Pain Management: FDA to Tighten Regulation of Extended-Release and Patch Opioid Meds

The Food & Drug Administration (FDA) is beginning a "massive new program" to reduce overdoses, diversion, and inappropriate use of powerful opioid pain relievers, especially targeting extended-release and patch formulations of fentanyl, methadone, morphine, oxycodone, and oxymorphone. On Monday, the FDA announced it had sent letters to 16 drug companies who produce the 24 listed products informing them they would now have to create a Risk Evaluation and Management Strategy (REMS) "to ensure that the benefits of the drugs continue to outweigh the risks."

That means physicians are likely to face new procedures in prescribing the drugs, and patients are likely to face more hurdles in obtaining them, an FDA official said at a Monday press conference. But pain patients already face serious obstacles in obtaining relief. The FDA action comes in the context of a campaign by the DEA to crack down on doctors it deems to have improperly prescribed large amounts of opioid pain medication -- even though prescribing what at first glance appear to be extremely large amounts is well with standard pain relief practice. Physician's fears of being prosecuted have contributed to what pain patient advocates describe as a crisis in chronic pain relief.

"Pain patients aren't drug abusers looking for a prescription fix," said Gregory Conko, senior fellow at the Competitive Enterprise Institute, which teamed up with the Pain Relief Network last May to create the Politics of Pain campaign to fight for patients' access to sufficient pain medications. "It's a genuine tragedy that the DEA often treats them and their doctors as if they were. It's as though the agency just doesn't care whether its single-minded waging of the war on drugs imposes collateral damage."

The Politics of Pain campaign has collected personal stories from physicians and patients who have explained firsthand how difficult it can be to either offer or find sufficient treatment for pain conditions. In one video interview, Gulf War veteran James Fernandez and his wife tell their story of how he, once a robustly healthy US Marine, is now virtually confined to his home because of severe, ongoing pain that has been under-treated for years.

In another interview, Dr. Alexander DeLuca, a board-certified specialist in addiction medicine, describes the obstacles faced by a physician trying to deliver the "standard of care" called for by his own medical training. According to DeLuca, virtually no patients in the country today receive proper treatment for chronic pain.

Still, there are a lot of pain pills out there. Last year, US pharmacies dispensed 21 million prescriptions for the 24 medications listed to 3.7 million patients. "This is a very extensively used group of medications," said Dr. John Jenkins, director of the FDA's Office of New Drugs at its Center for Drug Evaluation and Research. "This will be a massive new program."

Jenkins said that abuse, misuse, and accidental overdoses involving those products had been on the rise over the last decade, and the agency is concerned about doctors inappropriately prescribing them for patients who are not suffering moderate or severe chronic pain.

"We continue to see case reports where someone with a sprained ankle receives a fetanyl patch or extended-release opioid," Jenkins said.

Dr. Bob Rappaport, director of FDA's division of anesthesia, analgesia, and rheumatology products, told the press conference the agency was also deeply concerned with the rising non-medical use of the opioids. He cited a Substance Abuse and Mental Health Services Administration (SAMHSA) report released Monday that showed some 5.2 million people said they had used prescription opioids for non-medical purposes in the past month, and that the figure among 18-to-24-year-olds had increased from 4.1% in 2002 to 4.6% in 2007.

"This is an ongoing problem, and it's getting worse," Rappaport said.

Forcing the drug manufacturers to submit REMS plans is "our attempt to ensure the benefits outweigh the risks," Jenkins said. The agency will seek to find an "appropriate balance between legitimate patient need for such drugs and the threats caused by the abuse and misuse," he added.

But tighter regulation isn't going to happen right away; a series of meetings with various stakeholders over the coming months are being set up to arrive at final regulations, said Jenkins. They will include patient advocates, health care professionals, the pharmaceutical companies, and law enforcement. The first meeting with manufacturers is set for March 3. Hopefully the concerns of patient advocates get heeded and successfully addressed, but it's not clear whether that is even possible with a venture of this nature given the current enforcement climate.

