Big change to make it harder for patients to get pain killers like Vicodin

[bananas]

Source: KWGN

There are sweeping changes when it comes to popping the most common painkiller in the country.

<snip>

The Drug Enforcement Administration is reclassifying hydrocodone-combination drugs from a Schedule 3 Controlled Substance, to the more restrictive Schedule 2.

<snip>

Starting October 6, doctors can no longer phone in a prescription.

Instead, patients will have to see their doctor to get a new written prescription.

<snip>

Read more: http://kwgn.com/2014/08/22/big-change-to-make-it-harder-for-patients-to-get-pain-killers-like-vicodin/

[bananas]

1. ASCP Reacts to Rescheduling of Hydrocodone Combination Products

http://www.itbusinessnet.com/article/ASCP-Reacts-to-Rescheduling-of-Hydrocodone-Combination-Products-3458053

ASCP Reacts to Rescheduling of Hydrocodone Combination Products

ALEXANDRIA, Va., Aug. 22, 2014 (GLOBE NEWSWIRE) -- The American Society of Consultant Pharmacists (ASCP) issued the following statement today in response to the Drug Enforcement Administration's (DEA's) decision to reschedule hydrocodone combination products (HCPs) from Schedule III to Schedule II of the Controlled Substances Act (CSA):

"ASCP is disappointed that DEA did not consider the negative impact on patient medication access rescheduling HCPs would cause in the post-acute and long-term care settings," said Ross Brickley, RPh, MBA, CGP, past-president of ASCP and current chairman of ASCP's DEA Task Force. "Our members are very concerned for what this could mean for frail, elderly patients with chronic pain."

"DEA's ruling will magnify existing pain medication access barriers, which currently exist for Schedule II drugs in the post-acute and long-term care settings. Where relying exclusively on Schedule II drugs would prevent patients from receiving timely pain relief, access to HCPs in Schedule III had been viewed as an alternative. With this option eliminated, delays to pain relief will increase for post-acute and long-term care patients. This may adversely impact the quality of patient care," said Brickley.

"The Society fully supports taking necessary measures to prevent prescription drug misuse and abuse, and we are dedicated to assisting DEA with finding solutions to ending the prescription drug abuse epidemic in the United States," said Brickley. "We hope DEA and other policymakers will work with stakeholder organizations to find policy solutions to the new access barriers created by this regulatory change for long-term care patients residing in nursing homes, post-acute care, and assisted living settings."

For more information, visit ASCP's Hydrocodone Combination Products Upscheduling Advocacy Center.


About the American Society of Consultant Pharmacists (ASCP)

The American Society of Consultant Pharmacists is the only international professional society devoted to optimal medication management and improved health outcomes for all older persons. ASCP's members manage and improve drug therapy and improve the quality of life of geriatric patients and other individuals residing in a variety of environments, including nursing facilities, sub-acute care and assisted living facilities, psychiatric hospitals, hospice programs, and home and community-based care.

Visit www.ascp.com for more information.

CONTACT: Christine Polite
703-739-1300 x134
[e-mail]

Source:2014 GlobeNewswire, Inc. . All Rights Reserved

[riversedge]

3. Now all people will have to see a doc

to get it renewed. This is wrong!--Many elderly do not drive and depend on relatives and others to get to the doc. It can be a half day affair-. Ask me. Getting my mom in and out of a car and into the clinic and etc etc --whow. just whow! I predict many will go without the adequate dose--cut down so do not need to renew so often.

[totodeinhere]

18. I understand your concern but the reasons behind these new restrictions are well

intentioned. Addiction to pain killing prescription drugs is major problem and they are trying to address that. Perhaps we could come up with some sort of middle ground that could address the concerns you mentioned.

[jwirr]

31. Exactly. My grandson is addicted to pain meds and this should have been done years ago. It has been

way too easy to obtain them. However, I am not so sure that seeing a doctor is going to make much of a difference. That grandson broke his hip and while he was in the hospital being treated we convinced him to be honest with his doctor about the pills he was taking. They put his addiction in his file. When he got out and started with physical therapy one of the next set of doctors prescribed the exact drug he had been using for fun and kept giving it to him for at least a year. So unless these doctors start recognizing addictions and what they do to the patient this is not going to make any difference.


Edited to say what did make a difference was my grandson finally realizing how much trouble he was in. Has been to treatment and is "mostly" staying away from the stuff.

[totodeinhere]

35. Many families are facing similar problems. I wish your grandson the very best. n/t

[jwirr]

41. Thank you.

[kelliekat44]

194. This doesn't make it harder to get...just makes doctors richer. nt

[1monster]

56. We all know which roads are paved by good intentions.

In my opinion, the Drug Enforcement Agency needs to stay out of classifications of drugs period. That should belong to people who have been educated (perhaps even have degrees) in medicine and pharmacy. The DEA is an enforcement agnecy, not a regulatory agency.

Personally, I don't take anything stronger than Tylenol 3 and even then only extremely rarely, but I want to know that if I need something stronger, it is available. Pain is a terrible debilitator and the greater the pain, the greater the disability.

I am sick to death of those who make policy regarding drugs who think that the only solutions are to criminalize and restrict access to necessary drugs for those who need them.

If they were truly concerned about drug addiction, there would be better options available. Just for example, take cigarette smoking. The number of people who are addicted to tobaacco products has gone down dramatically over the years without criminalizing tobacco products. What did increace were treatment options, society's disapproval of tobacco use in social settings, and the information about the hazzards of tobacco product use information put in front of the users.

The difference between pain medications and tobacco is that pain medications are a necessary medical tool for millions of people at any given time and tobacco has no real purpose other than to ensure repeat consumers. Sooner or later, almost everyone on the planet is going to need a pain med (whether a controlled med or otherwise). No one is ever going to need a tobacco product...

[riversedge]

143. You are right. This is a

dangerous big step backwards-another Prohibition --punishing the masses for the actions of a few!

[Laelth]

157. I disagree.

I see little evidence that addiction to pain meds is a major problem. I don't deny that people get addicted, sometimes. I just don't see the problem with that. People in pain deserve relief. If they get addicted to the relief, so what?



-Laelth

[Warpy]

178. Well, addiction and dependence are different animals.

A person like a cancer patient will become dependent on pain killers. He'll not only feel an increase in pain load, sudden withdrawal of the drug will make him very sick. If he's the one case in several million that goes into spontaneous remission, the pain drugs have to be withdrawn slowly. While he is on them, he feels no compulsion to increase the dosage unless the pain gets worse and he does so with physician guidance. Once the drugs are withdrawn, he will experience no cravings.

Addicts, on the other hand, do compulsively keep taking the drug while they chase an elusive high. Withdrawal incites intense cravings. Tapering the drug down in a methadone program doesn't do anything to blunt the cravings. It will be a lifelong struggle to stay clean.

Real addiction is fairly rare, thank goodness. Most of the people the DEA screams about are dependent on the drugs, not addicted, and are using them to self medicate.

Prohibition only increases the anxiety around getting one's daily supply of enough drug to avoid withdrawal and quite likely contributes to the development of true addiction since the anxiet has to be treated along with the dependence.

However, since the DEA has been so incompetent at stopping drugs from coming into the country or being diverted by manufacturers, themselves, they're going to lean harder on doctors and, worse, people in pain.

This ruling is insane. Use of combination medicines is already self limiting because if you take enough to get high, you'll burn out your liver on the Tylenol. Addicts know this.

[mpcamb]

135. "Now all people will have to see a doc"

OR go to the ER.
I suspect that'll be one of the unintended outcomes of this rule.
It'll be the same for the legitimate and the addicted - unintentionally or otherwise- and the drug seekers, all descending when their prescription runs out and it'll take a significant amount of time to figure out how to wade thru those visits and handle them.

