It's Official: Forcing pain patients to pain management specialists

[pokergooch]

Wow. I thought it was just supposed to be advice. But, Here in my state, they sent a letter to all doctors that if they want to prescribe more than 60mg of morphine a day they have to be sent to a pain specialist. Im on a boat load of meds. On my last visit, I asked if I could lower one med and up the other, he said that the state has made a new law. so that if I want to do any changing i have to be referred to a pain specialist.

Now Im worried that he'll just boot me off and make me see one. The weird thing is, is that when I started seeing him I was at a pain clinic and he was a substitute doc. When that clinic shut shut down (owners moved to another state) the substitute doctors absorbed the patients. So, In my mind, I am seeing a pain specialist.

I cant believe the power of the fucking government with opiates. Its like they are sooo fucking paranoid. I think they assume that all drugs are diverted or abused..

PG

[taj]

When I could tell my first doc was gonna be going down(he was wicked shady), I made sure I was able to get referred to a real pain clinic before that happened. I do have legitimate chronic pain, and wanted to make sure I was going to be able to get treated properly, and so it didn't just look like I was going to him for the drugs.

I got into the pain clinic right around the same time that I found a new primary care doctor. The really retarded part was that the doctor at the pain clinic told me that they weren't prescribing narcotics to patients (which I knew that they at least used to, I had a couple of friends that also went there). They told me that my primary care doctor was going to have to do the prescribing. It made absolutely no sense, why would I be going to a pain clinic then?

So I stopped going and have just been seeing my primary care doctor the past four years. If needed he can refer me to different specialists, but he's the one I get my pain meds from, and I go to a separate doctor for my psych meds.


edit: I wanted to add that the pain clinic I went to was a branch of the main hospital in the northern part of my state.

[Duckfeet]

Yep: I use federal system--Veteran's hospital--and they've been that way for a while...which is why so many older vets are just worn out w/fighting the system, and get on methadone maintenance...for pain...sucks...but states are obviouisly following right in line...our country is really getting federalized in all areas...I guess online databases just make it one big pile of rules rules rules....

[pain-pateint]

Duckfeet and all ---

I was wondering if you could clear up a question regarding the VA system and their "pain clinics". I know they used to do urine tests on patients who received chronic narcotics, and those who tested positive even for just pot, were warned they would lose their pain treatment, and if the positive persisted, their pain treatment was terminated.

Several other activists and myself were appalled by this, esp. when Michigan became a legal medical marijuana state, and now the VA has issued a statement in regards to Michigan's medical marijuana program stating that:

1. The VA -- being part of the federal system and all -- will not issue ANY recommendations to ANY patients in support of their obtaining a medical marijuana card.

2. However, those patients who have received a medical marijuana card -- usually because the patient could afford a private pay doctor for the evaluation/recommendation -- and are in compliance with the Michigan law will NOT have their pain treatment regimens threatened at all.

Now, my question is that since this position on medical marijuana and pain was the result of local negotiations, will it apply to any other state(s) or areas? Have VA pain patients in other states even been advised of this statement (if you need the source for the quote, let me know and I will dig it up and post it) or are they still threatened with loss of their pain treatment for a cannabis positive U/A?

Thanks,

M

[nick]

I hate to say this,but the bottom line is there is going to be a much more stringent system of managing pain with opiates.Considering the large increase in diversion,prescription drug abuse and addiction and,of course,the subsequent increase in OD'S.

If I were you guys,I'd be looking for a compromise that enables patients to be adequately medicated and helps the state with diversion.If you don't at least look for a compromise.........you'll have to put up with whatever the state requires.

Time to get pragmatic,guys.

[southernbelle]

Or, it's time to move....jesus, I can't believe this.

[Restharrow]

I hate to say this,but the bottom line is there is going to be a much more stringent system of managing pain with opiates.Considering the large increase in diversion,prescription drug abuse and addiction and,of course,the subsequent increase in OD'S.

If I were you guys,I'd be looking for a compromise that enables patients to be adequately medicated and helps the state with diversion.If you don't at least look for a compromise.........you'll have to put up with whatever the state requires.

Time to get pragmatic,guys.
When I started on Oxycontin (in mid -1990's I think), IMO very few YOUNG PEOPLE were abusing prescription meds on a regular basis. In about a 15 year time period, prescription meds have become the drug of choice for the younger generation.

IMO pain patients will be dealing with a totally different set of rules for the remainder of my life. For me, I think my only problems will be dealing with closer scrutiny (like suprise pill counts, urine anal. etc.). As long as I walk a careful line, I HOPE I will still get my meds.

On the positive side (for old folks like me) there is some hope of political organization and by sheer weight of our numbers put pressure on the various branches of gov. On the negative side, very few people are willing to spend even the smallest amount of time doing political lobbying -- except sending pretty much useless emails.

1 time I got to have a 60 second conversation with a U.S. Senator, and I mentioned some problems with getting pain treatment. The senator expressed shock. He said that in his (very lengthy) political career, he had received THOUSANDS of letters from police, prison gaurds, probation officers, executives of company's building prisons and family's of drug addicts -- all demanding stricter laws on drugs. But he had NEVER heard from a patient having problems getting pain treatment. Pain patients have NOT had much of a lobby in Washington so far.