Permission to Reprint: This article is licensed under a modified Creative Commons Attribution license.
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FDA to tighten regulations

I have suffered from chronic pain for years. Degenerative Disc Disease exacerbated by Osteoporosis caused me to have a compression fracture of my L4 vertebrae several years ago. I also get frequent migraines. My last bone scan shows that the fractured vertebrae healed and now it's 30% shorter than the other vertebrae. Fortunately, I have a doctor that believes in taking care of her patients as needed. The law-enforcement community may have a job to do in preventing certain idiots from diverting their pain medication and causing overdose deaths and addiction. But for a government agency to try to pressure my doctor into not treating or under-treating her patients who are in constant pain in intolerable.
This failure of a so-called "drug war" has been an on-going bad joke for over 40 years that has cost the tax-payers of this country billions of dollars with no upside. The crime surrounding drug abuse is virtually always caused by the drug laws, not drug use. It's simply a very convenient crutch for failed law-enforcement policies to always automatically be labelled as "drug-related". The crimes and the law enforcement failures should be labelled as "drug-law-related", because that's much closer to the truth.
It is unconstitutional for a Federal law enforcement agency to go after doctors for treating their patients. If a crooked doctor is violating the law and the standards and ethics of his or her profession, that's a different case altogether.
The Federal government is violating states' rights in prosecuting these doctors, as the doctors are licensed by the states to practice medicine.
The mail-order pharmacy that my health insurance uses for long-term prescriptions has repeatedly harassed my doctor and tried to justify this by saying that she is exceeding the recommended dosage. How does a pharmacy have any right to judge what the correct dosage is for any patient when they aren't physicians and also have very little or no knowledge of any particular patients' physical problems?
I have forced myself to lower my dosage out of fear that the pharmacy will one day refuse to fill my prescriptions. Is this right or just in any way? If I were to lose my job, I would never be able to afford the medications that I take on a daily basis. I have been on Fentanyl patches constantly and on Oxycodone for break-through pain for several years, and the cost of the patches is unbelievable. Luckily, I have a prescription-drug plan. What happens to the people in my situation who have no such drug plan? The drug companies have been overpricing their products to enhance their bottom line for years. The difference between the cost of production and the price they charge is staggering. If the Federal government is going to bail-out the banks and insurance companies, they should also help people who have medical problems and can't afford their medications. Alas, I don't believe that will ever happen, because there are no lobbyists in Washington to bring this plight to their attention, let alone the money to guarantee a response.
I would like to thank StopTheDrugWar.Org for trying to right some of these terrible wrongs.

They really care!

Just tightening down the screws a little more! I never did disagree with trying to keep the diversion to a minimum when it came to pain meds.

But, to destroy the lives of the 97% or more, of real pain patients, that have been shown to never become addicted to their pain medications, is just plain moronic! I think I speak for all pain patients when I say I wish these "people" could suffer what we do daily, for just a day. Then, maybe, they would learn the terrible injustice they do to pain patients in the name of fighting the drug war. Why is it they still can't decrease the abuse of prescription drugs, after so many years of the drug war? Just another sign of failure. The people who are hurt most are the honest chronic pain patients! And its not only the pain patients lives, who are destroyed. Their doctors fair no better under the present war on pain doctors.

Just another sad day in this person's life, who suffers chronic pain, 24/7.

I find it ironic, that I now suffer with chronic pain, and cannot afford to get it treated! I know both sides of the disaster.

It could drive one to drink!

DEA Mindset Catch one Addict By Denying 1000 Americans Decent Me

It's the DEA that makes rules and  the DEA also has full power over any practice of medicine where a prescription for a controlled substance is written. 

FDA ! Walk in someone else's shoes, damn it!