[mwooldri]

149. For those patients who need refills...

...it just means extra work for everyone - doctors, pharmacies and patients. Doctors can write multiple prescriptions, and mark each script as "Do not fill before xxx date". Pharmacies could set up a system to keep these scripts on file. If they won't do that, patients will have to have a way to keep them safe.

I don't think this change will reduce hydrocodone abuse.

[Bette Noir]

163. I was in the ER with food poisoning a few weeks ago.

There were signs posted prominently that they did not prescribe pain medications for chronic conditions.

Unless you present at the ER with a broken bone, you're out of luck, in terms of pain management.

[politicat]

184. A lot of geriatric GPs have visiting PAs and NPs. For chronic conditions, this can be a lifesaver.

Start here - they take medicare.
http://visitingphysicians.com/house-call-physicians/

If your mom's primary doc isn't part, or doesn't have the staff -- perhaps zie can partner with a local visiting Doc to oversee her care?

I agree -- this is questionable. Better would be to work on the storefront "pain" clinics and actually pay for things like physical therapy, but for now, the above may be a workaround.

[brewens]

58. I've been on hydrocodone twice for several weeks following major knee surjury. I admit abusing

it a little. I figured out both times that the stuff wasn't letting me sleep really. So as soon as I could stand it, I cut the dose at night, even sleeping with an ice pack to numb the pain and try and get a little sleep. This left me with a few extra to double up on occasionally to get a nice buzz. I really like that stuff but knew I didn't want to develope a real habit.

When my doctors nurse cut me off, I was tempted to whine and claim I was still in serious pain to try and get one more refill. I didn't though. I suspect she would have known what I was up to and denied me anyway. I went as far as to enquire about buying some illegally but never did. I think at that time, they were about $2.50 apiece frrom my source.

I think they really have their cutoff day timed about perfectly. For about the next day or so, I had mild symptoms like maybe coming down with the flu. I got just a taste of what I'd have to deal with if I kept buying the stuff illegally. I'm really glad I didn't ever do that.

[DisgustipatedinCA]

86. I also enjoy hydrocodone

I always considered it a consolation prize for the dental work I had to get done. But with only one bottle for each root canal, and a limited number of teeth in my head, the potential for abuse was always limited.

[greiner3]

121. law of diminishing returns

Or until engineered teeth and/or 'Tooth Buds'.

[shanti]

95. hydrocodone

does nothing for me. i was prescribed it for severe back pain several years ago and still have half the bottle left. motrin is the only thing that really works for me.

[24601]

181. Hydrocodone is the narcotic ingredient. Norco and Vocodin are Hydrocodone plus Acetaminophen

(Tylenol). Vicoprofen is Hydrocodone plus Ibuprofen (Motrin).

Step up a level and you have Oxycodone (already a Schedule II). It's Percocet with the Acetaminophen or the less common Combunox with Ibuprofen. It's also common to see Oxycodone by itself (immediate release) or Oxycontin (time release).

Following surgery I was on Oxycodone (5 mg). A pharmacy error filled the prescription at 30 mg. After taking the 1st pill, I threw up an hour later. It took a day to figure out why I was getting sick three times a day. They documented the mistake and fixed the dose.

[phylny]

133. I took a different road to avoid abuse.

I had surgery at the end of March and I took the hydrocodone for about seven days for the prescribed amount, and then I used it only at night for about another three or four days. That's it. I didn't want to become dependent on it.

My mother-in-law has been addicted to it for years, so much so that she's still in pain even after taking it and Gabapentin. Shame on the doctors that continually refilled the prescriptions. At this point, her physicians say she's too old to go through withdrawal so there's no point in stopping it.

[pscot]

2. Good

[FrodosPet]

7. Try living with chronic back pain for 20 years

Sorry, folks, but sometimes (usually) MMJ is just not enough. And I am tired of the side effects.

So I have to eat aspirin or Ibuprofen or Acetaminophen like M&Ms because of pill junkies and a government who just wants what's best for me (as long as what's best for me does not entail pain relief).

[Recursion]

12. The US uses 90% of the world's supply of hydrocodone derivatives

How do people in chronic pain everywhere else get by?

[FrodosPet]

19. That is a good question!

Thank you for the idea. I am sick and tired of being sick and tired.

And I am sure a few people would be happier if I was out walking or biking the trails than sitting here getting crabby and posting. I know I would.

I am almost open to "woo medicine" because of this crap.

[Recursion]

20. I meant it honestly: what do they do elsewhere?

Hydrocodone is essentially unavailable outside of the US, UK, and Australia. What do people do in other places?

[FrodosPet]

24. If you are sincerely interested, I will let you know what I find

I need to spend some time studying something that I can control, and will positively impact my quality of life, instead of Islamic history and Latin American economics, which does little but give me something to debate on a message board.

[UglyGreed]

106. Well most likely

they kill themselves. Just like most overdoses from pain medications in this country are suicides and not people just having a good time getting high.

[Sgent]

169. Hydromorphone

Ie Percocet is widely used. It's stronger and even more addictive than hydrocodone. Codeine is often OTC as we'll.

[Prophet 451]

176. Here (UK), hydrocodone is rarely prescribed

UK doctors are more likely to prescribe some form of codeine. I'm on massive amounts of dihydrocodeine, for example.

[arikara]

43. I don't know what you consider to be woo medicine

but I had excruciating chronic back pain for 15+ years and attributed it to my back being worn out from the extreme heavy, awkward lifting from my job as a paramedic. Regular doctors did nothing for me beyond prescribing pain killers. The only short term relief I got was from chiropractic and massage. That is until I started seeing a doctor of Chinese medicine and having acupuncture and taking herbs. He diagnosed my back pain as gall bladder and magically relieved it in a few minutes and when it flares up now I take some herbs.

Woo? I think not. If an allopathic doctor had managed to diagnose it as gall bladder they would have removed it, not treated it at all. Now my main medical treatment is always TCM (Traditional Chinese Medicine) and I use allopathy only for emergencies which is where they excel. Pharmaceuticals are the absolute last resort and I just don't take them at all.

[Ruby the Liberal]

60. Out of curiosity

would that be Chanca Piedra?

[arikara]

138. Do you mean my TCM Dr?

... that's not her name. However if you are on Vancouver Island, I would be happy to recommend her to you.

[Ruby the Liberal]

158. Sorry - that question wasn't clear

What they are recommending for stabilizing a gall bladder. Chanca Pietra is a South American herb and seems to be working for me - I was just curious what they recommended for you. They want to take my gall bladder, but can't because of a scheduled surgery this fall, so are working to stabilize it. My hope is they never have to take it.

[Divernan]

51. I would research this country by country; here's some starting points.

Here's some info on specific countries - i.e., where to research to find out what they use for pain control. I agree strongly with the poster who commented that in more advanced countries with excellent health care, problems are addressed long before health deteriorates to the point that a lifetime of pain medication is the only answer. The guest speaker at my next month's AAUW meeting program is:
titled "Chronic Pain: Does it have to be a pain?" with physical and occupational therapy specialists presenting the talk. I will make it a point to ask them what is used for pain control in these European countries. They may not know the answer either, but it will give them something to think about.
http://en.wikipedia.org/wiki/Hydrocodone

