Skip to comments.Doctors told to limit opioid pain relievers
Posted on 09/15/2013 7:50:03 AM PDT by Innovative
Patients should not be prescribed long-acting or extended-release opioid pain relievers unless they need daily, round-the-clock care for pain that can't be managed by any other means, the Food and Drug Administration has told doctors.
The new guidelines - meant to stem the country's growing epidemic of opioid abuse and addiction - will not place formal new restrictions on prescriptions by physicians, but administration officials hope to chasten physicians who prescribe the medications for anything other than ongoing, intractable pain.
(Excerpt) Read more at philly.com ...
Says it all.
I've been on morphine. I really 'get' how addictive it could be, I also probably would have died of shock without it.
Had I needed to, I could've gotten un-addicted, getting un-dead is more challenging.
The Food and Drug Administration should but out of my business, as should the AMA and it’s minions. If I want to take a drug for any reason, including recreation, and suicide, it is my business, not theirs.
I was in a situation a couple years ago where some high octane pain killers were just the ticket. It made my tasks bearable. It had nothing to do with pain, I was care-taking, and it helped me sleep during short opportunities. When the need abated, I went back to my couple-beers-a-week habit. No doctor would have recognized my right to do this, arrogant bastards, so I did it illegally.
As for people who are not in control of themselves, and become addicted, give them all they want, and let evolution sort out the mess. Don’t punish those who are in control of themselves.
How about focus on the fraud and focus on cutting out meddlesome regulations like this one that only serve to inhibit a professional from their work. Maybe drug rationing is thee gubment’s hope to spread the drugs?;
Prescription drug overdose deaths now exceed deaths from motor vehicle accidents in many states. This is not a hypothetical problem. It needs to addressed.
Barney Frank calls for the legalization of coke and heroin.
Not by the federal government. They don't have the authority under the Constitution to do anything about it.
The kid, not more than 25, almost didn't fill it because my husband could not be there himself to fill it. (not kidding). then he wanted me to have his ID.
The whole time I could tell he was eyeing me and asking questions, trying to determine if I was some sort of pill abuser.
It was ridiculous and humiliating.
Obesity is a problem too, but i dont need the government dictating what I can or cant eat drink, or in what quantity. I practice self control and personal responsibility
So is the solution to stop prescribing medication to everybody because there are stupid people who DO NOT FOLLOW THE PRESCRIPTIONS?
It's the only way government knows how to act.
My husband was on chest patches for pain, similar to morphine, all the time due to a bone disease and pain all the time and those patches are very addictive. It was either the patches or he couldn't function. I read kids steal these patches from a parent who takes them, and they squeeze the liquid from the patch and swallow it and a number of them die from doing that. These patches are sold on the street by drug pushers.
My husband never put on more than one patch and had a schedule when to change a patch. Those patches are highly regulated because they are so addictive and dangerous if instructions to use them aren't followed.
People who abuse these drugs make it harder for a patient to get them. That is a pity for people who need them.
We already know that’s what they’re smoking in Congress.
Remember the pro-abortion argument - “we don’t want the government to come between the doctor and the patient.”
My house was broken into on Christmas Eve a few years ago by addicts hooked on Oxycontin.
A longtime friend lost his house and everything he owned because of financial problems stemming from his wife’s addiction to Oxycontin.
Another longtime friend lost his wife to suicide related to her addiction to opioids.
Opioid based painkillers replace one type of pain with another. No thanks; I’ve seen the damage done, and I’ll have no part of that.
I am not in favor of more gov control however many docs out there are doing this to earn a easy living. Every month the addict comes back with his money or government insurance card.
It has stopped being about helping people to recuperate or live without pain. This is not every doctor and every case but its true for a large part. I had to go to pain management last year and the first thing he did was prescribe three times as much as I had ever had before.
I walked out in April and have not been back, Its easier to live with pain then to be treated like a jr high schooler and forced to pee in a cup.
Screw the guv and their regs
If it was an abortant, they’d be available to minors without a prescription.
I am personally totally against unnecessary and overuse of painkillers, however I am also totally against the government telling doctors, who know their patients best, who should or shouldn't receive certain medications, including pain killers.
Oh, fine! Go ahead and be realistic, Innovative! See if I care! In full seriousness: control of the citizenry is to the feral government as heroin is to drug addicts.