I wish each FDA official would undergo two hip replacements, experience bone cancer, or any one of the chronic debilitating painful conditions that tens of millions of Americans suffer day in day out....let them experience the miracle pain killing of the patch or oxycotin....and then have their doctor withdraw it permanently....and then see what they would do.... these morons are f'ing clueless what it is like to live in chronic pain...opioids are the least expensive and most effective pain killer available....I tell you after two hip replacements I wouldn't have made it through the pain and it infuriates me how patients are treated like either infants or criminals! A pox on them all!

FDA! The Three Stooges Would Do A Better Job!

more on the proposed restrictions and hoops for prescribing pain killers to people who need them;
medically necessary medicine being withheld because the FDA actually believes in doing so recreational or addicted users will all of a sudden disappear? really...because heroin is saturating US high schools, then with holding medically needed medicines and making physicians jump through impossible hoops to try to provide such medicines to their patients means no more drug addition in the USA?

maybe these guys need psychopharmaceuticals to think clearly and logically and deduce their proposal is illogical and moronic.


How pain patients are treated in this country is an absolute travesty of justice. As it is most doctors are afraid to adequately treat pain and now the government is going to make it even more difficult? This is absurd. And the biggest problem with the whole thing? It will do NOTHING to the illegal market.
The VAST MAJORITY of these pills on the black market come from supply chain theft and professional doctor shoppers, whose methods I won't discuss, but let's just say they won't be affected by these new policies, only legitimate patients will. There was one supply-side dealer busted who had a hookup inside the factory, and sold 5-10000 OC80s (the strongest of the OxyContin pills) *every week*. Who in their right mind thinks that refusing to give people in documented pain 1/1000th of that per month is going to have any impact at all on the illegal market?
These assholes have to look like they're doing something to combat the "evil" drugs, so they go after the low-hanging fruit just to show they're making arrests and completely disregard the horrible effect it has on the lives of people with genuine need for these medications.

Stop further hurting chronic pain patients

While it is obvious that abuse of prescription drugs is a real problem, dont turn a deaf ear to the problem that people who rely on opiates due to chronic noncancer pain. You are saddly mistaken if you think a high is achieved by people like myself. What opiates do for me, as well as the majority of others with chronic pain, is allow me to maintain some function in my life. Thanks to these medications, I can mother my two children. I can do simple tasks that most people just assume come easy to everyone else-vacuum, do some grocery shopping, help my children do their homework, go to a family reunion, and the list goes on.
I hide the fact that I gain my quality of life through oxycodone. Why? Well, because of the witch hunt that has occurred attempting to rid the country of drug abusers, addicts and illegal criminals hasnt stopped with just them, it has crossed over to innocent folks who have it tough enough already without being scrutinized for taking a pill to help them get out of bed. I am a mother of two daughters, I went to college, have been married to a wonderful man for over 20 years and have never so much as had a speeding ticket. I wish the summary of my life continued to be positive but chronic pain showed up and changed my life forever. I have tried every treatment available for multiple afflictions from endometriosis, lower back pain due to arthritis and degenerative disc disease and chronic sinus headache pain. Although I knew immediately that opiates worked wonders for me to lead a somewhat normal life, I knew of the risk of dependency so I tried every other alternative that my doctors suggested. Each time I was disappointed and led back to the one thing that really worked. The problem was that my miracle cure was something others used to "get high". I take my meds as directed and do not sell them. I know that for each tablet I swallow I am fortunate to find the relief at that moment because with the best of intentions, the government has put my pain relief at tremendous risk of being taken away. My physician is a good person who is a graduate of Harvard. She can see how well these medications work for me BUT she doesnt want to prescribe them because she feels it puts her practice at risk. Since she knows that my pain is obviously legitimate(with MRI's, past exploratory surgery etc) but she worries that any script written regardless of reason, will bring scrutiny and perhaps, even a loss to her livlihood due to someone misinterpretting her best medical judgement. So, in order to try to still help me and protect herself, she prescribes my percoset in 2.5 tablets and has to give me a lot to alleviate my pain. That would be fine, except the dose of tylenol I must take is borderline overdose. It is what I have to do to live a quality of life....this is not right. The damage to my liver is unnecessary but since these well intentioned regulations have been inacted, my doctor feels this is the only way she can protect herself and get my pain under control.
Truth be told, I am actually one of the lucky ones. There are many people with conditions just like me and pain equal or even worse than mine that have no choice but to purchase their meds off the street or the internet. They can not find a doctor who is willing to help them because they have all become fearful and paranoid and worry the DEA will come knocking if they treat any pain with opiates-this is truly sad. What ends up happening is the street dealer is offered more demand because legitimate pain sufferers and nonaddicts have no alternative but to seek treatment from a street dealer if they want to live at all. Please stop this insanity and let physicians treat the patients they have with chronic pain in a humane way with what works, regardless of what is used on the street. Why should I be punished for people abusing drugs when I am not? It would be like banning alcohol all together because a few people are alcoholic, well all except the recreational wine drinker doesnt depend on that glass of wine to be somewhat functional in every day life. Thanks for listening. Denise from Massachusetts

