I Have Been Taking Hydrocodone 10 And My Doctor Just Changed Me To Acetaminophen Codeine 3 (Page 3)

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I have been taking Hydrocodone 10 since March for RSD the doctor changed me this week to Acetaminophen/cod3. The doctor said that the law made it where he can not give the hydrocodone any more. I want to know if they are the same? I was told they are the same. I'm scared to take it because I have sleep apnea and a real sensitivity to codone. I get breathing problems and rashes. Not sure what to do at this point. I can not take most opioid drugs.

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41

I use the level of discourse called for by the situation at hand. As a clinical professor at a major medical school, I never expected anyone else to do my homwork for me. If you have Lexis/Nexis Access, try it out. And I did have a 4.0 average undergrad and in my PhD program.I'd be lying if I said I sailed through med school with the same ease. My grades were god, but I didn't graduate n the top 10 in my class. Seriously, you're talking about hours pf research. I get paid — ad very well — for my time. Ive been home for the summer because of a bizarre accident in my condo's paring garage. Level f discourse does not necessarily correlate to a person's educational accomplishments or degrees.

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42

DrJoey, the reason I asked for the references is because often pcps will tell their patients that they can't prescribe pain meds because it is a new law, which isn't true. Unfortunately, many people believe what they are told, especially by a Dr and they won't take the time and energy to check it out themselves. I have researched a number of states and so far I haven't found one where a Dr must be a pain management Dr to write pain Med prescriptions. It is the choice of each individual Dr what they do and don't write prescriptions for.

Personally, I find it strange that you have prescriptive authority but don't know the laws in your own state. I also find it strange that another Dr puts his career and license on the line for anyone, friend or not. The federal regs are clear regarding Schedule II pain meds. The Dr that writes the rx must see the patient and have a Dr patient relationship with them.

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43

I could look them up, but shrinks, especially with as many certs as I do, can pretty much write for anything medically necessary. I don't write very often for opioids anyway, and I have the decades-old informal waiver that allows us to prescribe psych drugs according to our best judgement. If I had a specific question, I'd call our Regional DEA Office.

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44

A patient doesn't have to be seen in order for me or anyone to write a C-II script. That prescriber was from NJ, where the regs always have been looser. CS Regulations HAVE THE FORCE OF LAW; they are not laws unto themselves — but that's semantics. Btw, I knew that doc casually; his son was one of my best Residents. WE'VE ALL COVERED FOR COLLEAGUES AND WRITTEN ALL CLASSES OF CONTROLLED DRUGS without consequence. I don't think a 40-year veteran anesthesiologist's one script for Dilaudid and a half-dozen Dialudid-HP Unit of Use Syringes would even be noticed. You have DEA paranoia and I know he did the paperwork for me ass a private patient because he emailed me and asked me to complete some forms - med hx, etc.

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45

Well ive got bad (grammar) and ive always had a 3.8 gpa or higher of any class i took so your wrong. The only time my grades have ever suffered becouse of my grammar is the 12 year's of school you go tru when your a kid. It has never influenced my grades in any college iv been to. so you can keep thinking what you want but the fact is i have a 4.0gpa and i have bad grammar. Pluse i know lots of other peaple that have bad grammar that also have a 4.0 gpa or graduated with 4.0 gpa so im sorry to tell yall this but u wrong. when you have s*** to get done know one cares about grammar they care how good you are how much money your making them. Atleast for the feild im going into; chemistry. If i were a writer or was studying in a feild that grammar matters id care more but im not. if i am required to have proper grammer i can certainly take the time and do it but 99% of the time thare is no time in my work. Pluse anybody with half a brain can figure out what im saying.