I have Psoriatic Arthritis which means I am in pain 24/7 to varying degrees. I cannot go without pain medication and frankly, I don’t care about the addictive side effects. I also don’t over use or abuse it. I am very careful with it. I have a great rheumatologist who monitors me constantly, but he is getting older and I do worry what will happen when he retires. My personal physician seems to let the gubmint tell her how she should practice medicine and is perfectly happy to do that. Not sure changing doctors is an option there, I have a feeling I won’t find anyone any different than she is.
Oh, fine! Go ahead and be realistic, Innovative! See if I care!
In full seriousness: control of the citizenry is to the feral government as heroin is to drug addicts.
” control of the citizenry is to the feral government as heroin is to drug addicts.”
Unfortunately, very true. And what is worse, is that the people accept it, because it is so gradual. Where do you draw the line?
It always reminds me of the story about the frog.
If you throw a frog into boiling water, it immediately jumps out. If you put it into cold water and very slowly turn up the heat, so the temperature difference at each step is very small, it just sits there, until it’s cooked.
We are all just like that frog in the slowly warming water...
Proof of the existence of entropy may be found in the devolution of an iconic Democratic President’s famous “I feel your pain”.
Now, the Democrats are letting teh citizen feel their own pain and are trying to dragoon physicians into not prescribing pain meds.
“Let ‘em eat aspirin.”
Oops, make the: “Let ‘em eat generic aspirin”.
I am sorry about you and your friend’s experiences — but the drug is not to blame, it’s the people. Many illegal drugs are illegal and people still find and take them.
You can’t blame the car for people driving it recklessly, nor the alcohol for people abusing it.
Also — just because some abuse it, that is no reason to make it unavailable to everyone else.
There may be some unethical doctors who write prescriptions wholesale, but the vast majority are ethical and now they will all be afraid and won’t want to write prescriptions even for people who truly need it.
Doctors are already even reluctant to write prescription for “regular” medications, which are not at all in the addictive category — just to save money for the insurance company, writing prescriptions for cheaper drugs, that are not the most effective for the condition and are reluctant to write prescriptions for ones that are more effective, but more expensive. Same with ordering tests.
Doctors’ judgment is being substituted by government edicts of “one size fits all”, to the detriment of patient care.
The art of statist is to oppose controls on everyone in the name of those who might actually need the help of the government.
That is what, "it's for the kids" is all about. We as a society assume that children are incapable of taking care of themselves and therefore someone or something must interpose itself and control their lives. If you go under the ghetto and find children who can't read and teenagers shooting each other dead in drug wars, the statist has all the excuse he needs to step in and legislate or regulate. These are extreme examples, but statist do it when they oppose homeschooling and we do it across the board once we have raised the justification of "for the children."
Liberalism seeks out the eccentric to justify control over the normal.
The State of Washington has already clamped down on opiate prescriptions to the point that doctors feel that they are playing Russian Roulette with their license to practice medicine every time they write one. It is not a tenable situation for doctors or patients.
“Opioid based painkillers replace one type of pain with another. No thanks; Ive seen the damage done, and Ill have no part of that.”
Easy to say, until you find yourself thrashing about, out of control, with pain that only opiates can control.
Been there, experienced it. In my case, surgery relieved the pain but without the opiate based pain killer, I was unable to hold still for the CAT scan which I knew was essential prior to any operation.
SOmetimes, will alone can’t overcome pain.
As for addiction, remove the government and most of those issues go away.
Just removing the War on Drugs and the militarized Geheimness StaatPoleitzi we know as SWAT teams would be worth any number of addicts killing themselves with open market drugs.
Cheap drugs remove the major reason that druggies commit crimes - that reason being crime is presently their only way to finance their addiction.
Decriminalize drugs, remove criminals largest motive to commit crimes
Their life is their business. Don’t “protect” them by infringing my rights!
Druggie deaths is never a valid reason to infringe the rights of American citizens.
Might this be what you meant to say?
I can blame Dragon NaturallySpeaking software for making the mistake but I don't know whom to blame for failing to proofread.
This area of medicine is very complex and often mismanaged by emotions versus results.
My wife and I are on the opposite end. We do terrible with the narcotics/opiods.
We have to go through hoops and bs not to get these drugs.
My wife gets very sick GI/nausea with a single dose of an injectable or po dose of an opiod. The last thing you want when you are post op. She, also, develops bizarre mental reactions from these drugs.