FDA = Gestapo

What do they know about what pain really is? I have never had a Dr. Give me anything but Tylenol 2 for a sprain. A Fentynl Patch for sprained ankle? Where? Who? What state? What kind of Dr.? I would love to get a hold of a Dr. that overperscribes rather than under. We are in trouble. Chronic pain is just that.... CHRONIC. it needs meds and enough to keep from suffering. Otherwise... What good is it going to PM???

Pain Medication

It all comes down to money, always has always will. The DEA wants more money (funding), that’s all. So now they go after pain patients because it's easy pickings. They don't care about you or your pain, if you live or die. They don't even care about the street addict’s pain. They just want more money to buy bigger guns and produce more raids to make them selves feel good and seem like a legitimate agency when in actuality they are a terrorist agency supported by the pain patients through taxation.

I like that

It's so true DEA is a terrorist agency. I start to get a headache every time I return to this site. The freedoms our government takes from us is staggering. STOP THE DRUG WAR. Give PEACE a chance.

FDA and their oversight of opiate pain medication-STOP IT!

Hi there, I never anticipated becoming a pain patient that requires opiate pain medication to get through the day.

I am a mother of two, a grand-mother of one. I have been 'sick' with a congenital disorder that is rare, and there isn't a cure. I searched high and low while I was still working to get the answers that I desperately needed.

I went through six years of pain with perhaps 30 5/500 hydrocodone tablets to last 30 days. I had to figure which day/time/hour was the worst to take a pill.
I was finally accurately diagnosed in August 2005, and I hit the ground running. I found a specialist in NY, and found out, no cure.. but surgery could slow the progression.
I elected to have the craniectomy, the extraction fusion from my skull to c4. I thought my life would resume! However, while many of the symptoms reduced, there are still days following the 2006 surgery, that I cry, huddled in my bed. Not many will see me this way, because oxycontin has given me my life back. I know that I will be in pain for probably the rest of my life, but thanks to opiate medication, the compassion of my PM doctor in WA, I have days where my pain levels hover around 2-3.

My PM doctor is careful, I have urine screenings, I have had the psychological profile done to determine if I were an addictive person. I understand that the rules are strict, but I am so willing to go through this tests to keep my pain levels down. My doctor risks his career, his license for chronic pain patients. I understand this.
What I want to know is, why are you doing this? Chronic pain, non-cancer pain is debilitating, and is life-robbing. For people like me, that have a semblance of life are thankful for these medications. Please don't make it harder for the doctors, for the patients. You, your government agency is effectively turning practices of PM doctors, to not prescribe to those that need these medications to be able to interact in just daily living.

Please, please consider this letter, my plea, to stop this madness! This government, while you think are protecting us from ourselves.. isn't the case.
If there is something I can do, letter write, contact my congress-people, I am willing to do this.
I just don't know what else to say, I am disappointed in my government. Don't protect me from me. Please.