Australia
In Australia, hydrocodone is a Schedule 8 (S8) or Controlled Drug.
Austria
Hydrocodone is regulated in the same fashion as in Germany (see below) under the Austrian Suchtmittelgesetz; since 2002 it has been available in the form of German products and those produced elsewhere in the European Union under Article 76 of the Schengen Treaty—prior to this, no Austrian companies produced hydrocodone products, with dihydrocodeine, nicomorphine, and nicocodeine being more commonly used for the same levels of pain and the former and last for coughing. The latter two were Austrian inventions of the first years of the 20th Century. Nicocodeine, the nicotinoyl ester of codeine, is virtually identical in strength to hydrocodone. A third, nicodicodeine, the dihydrocodeine analogue of nicocodeine, and acetyldihydrocodeine and thebacon, acetyl esters of dihydrocodeine and hydrocodone respectively, were also used. Nicocodeine is known as Tusscodin, and abroad as Lyopect. It is a prodrug for nicomorphine in the same way hydrocodone is for hydromorphone; nicomorphine is a strong opioid of the 3,6 diester (heroin-nicomorphine-dibenzoylmorphine) type which is also stronger than morphine but not quite the milligramme strength of hydromorphone but with a faster onset of action.
Belgium
In Belgium, hydrocodone is no longer available for medical use.
Canada
In Canada, hydrocodone is a controlled substance and is available by prescription only. Hydrocodone is prescribed alone as well as in proprietary combinations, typically with an NSAID or paracetamol,
France
In France, hydrocodone (Vicodin) is no longer available for medical use. Hydrocodone is a prohibited narcotic.
Germany
In Germany, hydrocodone is no longer available for medical use. Hydrocodone is listed under the Betäubungsmittelgesetz as a Suchtgift in the same category as morphine.
Luxembourg
In Luxembourg, hydrocodone is available by prescription under the name Biocodone. Prescriptions are more commonly given for use as a cough suppressant (antitussive) rather than for pain relief (analgesic).
The Netherlands
In the Netherlands, hydrocodone is not available for medical use and is classified as a List 1 drug under the Opium Law.
Sweden
Hydrocodone is no longer available for medical use. The last remaining formula was banned in 1967.
United Kingdom
In the UK, hydrocodone is not available for medical use and is listed as a Class A drug under the Misuse of Drugs Act 1971. Various formulations of dihydrocodeine, a weaker opioid, are frequently used as an alternative for the aforementioned indications of hydrocodone use.

[Betty88]

21. I don't know about the rest of the world

I guess they suffer. That's not alright with me, but I guess it's ok by you.

[Recursion]

30. Isn't hyperaesthesia a side effect of hydrocodone? (nt)

[Betty88]

38. I think most of my side effects come from chemo

like everything I it depends on the person

[Spider Jerusalem]

130. Hyperalgesia is a side effect of long-term opiate use generally

http://en.wikipedia.org/wiki/Opioid-induced_hyperalgesia

[Granny M]

146. Interesting.

That probably explains my friend's problems, and why she keeps getting worse pain despite increasing her dosage. She also seems to get pneumonia frequently. I wonder if her respiratory system is being effected as well. Dangerous drugs.

[Spider Jerusalem]

147. One of the other effects of opiates...

is the relaxation of involuntary muscle movement; that's why opiates cause constipation, but they also cause respiratory depression (which leads to an increased risk of pneumonia and lung infections).

[pscot]

37. Suffering builds character

Or so I've been told.

[totodeinhere]

25. As we know most other developed countries have universal health care. So residents

Last edited Sat Aug 23, 2014, 08:32 PM - Edit history (1)

of those countries are more likely to get treatment for the underlying causes of their pain because they have better access to health care. Whereas in this country too often by the time a patient can get care the only recourse is to provide the band aid of strong and highly addictive pain killing drugs.

[christx30]

48. Yup.

I had gall bladder disease 3 years ago. When I didn't have insurance, I would try to manage the problem by staying away from fatty foods. When I had an attack I would either pop pain meds or go to the ER and fake like I didn't know what was going on. They would do a quick scan, send me off with a prescription and a $3000 bill (which I had no intention to pay). I wanted to have surgery to get rid of the gall stones.
Then I got a good job and got insurance. 12 hours after my insurance kicked in, I got a gall stone attack. Suddenly, it was bad enough to warrant surgery. I went under the knife, and left 2 hours later, sans gall bladder. It was an amazing experience, and it taught me a great deal about the state of health care in this country.

[SheilaT]

83. Gall bladder surgery on an outpatient basis?

Oh, my. Or maybe you really meant you left 2 days later sans gall bladder. Whatever the time frame, glad you finally got it taken care of!

[christx30]

97. I was in otherwise really good health.

I don't have a car, so I walk quite a bitl. I went in on Friday morning, they did the surgery, and I was out about 2 hours after I woke up from the anesthesia. My mom (who picked me up) was astounded. I called in sick to work the next day, but was back at work on Sunday afternoon.

[riversedge]

116. no,they do by

laparotoscope now in many hospitals. Actually mine was done in 2009--small jabs into abdomen and then a scope is interserted (actually, i had 4 small cuts)--then a gas in injected to blow up the abdomen and make the area more visible for the surgeon. Then snip--out comes the gallstones. Discharged after a few hours. Sore but all went well.

[NutmegYankee]

144. It's an outpatient surgery now.

[Ms. Toad]

46. I get by by living on a heating pad -sometimes 24/6

and by decades of figuring out what triggers the worst of the pain and avoiding it.

Fortunately, my pain level ranges from 1 to 5 - and when it gets to 5, I can live with it for a short (a month) period of time until the 24/7 heating pad takes it back down to its normal background level of 1-2.

But my chronic back pain isn't the kind that is treated well by narcotics - and the only medication which addresses it at all creates both physical and emotional depression. So I avoid it unless I am completely non-functional.

But, as far as chronic pain sufferers, I am lucky. I have a non-pharmaceutical treatment that keeps it to a dull roar. Many don't - and this change will make their lives immeasurably harder and they may, as the wife of one of my professors did, just decide the drain of keeping the pain to a manageable level (which will be significantly harder now) is too much and end their lives.

[enlightenment]

47. While this report looks

primarily at opioids for treatment in cancer and HIV/AIDS, it does give you a good idea of how different nations handle pain relief. Many don't manage it . . .
http://apps.who.int/medicinedocs/documents/s18774en/s18774en.pdf

A lot of people with chronic pain simply suffer with it. Just because the US prescribes more doesn't mean that places that don't prescribe as much are doing a better job of managing pain - they might just be telling people to suck it up and stop complaining (Germany springs to mind - they are just beginning to realize that pain isn't always something you can wish away).

[Feral Child]

57. Codeine/morphine.

Or synthetic opioids other than Hydro.

Hydro is highly prescribed in this country because it's patented. BP salespersons entice/cajole/ bribe doctors into prescribing it because it's a high-profit item. Lobbyists influence FDA/DEA with industry funded research that indicates it's free of the "euphoria" of other narcotics. The government puritans that control our access to medicine are less concerned about actual addictive properties of drugs than they are that the might make you "happy" as well as relieving your pain.

The medical industry in the US is just a huge grift.

[Strelnikov_]

90. "The Real Reason Pot Is Still Illegal"

This article was an eye opener for me.

http://www.thenation.com/article/180493/anti-pot-lobbys-big-bankroll

Given that CADCA is dedicated to protecting society from dangerous drugs, the event that day had a curious sponsor: Purdue Pharma, the manufacturer of Oxy-Contin, the highly addictive painkiller that nearly ruined Kennedy’s congressional career and has been linked to thousands of overdose deaths nationwide.

Prescription opioids, a line of pain-relieving medications derived from the opium poppy or produced synthetically, are the most dangerous drugs abused in America, with more than 16,000 deaths annually linked to opioid addiction and overdose. The Centers for Disease Control and Prevention report that more Americans now die from painkillers than from heroin and cocaine combined. The recent uptick in heroin use around the country has been closely linked to the availability of prescription opioids, which give their users a similar high and can trigger a heroin craving in recovering addicts. (Notably, there are no known deaths related to marijuana, although there have been instances of impaired driving.)

. . .

So it’s more than a little odd that CADCA and the other groups leading the fight against relaxing marijuana laws, including the Partnership for Drug-Free Kids (formerly the Partnership for a Drug-Free America), derive a significant portion of their budget from opioid manufacturers and other pharmaceutical companies. According to critics, this funding has shaped the organization’s policy goals: CADCA takes a softer approach toward prescription-drug abuse, limiting its advocacy to a call for more educational programs, and has failed to join the efforts to change prescription guidelines in order to curb abuse. In contrast, CADCA and the Partnership for Drug-Free Kids have adopted a hard-line approach to marijuana, opposing even limited legalization and supporting increased police powers.

