2014 New Pain Medication Laws Dictating To Doctors That They Cannot Prescribe Anything Equivalent 120 Mg Of Morphine Or Higher A Day Per Patient

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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REPORT

Yes, it is true. New regulations were put in place last year that restrict how much of any pain medication they can prescribe, with exceptions being made for those that suffer from intractable pain due to a possibly terminal condition, such as stage 4 cancer.

The 120mg limit might be an internal thing to that clinic, there is nothing regarding that specific amount that I am aware of, but they are supposed to restrict their patients.

This is a narcotic analgesic, so it has the potential to be habit forming and may cause side effects, such as nausea, dizziness, drowsiness, dry mouth and constipation.

Is there anything else I can help with?

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Your doctor is either lying to you or doesn't understand the new regulation. In simple form it basically says if you are at or exceed the 120med then the docs are required to do what they call a reset. Basically they have to look at your case history and determine if you really need that much medication and if you do you get it. But they have to be able to say why to the DEA. About 6 months ago I had to go through it with my doctor and I was concerned I was going to be cut. But it all stayed the same. My doctor is pissed but he has to do what he has to do. Don't bother looking for a law there is done, it is something that the DEA has come up with. Ask them for a copy of the new MED schedules and requirements. Under the freedom of information act they have to give it to you.

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Hi, I have heard about this DEA thing too. My dr hasn't mentioned it but I am in severe chronic pain. I was a cancer patient, during that time I was on very high doses of different meds. The only ones that actually helped my chronic pain was 100 fentanyl patch with #8 Dilaudid. The dr who gave me that is gone. The PM clinic I go to only makes recommendations to my PC then she makes her own decisions on what I get. Right now I am on 3 30mg morphine & 6 10/325 Norco which she just cut back to 51/2 per day weening me off. I have been pleading with her for the fentanyl Dilaudid combo to no avail. Morphine doesn't work for me & Norco makes me hurt worse. I moved here (MO) from CO where I had a wonderful PM dr. My question is does anyone know of a good PM dr in or around St Louis? I hear this is the worst state to be in for chronic pain sufferers. My issues are many & my tolerance high but I do know something that helps just need to find a great dr who takes Medicaid. Medicaid comes from the cancer time I haven't recovered well at all, plus now they are seeing something in my brain plus blood work is suggesting possible colon C. I will not have anymore chemo because of the poor recovery from last time plus if nothing else if I end up terminal I get hospice & I can finally get the drugs I need, how sad is that?? I'm with the person above on defending myself as I don't take these drugs to feel high, I take them for pain & believe me I wish I didn't need them. I don't like having a high tolerance nor do I enjoy the BS the drs put you through when all one is looking for is relief from 24/7 severe pain. I have a high tolerance to pain as well so I'm not joking about the need for a doc who understands & will write for what's needed & will listen when something doesn't work! The topper here too is that I've been asking for a few visits now to change & of course UA each time which have all been fine, appropriate etc as I do NOT buy or use street drugs (couldn't afford them anyway) my last result shows positive for hydromorphone. I've NOT taken any!!! Does anyone know of anything that could make the results show positive for that besides the drug? Any food or supplement as I take a bunch of supplements for joint pain etc, I'm totally bewildered & also afraid that they will cut me off for non-compliance, any help with that will be greatly appreciated as well. Thank you in advance for any help anyone can give me. Many Blessings! G

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I live in Tennessee & also learned of this new government intervention into my life Monday. It is outrageous that legislators are dictating how much medication is needed to treat my chronic pain. I did find Tennessee's version of the law at tn.gov. It is a 36 page edict which limits non-certified pain specialist to prescribing 120 mg.morphine equivalent monthly. Having been a chronic pain patient for 10+ years my tolerance is high & I am never totally pain free on current dosage. Cutting my medications will make it almost impossible for me to walk & thus to work. As a result I will end up becoming a burden to tax payers because I will file & qualify for disability. If anyone has any suggestion as to how we can get these non certified law makers out of our lives please post. It will take lots of money and political connections to undo this unjust law overturned. Surely there are chronic pain patients who are willing to make financial contributions to fight this.

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For info on this government intrusion into the lives of those who are chronic pain patients go to "chronicpainguidelineshealth.state.tn". This is a 36 page edict explaining the changes in prescribing limitations of non-certified pain relief providers.

The REPUBLICANS are always complaining there is too much government intervention in our lives. If this is the case, why are they allowing this to happen? I too have been a chronic pain patient for 10+ years & have a high tolerance. I take what I need to be able to walk, do not abuse or blow medication up my nose. Have always been a compliant patient & never failed a drug panel.

Now the DEA & STATE are telling me how much pain I am in. I am in the process of attempting to find an attorney with a good track record of winning legal suits. If ever there were an issue that needed litigation this is it. If any reader of this is, or knows, an attorney willing to take this on, reply to me through this forum. I AM NOT GONNA TAKE THIS CRAP ANYMORE

Grace C.