Will

[Flowergirl]

Pain Patient, my father, who is now deceased, sought treatment at the VA hospital in Saginaw, MI. At the time of his death, he had been going there for a good 25 years. He was also fortunate enough to see doctors outside of the VA system using private insurance.

When he could still speak, he did ask about the medical marijuana issue. His urologist told him VA patients were not eligible because of the Federal ties. A phone call to his regular doctor, not within the VA system, straightened things out. The next month, his urine was tested and he was asked to find a new doctor.
The man was 85 years old and a completely disabled WWII vet, and he got taken off his whopping hydrocodone/apap 10/500 for marijuana. Completely pathetic. This was in the late fall/early winter of 2008, fyi.

We didn't really have a chance to fight the issue. He was then hospitalized (not within the VA system) and went back and forth between hospitals and nursing homes until he finally passed away earlier this year. That incident effectively halted any involvement he had with the VA medical system.

Not that this necessarily relates to this thread, but the way this country's gubbermint takes care of (or not) it's veterans is disgraceful and disgusting. They deserve better.

[Synack]

I'm in the same state as PG - I was told my doc would no longer treat me, so I went to a pain clinic - then I checked my file - my old doc write 'contract violation, referring to pain clinic' in my notes... what kind of fucking shit is that... ugh.

[jacky]

I know two gentlemen....

one was partially crippled from a motorcycle accident that left him barely able to walk with crutches....

the other was an amputee that lost his leg to cancer.
the amputee was getting his masters in archeology, and would spend weeks out in the desert, making do with his limited mobility.

both these guys were forced by the Idaho state pharmacy board, to quit their pain medications...both were managed on vicoden, percocet, and sometimes darvon.

after some 10 years for the amputee on pain meds...and 20 some years for the guy involved motorcycle accident, within a few months they were forced off of their pain meds.
the amputee was threatened to be made a ward of the state, because he had mental problems associated with not wanting to experience life without painkillers...he had ghost pains from his amputation...and pain associated with his body having to compensate for not having a leg.

both were my freinds...
and they both died from heroin overdoses a few years apart.

they died in part I think because there was no methadone maintenance in our state.
the state doesnt allow for outpatient treatment.
I know a few wealthy jocks that get methadone because they get sore from working out and basically destroying their body with too much exercise...
and I know the state pharmacy board in Idaho refused to investigate the inordinate amount of narcotics and methadone being prescribed in Sun Valley Idaho to rich people. apparently, methadone maintenance is OK for rich peoples kids that agree to keep their kids on a long leash in Sun Valley. not to mention that for some reason a small town like Sun Valley was being scripted as much pain meds as some towns nearly 3-4 times the size in the same state.

as long as the feds/state seek to limit pain meds that are opiate based...cancer patients and others getting terminal pain med treatment will continue to outsource their meds to addicts that trade for heroin...
I knew for a few years that my oxys I was getting were coming from cancer and aids patients that had joined into some sort of distribution hub.

Billi started junkielife, as a reaction to portland police following aids/cancer patients around after they would get their scripts...the police would try and force these pain patients into going straight home after they got their meds.
the police tried to limit their movement, they tried to limit these peoples social rights/human rights...

its an out of control system, the overdoses are not going to stop just because one or another drug is substituted for another, the forgerys are not going to stop.

I hope that some people just start growing their own, cheap opium, or pod products in the face of federal/state meddling in peoples health issues.
if medical cannabis can gain a foothold, I think that some pain patients might be able to attract some attention towards a similiar activity with growing the opium plant.
at least in certian states.

I dont have major pain issues...but I know that could change at any time.
from what I see, I dont know if I would even attempt to treat the pain by going along with the system, I would probably have to relocate, and leave this backwards state for another that allows methadone maintenance.

[Duckfeet]

Well fucking said, Jacky ^^^

I've been an opiate addict forever, even w/many years off of them, and only in last few years, have I found myself crossing over two the side of the people in chronic pain, and I don't even know anymore which side is harsher, as the cruel and unjust laws affect us all.

And the saddest thing, for me, is to go to my monthly methadone "group" that is required by V.A. for us to get free methadone: and to more and more old guys who cannot be prescribed decent opiates for pain, and have to go thru all the "junky" hoops to get methadone, and they have all the terrible constipation that older people have anyway, and are just distressed.

And about half of them cannot even drive anymore, and have the terror of taking buses, and maybe being late for clinic, or getting robbed on way home...The online database that the feds now have, branding us all now and forever as drug-addled, ensures that the only option available to me, for pain, will be just more of the methadone clinic.

Such a country.

[feelings of u4ia]

It's always been my understanding that most doctors aren't really allowed/supposed to prescribe pain meds...and that if you need to be on them (well, anything more then a few vicodin a month) that you are supposed to be seeing a pain management specialist.

I don't really see your situation as being something bad...if you go to an actual pain management doctor, chances are...you will have your pain managed much better. Pain docs are more understanding and obviously feel more comfortable then other docs with prescribing narcotics.