Pain Medicine: DEA Set to Ease Restrictions on Schedule II Prescriptions
Under a proposed rule unveiled Wednesday, the Drug Enforcement Administation would allow doctors prescribing Schedule II drugs, such as morphine or Oxycontin, to fill prescriptions for 90 days instead of 30 days. Currently, pain patients can only get 30-day non-refillable prescriptions, requiring them to make additional visits to the doctor's office just to get a new prescription written. Doctors and patients have complained that the DEA's strict regulation of Schedule II drugs has forced doctors to limit their prescriptions, with patients going untreated as a result.
At a Wednesday press conference in Washington, DEA administrator Karen Tandy attempted to signal that the agency was hearing those concerns. "Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards," said Tandy in remarks reported by the Associated Press. "Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged."
While the number of doctors who faced federal charges over their prescribing practices is relatively small, it is increasing -- from 38 in 2003 to 67 last year. Other pain management physicians have faced state criminal charges of administrative sanctions, and pain patient and physician advocacy groups complain that the agency is interfering with and having a chilling effect on the practice of pain medicine.
The move was welcomed by the American Medical Association, with AMA board member Dr. Rebecca Patchin telling the AP it was a step toward improving the care of pain patients. "Relieving suffering while doing everything we can to prevent the abuse of controlled substances reflects appropriate patient care, a standard which is easier to achieve when a strong patient-physician relationship exists," said Dr. Patchin. "We need to provide access to pain relief for patients with legitimate needs, and the DEA proposal would help in doing this."
Others were less sanguine. "Ms. Tandy states here, as she has on many occasions, that doctors need not fear criminal prosecution as long as they practice medicine in conformity with what these drug cops think is 'appropriate,'" said Siobhan Reynolds, president of the Pain Relief Network. "If that isn't a threat, it will certainly pass for one within the thoroughly intimidated medical community."
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redditRX FOR PAIN
Comment posted by Anonymous on Fri, 09/08/2006 - 5:42pmIt has never ceased to amaze me how those on each side of this argument are separated by the thin line in the sand that I call "holy shit, this really hurts!" Once they experience true unrelieved pain, either personally or vicariously, they are quick to jump to the enemy side, never to question "the right to be pain free" again. I have been a legal dispenser of class 2 narcotics for many years, always seeing things from the paitients viewpoint, and yet, I was always made to feel as if I had inferior morals and a poor attitude. About 5 years ago I was hit with physical problems that caused me to experience the "holy shit, this really hurts!" type of pain. At first the doctors were quick to prescribe class 2 narcotics while they were "fixing" me. Then they were done, and I had to be better. The only problem was that I felt worse then I did before they worked their magic. I was left a semi-invalid for another 2 years because the surgeon would not admit that he had used the wrong size hip replacement. Within a year, he had given up his practice to do hair transplants. No lawyers would take my case because of the close knit group of professionals that predominate in the Maryland area. Even surgeons who told me that I had been given the shaft(actually it was the wrong size shaft!), would not agree to testify. In the mean time, I was suffering and going down the "chronic pain drain". This is where the situation became problematic because ,like I said, I was a dispenser of class 2 drugs. Get the picture? I am in mortal pain with narcotics all around me! This story does not end happily but if anyone wants to know the conclusion, send money to produce the movie.
DocA
RX FOR PAIN
Comment posted by Anonymous on Fri, 06/27/2008 - 1:17pmI too have always been very sympathetic to patients need for pain medication. As an ER M.D. I see lots of suffering. I have been chastised by nurses who often refuse to administer the ordered drug saying I could administer them. As soon as I do that then I am whispered about "loudly"
as possibly being an addict because of this practice. The physicians I work with often give nothing but NSAIDS even for fractures. Occasionally giving Toradal for a hip fracture. I have always regarded these people as never having been in pain. Boy when they have pain it really changes their thinking. I have Lupus, My mother has Bechet's, add several more dx's for both and I personally know what being in chronic pain is. I no longer practice in the ER because of pain and fatigue but am continually told that patients with Lupus aren't treated with pain meds! Or my mother's rheumatologist told her he didn't prescribe Vicodin when she asked for a few to take on vacation if her pain became severe. Oh but prednisone with
dire effects is handed out frequently. Or the usual course with chronic pain is that you will be treated during the acute surgical phase or perhaps for one or two years and then told either that you should be better now or that you've become an addict and they can't see you anymore. Yet I read the memo's sent out by several states telling doctors under treat pain (big surprise) and to be more liberal. Then I read about prosecutions of doctors but they are usually doing something illegal. I have found as you have that if you do what is right for the patient an keep reasonable records you will stay out of trouble. this only applies if you're not in chronic pain. It ruins you're health, quality of life and negatively affects all your relationships. You represent the old saying NO GOOD DEED GOES UNPUNISHED. I only wish I had an answer for you.
Pain Meds
Comment posted by Anonymous on Sat, 09/09/2006 - 12:54amI am a pain management patient and where I live I must travel 2 days to see a doctor to get the medication that I need, It really is so unreal that the "powers that be" would rather we pain patients to suffer the rest of our lives rather than have a normal pain free (so to speak) day. But then we in America have no civil liberities anymore. It's really a damn shame.
Xaliax
Back pain
Comment posted by Anonymous on Fri, 09/15/2006 - 7:36pmIts so hard for me to get medication for my back pain. i cant sleep at night and i cry sometimes because it is killing me, but most doctors dont like giving out pain medication, and all my x rays show that my pain must be terrible. sometimes i want to die because i cant deal with this pain 24 hours a day, i wish someone could help me. markbertucci@hotmail.com
Refills on Scedule II Narcotics woud be a blessing.