A close look at the broader political coalition lobbying against marijuana-law reform reveals many such conflicts of interest. In fact, the CADCA event was attended by representatives of a familiar confederation of anti-pot interests, many of whom have a financial stake in the status quo, including law enforcement agencies, pharmaceutical firms, and nonprofits funded by federal drug-prevention grants.

[Feral Child]

173. Do you suggest that American "altruism"

is tinged with personal gain?

[Prophet 451]

177. But pot doesn't work for everyone

In addition to the physical problems that cause me to gobble dihydrocodeine like candy, I'm mentally ill. Taking anything that messes with my perceptions is a really bad idea.

[Feral Child]

188. You are an exception

but that exception doesn't invalidate the premise, nor does it address the issue of whether or not it should be available.

Doctors could still prescribe you the specialty medication you require without forcing me to pay for the specialty-cocktail purely for purposes of mandating morality.

[Prophet 451]

190. Don't misunderstand me

I'm very much in favour of legalising pot for both medical and recreational use (subject to the kind of regulation we put on booze).

[Feral Child]

192. Copy that.

[CTyankee]

182. when I have needed a painkiller I always tell the doc to prescribe hydocodone instead of

oxycodone since I get no relief from it.

When I take the hydrocodone it is for pain and I never feel "high." I feel relief from pain. Since it is usually at night when I am most conscious of pain, the painkiller helps me get sleep, but I wake up feeling no after effects at all.

I am a total sissy when it comes to pain. I just want it to stop. Sometimes Tylenol will be sufficient by itself so I always try that first, but I don't take lots of it. My liver is fine.

[Feral Child]

187. Not sure we're on the same page.

If you have pain, seek relief where you can. I'm not saying that hydro isn't effective, I'm saying that it isn't any more effective than
other, pre-existing opiates that don't come with the price tag.

Whether hydro is euphoria-free or not (and I believe that differs somewhat from patient-to-patient) it is still addictive. The philosophy that any painkiller that is also fun is scary-addictive is myopic puritanism; an equally valid argument can be that hydro can be more addictive because it's innocuous and it's easy to start taking it instead of Tylenol.

My point is that the drug cartel known as "Big Pharma" is motivated by profit, not our well-being. Many foreign countries have codeine available with-out prescription with no more per capita addiction than the US, and I'd hazard to guess with considerably less. Meds like hydro are certainly abused to an alarming rate in this country, euphoria-free or not..


Aside from this is the humanitarian issue: shouldn't people who are sick, especially those with debilitating chronic pain or a painful, lethal malady get a bit of a morale boost with their medications?

[CTyankee]

189. I agree with you on the points you have made.

I try the Tylenlol first and that usually works.

I guess I don't understand addiction to painkillers very well. It seems to me that if a certain drug works to ease pain, then your "addiction" is to easing the pain. But doesn't everyone want to ease pain they have?

My preference would be physical therapy. I never felt better than when I was seeing my PT twice a week. She brought me out of pain and I worship the ground she walks on!

[Feral Child]

193. Addiction isn't subjective.

Sure, people often continue pain-meds to ease chronic pain.

Some continue using them, after the condition causing their pain is resolved, to avoid the pain of withdrawal. ALL opiates have a significant chance of ensuring a physical dependency or "addiction". Withdrawal, if unsupervised, can be catastrophic, up to and including death. It also hurts like a motherfucker.

PT may be effective in combating some types of pain but certainly not all.

Again, the antics of BP and the FDA/DEA have nothing to do with preventing addiction to prescribed painkillers. They only want to insure that we take profitable meds; hence, blocking access to simple opiates and providing only high-dollar synthetics that drug companies hold patents on. They prey on American puritanism to ensure their profit margin.

[grahamhgreen]

78. Codeine is available over the counter.

[pscot]

114. But if you're downing more than one or two

bottles a day, the authorities take notice.

[Spider Jerusalem]

131. Nope, codeine requires a prescription

It's OTC in low-dose combination with aspirin, ibuprofen or paracetamol in the UK, Canada, New Zealand, and Australia (and possibly other places) but not in the USA. (Some codeine preparations are schedule V but most pharmacists won't dispense without a prescription.)

[grahamhgreen]

137. I meant outside the US.

[Spider Jerusalem]

139. Hydrocodone is 6x more potent than codeine (n/t)

[grahamhgreen]

140. I really don't understand why you can't grow your own poppies

[Spider Jerusalem]

141. You can, you just can't extract anything from them.

Raw opium is a scheduled substance, and production of raw opium is a felony. Didn't stop people from selling dried poppies on Ebay for people to buy and grind up to make opium tea...until some college student ODed and died, which along with pending federal investigations led to Ebay cracking down.

[Comrade Grumpy]

98. They suffer.

http://www.who.int/mediacentre/news/releases/2004/pr70/en/

World Health Organization supports global effort to relieve chronic pain

WHO/Eric Miller
11 OCTOBER 2004 | GENEVA - The World Health Organization (WHO) today co-sponsors the first Global Day Against Pain, which seeks to draw global attention to the urgent need for better pain relief for sufferers from diseases such as cancer and AIDS. The campaign, organised by the International Association on the Study of Pain (IASP) and the European Federation of the IASP Chapters (EFIC), asks for recognition that pain relief is integral to the right to the highest attainable level of physical and mental health..

WHO representatives will join global specialists in chronic pain management and relief at a conference in Geneva convened to highlight the Global Day Against Pain and to press for urgent action from governments across the world. The conference coincides with the release this month of the Council of Europe's newly formulated recommendations on palliative care including management of pain. The recommendations provide detailed guidance for setting up a national policy framework, and are available in 17 European languages.

"The majority of those suffering unrelieved pain are in low- and middle-income countries where there is a an increasing burden of chronic diseases such as cancer and AIDS," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. "Limited health resources should not be allowed to deny sick people and their families the dignity of access to pain relief and palliative care, which are integral to the right to enjoy good health. We strongly support the Global Day Against Pain and the efforts of IASP and EFIC."

New statistics released by IASP and EFIC indicate that one in five people suffer from moderate to severe chronic pain, and that one in three are unable or less able to maintain an independent lifestyle due to their pain. Between one-half and two-thirds of people with chronic pain are less able or unable to exercise, enjoy normal sleep, perform household chores, attend social activities, drive a car, walk or have sexual relations. The effect of pain means that one in four reports that relationships with family and friends are strained or broken, according to the IASP/EFIC data.

The statistics also reveal that pain is second only to fever as the most common symptom in ambulatory persons with HIV/AIDS. Pain in HIV/AIDS usually involves several sources at once. The causes include tissue injury from inflammation (including autoimmune responses), infection (e.g., bacterial, syphilitic or tubercular) or neoplasia (lymphoma or sarcoma): so-called nociceptive pain. Nearly half of pain in HIV/AIDS is neuropathic, reflecting injury to the nervous systems.

Oral morphine has proven to be a cost-effective pain medication for the treatment of moderate to severe pain when the underlying cause is cancer or HIV/AIDS. However, opioid analgesics are not adequately available, particularly in developing countries with limited resource settings, due to ignorance of their medical use, restrictive regulations and pricing issues.

“Pain relief should be a human right, whether people are suffering from cancer, HIV/AIDS or any other painful condition," said Professor Sir Michael Bond M.D., President of IASP. "Today’s Global Day Against Pain marks an immense growth in the interest in this area and today’s WHO co-sponsorship of our campaign shows that now is the time to take pain seriously.”

