled Life. Being a 60 yr. Woman,with 100% disc degeneration, a 3-Level Lumbar Fusion... Just diagnosed with fragile Bones due to Severe Osteoporosis of the Spine, the Best place for me would be near Family & Friends. Unfortunately, they ALL live in Florida, an Entire State Suffering in Pain. I will NEVER return to my Mother's Home, where Moss hangs from the Tall Oaks in the yard, and Memories Return of a Wonderful Life before EXTREME GREED took over the Land and a New Order and Way will leave millions, looking for Death to End the Agony of MisTreatment and PAIN.!
Those who chose to Condemn Others to a Life of Pain, will One day find THEMSELVES In Similar situations, with NO HELP on the Way..... .

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BL-Yes Dr. Tennant tells patients save meds for emergencies. Need protect against situations beyond normal control. Only makes sense if you not want jeopardize witdrawals or worse. Apparently your pain s not that dire or you would see how this makes perfect sense. My pain levels are such when I obtain even a shred of relief I thank everything there is - I honestly do not know how I am still (semi) sane. My organs & systems are being damaged more & more by undertreatment stressing entire body so guess won't need keep sanity too much longer anyhow, my body is going due to this constant attack.
An old pill is better than zero when in my condition:(
Chris

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I became a shrink partially because I abused pills big time in high school and college. We didn't know much about MOOD DISORDERS back in the day. I'm careful regarding what I prescribe for my teen patients, but don't deny them the drugs they need.

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I think the government has over stepped it's authority with this. People need this medicine and can't get it because of door heads and pushers. They need to crack down on this instead of suffering people. They've got their nose to far up my ass and not doing what needs done. But that's the way it works, sick get worse and pushers get rich. What a mess.

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Pain meds. They come and go. They dropped me from 130 mg. of methedone to 75 mg. This is inpart the fda, state and federal gov.,who decide if and when they will begin using this possible recomendation until the FDA makes it a recall or Ammends its current requirements.
Drs. Can use this to their discretion to profile patients as addicts or those who they THINK are truly in severe pain. Apparently, they profiled me in the "addiction" category! Weined me down in 2 months. Sorry about your pain. Too bad everyone doesnt have real compassion! Take care.

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Hello, I've been a Critical Care Registered Nurse and Clinical nurse specialist critical care/trauma for 30 years. I'm currently disabled from an adverse medication side effect (nonopioid). I have other health issues but what recently dropped into my lap is lovely peripheral neuropathy. It has become the focus and bane of my life and I'm livid regarding the draconian changes that are being made. What people say here is mostly intelligent and right on the money. At the time I was diagnosed with PN 5 years ago I just cried and cried knowing at that time the only thing that could be done was to live a life on narcotics. I knew it wouldn't be much of a life. The person that said chronic pain patients are the collateral damage to these unrelated drug overdoses is so correct. I think it's very important to be out and vocal about your needs and what works and doesn't work. Giving up is the worst you can do for yourself and others. This takes energy which has been sapped out of us from pain. Fortunately there is hope on the horizon for me and no opioid treatments. But I still want to be an advocate. I'll never forget what my undergraduate nursing instructor told me as I was on the orthopedic floor of a local hospital. She wanted an update on my patients and I rattled off a bunch of things all with the same level of urgency or need. When I mentioned so and so has pain and she has a history of "drug seeking". A term which is used loosely and is unfair. Anyway, she stopped me as I began getting dinner trays and said get that lady her pain meds that is your first priority. I was but I was getting her dinner too. The instructor made common sense when she explained the urgency of treating post op pain first and not to worry or council about drug addiction because I couldn't change anything-pain meds were required here. But to let her know that later at home it might be difficult getting off the pain meds. I didn't understand this but that's what I said and the patient understood. We've or health care and government intrusion and law has warped common sense. An addict post op will have the same or more pain post op. Are we treating pain or addiction here? Common sense to me says pain treatment is ALWAYS a priority over addiction. One way or another the addict must get treatment for pain just as the non addict and so it is at home and throughout the clinics. It's immoral to let someone cry in agony even if you think they will get hooked on the pain med. Getting off the pain med can be done later but those of you that know pain as I know pain on both sides of the aisle so to speak. -don't mess with pain treatment. Pain treatment outweighs addiction fears and rufusals to treat by an infinite degree. Pain is now, addiction is later and can be dealt with and isn't the end of the earth and can be healed. The overdose demographics have nothing related really to chronic pain patients except suicide. I'd say coronors are not writing suicide in the books to spair the family pain. You know this happens. It's the invisiable elephant in the room at CDC. If you get an addiction label of any kind, in health care, you are not offered many of the best treatments available to others. I've studied extensively on this subject and have lived it and what is happening now is quite strange. The pendulum has swung so far the other way itrs beyond rediculous. It was only about 15 years ago I went to a seminar where the intructor warned health care providers that they can be sued and patients can win if they say they didn't get adequate pain treatment. Where did that idea go?? I'd say bring it back and be your own best advocate. Only you know truthfully, if given the education what is best for you and nobody has the right to invade your body with U/A's to determine if you are telling the truth. U/A's are costing this country billions of dollars per year. For what? The outcomes do not warrent the cost! The military alone has a stagerring budget in the billions for drug panels. We need to treat every one the same the best way we can and let the cards fall where they may. Pick up those cards and carry on without this horrendous collaterol damage to innocents.

I had planned to just reply to the person above this post that what you are are saying isn't really the case. It can be hypothesized but it wouldn't be the reality. Now MD's have given up thier leadership, power, and art so much so they all can be replaced by computers that follow a protocol just as well. The only thing MD's should have been offering is what computers can't. Compassion, understanding, ingenuity, bravery, advocacy, concern and know how when nobody knows how. It's so sad to me to see that the attorny's are dictating healthcare now without a license to do so. I read an opiod patient agreement which on every line said we will take away your paiin meds if you do this or don't do this. Having no understanding of the sequala, It looked like it was written for people in prison. But, that's what we are. Aren't we? As long as someone else has control over your well being, energy and mood and joy of life. They've got the power and ability to torture if they feel they must. That is why I am seeking any and every alternative to opioids. I want to travel and not be tied down to the whims of a doctor or lawyer or senator that doesn't have a clue what chronic pain does to ones soul. I could go on but I think I've said my point. Hang in there, don't let them win on the cost of your happiness and freedoms. I say we need to organize, challenge and breath common sense into all this idiotic fear.

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