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

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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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8

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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2

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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12

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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11

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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5

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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4

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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15

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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3

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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17

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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20

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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14

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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21

You're right, Bart, it isn't a law. I think what the commenter is thinking about is the LAW which changed the schedule status of the drug Hydrocodone from schedule III to schedule II which is a major big deal in that Dr's now have to write a script every 30 days, no more refills or calling the pharmacy. That in itself changed the scope of opioid prescribing for anyone taking the drug for chronic pain.

The second letter I saw was about morphine. The first 2/3 of the letter described new thoughts on the drug. It suggested that 80mg of morphine had been set as "trigger point" signifying the Dr should stop and reassess the Patient. It suggested more than 80mg of morphine was found to be non therapeutic blah blah blah. Then finally, in the last paragraph it did state the Dr should use her discretion in managing those patients on higher doses.

No it didn't change any laws regarding Morphine doses but it implied heavily that prescribing as much as or over 80 mg Morphine was frowned upon heavily. It may as well have been a law because it scared the CRAP out of my Dr. I'd been on extended release morphine for more than 22 years. I was taking waaay more than 80mg. I think I was taking 300 mg split into 2 doses which was immediately cut in half. I WAS given Vicoden or Lortab to take, only if needed, between the two doses of morphine. Also I was told to expect an even greater cut in my dosage the following month. I was a complete wreck. The month after that I taken completely off the morphine and put on 40 mg Oxycontin. One, twice per day plus Lortab for breakthru pain. I've never been so sick in my life. I'd been a patient of this dr for nearly 10 years. During the appts, his nurse would sit near him and not look me in the eye. I was afraid to try to talk during the appt, scared I'd start crying and not be able to stop.

I'd had a great job I loved and had to take a medical leave of absence. Couldn't take proper care of myself or my home. The last time I saw that dr was March, 2014. He left the state. I was referred to another pain specialist where I was made to feel like a criminal, drug addict. He would not prescribe ANY narcotic pain medicine though I was given a u/a before every appt. He sent me for physical therapy, which I did. What I said "no" to was the repeated tries to send me to "their" Psychiatrist. I have a psychiatrist I've seen for 15 years, my insurance won't pay for me to see 2 psychiatrists and finally I don't need two psychiatrists! I finally told that a**hole from hell where to stick it.

I've had to start completely over, going to a specialist for my syndrome. Repeating all the painful diagnostics, examinations & procedures I went thru years ago. I've signed petitions for DEA reform blah blah blah. So, no, there's no law, other than the new scheduling for Hydrocodone which has caused far reaching catastrophes for thousands of American people.....

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526

Officials are concerned about the "accidental" death by opiates. What about chronic pain patients who commit suicide because they can't get the medication needed to make life bearable? Who is keeping up with this stat?

How many folks reading this forum have considered making the move to the other side because the quality of life is next to nil?

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25

This is so utterly wrong. All of America would be in an uproar if this pertained to any population OTHER than pain management patients!

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32

I live in Tennessee and this is happening here starting this month as well... I have done research since my last post and please forgive any auto correct errors since I am using my cell to respond. Here is what I found out so far.. and it's in multiple but all equally important steps. To state the obvious they don't know the difference between long acting and short acting meds so to lump together is quote frankly going to cut me by 3/4 and sadly was just getting to true functional level go figure =(.

1st. Dr's can write however if they do they get audited and threaten to take away licence if they don't like the answers of why we are prescribed. So it says they won't be fined or get put in jail. They will just make them not have licence which threatens their job..

2. They are starting with only some insurances and of course medicaid is first. The people like me that just lost job and needed insurance for my many issues M.S/fibermyligia/slipped L5 disc/post tibular tendonitis both ankles and many other issues.. Poor working class people with jobs that have kids and seniors that are not on medicare yet.

They were sneaky. First they ate using Medical definitions in new law that have been proven incorrect 15 years ago. They also are using outdated treatment terminology to make it fit agenda. They do not have the true definition of addiction listed in law so they are confusing it. It has been proven that people like us are not addicted to these meds they are like Tylenol to use because we use them only to function in work take care of kids and not be bed ridden.

3 The state health department is mandating 3 to 6 URI E specific tests a year. (Very different then the ones you take every time you go in these get sent to lab and cost $650 or more a piece.

4. The insurance company will only pay for 2. I asked if I could pay out of pocket for 3rd and was told he was not allowed to take my payment in cash.

So if insurance company only pays for 2 and state mandates 3 or more. And only if you are taking 120 milligrams Morphine equivalent they are not allowed to see you until next fiscal year since state mandates more he or she can not write without being audited.

I AM VERY AFRAID!

they also stopped covering my adderall that finally controlled the Fatigue that comes with my disease. Not allowed to take that with any opioid!!!

I HAVE HAD THIS THIS PAIN SINCE 1996. I did not start taking meds till pain was so bad I couldn't get up without crying and had 2 toddlers under 4 to take care of. Also I was having panic attacks my pain I was trying to ignore was internalizing once pain controlled those stopped. I don't want to be bed ridden . Why should I have to be because of the true addicts that abuse anything they get hands on and have nothing to do with people like us that are lawful and always have been.

When you break your arm they give you something, it however goes away and you forget pain.

I wanna know if someone beats their legs with a baseball bat till black and blue. And then keeps hitting them every 5 minutes 24 hours a day 7 days a week. Then tell them we have meds that will help you but to bad.. Instead you need to be bed ridden instead of a productive member of society.