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46

You can check Florida's CS regs. My brother is a Cardiothoracic Surgeon/Interventional Cardiologist and he DOES (or DID) write for C-II narcotics. He's SO professional that he asked me to examine his wife and her headache profile and write for whatever I thought I was best. (I have a FL license; truly, any i**** can pass that exam!). In fact, he was a very conservative prescriber, but opted to retire this year at 65. "I have enough money and no more tolerance for bulls***, but I'll keep my license and DEA Registration". Ultimately, I wrote for Tylenol #3 and Valium 2mg. What keeps the bad guys working and selling scripts and pills is "cooking the medical records". I would have to check the Federal Register to see if any of this made it into Federal Law. Suggest you try, too. It's not too hard to get around.

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47

Federal law states as well as individual state laws that a Dr can't write a rx for.a Schedule II meds with seeing the patient at least once every 90.days. A Dr also can't write a Schedule II rx for a patient he has never seen. That said, in some teaching hospitals a Dr with their DEA # and CDS License can write a rx for a pt if the medical professional isn't able to. But those situations are rare. If a Dr has a relationship with the patient they can write a Schedule II rx if they have seen.the patient recently. Although this is rarely done.

If the patients you are talking about are terminal, the laws for chronic pain patients do not apply.

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48

That wasn't the case in NJ 10 or so years ago. And we have Exception Codes for C-II Amphetamines and Ritalin for ADD/ADHD or Nacolpesy; for Xanax for Panic Attack Disorder w/ or w/o Agoraphobia. We can write for 90 day supplies in each instance. There's an opiod exception I don't deal with that except for having signed off as Chief of Psychiatry that one of my pt's conditions and painful and terminal. The Attending Doc handles the paperwork. Doesn't happen very often in psychiatry, but when I'm covered for my Distinguished College, the Chief of Neurology, I have had to review files and sign off.

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.

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49

You cannot be issued your own DEA Reg No. unless your first are a full licensed physician. Otherwise, you're using a hospital's license and DEA Reg #. Where in federal law did you find this? It's good practice, for the most part, but I"d like to see the Black Letter Law. (I've been home close to a year in the aftermath of a bizarre accident and I'm much improved, but I may need pain meds ad infinitum; these are arthritic type pains and probably caused by injuries sustained when my hips was dislocated. I'd NEVER expect ANY patient to sacrifice his LIVE on the altar of bureaucractic psychosis and I won't take toxic doses of APAP, as one truly idiotic cardiologist suggested. He thought I was "only" a PhD. I told him otherwise and mentioned I attended better schools than he did, I was unequivocally smarter and for his statement, "I"m not going to be your drug supplier," he will have to answer charges before the Disciplinary Unit of the Office of Professional Conduct. It will cost him 10K to fight this charge, or he could take a License Suspension of about two years. "And if you don't think I have the juice to do it, just try me. He glared at my Crucifix and Miraculous Medal I wore with a quality t-shirt — easier for cards or pulmonologists to work, but this clown NEVER physically examined me and THAT'S another violation. I can't take methylprednisolone or dexamethasone-type drugs p.o. or by any kind of injection because I"m a Type 2 Diabetic; NSAIDs are out because I take Coumadin. We'll find the least potency and most effective drug, regardless of how its scheduled. My orthopedist is perhaps the best in my state and he IS an Orthopedic Surgeon. Whatever we decide will be written for and filled.

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.

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50

DrJoey, Schedule II pain meds for non.terminal related pain can be written for 90 days at a time, 3-30 day rxs. Although few drs chose to write them that way. The federal laws and most state laws governing Schedule II pain meds are different than those governing other Schedule II meds, like ADHD meds. The Dr doesn't have to see you.at least every 90 days for ADHD meds.

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51

My big bro, who is a cardiologist is Florida, said its on the books, but he's not sure whether it's state law on Pharmacy with the force of law. His wife gets infrequent severe migraine. He had to send her to Anaesthesiogist l friend, along with her medical records and HE wrote for Perococet-10/325.

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52

DrJoey, state laws say a Dr can't prescribe those meds for family members. A.Dr can have their license to write CDS suspended by the state medical.board for a few years if they do.