“Chronic pain is one of the most underestimated health care problems in the world today, causing major consequences for the quality of life of the sufferer and a major burden on the health care system in the Western world," said Professor Harald Breivik, President of EFIC. " We believe chronic pain is a disease in its own right. For people in developing countries, where pain relief is at its most minimal availability, the consequences of unrelieved pain are great.” Professor Breivik said the decision to hold a Global Day resulted from the success of the European Week Against Pain, launched by EFIC four years ago under the leadership of its Past President Professor David Niv.

[pscot]

29. Forty years and counting

Watch out for that Ibuprofen. It messes up your stomach and your kidneys. If you take a lot of it have you urine checked regularly. I have found acetaminophen to be worthless. Keep moving. For myself the major benefit of weed is that it helps me to keep moving.

[Ms. Toad]

40. And blood pressure.

When I was on it for an extended time, my blood pressure was in the highest range (extremely dangerous) before I had a clue - and I only discovered the high blood pressure (and the connection to ibuprofen) accidentally.

[LynneSin]

49. Naproxen is my friend

I have had knee issues for a few years now and I have found that Naproxen is the best bet. I use to take prescription Naproxen but now find that 2 Aleve (OTC Naproxen but 50mg less than prescription) works just as well.

[BobbyBoring]

33. What side effects are you referring to?

I've had chronic back pain for 20 years as well and MMJ does nothing for it. I used to take Vicodin years ago when I had no insurance. It was cheap and my doc would write 3 months worth. If I were still in that situation, this would screw me big time! Instead of spending $320.00 a year at docs, it would be $960.00 plus gas, time,etc
Once again, those that need narcotics for legitimate reasons are screwed by assholes that just want a buzz and the DEA.

[Beaverhausen]

92. People who don't have chronic back pain just don't understand

There are some conditions that just can't be cured with surgery or therapy and the patient has to live with Chronic pain and a good pain management doctor.

Having to drag oneself to the doctor every month/week/whatever isn't so easy for many of these people.

and yes, I know many people abuse it. But don't make it harder for those who really need it.

[UglyGreed]

107. I hear you, 25 years here

now up to 11 herniated discs. 6 in my neck and 5 in my lower back with a sprinkle of hydrocephalus to boot.

[Aristus]

134. Next time you have a visit to a primary care provider, ask him or her about treatment with tricyclic

antidepressants.

It's natural to ask why antidepressants are being used to treat chronic pain. Years ago, providers noticed that when they prescribed a tricyclic antidepressant like amitriptyline for patients with depression and chronic pain, that they experienced marked relief from both.

It's kind of a double-barreled shotgun: Chronic pain can cause depression, and depression can make chronic pain worse. TCA's can interrupt this vicious cycle, with substantially fewer side effects than narcotics. The most common are drowsiness and dry mouth. Some less common side effects can include cardiac arrhythmias, so periodic EKG's may be warranted. But TCA's are not physically addictive, and represent a huge improvement over opiates in the treatment of chronic pain.

[politicat]

185. Tcas, especially amitriptyline, have a narrow therapeutic window.

The margin between an effective dose and lethal is narrow. With an opiate or opioid, even at low doses, it gets narrower.

Be careful, and talk that one out with your md. When it works for pain, it's amazing, but when it doesn't... That's why that treatment isn't more widely used.

[snooper2]

150. I've had chronic back pain and my right should since I was 17

painkillers are bullshit...use it or lose it...

When I'm laying tile or doing some other project it actually starts feeling better the more I move-

Sitting around in my cubicle is when it is the worse-

[JCMach1]

195. there are seriously good (non-addictive) options that are not approved

by the FDA because they are WAY TOO SLOW on the uptake...

[WinkyDink]

8. "delays to pain relief will increase for post-acute and long-term care patient" is "good"???

[Betty88]

9. Why is this good?

[Recursion]

15. Because prescription drugs are killing an absurd amount of people in the US?

And we're using an absurd amount of hydrocodone derivatives, which keeps other countries from getting any.

[Betty88]

23. So your answer is make it harder

for those of us in constant debilitating pain to get our meds and also add to the cost of a bottle of pills by $100 (what is costs around here to see your doctor for 3 min.)

[mwooldri]

148. As a user of a schedule II drug, there is a simple workaround.

My prescriber gets her prescription pad and writes up to six prescriptions at a time - this depends on when my next follow-up visit is. Each subsequent prescription is marked "Do Not Fill Before (date)." I then take this stash to my pharmacy (an independent one, not one of the chains) and they store them on file. It does mean that I (or someone with a driver's license) has to go to the pharmacy each month for the refill. Other doctor practices may want to keep them on file and a trip to the doctors office would be needed. Some pharmacies may not want to keep them on file so then the patient will have to keep them safe.

As such, I see this change as making more work for doctors, pharmacies, and patients in obtaining the medication they need.

It won't make the drug less accessible. To get hydrocodone you need picture ID anyway. You can't get it through a mail order pharmacy, so a monthly trip to the pharmacy has been required for some time now.

This arrangement means I don't have to see my prescriber every month and I can still call in a request for a refill for me to collect later.

[pscot]

32. The stuff is highly addictive

Stronger and stronger doses are need to get relief. Mix it with booze and it can kill you. Strung out is strung out, whether the drug is legal or not. Big pharma finds addiction to be a highly lucrative racket.

[UglyGreed]

108. higher doses are not a sign of addiction

it is a sign of your body building up a tolerance which is perfectly normal. Mixing it with booze is a sign of seeking a high, which in my eyes is a red flag. Most people with chronic pain do not get high from pain meds.

[pscot]

113. Painful withdrawal symptoms

with shakes, leg cramps and nausea are.

[UglyGreed]

115. Well when I

weaned myself off of fentanyl since I was losing a lot of weigh due to appetite suppression, I did not go through any of those symptoms even after being on it for over two years. So perhaps chronic pain suffers react differently than those who are addicted and using these drugs to get high????

Fentanyl (also known as fentanil, brand names Sublimaze,[3] Actiq, Durogesic, Duragesic, Fentora, Matrifen, Haldid, Onsolis,[4] Instanyl,[5] Abstral,[6] Lazanda[7] and others[8]) is a potent, synthetic opioid analgesic with a rapid onset and short duration of action.[9] It is a strong agonist at the ?-opioid receptors. Historically it has been used to treat breakthrough pain and is commonly used in pre-procedures as a pain reliever as well as an anesthetic in combination with a benzodiazepine.

Fentanyl is approximately 50-100 times more potent than morphine.[10]

Fentanyl was first synthesized by Paul Janssen in 1960[11] following the medical inception of pethidine several years earlier. Janssen developed fentanyl by assaying analogues of the structurally related drug pethidine for opioid activity.[12] The widespread use of fentanyl triggered the production of fentanyl citrate (the salt formed by combining fentanyl and citric acid in a 1:1 stoichiometry),[13] which entered the clinical practice as a general anaesthetic under the trade name Sublimaze in the 1960s. Following this, many other fentanyl analogues were developed and introduced into medical practice, including sufentanil, alfentanil, remifentanil, and lofentanil.

[wordpix]

191. had fentanyl in hosp after major operation & no high at all

of course, the hosp limits the drug for those pressing on the auto-drug button so at times you're getting nothing.

Friend who has lots of health probs and surgeries says he doesn't get high from opioids when he takes them for pain. That was my experience, too. Mostly, they made me sleepy and I decided getting up for exercise was much more important for my health so I didn't take them for long.

[WinkyDink]

151. I'll let my 90-year-old mother know.

[stonecutter357]

16. how is this good?

[Ms. Toad]

34. Obviously you have not lived with chronic - or even longer than expected acute - pain

and have unlimited time and money to visit the doctor.

I have chronic pain - fortunately I don't need narcotics to control it. If I did, the increase to my family's already exorbitant medical bills would be significant because of the additional number of doctor's visits that would be required to get the medication needed for pain control.

I have also had post-surgical pain that lasted longer than expected. The surgery was 50 miles away (and many people travel much farther to visit this particular facility), so I would need to travel 100 miles round trip - in pain - in order to get relief from acute post-surgical pain.