Comment posted by Anonymous on Wed, 09/20/2006 - 3:05pmI have suffered with intractable low back pain for almost 9 years. I thank god that I was able to find a compasionate reliable doctor (there are a few out there). I have been on a stable dose of narcotics now for 4 years with only a small increase of break through medication during the period. My problem is financial. I am forced to go back every month for a refill on 1 of the three medications because of the schedule 2 restrictions on refills.
Living below the poverty level makes it almost a miracle when I come up with the $115.00 every month (thank god for Mom). The change to getting refills on this medication would not only relieve some of the financial burden 66%, it would help relieve the stress involved knowing that I must borrow this money every month.
Please make this law as soon as possible, the relief would be greatly appreciated not only by myself, but by millions of low income patients all around the country.
slow2poet@aol.com
chronic pain and addiction
Comment posted by Anonymous on Thu, 01/25/2007 - 1:28pmafter being diagnosed w/ fibromyalgia my pcp feels the need to constantly remind of the dangers of addiction.
i understand what what the word means obviously, however i feel it should be my choice whether or not the risks outway the benifits. if you are given the choice to regain some of your
mobility and some degree of pain relief through the administration of an fda approved substance and being labled
an addict, its obvious that anyones opinion as to whether or not this decision constitutes addiction is highly subjective.
i wonder if doctors suffering chronic pain hesitate in self medicating, i highly doubt it.
so now what do we have here, is it because we as patients are
less educated and to arrive at the assumption that because of
that education they are in a better position to deal with the possibilty of addiction then we are.
High level of pain
Comment posted by Anonymous on Mon, 02/19/2007 - 7:09pmI have been diagnosed with some pretty severe conditions and will require pain medication for quite some time. My dilemma has been the doctor being afraid to prescribe a higher milligram of the medication I have been taking because the medicine is no longer giving me the pain relief that it once did. I am being looked at as an addict! How sad is this! I can clearly read the pharmacy leaflet that states if this medication is no longer working speak to your physician. Well I have done that now I feel guilty when my medication is about to run out and I have to schedule another appointment and go back so many times, it might look as though I am having some sort of a problem but that is not the case. We should be allowed to be pain free in this day and age. Why must I go to the doctor so often to be out of pain. With the level of pain I am afraid to not have my medication and be in agony. When are they going to pass this law so the doctor doesn't feel as though she is under a microscope, and get me out from under the microscope also? This law would be a blessing.
High cost of Health Care
Comment posted by Anonymous on Wed, 07/25/2007 - 2:22pmI have been on low-dose transdermal narcotics without problems for a while, and I expect to be on them for the forseeable future. It seems excessive to require a monthly visit to a specialist - my primary physician will not prescibe this drug - which is not only expensive but also causes me to lose significant time from my job. At least I have learned from this site that I am not alone; and it's not just a greedy doctor wanting me to pay for a visit 12 times a year just to hand me a prescription. Change to this regulation definitely is needed!
Cost is partly passed on to Medicare
Comment posted by Anonymous on Thu, 08/23/2007 - 3:13amThose extra unnecessary doctor visits to get refills, in many cases get billed off to Medicare. Medicare pays out more while the patient consumes physician time for something that should have been scheduled for three month review. Money wasted at a time we can't afford it.
"SAME OLE SHIT"
Comment posted by Anonymous on Thu, 08/30/2007 - 8:32amIT,S THE SAME EVERYWHERE IF YOU,RE IN PAIN, BE ADVISED DOC. WILL USE EVERY EXCUSE THEY CAN NOT TO GET YOU THE MEDS YOU NEED. EITHER THEY QUOTE THE D.E.A. OR SAY YOU WILL GET ADDICTED. WHAT A WASTE PEOPLE SUFFER DAY IN AND DAY OUT AND VERY FEW GIVE A RAT,S ASS , MY DOC. TELLS ME "I GIVE MY CANCER PATIENTS THIS MEDCINE" DOCTOR I TELL HIM, I DO NOT HAVE CANCER, I HAVE BACK PAIN.. AND OF COURSE I HAVE TO GROVEL TO GET ANY SORT OF PAIN RELIEF, AND MY BACK IS A MESS, HERNIATED DISC, ARTHRTIS IN THE FACET JOINTS, CURVETURE OF THE SPINE, BACK SPASMS THAT START UNDER MY RIBS, IF THEY WERE IN OUR SHOES I,M SURE THINGS WOULD BE DIFFERENT,NOW I,M 65 NO QUALTY OF LIFE,NOT MUCH TO LOOK FORWARD TO EACH DAY, EXCEPT "MORE PAIN"
pain and more pain
Comment posted by Anonymous on Fri, 09/28/2007 - 6:54pmMany people suffer from any kind of pain, i'm one of them, i have back pain becouse i work with heavy stuff, i know there are many like me,and the problem is the money for the drugs, Where to find cheap drugs ?? why prescription ?? well i want to give you an advice one find a doctor friend, two surgery, tree use drugs, the easy is the number 3 i give you a link where i go, a place that work for me, where they help me www.trustedprescriptionsonline.com, or go to your doctor and see the real problem, hope i help you
thank you
Cause for Hope?
Comment posted by Anonymous on Fri, 09/08/2006 - 2:18pmI think perhaps this issue hits home for at least a few in law enforcement, as they, or their loved ones may have experienced a period of intractable pain and were unable to get sufficient medicine to deal with it; or remains in the minds of many of them as a potential if physicians refuse to prescribe for fear of prosecution. The threat of severe, prolonged pain is a powerful force.