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Vernon or Anyone- Do you know of ANY legitimate providers in or within 100 miles of Knoxville? My provider was recently indicted in the now defunct Broadway Health of Maryville money laundering scam which occurred in 2009-2010. I thought I had done my due diligence when I decided to use Serenity Health in Alcoa. I asked the principle provider if there was any reason she would not be around a year from now. Of course she said no. I am a legitimate & compliant patient who wants to.do the "right thing" & it seems almost impossible. I would appreciate help & guidance. I am at my wits end & need a provider who accepts self pay patients & doesn't charge an arm & a leg for services. Thanks

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Hello, Grace! How are you doing? I'm very sorry about what happened to you, that's horrible.

I wish I knew of a doctor there, but unfortunately, I don't. I'm in the Pacific Northwest, so quite a ways away.

Can anyone recommend a good doctor in that area that can help Grace? Pretty please?!?

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This 120 mg limit is total bulls***, from some jacka** that has never lived in pain and doesn't care or understand what real pain does to a person. I have had over 23 major operations and suffer from hereditary neuropathy and to be told by some jacka** that doesn't know what real pain is that 120 mg is enough or to much is total bulls***.

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I am going through the same thing in the state of Oregon. I don't know if it is a law here, but it is creating havoc with my mental health as well as with my chronic pain from two back surgeries that haven't done much. Have you learned anything more about if it is a state or federal law? I am thinking about moving from Oregon and I am scared to death that I might have to leave the country....hi my name is Samantha I am Eileen's daughter I just walked in and she explained to me about your post I sure hope this post finds you well I am really worried about my mom and any help you can give us would be really appreicted I'm am just at a loss when it comes to giving her any advice because I really need more knowledge to be sure because this is my mom whom my god I love dearly our prayers are with you thank you sincerely Samantha

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Hi Vernon,

I am in Oregon and this changing meds is bull****. I've had two back surgeries and neither one took very well. Now they are telling me I am on too high a dose of pain meds. What I****S. My Dr. Is having a fit with them. But he says there is nothing he can do. Do you know if it is a state or federal law? Well Vern I really hope you feel better!! Eileen

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I'm in Alabama on high doses and my doctor says that's it's not an actual law or ruling but the Medical Board is putting pressure to lower doses by sending the out PDMP Reports to doctors for patients on high doses. I'm absolutely dependent on this for any quality of life and have improved tremendously with it. I fear I'll lose all I've gained. Prior to this I'd developed cardiac adrenal syndrome from ongoing pain, had very little immune system, and lost over 40 pounds despite being thin already and having a high daily calorie intake. I had pneumonia repeatedly. I'm in a wheelchair and finally was able to affiord transportation and trust my ability to drive after seven long years once I was treated. Spasms from the genetic condition I have are getting much worse and I I've only driven a few miles twice since this started. I had just accepted a part time position that was truly perfect for me after so many years of endless searching. There is no way I could ever handle it though and I had to call back and tell them I could no longer accept the position. This would have done so much to improve the tenuous financial circumstances I have. My doctor said he hates to think of how much he'll have to reduce my dosing. I truly feel as though I'm losing everything including the simple ability to live independently which I've fought so hard to maintain due to the bad choices some people make. All this while I'm not a given a choice. Thanks to the Alabama Board of Medical Examiners I've revised my Living Will and will likely refuse treatment when and if the issues I had before return if there doesn't seem to be any help in sight. I'm not old at all, way too young for a decision like this. I've done nothing wrong yet I'm punished severely so that others who make poor CHOICES that may lead to the disease of addiction if so predisposed.

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The DEA, Pharmacy Board & even the governor of your state are in control of your licensed pain manager physician. A Pharmacist now has the power to decide whether or not you deserve to have your pain medicine prescription filled depending on their mood or what their opinion of the amount of morphine your Dr has ordered for you is. It started in Florida. The second biggest takeover was Northeast Ohio and after that I've read nightmarish accounts of folks medication being cut by half or more in one days time from just about every state in the union. It has been a nightmare for two years. They came around 11:00am while the place was packed. All the patients were kicked out and told they didn't know when the office might reopen." Could be today, possibly tomorrow. Might be never". Shrugging their shoulders and shaking their heads to people's faces.The arrogance! The office did reopen the following week thankfully but it didn't last. By March 2014 the office was closed for good. I've had to start all over with my care for my disease but a new pain manager only wants to prescribe me neurontin which literally made me feel homicidal. I've signed petitions and even emailed a letter to the governor. My letter ended with the phrase "some days I just can't take this pain any longer". That afternoon two young men from a local mental health clinic were on my step. I s*** you not. Have you ever in your life? I certainly never wanted or expected the governor's office to be so afraid I'd off myself they'd send the guys in the white coats. But it happened. I could write a book but there's not enough time. Wish I had some encouraging words. The only way we'll get proper pain care back is if we all stand together and stop paying our taxes and demand they stop with the craziness.