The abuse of the system by a few does not justify imposing these additional barriers on a population which lives in managed pain - because even the best medical care does not really alleviate it - which will increase their pain (and likely suicide rate - which is already a significant issue in this population.

[pscot]

71. I could trot out my medical history here

Instead I will just say that I understand what you've gone through. I don't think it's good to deny medicine to those who need it, but painkillers like vicodin and oxycodone are the most widely abused drugs in America. They're called hillbilly heroine for a reason. They're highly addictive and dangerous when mixed with alcohol. I speak from experience here. I also don't think they're that effective, except maybe in so far as an addictive craving takes your mind off other things. Pain is a part of life. There really is no way around that. Analgesics may help some, but the best we can do is to grin and bear it.

[sorefeet]

75. You grin and bear my

NEUROPATHY and I will kiss your ass on main street and give you an hour to draw a crowd. At the end of that hour you will be off the deep end with pain and electrical shocks and not enough balance to walk. Enjoy.

[pscot]

85. Neuropathy? Check.

Don't try to go to the john in the dark. You can fall and really mess up your shoulder. Very painful, and slow to heal if you're older. How about gout. An attack of gout can light you up pretty good. A very intense experience.

[sorefeet]

88. Pain pills did zero

for my gout. 5 colchicine pills at one hour interval and the gout has never come back. And hydrocodone doesn't do much for my stenosis but it is a must for the neuropathy.

[pscot]

91. I take small doses of gabapentin

which helps some with the neuropathy. I hate the stuff. It zombifies me. Weed gives me as much relief as anything, which isn't saying much. Edible products seem to work best. Oxycodone provides it's own justification, but it never did much for my pain. Maybe that's just me.

[Mojorabbit]

145. Gabapentin Did not do a thing for my neuropathy from MS

Nor has anything else I have tried and I have tried them all.

[Marrah_G]

119. I use Neurotin for my Neuropathy

I used to use Cymbalta but my medicaid doesn't cover that now.

I have peripheral neuropathy in all 4 limbs from an adverse reaction to an antibiotic. the combination of aches, pains and the feeling of having on to tight socks and gloves is pretty unbearable without meds. Opiates don't help nearly as much for me.

[Ms. Toad]

103. Unless you are treating them

You don't have the right to make that decision. Appropriate medical care decisions are left to the doctor and patient - same as abortion decisions are. The decision about how frequently face to face visits are needed is a medical decision, not a policy decision. It is no more appropriate to require a face to face visit premised on the policy concern that you might do something illegal, than it is to require a woman seeking an abortion to sit through a waiting period as a policy concern to discourage abortion

[WinkyDink]

4. Great. Hydrocodone is exactly my 90-yr-old mother's pain prescription. But her Dr. already said he

couldn't just call it in (to the small-town pharmacy down the block).

FTR: It's for a slow-healing broken arm.

[enlightenment]

5. Over-reactive and

typically crude reaction from the DEA.

[RKP5637]

13. SOS, and then they fuel the black market. n/t

[heaven05]

22. haven't you heard?

it's the war on drugs.......

[Betty88]

6. Another stupid drug law

They complain about the cost of medicine, then keep finding more ways to make us spend money on seeing the doctor and taking up his or her time when they could be seeing others.

[TreasonousBastard]

10. I'm no longer sure why there should even be a DEA any more...

making medical decisions.

Some people get high off this stuff and that's a big enough problem to make it harder for legitimate patients to get it?

[SnakeEyes]

11. I have chronic back pain

I don't like this

[99th_Monkey]

72. Me too. This really sucks hard.

Chronic pain is no damn fun and this is really going to mean a world of hurt for LOTS of innocent people who need relief.

My Doc is pretty cool, and will probably still find a way to work it so I can get my Vicodin but still he's a rare bird.

I've seen this coming for quite awhile now, and I just don't get why some people get so weirdly anal about knowing that someone else can get to use this kind of medication regularly for pain.

[ctsnowman]

14. No doubt

brought to you by big Pharma. Try one of our new psychiatric meds that alter your brain chemistry and may cause you to kill yourself or someone else.

Ask your doctor today.

[LynneSin]

50. Big Pharma is getting rich off of hydrocodone addiction

Sure the medicine isn't that overpriced but with millions addicted to pain killers they rake in the cash.

[ctsnowman]

62. It cost$

1/10th the price of the crap that'$ being pu$hed a$ a replacement that doe$n't even work and ha$ $ide effect$ that make Hydro $eem tame.

It'$ alway$ about money in the American medical $y$tem.

[4b5f940728b232b034e4]

127. $ is right

It's all about the $s.

I've been in two serious motorcycle accidents, and neither time did the ER doc give me a prescription for a pain killer. Both times they recommended I make another appointment with a different doctor during the week. They only did that to make more money for their friends.

[Sgent]

170. How

A months worth of hydrocodone costs $10 without insurance. Cymbalta is $400

[PatrynXX]

26. Great and mom who's recovering from back surgery

has to walk and see her. way down in cedar rapids... an hour from here

sick..

not only that most of the time we don't actually get Vicodin but it's Morphine related cousin that puts most of us to sleep. And that one is highly addictive. (generic) I actually had to have the doc stipulate VICODIN only. CVS had to order it. They'd never actually had someone request VICODIN specifically O_O

[Faux pas]

27. Good! I know and have known too many

pain killer addicts. It's about time.

[Doctor_J]

45. says the guy with a pot avatar

You support the war on SOME drugs I guess

[LynneSin]

52. Except pot isn't addicted and shouldn't be illegal

I think in the 13 years of the TV Show "Intervention" they had one 'Pot Addict' featured and they had dozens of people addicted to some form of opiate painkiller pills.

[Doctor_J]

59. So you and the previous poster support the war on some drugs

How many people on the TV show were alcoholics? Do you think the Volsted Act should be revived?

[Faux pas]

63. I don't trust what man makes. I do trust

Mother Nature though S-A.

[Doctor_J]

125. so you're for prohibition on distilled alcohol then

Serious that's the dumbest post this year, including the BOG.

[Faux pas]

154. Yes I am. I survived a house full of alcoholics and guns, thank you very much.

I'm so glad that you are the Supreme Judge of posts. Must be great for you.

[NutmegYankee]

142. Many synthetic opioids have now been found in nature.

Even the mild Tramadol, a savior when my hemorrhaged disks act up on a crappy day, was once a full synthetic, but has now been found in a 1% concentration in an African tree root.

[Faux pas]

155. Sorry for your pain, I can relate.

Arthritic spine, fibromyalgia and calcified shoulders. My avatar represents my choice for pain management.

[rexcat]

186. By your logic...

your would be for opium but not opioid derivatives. How interesting!

[SoapBox]

69. Absolutely agree with Doctor_J.

[Erich Bloodaxe BSN]

28. Lousy change.

Yes, I know a lot of people are abusing those drugs. But the people who actually are in pain (especially those with chronic pain) don't need to waste even more money and time refilling prescriptions.

[gvstn]

80. Really is lousy.

A friend of my mom's is 89 years old and addicted to Oxycontin (chronic leg pain and too old to worry about going through detox). I think it might already be a Schedule II drug because he has to go through this rigamarole every month. He has to pick up a paper prescription from his doctor and then go from pharmacy to pharmacy to get it filled. A lot of pharmacies don't even carry that drug on a regular basis (of course, his regular pharmacy should know by now that he will need a refill on a certain date but they are so afraid of the regulators that they would rather just send him elsewhere).

Bad enough on a good day but what in bad weather or when his doctor is out of town and forgets to leave his prescription at the office it becomes even more of a nightmare. And one should remember that Oxy was touted as a non-addicting pain reliever when it was first released and actively pushed on pain patients. I understand the need to try to keep these drugs off the black market but there should be an easier way for longterm patients to get their medicine without being treated like garbage.