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53

Not if there's a legitimate and provable diagnosis. I wrote for Klonopin 2mg after our Mom passed. She's a former New York County Office of the District Attorney Bureau Chief (Sex Crimes). She's been my patient. She called an ADA she used to supervise who now is the Chief of the Narcotics Bureau. His reaction: "It's all legal. You think the DEA is worried about 120 Klonopins, hon? Your brother's a legit MD, at the very least and if you've been his patient, no one can stop you from accessing the medical care you need. You want me to have one of my boys and girls pull up cites that reaffirm my statement?" She said, of course not. My sister-in-law has been my patient, too — and she's NOT a "blood relative", btw. Actually what my sister said is that if there IS such a law, it's unconstitutional (she's a Con Scholar) because it violates at least. the Equal Protection clause. Although I think if anyone ever challenged that law that dispenses with physician-patient-pharmacist privilege makes it to the High Court, conservatives and liberals both will vote it down — and when the High court rules, that's the law of the land. I NEVER had a a script challenged except for the occasional new patient when the pharmacist didn't know me either; that's just due diligence. It's not difficult to write a script and although you could get into Ft. Knox more easily than to my script pads, accidents happen.

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54

Hey Bill
You need to read what the Dear Doctor said again!
His big brother who is a cardiologist; has a wife who gets migraines so he sent her to an Anesthesiologist FRIEND .. I do not see how you got anything out of that which gave you the idea that The Dear Doctor or any Doctor for that matter, treated a family member at all muchless treated them with any type of medication!

HOOKED ON PHONICS! :)

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55

DrJoey, knowing the right people can prevent a lot of.troubles that everyday people that don't have these contacts go through. The medical boards don't turn their heads like they use to.

Have a safe Labor Day!

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56

Thank you, Patty!

The first line of that oath I tok close 30 years ago is" "Primum non nicer," which means "first, do not harm." To allow a patient I know to writhe in anguish because her own husband couldn't prescribe the opioids she needed. He was a legit patient of his practice and a legit private patient in my private practice. A patient does't have to PASY to establish the P/P relationship.

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57

You, too, buddy. I'm impressed with you medical and medico-legal knowledge, ad your concern. You don't, my mentor asked to hire me for the afternoon of 12/31 or 12/30 to ask if I"d review requests for CONTINUED (i.e. NEW) benzodiazepine scripts. All patients were presently taking bentos. However, on New Year's Day, my crazy state would start treating them as Schedule II drugs. He asked me how old I was. I laughed, told him and he said, "So you're Board-certified; excellent." If I wrote a scripts BEFORE New Year's Day, the refill provision (5 refills within 6 months) would be honored. On 01/01, we'd have a write those Rxs on "triplicate scripts" b;banks, no refills, etc. The Feds NEVER stopped treating bezodiazepines as the Federal CIV Controlled Substances that are actually are. In our discussion during a break (and, regardless of my creds, Charlie occasionally spot checked my work and said, "You're good." I had rejected a few requests because I saw to many midnight refills" needed/ ), e expand the THIS won't stop the bad guy, Joey. You'd never get another doc's patient its and create patients for your practice, falsify an Initial Exam, Dx: Anxiety Disorder (Chronic) and Rx is 10mg every 4 hours OR, better still dispense it yourself. You'd make a great shrink yourself, bud.

Have safe and happy Labor Day, my friend!

Sincerely,

Jory

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.

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58

DrJoey, each state can.place a Med in a higher schedule than federal has them, if they chose. For example in Louisiana Soma without codiene is a Schedule II, with codiene its still a Schedule III.

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59

Absolutely true, when fed and state CSRs conflict, the stricter scheduling prevails, but Soma #3 in Schedule II — Soma's a weak drug — and I assume Tylenol #3 and
Fiorinal #3are still Schedule III drugs, that s just plain crazy.

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60

Rght on! Is doesn't have to be formal or professional discourse, but it has to be readable and understandable. The clown's posts aren 't. I was an undergrad bigness and Journalism major and I wrote more coherently ad correctly when I was a 10th grader

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