Watching the agony

While I am not experiencing the pain that requires morphine levels of medication, my brother is. I watch him struggle daily with managing his pain and periodically, forcing himself into withdrawal in order to reduce the grip the drugs have on his system. The enormous effort under intense pain is something to applaud as he battles with unending pain that grows each day.

And now he has to endure the worst pain of all - FDA-induced agony. The fear that his only ally in keeping his pain managed will be torn away from him because of the ineptitude of the FDA whose "experts" can not differentiate between illegal use and necessary use. Their policies are causing those in pain to endure unbelievable and unnecessary agonies while the FDA twiddles their thumbs trying to figure out how to control illicit demand.

It looks like Mexico and the President are right when they say the problem is not the supply but the demand. The FDA should focus where the source of the problem is and STOP torturing those who are already expereincing the torture of their own bodies.

Alan Whittall - a perplexed and bitter observer

Fibromyalgia Pain Sufferer

About 4 years ago I was hit with a chronic pain condition known as fibromyalgia. Along with this I also have 4 herniated discs, two lumbar and 2 cervical. It took a couple years of horrid pain to find a doctor finally that would prescribe for me accordingly. We discussed the pros and the pitfalls of opiod type medications and both agreed this was the best for me. My life now is "bearable" and I am able to function. Without my pain medications I am in horrible pain 24/7. QUALITY of life is important also! Plus my own doctor told me that those who take these medications for TRUE PAIN and not "recreation" are NOT the problem. In fact, the medication does not go to our "brain" (the 'high' recreational users experience) because it is working on the PAIN! It frightens me that someday soon I will not be able to obtain what makes my life pain medication. And I'm so tired of those who look down on chronic pain sufferers like we are just drug addicts looking for a "fix". WE ARE IN TRUE PAIN! I've tried every other potential remedy there is, and nothing else works. My life is livable now. If I lose my pain medications, I cannot even imagine going back the way I was. My doctor is very cautious with my doses and monitors me closely, plus all patients have to sign contracts. We are NOT addicts, we are PATIENTS with TRUE PAIN!

Stop the insanity!!!!!

I recently broke my pelivis in multiple locations and while recovering I am having to take narcotic pain relievers. I was told that the doctor needed to run some tests and was handed a cup to pee in....I was not informed that the "tests" were in fact a drug screen. I, like millions of adult americans, smoke marijuana for medicinal purposes and live in a state where it has not yet been legalized. Now, just weeks after breaking my pelvis, I have been told that I will no longer receive narcotic pain relievers becuase I tested positive for drugs....
Wake Up People!!!!!
This is absolutely absurd. Because I smoke marijuana, I am not intitled to the same pain relief as a non-smoker? Is this not a clear case of discrimination? I have suffered from Chrone's Disease for many years, as well as multiple medical issues that the use of marijuana drastically improves and am being lumped into the same group as a homeless junkie or crack head. THANK YOU AMERICA!

Health Care Reform??

Anyone here who is politically active should make it known to their elected officials that reform of health care in the U.S. MUST include ending the governments war on chronic pain patients. Even from a rigid cost/benefit analysis standpoint this is beyond ridiculous: the FDA official states "we continue to see case reports where someone with a sprained ankle" gets heavy duty narcotics (the incidence of which I suspect would be numbered in the single digits), which then is used to justify a "massive new program." So called "liberal Democrats" should absolutely have to publicly account for their support of BS like this, since one of the stated goals of the health care reform they supposedly support is making medical care available to the "excluded and vulnerable." Instead, they're escalating the war on us as if they were Rethugs. Let them know, if this continues, they've got to go!

RE: Fed-UP!

I am so fed up with hearing about the DEA stepping in to shut down a Pain Clinic or what they might call a "Pill Mill. They make it sound so bad, they say things like: "The doctor at so and so clinic was arrested for prescribing an inordinate amount of pain killers to many of his/her patients." Its like, WAKE UP, the place is a PAIN CLINIC, and PAIN MANAGEMENT DOCTORS PRESCRIBE PAIN MEDICATION for PAIN PATIENTS!!! So of course its going to look like the doctor is prescribing a lot of pain medication, because they are, and for a GOOD reason! The patients need relief! What would people say if a doctor refused to prescribe insulin to a diabetic person? That would be STUPID! So what's the difference when it comes to undertreating or NOT treating pain in a pain patient! That's all I have to say!