[deathrind]

36. This is a bad decision.

Just another way to get more money out of patients. A total knee jerk reaction by the DEA.

[riversedge]

117. It has the potential to add up costs to the entire 'system'

also. Imagine, after 30 days (I think they only can be renewed each month--not sure--but it is relatively short time), time for another office visit. Cost of office visit each time?? or co-payment each time. whow. This move will NOT keep costs down!

[logosoco]

39. You know what would be really nice...

if the doctors would speak up about this. The article talks of pharmacists and pharma companies and the DEA and the people who have abused these drugs. Wouldn't it be great if doctors, who are a big part of this issue, could think of a way for their patients who need this medication to function without having to deal with more problems.

(Maybe some are, but this article sure is in a tone that neglects this part of the circle).

[sorefeet]

70. Because most doctors are spineless

puppets and the wouldn't say shit if they had a mouthful. It's 40 miles one way for me. I just can't wait until it's 30 fucking below and asshole deep in snow this winter to RISK a drive to Billings. Fuck the DEA and fuck the entire medical system. Where do I find poppy seeds? I'm sure I can figure a way to make my own pain meds. And no you don't need more and more pills, I have been on hydrocodone for about 10 years same fucking dosage. UNLESS you are just a loser addict looking for the buzz. Then it's all just a game until you od and die. How about the pill mills in Florida, WHY are they still in operation, knowing that 90% are going for sale on the streets??? Because it's organized crime by the DEA. NEUROPATHY from my toes to my nose, try it some time. Talk about torture, it's either medication or suicide. You don't just cope with it.

[thatgemguy]

81. I think that pain doctors

are afraid of the DEA. The DEA has the power to hurt or destroy their practice.

I suffer with chronic back pain and go to a pain management clinic. Their drug policy is outrageous, I have to report any pain meds given or prescribed by any other doctors, within 24 hours, I'm subject to random drug screens, with the understanding that they will refuse treatment if I do not comply. I feel like I'm being treated as a child. I'm 60 years old and getting drug lectures from PA's half my age.

When I question the policy I usually get the runaround from them, until recently. I finally got my doctor to admit that the DEA was behind it.

[sorefeet]

84. I had one doctor tell me

the DEA are unconstitutional and should be done away with. He also told me he was moving to another country when he retires.

[Stonepounder]

42. Great! So, because some people abuse a drug, people who don't have to suffer?

This is nuts. Crack down on the pill merchants, not the users. It is just like any other drug, law enforcement seems to go after the users and never bother with the suppliers.

About 5 years ago I broke my ankle. It was a nasty break, requiring surgery, a pin, and a plate. Then a cast. PUtting a cast over surgical incisions is not a whole lot of fun. I could get through the day OK, but I absolutely could not sleep in a bed - there was no position that didn't put pressure on one or the other of the incisions. So, for six weeks I slept in my recliner because I could hook the heel of the cast on the foot rest and let the bottom of my foot take the weight of my leg. Even then, I needed my pain meds if I expected to get any sleep at all.

The day the cast came off was the last time I took a pain pill. So now, if I need pain pills it is a whole lot harder to get them, simply because some doctors over-prescribe them and some people abuse them.

For that matter, my wife takes Clonidine for her hypertension. Clonidine is the new pill of choice for drug addicts because (theoretically) it increases the 'high' when used with other drugs (like hydrocodone). Should we make Clonidine a Schedule 2 drug as well since some people abuse it?

[Treant]

44. I don't get it.

Sure, some people abuse it. Some people will abuse anything, including freely-purchasable alcohol.

Shouldn't your doctor know if you're abusing it? Is there no good avenue to report that?

If not, there should be, which would reduce the need for heavy-handed rules like this.

[hollowdweller]

53. If you take opiate drugs you will become addicted to them.

Even if you are using them properly. You will eventually require more and more to get the same effect because your bodies own painkilling producing sites will shut down.

Opiate drugs are good for acute pain but they are really a bad thing for chronic pain.

Basically your body starts producing pain so it can get more drugs.

They have their place for sure. However they are WAY over prescribed.

Also a lot of people develop pain as a psychological symptom and only have a minor organic cause for any pain and wind up hooked on them. Where psych drugs and psychotherapy would be a better option.

[blue neen]

77. I have to disagree with that assertion.

Many, many people are able to take opiate drugs on occasion without getting addicted. It is not correct to make a blanket statement that if you take pain pills you WILL become addicted.

I do agree that a lot of patients would be better served by anti-depressants and psychotherapy-----people use pain meds to self-medicate for pain other than physical, just like they use alcohol.

[hollowdweller]

96. I'm sorry you are right.

I meant if you take them every day for chronic pain.

You can take them for acute pain and for short periods.

But for instance a lady I work with that has pain just due to arthritis started out on 1 Lortab a day, now she's up to 3 and her pain hasn't increased just her tolerance.

If she would stop taking them all at once she would be sick and also have a LOT more pain.

I had a friend who had migraine headaches who got addicted to Fiorinal(sp?) she called them "headache pills" because once she started taking them if she missed taking them she'd have a huge headache. This finally progressed to her being addicted to heroin for a good while till she finally got totally clean and her husband dying of liver cancer due to Hep C from contamination.

[blue neen]

105. Yes, Fiorinal (with aspirin) or Fioricet ( with acetaminophen) can be very addicting.

It is a very effective migraine medication, but it must be taken with care. It's a combo of caffeine, acet or aspirin, and butalbital.

[Divernan]

54. Some docs get a reputation for handing out Rxs much too freely.

However, they usually require that the patients come in every month for a 2 minute "exam". Once in a while one of them will be prosecuted.

[SoapBox]

65. We ARE required to go in monthly for that 2 minute visit...

See my Post 64.

We do this for my Mom's generic Percocet.

Oh...appointment 2 minutes...wait in lobby for an hour.

[hollowdweller]

99. I think they just hand out too many at one time.

My wife had some back pain and the doctor gave her like 90 or something, Lortab.

I used to work with a friend who had some female surgery, the doctor gave her 90 I think, I think she took maybe 5 of them till she was healed and then sold the rest to the people in her trailer park and totally paid off all of her deductible.

I know another guy who had disc surgery, he got Vicodin for 9 months but he had stopped taking it after 2 months. Since he was physically no longer able to work as a roofer and made half the money at a job he could do he used the Vicodin to make his truck payment and child support till he was finally cut off.

We talk about declining wages, around here at least it seems like a LOT of people who have an actual legitimate reason to be prescribed the drugs don't take them all the time but just use them as a supplement to their salary.

The extras my wife got we dumped after a while. I am a caseworker and really see some terrible stuff due to pills. Couldn't bear to be a contributor.

[happynewyear]

153. These people selling these drugs to others ...

If they get caught they will end up in PRISON for life.

I'd never post something like this on the internet! Where your "neighbor" lives can easily be determined!

btw: Shame on you.

There are people out that that DO suffer with CHRONIC/SEVERE pain and yes, I am one of them sadly.

The MEDICATION I take for the pain I have is effective and enables me to do many things I would otherwise not be able to do. Too bad that the DEA doesn't seem to care to recognize this.

In the meantime, your neighbors are selling their stash to others. This is EXACTLY why this has happened.

I'm no fan of Vicodin (been there done that) but whatever works works. A person should not have to drive over 100 miles to get an RX they need and yes, I know someone that has to do this every month. Its down to either take the pain medication or ... have a spinal fusion.

[hollowdweller]

168. Can you work?

I know several folks who have had fusion and it worked out great for them.

These folks I'm talking about weren't my neighbors, however I do have one neighbor dead from OD and another in prison.

It's a plague around here. Plus where they have cracked down on prescriptions now we got people moving heroin in from Detroit to fill the demand.

This stuff is being way overprescribed.

[happynewyear]

172. No I can no longer work

I was "retired" (aka dumped) from my job and got too sick to ever find another one.

