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 5) (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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I haven’t heard anything about the DEA regulations. I’ll have to check that out. My pain specialist talks about the restrictions put on doctors by the CDC, and I’ve researched that. According to the CDC, their recommendations are for a daily maximum of 90 mg MME’s (Morphine Measurement Equivalents is what I believe it stands for). When my Primary Care Physician was no longer allowed to treat chronic pain patients, I had to change to a pain clinic. They immediately cut my daily dose of 180 mg MME to 115. I have neuropathic pain which has remained with me since a fall on the ice in 2012 and spinal surgery later that year. My research on that recently indicates that it takes a larger dose of opioids to control such pain, that dose tolerance is rarely achieved, and that the patients don’t become addicted to the medications.

I was functional in the world under the care of my PCP, but, since changing to a pain specialist a year ago this month, I’ve become homebound. My pain specialist says his hands are tied, and that he already has me slightly above what the CDC wants, although he’d really love to help me. I was suspicious, too, about whether or not he was telling me the truth, so I checked out the CDC regulations myself and found him correct in what he was telling me.

I’ve been in isolation from the world since losing the amount of medication, last year, that I need to take the edge off my pain. This isolation has left me increasingly desperate, so I’ve recently had a new MRI and will be seeing a new spinal surgeon soon to see if there’s anything that can be done for me surgically now. My seven years of Friday-night-dinners-out with my husband’s and my best friends ended in March 2017, as did my Sunday School and church attendance, parties at friends’ homes, shopping trips with my husband, etc. Even though my husband is awaiting double-hip replacement surgeries, he’s still the one who has to do all grocery shopping and cooking. Worse, he misses me terribly. But clothes hurt me so badly that I only wear street clothes now to go doctors’ appointments. I could return to work next fall on the same faculty my husband still is part of, but it takes me a full day just to recover from two hours’ out to see a doctor. How can I work?

I know well the fix you’re in. I’m living it already. What angers me so is how we chronic pain patients have been lumped in with a fake “Opioid Epidemic.” That’s what’s hurt us so badly, I think. This epidemic is grossly misnamed, and I think we all should be fighting against it. What this country has is a “Heroin Epidemic!” Statistics show there’s been a 65% increase in deaths by heroin, yet a 10% increase in deaths for chronic pain patients being treated by prescription opioid medications. We’re being hurt by a misrepresentation of what’s really going on in this country, and I get so angry when I hear that term “Opioid Epidemic” (or Crisis). It’s chronic pain patients who are in crisis by being thrown, without reason, into what illegal drug users are doing.

I’m very sorry for your pain and wish you a better ending than what my life appears to be taking. I could be a productive member of society again, but young people looking for a high aren’t the people the government can save so they’ve picked us as people they can regulate to try to make themselves look like they’re controlling a problem they can’t control — people on street drugs.

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Re: keikee (# 12)

Long story short. I had a prescription which I could not get filled anywhere so I finally went to ER in hopes of getting it filled at the hospital. The doctor, however, called across the street to a Walgreens who had just informed me that they did not have the medication. But the doctor was told it was in stock. So, I waited at the hospital and my friend dropped the prescription off and was told it would be ready in an hour. After getting home I got a call from the pharmacy who informed me that they made a mistake and did not have the medication. So we went back to Walgreens and talked to the pharmacist and explained that it was me that the doctor had called for. She looked at me and told me that I was told more than once that they did not have the medication and it did not matter who called; she did not have the medication.

During our conversation I used the word 'desperate'; as I had been out for days and it was going to be labor day weekend and I knew I would continue to be without unless someone helped me to fill my prescription. I got nowhere and ended up back at the hospital where the doctor finally wrote me a prescription few pills so I could then fill it at the hospital. She wrote for just a few to last until I could hopefully get my prescription filled after the holiday. I had not been home but a few minutes and the Sheriff was at my door. I was told that CVS pharmacy called them because they were worried about me! BS! Although I had proof that I had some medication after the second ER visit of the day, the Sheriff handcuffed me and had me admitted where I spent the holiday in the hospital instead of with my family. Lastly I paid 2 $100 co-pays for the ER visit and more than a $1000 to the sit in the psych ward until I could be seen by a psychiatrist!

I thought I was the only one with such an awful story; I now know I was sadly wrong!

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For your own sanity, stop trying to validate your dosage of medication to anyone. Our bodily systems build tolerances to all sorts of medicines. You could have a condition which processes medicines much quicker than other people.

I’m saying, the only person you need to explain anything to is your doctor and IMHO it DOES sound like he’s running scared from the two diabolical federal agency’s with three letter abbreviated titles.