Thank you a Million times over for standing up for us all...

I had no idea there was such a great community of people filled with such empathy. Fighting to help people like myself who are in pain, from unfortunate life events or just simply because the good lord decided we could handle it and gave it to us at birth.

I can't help but wonder though what happened to the days when Opioid's were first introduced to our communities to assist in alleviating pain. I personally can never achieve total pain relief but for someone who lives in such excruciating pain all the time when you have a 2-3 day it's a beautiful day no matter what the weather man says.

If it wasn't for the Doctors who spent the majority of their younger years in school, studying... researching... and proving they have what it takes to properly diagnose a patient in regards to pain that is hindering their ability to live a normal life. I don't know where I would be.... I'm only 22 I have experience more pain in my life than I thought any one person could handle. I have a son who is to be 2 in May and without the kind hearts and empathetic doctors here to help make the pain bearable with treatment plans and medication. Not only would I miss out on the best thing in my life but my son wouldn't get to spend the quality time he does with his mommy nor could I explain to him why either. So thank you to EVERYONE for being open with your opinions and making sure to use your voice publicly to defend the treatment put in place ages ago for the same reason it still exists today. THANK YOU A MILLION TIMES OVER, to the doctors whom aren't afraid to assist patients like myself, and for their willingness regardless of the possibility of unjustified ramifications. These Men and Women are hero's and they are proving over and over to keep their word to their communities, upholding the oath they made to help and take care of those whom aren't capable of fully doing so themselves or whom might be in need of their professional assistance.

Love Life & Let Life Live

I truely understand chronic

I truely understand chronic pain, my mother suffered from stage four cancer in 1980 she ived 24 years on weekly pain shots given by her doctor. Sometimes two and three shots a week. However I am having an extremely hard time understanding how doctors can give scripts all in one visit (one for oxys, one for methdone and zanix) I just really dont understand why there is not something in place to stop this. People are dieing. My husband was addicted to opiates, he was given them for severe back pain, ten years later a hard addict. I seen him go through the withdraws, it was so hard to watch. I believe that there is such thing as chronic pain, but I also believe that too many doctors hand out pain meds like its candy. My husband went to a pain management doctor once a month got his script for morphine plus took wat he could find on the street. It is killing those who think they can take methdone with zanix, those two scrips should not even been written to the same person or the same time.

Morphine (chronic pain)

I was just informed by my Dr that I have to see Him every other month in order to get prescript for my Morphine.  I have been on several different pain meds for over 3 yrs.  And never have I been told I have to see Him like this.  Further more I have been to see Him on 8 occasions anyway.  So why do they tell me I have to go every other month.  It is not like I don't go and see him for months.  I have fibromyalgia, osteoaritis, and a bad back surgery, some bad diskc.  Chronic pain for sure.  Being in supposed Golden yrs and aren't good now this my life with medical personal sucks.  FDA go get the drug crooks and leave us alone.


Our elected officials are failing to protect us from one of the worst things that plague the citizens in this country - ITSELF.  The jokers in Congress, FDA, and DEA are out of CONTROL.  Our government’s addiction to controlling certain substances is almost as bad as its addiction to spending and increasing the national debt.  The authorities are far more concerned with diversion and potential misuse of certain substances than they are with under treated pain.  Our government has taken extreme measures to ensure that no controlled substance gets misused.  Under treated pain has become an epidemic in this country.  The worst part is that those who legitimately need pain meds have no choice, while illegitimate use is always done by choice. 