Does anyone reading that does not have pain volunteer? Have to do it for 6 months minimum to understand. Make your choice remain in bed or take something and Live Life?

I talked to many M.S patients that are bed ridden..I am not yet.. the only difference they were not given pain meds to function legs hurt to bad to want to keep walking and their muscles became to weak..

I KEEP MOVING BUT ONCE YOU MAKE IT TO PAINFUL TO DO SO YOU WILL MAKE ME BED RIDDEN YEARS BEFORE I NEED TO BE.

NOT SATISFIED? GOT TO LISTEN TO HYPE OVER THE TRUE ADDICTS THAT HAVE BEEN AROUND SINCE BEGINNING OF TIME?..

BACK IN THE DAY THEY USED COKE. THEN THEY SWITCHED TO OPIATES.. THOSE WERE TRULY ADDICTIVE..SO THEY FINALLY MADE A BREAK THROUGH MEDICALLY AND MADE PERCODAN WHICH IS WHAT IS NOW CALLED PERCOCET IT'S NOT NEW!!! GROW UP PEOPLE PLEASE AND READ YOUR HISTORY!!!

SO NOW WHAT'S THE NEXT STEP TO BATTLE THIS BREACH OF OUR PATIENT RIGHTS? YES WE DO HAVE RIGHTS. THEY WROTE A BILL TO KEEP US OUT OF PAIN. HOW IS THIS NOT BREACHING THAT?

RANT OVER. PLEASE WE NEED HELP WITH OUT BEING TREATED LIKE THIS.. STRESS IS WORSE THAN ANYTHING ON PEOPLE TRYING TO FIGHT THE DISEASE THEY DID NOT ASK FOR. AND MAKING US SWALLOW TONS OF TYLENOL THAT IS KILLING MY LIVER TO CALM QUIVERING PAIN IS GOING TO COST MORE IN LONG RUN TO TREAT LIVE CANCER. IT'S HEALTHIER TO GIVE US WHAT WE NEED AND WE TAKE LESS THEN THE GOBS OF TYLENOL THAT DONT WORK BUT YOU ARE HOPEFUL AND TRY ANYTHING.

I AM SCARED FOR SOME PEOPLE THAT ARE WORSE OFF THAN ME. THAT MAY NOT BE AS.STRONG WILLED. SOME PEOPLE CAN'T TAKE PAIN AND THEY MAY WONDER WHAT'S THE POINT?

THAT IS BLOOD ON THE OVER REACH OMG GOVERNMENT'S HANDS IF YOU ASK ME...

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351

Yep, i feel ya ........i think since we have pill counts and UA's ALL medicine takers should.....if a dude eats a candy bar and needs extra insulin--fire him! If lady worked on her garden for too long and her knees are swollen and she took an extra anti-inflammatory: fire her! Old guy forgot to take his blood thinner last night? Fire him! Yes! Do to all other folks, same as we have to do...grandad had a martini before bed? And then took his sleeping pill? Fire him! Bob knows not to eat a certain food and to increase his veggies for his cholesterol but had company last night and went for the spicy hor dourves .....had to take an extra cholesteral pill...and quick too! Fire him! Think they'd realize the damage they cause pain patients?

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391

OHH BL you are a broken record that plays the rules of pain management over & over & the worse treatment becomes for true legit pain patients, the more you enjoy pointing out specific changes that are hurting the patients. You automatically assume all are druggies & that the less treatment we get the better.
Like I said before you really do not have a clue what true chronic pain is & how devastating it is., maybe karma will get you before my pain kills me........sure hope so.

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401

I don't know your laws. I AGREE WITH YOU 100%. I have been a nurse for almost 2 decades and what they are doing to true patients is unforgivable... A junky will find what they want. Its not our fault. If a person will have proper treatment chronic will make anyone addicted to there meds... That's not a junky!!!! Common sense. Good luck. I will pray for you and all like you....

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592

Yes there is more to M.S than pain those a which are the reasons I am in the pain I am in sadly. Over 20 years of living with it trying everything possible to see what works and doesn't. I have found opiods for me personally help greatly with my pain and also notice when my pain is controlled I have fewer relapses. When my pain is controlled my body and mind are freed up to take on other complications that may arise and many times don't cause as much damage however if not controlled my system is in a free fall and hard to recover if at all.

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662

I too have suffered with long term severe chronic pain. I have been treated like an addict. I have never failed a ua, always take meds as prescribed.
This recent suggestion from the DEA is just that, a suggestion. They are coming down on all doctors to have supported documentation for their patients & their need for the high levels (they deem as high) of pain meds. I've heard that the doctors need to fill out a form(s) supporting the patients need for higher doses. I think a lot of docs are unaware of this or they just don't want to be bothered & are just afraid of ruffling feathers.
It primarily stems from people who have lost a loved one who took pain meds. It's unfortunate that there have been deaths due to overdose.
Especially those from teenagers grabbing pills that were not secured by the family/friends.

These parents who lost their child are angry & heartbroken. I can't begin to imagine their pain.
They have the need to blame someone so now it's focused on the drugs, the pharmaceutical companies, the prescribers etc.
Which among other things has led to the recent events. Now everyone is being made to suffer.

No one should be allowed to set these limitations especially those who are not doctors & have no experience dealing with pain, much less chronic pain.
From what I heard these limitations are a suggestion.
It's not fair to the people who are compliant & are truly suffering.

I think the pain docs should stand together & support their patients.

Med prescribing & doseages should be left up to the physicians discretion.

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