I personally believe the DEA got CDC to write the letter with the original misinformation that ruined thousands of good people’s lives. I believe they did that thinking job security since their decades of annual billions spent on an unwinnable drug war would certainly have to eventually cost them their jobs.

Defund the police is ridiculous. It’s the DEA that needs defunding.

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Addendum: This new guideline is from 2014! Why is it being Posted as something recent?

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Yeah you can talk about something you know about. There are no laws on the books restrictioning pains meds to 120mg per day. I
Challenge you to quote such a law with reference you won't find it. Doesn't exist. Who ever started this thread doesn't know what he is talking about.

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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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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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dilaudid is hydromorphone already

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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

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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.

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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.

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If I'm not mistaken rulings of a State Board of Pharmacy are considered to have the force of law. When Federal and State regs class — the more restrictive regs win out — an that is in the law. It bothers me having to write scripts for Klonopin as if they were for Oxycontin, etc.

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Mona,
If your old Dr. Does not want to make referal out of state. Just set up aNY appointment with a pcp once you get in and they realize what is needed they will refer you to a clinic some also will take over treatment until you get in at least that is what was done for me at the time. They to said they didn't prescribe when I called and I never asked it was just what they were telling everyone that called. However once the Dr. Sees you if they are a good caring Dr. you shouldn't have any problems. I have seen many doctors over the years sadly there are not many good ones so when you do find one hold on for dear life!. I am an easy patient only if they are knowledgeable or listen and are willing to admit they don't know everything and look up and confirm what I have learned before shutting me down. For example you can take Methocarbonal (Roboxian) and Tizanadine (Mobic) rotating these can take care of different parts of body one helps over all and upper body the other is a skeletal and helps lower body so taking both help's all not just half of you. Some doctors and nurses don't realize it. I have had one come back to me the next time I was in and apologized to me after she researched herself. Now that was gratifying!
I research everything and take true advice and never take first opinion unless verified. Some are very intimidated sadly especially some of the nurses.
GOOD LUCK!

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This is not an official "regulation", it is a "rule" which means it is not technically a law per se but something they can enforce by practice. Each state and certain areas within those states may vary highly as to what the "rules" they are choosing to enforce are. Ther DEA has hundreds of field offices throughout the country and each one functions semi independently. For example, in Houston TX, which is known for its hundreds of "pill doctors" has much tighter rules that they enforce because the rate of abuse is much higher than say...Missoula MT.

The doctor is telling you that it is a law...it isn't technically a law...it is a guideline which the DEA Is making them enforce in your area.

To complicate all that, your state can also make more restrictive laws....

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I would be delighted to see an actual link to a law regarding 120mg of morphine equivalent...issued by the federal government as part of the Code of Federal Regulations that the DEA is to enforce....it does not exist in writing. I am a pharmacist and though they may be telling you so...it is not true....exactly. Please see my other reply

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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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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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P450- your post on pumps & ball(less) drs. is correct- I have now been to enough actual appts. gone thru BP, U/A then paid in full only to be told "Oh we cant do this prescription- you must see a specialist or go to Mayo Clinic or....your case is too complex for this office. WTF??! Either you are not sick enough for pain meds or youre too sick for them to handle... I need a dr. with guts enough to see my stable meds for almost 15yrs saving my life & now am dying on 1/10th of my stable functional dosage. I will be dead soon too nurse lady wonderful- lets pray for all of us extreme cases that are being sacrificed in name of drug abuse, which is not being affected, only us. I wish there was a dr. SOMEWHERE with true grit. Chris-FL dying of intractable, debilitating uncontrolled agony

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I Just found a post and it is on the ACLU website. They did pick up and started a legal case in the state of Indiana. It shows that the case was filed in 2013/2014 and that it's still open. They will need common sense feedback to nail it home! It is about the constitutionality violating our 4th amendment rights on how they treat us i.e. u/a's, etc.. that is a big step and needs to be followed to every state. These are the loop holes the state of Tennessee is using to cut down medications.

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This document must be older than I am, since Preludin was discontinued in the early 1980s and Fenfluramine (the "fen" in "then-fen) at least 20 years ago. Tar diagnostic categories are Neanderthal and very much subject to wide, "Elastic Clause" interpretation. If this is the state of medicine in Tennessee, I feel sorry for the whole state. Talk about loopholes — but they have to be verified by the "the state" (before or after the Rx is filled? Or do you folks leave a kid with runaway ADD/ADHD waiting a month for approval of a non-refillable script??

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