I have zero pain relief with these narcotic/opiate drugs. When, I take them post op, it like getting hit in the forehead with a baseball bat wrapped with a lot of gauze. My mental processes go to hell, and I’m very shaky when I try to get up to answer some of nature’s calls.
Last week, I had some lengthy and complicated foot surgery, and the Orthopod/foot surgeon as per my suggestion used Toradol IV during and on closure.
He gave me an rx for po Percocet an rx for Toradol. Re the Precocet, which I took as directed for one day and half the dose for the next day and DCed it on the third day. No real pain relief besides filling like someone hit me in the forehead with the baseball described above. Constipation for me comes with a single dose of a narcotic/opiate.
In spite of warnings that PO Toradol, a non steroidal, might not cover the pain. I started rotating the doses of the Toradol and Percocet on the first day at home post surgery., I’m doing fine with it and had no narcotics after the second day. I started walking with the boot two days ago, and I am apparently about a week ahead of schedule re recovery.
I take 4 15mg ER morphine tablets per day for lower back pain. It dulls the pain enough to let me function at a much reduced capacity. Without it I can barely move. I am caught between the pain if I don't take them and the nausea if I do. I go through a sleeve of saltines a day fighting nausea.
The only good news here is that I am not experiencing any feelings of opiate addiction. As a Friend of Bill W., I have a pretty good handle on that.
SweetiePalm can't drive any more so I have to do the grocery shopping. If I am going out I have to wait so long after taking a morphine that I usually can barely get the car unloaded from the pain. I take a morphine and have to sit or lie down until it takes effect, usually about an hour.
I am very concerned that some unknowing bureaucrat is going tell my doctor that he can't prescribe for me any more or reduces the amount to where I am bed ridden.
Garde la Foi, mes amis! Nous nous sommes les sauveurs de la République! Maintenant et Toujours!
(Keep the Faith, my friends! We are the saviors of the Republic! Now and Forever!)
LonePalm, le Républicain du verre cassé (The Broken Glass Republican)
The unfortunate situation is that true personalized care is becoming non-existent. Doctors used to be well acquainted with the patient and their reactions to different medications and would tailor them to the individual, but unfortunately most doctors don’t bother anymore and it’s only going to get worse.
Those who don’t fall into the “average patient” category will and are suffering — as you shared your and your wife’s experiences.
‘Recognize it as an emphatic warning about Opioid based painkillers. Recognize their dangers.”
I couldn’t agree with you more — it is unfortunate that some take it, even though they don’t really need it, but that is no reason to deny the meds to those who truly need it. This is where a normal doctor-patient relationship would be helpful — where the doctor knows the patient and his/her needs and reactions. Unfortunately this is fast becoming non-existent and is being replaced by “one-size fits all” — but it doesn’t...
I’ve never taken anything stronger than ibuprofen but I have see Oxy and such wreck a lot of lives.
I was prescribed hydrocodone and oxycodone for pain caused by a back injury from a car accident. The medication worked very well to manage the pain and I typically only took it after physical therapy or at night to sleep. The doctors then switched me to Tramadol stating that they felt it was better if I took a non habit forming pain medicine for long term therapy. Yeah, that worked out great! The Tramadol didn’t touch the pain so after a couple of weeks I simply quit taking it and coped with the pain. I was only able to stop taking the Tramadol for a few nights. I had severe physical withdrawal. It was an absolute battle to get off that crap. I shared this with the doctor and he just wrote me a prescription for something else.
Well I filled the prescription, went home, and read the informational packet that came with the medication. It was an anti depressant that had a wide range of possible side effects such as suicidal episodes and psychotic episodes. I immediately called the doctors office and let them know I refused to take it because of the possible side effects. The doctor told me he’d just give me more Tramadol. I told him to shove it.
Personally, I’ve never had an issue with withdrawals when I stop taking Percocet, Vicodin, or any of its generic forms. No bad side effects, nothin. That synthetic “non habit forming” crap was horrible though.