The truth about addiction is that it is not the serious problem our politicians want us to believe.  Numerous studies have been done on addiction rates for patients requiring long term pain management with strong opiates.  Long term usually means 4 weeks or longer.  These studies involved patients requiring long term hospital care because both the patient and drug can be carefully monitored.  The strong opiates required are believed to be the most addictive. Examples include fentanyl, Demerol, morphine, hydromorphone, oxymorphone, levorphanol, and even heroin (Europe only).  These studies have been done independently, have been conducted all over the world, and most importantly, they consistently agree.  The addiction rate for patients requiring long term strong opiates IS LESS THAN 0.1%.  That’s less than 1 in 1000.  The low addiction rates are believed to happen because the meds were given with the prescribing guidelines.  Bottom line is that as long as a patient takes meds as prescribed, there is virtually no risk of becoming an addict.

Additionally, these extreme efforts by our government play a role at driving up the costs of our healthcare.  Just notice the efforts that doctors have to deal with when prescribing a control II (C-II) med.  The average patient doesn’t notice.  Behind the scenes the doctor has to be very aware of the amounts of C-II that they have been prescribing.  Over prescribing C-II meds could potentially mean loss of medical license and even the possibly of jail time.  Then there are the efforts that pharmacies and manufacturers go through to ensure that none of the C-II meds are diverted.  Those efforts are extreme.  Secret transports that are monitored by satellite.  Security requirements are almost as strict as what’s required for banks.  The costs and resources required to prevent diversion are a heavy burden on our healthcare.

Chronic Pain patients are NOT addicts STOP treaing this THIS!!

It is now become uncomprehendable how chronic pain patients are being treated in Florida. Because of pill mills and addicts have ruined the care that patients are receiving. The pharmacies are denying patients of their much need medications that help them live a more functional life, close to normal as possible. Patients are at the point of near withdraw right now and pain is though the roof and many will not be able to continuing working to feed their families in this horrible economy. Florida housing crisis and jobless rate will increase due this serious problem. Our state legislators and attorney general are going over board with their war on pain patients. Just because a few addicts overdosed or had babies born to oxycodone the patients have to suffer. Arrest these mother's for child abuse and the addicts will find their fixes but patients are suffering!! The majority of these people are not prescribed and taking these medications ilegally The patients that take as prescribed are being tormented with pain and the stigma of negative media isn't helping make matters worse!! WAKE UP OBAMA!! These people are in moderate to severe pain! Your mother had cancer, you should understand! There many more diseases that hurt just as much cancer that need to treated for pain. If the DEA doesn't back off and state politians don't start understanding we are going to have a lot more crisis in Florida with more people applying for SSDI that are currently still working but will have to quit!! We the people of Florida and all across the country demand to exercise our right for pain relief!! Our medication choices have been diminished with Opana out of the picture and oxycodone being attacked. The new formulas aren't effective! They have been moderated to the point if you eat they don't work at all!! They release the medications properly It's simple. Just add niacin or cayenne pepper and they won't be abused in the manner previously. I hope ACLU gets involved because our civil and human rights are have been violated!! Because our current state legislators can't fix the our housing and jobs they looking for kudos from the citizens that don't understand pain YET! but theywill   someday and by then they will be on the suffer wagon too. Someone needs to read constitution and get America back to freedom and liberties. There needs to be a class action law suit against the people trying to take pain care away. We the USA and our should people should NOT have to suffer!!

DEA is Shafting us!

The DEA and Doctors give you every reason why you are being taken off extended relief ms cotton after 12 years of being on them, I am just now functioning and BOOM-DEA or who ever wants everyone at the clinic off pain meds. do these people know what they are doing to the quality of our lives? I can go into why I am on the pain meds. but it would not  matter because Mr. Big Daddy DEA says Tough Shit! May what goes around comes around. We are not America the land of the free,we take care of everyone else except our own. I,m a disabled Vet and though they would help me. I would live my life with the quality with meds then live no life at all.