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Hi I live in the state of Oregon. My doctor is very upset about this new law. I was sent to a pain management to be "reset" He told me with my problems there is no surgery to help me and that I am doing everything right, that I would keep the same does of meds. When I went to see my primary doc he showed me a letter from the pain management that said take me off of everything! Even the 120 mg law. WTH???? We are leaving OR. Looking for a state that will keep me on the meds that I am on now. Anyone know of a state that is still good?

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Grace...I live in Knoxville. Not sure if you are still in need of a doctor or not since its a old post. If you are let me know and I can provide you with a few doctors.

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Not a law but last year at the Pain Convention at Opryland Hotel here in TN I THINK, it was decided on by doctors, nurse practitioners, pain doctors and such that four pills a day should be all that's needed of anything. I don't know how they made that decision when there weren't any pain advocates or patients present!

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alwaysNpain, please msg me {edited for privacy}. I'd really appreciate a few names :)

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There is a group who has begun an attack on this drug war and since one member is a higher up with pharmacy board he has connections that will get results. It will be a definite stab in these uncertified political, i****s that are killing us. I am in FL so am going down for the last count before being drowned totally. Already been bedridden for a year now I cant find a dr. for ANY meds. So I am writing here & giving one last try to save myself. Too young to die. I also redid my will, just praying for a miracle.

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Chris, I think I know which group you are talking about. Thanks for your post.

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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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It isn't an actual written policy but the pressures and fear of disciplinary action by the DEA or Board have never been worse. This is causing many physicians to taper patients or refrain from prescribing all together.

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No, that is NOT true at all. It is up to the doctor's judgement, especially after the CDC clarified the 2016 guidelines with their letter in 2019, then they UPDATED the guidelines in November, 2022, removing any mention of MME entirely in them.

They are still recommending no more than 50-90 MME, but it is NOT in the OFFICIAL guidelines from the CDC.

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Re: Steve (# 719)

This is old news, this is not happening today. I’m really tired of getting old threads that freaked me out and then I realize it’s just being sent because someone replied recently.

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My apologies again! I'm a 20+ year Chronic Pain Patient, and as you've probably noticed I'm starting to ramble in my disgust of this "War on Chronic Pain Patients!" You cannot make me believe that all of my Doctors over the past 30 years are wrong! I had been doing great on my opioid regimen of pain medications, until they were suddenly taken away: no need for breakthrough meds, 80% pain free, a positive outlook for my future, and now all of that is gone!

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Second addendum: My apologies; I meant to say that the comments were from 2014!

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

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Upon researching this, it is a guideline for Acute Pain, not Chronic Pain! Can anyone enlighten me on why this fact wasn't highlighted?

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I understand your situation a hundred percent. I also have been treated by a pain clinic for 22 years. i understand the 28 day cycle I totally relate to friends and relatives, even people who don’t even know me giving advice or opinions about something they know nothing about. over the years, as far back as 2001 i’ve been put on doses of medication that today would absolutely not be acceptable. However, in all of those years i’ve never mistreated my prescriptions, i never missed my monthly appointment, i’ve never felt any type of reaction like you see on tv when someone goes in for treatment and says “oh my i feel so fine” i get so tired of bureaucrats dictating to Doctors and Pharmacies, they are not Doctors and they probably would never have to worry about a bad back or injury where they would be told. gee sorry cannot help you with your pain issues. The doctor that i had for over 7 years ultimately retired because of the endless calls from pharmacies and insurance companies regarding his scripts, In 2019 i went to a orthopedic surgeon. and the first thing he said to me was I can’t operate with the high doses of medication that you are taking. I go to my next pain clinic appointment and I ask the Doctor should i look at rehab centers and he says to me why would you do that?? I said I don’t know that just seems to be what everyone has to do. He says no, don’t be ridiculous you will be fine. i was fine 6-9 months later I was within the doses the surgeon felt comfortable with, no withdrawal no physical illness, all that happened was, of course, my pain and discomfort went up. i hope you were able to work out your situation and you have all of my empathy with this I wish you the best

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Good luck, I understand, have not heard that either. I take 3 8/2 Suboxone strips a day wonder if that affects me?

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Re: Grace C. (# 5)

Both parties are ignoring the issue because no one understands it. The MSM does more harm. Insurance saves money - now billions. If we were Transgender we wouldn’t have a problem.

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This was in The Guardian 5-6 years ago:

The truth about the US "opioid crisis" - prescriptions aren’t the problem

The overdose epidemic is unmistakable. But it’s driven by illicit use of drugs. If moral panic results in more patients in pain, that would be a disaster

The news media is awash with hysteria about the opioid crisis (or opioid epidemic). But what exactly are we talking about? If you Google "opioid crisis", nine times out of 10 the first paragraph of whatever you’re reading will report on death rates. That’s right, the overdose crisis.

https://www.theguardian.com/commentisfree/2017/nov/07/truth-us-opioid-crisis-too-easy-blame-doctors-not-prescriptions

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