Have lived a fairly normal life thanks to hydrocodone for the past 6 years. I personally fear decisions and attitudes that will affect my access to these drugs. In my case, they are cheap and effective, giving relief that expensive man made alternatives have failed to do. I am fortunate that these drugs do not give me a high or make me sleepy. Instead they give me energy and reduce my pain level to the point that I can sit through a movie or perform minor work around the house. Continued access to these drugs is not automatic. I have to periodically see my pain doctor and have blood work performed. On occasions when pain is out of control or special situations (travel w/o access to medical treatment in U.S.), I’ve had to have an epidural. The cost of an epidural is around $1,800 versus $50 for a 90 day supply of hydrocodone. Besides the cost, there are risks associated with epidurals as well as negative long term effects from steroid injections. I gladly prefer the hydrocodone to riskier treatment, higher costing drugs, and the prospect of no treatment.
Well, good for you. But do you have the insight to understand that what is good for you is not necessarily good for everyone else?
Prescription drug overdose deaths now exceed deaths from motor vehicle accidents in many states. This is not a hypothetical problem....And..What is the problem? You die of something, anyways, and Obamacare is taking care of the old age hypothetical problem.
I have a new tag line unless you object.
Yes, I have been on morphine twice for a week or so. Kinda needed it. The severe amount of pain was reduced to zero after brain surgery, which was a little scary as I was afraid I’d move wrong or touch the affected areas. But I didn’t.
Then I went home and was lying in bed with the sound of the TV in the next room boring into my head like a drill. I lay there silently shedding tears in agony wishing for another shot. That was my understanding of addiction. However, oral opiates helped for a bit until they could remove the metal spacers a week later, which dramatically reduced the agony, and then I slowly recovered with no pain meds at all. Never had another desire for the drugs. Didn’t “enjoy” them in any recreational sense but sure as hell needed them.
Liberalism seeks out the eccentric to justify control over the normal.
This is a brilliant quote.
You wouldn’t believe all of the precautions I have to take in order to prescribe opiates to patients with chronic pain. The over-riding concern I have is maintaining my license and DEA number. Therefore, I do urine drug testing on each visit, frequently check the state court site for drug crimes, check the state database for doctor shoppers, and have patients sign paperwork holding me harmless for side effects/death. On each visit, patients must sign that they are not under investigation for drug and drug related crimes, and that they have not gone to another doctor for narcotics for chronic pain. I have camera surveillance for the public areas (we have observed non-patient individuals asking patients about their prescriptions in the office) and an armed security guard (very helpful for discharges).
I order to stay in practice, because of the DEA, I must consider that any patient could become an informant for the DEA. I must also profile new patients to determine whether they could an agent on a sting.
We have had patients bringing in urine in condoms, or trying to get their child to produce urine for them in the bathroom. We have had tandem teams come in with one person going to the bathroom and leaving urine for the patient who comes in next. We have patients shaving in opioid to test positive on the rapid screen to prove that they are taking the medications. We have had a patient use their cell phone to record activity in the clinic. (this patient told me this, so we don’t allow cell phones in the exam rooms) Nothing surprises me now.
If he didn’t he could win a trip to the Graybar Hotel. Pharmacists can be held responsible if they “should have known” that a script was illegitimate.
“Did you really think we want those laws observed?” said Dr. Ferris. “We want them to be broken. You’d better get it straight that it’s not a bunch of boy scouts you’re up against... We’re after power and we mean it... There’s no way to rule innocent men. The only power any government has is the power to crack down on criminals. Well, when there aren’t enough criminals one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws. Who wants a nation of law-abiding citizens? What’s there in that for anyone? But just pass the kind of laws that can neither be observed nor enforced or objectively interpreted and you create a nation of law-breakers and then you cash in on guilt. Now that’s the system, Mr. Reardon, that’s the game, and once you understand it, you’ll be much easier to deal with.”
- Ayn Rand, 1957 -
Ayn Rand wsa a visionary — unfortunately... yet people here today still don’t see it, until it will be way too late.
Government Seeking Inclusion of Social and Behavioral Data in Health Records [more spying]
Thank you for sharing your experience - scary, but I believe every word of it.
Doctors are forced to put the government threat over the treatment and well being of the patient... and it’s only going to get worse.
The other day a public radio station talked about pain medication. The retired head of MD Anderson Cancer pain clinic said the medications are a lifesaver for many.
He said the problem is any Doctor can prescribe them without the proper training and that is the problem.
I believe too, it’s best to regulate who can prescribe them rather than making criminals out of doctors. Highly addictive drugs should be in the hands of Pain Management doctors instead of any physician with a medical license.
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