DEA FDA injustice

Thank you to all the supporters. I am 40 almost passed at 29 was loaded with heavy metal's and chemicals on the job. I  am on comp SSDI and LTD comp court ordered my meds to be paid for as I have toxicity, AML, and CML leukemia's bone and blood cancer in severe pain. I had fentynal lollipops for severe break through pain morphine ER an Exaglo well the FDA came up with a TiRF-REMS program in which the DR needs to be a part of my doc opted not to, well now since I saw a doc nobody will take me on. Even Dr's on the program will not take me. One is trying to help  by sending me to doc after doc but only prescribes low dose. It is a shame you can go to a high school or internet and get what you  need but not a legit Dr who will watch you urine test you and change up meds if needed. Our health care is shot but if the boys in Washington D.C. need somthing they get it. Thank you US of A for letting me suffer with a wife of 21 years and 4 kids and all I think about is takeing my own life as I can NOT bear the pain anymore BUT Hospitals get $$$ for Palytive care for cancer but will not prescribe OH and thanks for the with drawls but lets dope our kids up on ADHD meds  Where ever the $$$ is right. Time to go to Canada or Europe for help and leave this constitutional republic. These meds help us work they don't want that. I think they want pain sufferers to die so insurance co.'s can wash there hands..........Used to love my country used to.. 

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Drug War Issues

Criminal JusticeAsset Forfeiture, Collateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Court Rulings, Drug Courts, Due Process, Felony Disenfranchisement, Incarceration, Policing (2011 Drug War Killings, 2012 Drug War Killings, 2013 Drug War Killings, 2014 Drug War Killings, 2015 Drug War Killings, 2016 Drug War Killings, 2017 Drug War Killings, Arrests, Eradication, Informants, Interdiction, Lowest Priority Policies, Police Corruption, Police Raids, Profiling, Search and Seizure, SWAT/Paramilitarization, Task Forces, Undercover Work), Probation or Parole, Prosecution, Reentry/Rehabilitation, Sentencing (Alternatives to Incarceration, Clemency and Pardon, Crack/Powder Cocaine Disparity, Death Penalty, Decriminalization, Defelonization, Drug Free Zones, Mandatory Minimums, Rockefeller Drug Laws, Sentencing Guidelines)CultureArt, Celebrities, Counter-Culture, Music, Poetry/Literature, Television, TheaterDrug UseParaphernalia, ViolenceIntersecting IssuesCollateral Sanctions (College Aid, Drug Taxes, Housing, Welfare), Violence, Border, Budgets/Taxes/Economics, Business, Civil Rights, Driving, Economics, Education (College Aid), Employment, Environment, Families, Free Speech, Gun Policy, Human Rights, Immigration, Militarization, Money Laundering, Pregnancy, Privacy (Search and Seizure, Drug Testing), Race, Religion, Science, Sports, Women's IssuesMarijuana PolicyGateway Theory, Hemp, Marijuana -- Personal Use, Marijuana Industry, Medical MarijuanaMedicineMedical Marijuana, Science of Drugs, Under-treatment of PainPublic HealthAddiction, Addiction Treatment (Science of Drugs), Drug Education, Drug Prevention, Drug-Related AIDS/HIV or Hepatitis C, Harm Reduction (Methadone & Other Opiate Maintenance, Needle Exchange, Overdose Prevention, Pill Testing, Safer Injection Sites)Source and Transit CountriesAndean Drug War, Coca, Hashish, Mexican Drug War, Opium ProductionSpecific DrugsAlcohol, Ayahuasca, Cocaine (Crack Cocaine), Ecstasy, Heroin, Ibogaine, ketamine, Khat, Kratom, Marijuana (Gateway Theory, Marijuana -- Personal Use, Medical Marijuana, Hashish), Methamphetamine, New Synthetic Drugs (Synthetic Cannabinoids, Synthetic Stimulants), Nicotine, Prescription Opiates (Fentanyl, Oxycontin), Psilocybin / Magic Mushrooms, Psychedelics (LSD, Mescaline, Peyote, Salvia Divinorum)YouthGrade School, Post-Secondary School, Raves, Secondary School