I have a progressive disease.

I know what you mean however, folks that you describe are a dime a dozen around here.

They are desperate. So desperate that they went so far as to steal an old blanket I was airing out in the yard a few days ago!

[sorefeet]

76. Sure they know

they make us take a drug test, they know exactly what and how much is in our system. They know what is chronic and what is a broken bone.

[csziggy]

79. If you are treated by other doctors they may not know

If you have a tendency to abuse drugs. No matter that the doctors are supposed to share records so they don't have to trust the patient's memory or willingness to tell them every detail - it doesn't happen.

Since 2001 I've changed my primary doctor and seen at least seven different specialists for various things. The ONLY one who read my complete file was my new primary doctor. I am very allergic to one antibiotic - one of the doctors prescribed that one even though it is in my records and on my page of prescriptions, allergies and operations I give to every practitioner. I had to catch that and request something different.

Every one of the seven specialist prescribed heavy duty pain killers - Vicodin or Oxycontin. In addition, a periodontist also prescribed Vicodin. Of course during my treatment by each I had surgery and the pain killers were needed for after care.

I hate taking those drugs - they don't really control the pain for me, they just make me so foggy I don't care if I hurt. I call the my "stupid drugs" because taking one makes me stupid for 24-36 hours. I just hate taking them and prefer using something that leaves me functional.

Same type of thing for my husband. He's had a couple of operations in the last few years and had Vicodin prescribed for after the surgeries. He might take it for a day or two, then just uses OTC medications.

We have several bottles of Vicodin and one of Oxycontin in the freezer. I'm not sure why I'm keeping them - I probably won't use them without having something serious enough to see a doctor and then they will likely prescribe more drugs I don't want to take.

Of course the next time I get a severe injury it could be handy until I can get to a doctor!

[Divernan]

55. Anyone had experience with hypnosis and/or acupuncture?

I have never tried either myself, but know a few people who report pain relief.

[SoapBox]

66. Unfortunately

This won't really help with bone-on-bone pain or extreme nerve ending damage.

[Rhinodawg]

61. Thats a Buzz Kill.

[SoapBox]

64. Those that are not in constant and chronic pain have no clue

how it makes your life almost unlivable. Aspirin and Tylenol do NOT cut it.

I already jump through hoops for Mom...she has/had severe osteoporosis and had multiple vertebrae crack/crumble at age 85. She is now 93...we must see her pain management doctor every 30 days and hand deliver a new prescription to the pharmacy. Her name gets run through a data base to check to see if she is getting pills from other doctors or pharmacies.

Oh...and she is subject to annual drug testing.

I must then jump around the office schedule for each/next appointment by taking off from work...gawd forbid that he be on vacation or off for something.

Making Mom into a criminal, when she just wants pain relief is absurd.

[ctsnowman]

68. X 1000

[otohara]

118. Drug Testing a 93 Year Old?

OMG - just curious what state are you in and what is their reason for testing her?

[kag]

128. Thank you Soapbox...

I was going to post this same information until I saw your comment. I don't understand what is "new" about this policy. I, too, suffer from severe chronic back pain, and have been enrolled in a pain-management clinic for almost ten years. I have NEVER been able to have a doctor "call in" a prescription for narcotics--hydrocodone, oxycodone, fentanyl, morphine, etc.; doesn't matter what it is combined with or if it's just straight opioids--I have to have the paper prescription, and it can't have any white-outs, scribbles, strike-throughs, or anything like that. If the doc screws up and puts the wrong date or spells my name wrong, they have to start over and make it clean. I have to see the doc once a month, and have to submit to two urine tests and one blood test every year at times chosen randomly by the clinic.

This has all been law for at least as long as I've been enrolled at the clinic, so I don't understand what this "news" is all about. Now, it is the case that last summer, because of a big bust in Florida involving certain doctors, patients, pharmacies, and pharmaceutical wholesalers, there was a huge crackdown on enforcing these rules. I don't know if it has helped fight the problem of abuse and overdosing, but I do know that the people who are suffering from this crackdown are people like your mother and myself. I have a two-day window to to get my meds refilled--meaning from the time I am allowed to get my script filled until the time I run out, is two days. So if the pharmacy (the only one within twenty miles of my small town) is closed for a holiday, or is out of the drug I need, I risk going into withdrawal. If my purse is stolen, or if I accidentally spill my pills, I'm just SOL for that month.

And what really sucks is that I can't see how any of this is keeping people who want to break the law in order to get their hands on opioids from doing so. The problem isn't that we have too few laws or that they're ineffective. The problem is that they're not being enforced. Those people in Florida who got away with fraud, theft, and illegally distributing a controlled substance, are not going to be stopped because I'm getting my pee tested every few months.

What a lot of people don't understand is that those of us who have to take these meds just in order to function would give anything to NOT have to take them. If I could get through the days without popping strong narcotics every few hours, believe me, I would gladly flush them all down the toilet. To not have to live with horrific constipation, constant sleepiness (while also having much difficulty sleeping), breakthrough pain that can knock me off of my feet for the rest of the day, the frequent hits to my self-esteem because of sideways looks from pharmacists, nurses, dentists, and anyone else to whom I must disclose my daily medications...would be heaven--or as most people call it--normal daily life.

Anyway, I didn't mean to ramble on so much. As you can see, this is a subject about which I am kind of sensitive. So, thanks for posting your info, and the best of luck to your mom.

[alarimer]

167. This is sad.

I mean who really cares if a 93-year old is addicted? It's not as if she is out driving under the influence or something.

Some of these rules seem to be pretty ridiculous.

[roody]

67. More money for doctors

[McCamy Taylor]

73. Untreated sleep apnea makes your body fight the effects of hydrocodone and opiates.

One in ten people over 40 has OSA (obstructive sleep apnea) (at least) in this country. 80% of them do not know it. If you look just at people with "chronic pain" the percentage with sleep disorders is much, much higher, but the percentage who do not know that they have a sleep disorder is still sky high because doctors are so extremely bad at spotting sleep disorders.

They did a study in which they exposed people to painful stimulus after giving them enough codeine to block their sensation of the pain. They then sleep deprived the subjects and gave them the same painful stimulus. It took more codeine to block the sensation of the pain in the same people. Conclusion---sleep deprivation makes your body resist the pain relieving effects of opiates. This makes sense from an evolutionary standpoint. If you are sleep deprived, your body wants you to be alert before all else, and so it tells you to shut off your natural endorphin system so that you are prepared to run from a tiger etc. Opiates like hydrocodone work on the endorphin system.

People with untreated OSA are like sponges. They can absorb enormous amounts of opiates and still be awake and still be in pain. In my experience, they are not addicted. Once their underlying sleep disorder is diagnosed and treated---i.e. as soon as some doctor thinks to ask "Do you snore at night? Do you stop breathing? Does anyone in your family have sleep apnea? Do you sleep flat on your back? Do you get up at night to urinate? Do you wake up with a dry mouth, a headache and elevated blood pressure?"---they stop demanding increasing doses of pain medications. Usually they cut back on their own. The number one way you can tell them from addicts is their primary concern is "I want to go back to the way I was before." I.e. back to the way they were in the days when they could sleep. They think pain is the reason they can not work because they have never heard of OSA and their doctors are not trained to recognize their OSA.

Also---this may not apply to everyone---if you have chronic pain issues and you think an undiagnosed or untreated sleep disorder may be part of the problem, while you are trying to get the sleep addressed, consider alternative medications that target other parts of the body's pain response like tramadol or lyrica. A real addict will tell you "Tramadol" does nothing for me. They want the opiate buzz. Someone with untreated with OSA will often say "Yeah, if I take tramadol between doses of hydrocodone, it helps a lot."

As for the schedule 2 change, consider Tylenol Number 4 (codeine). It is equivalent to hydrocodone 5 and as far as I know will stay non-triplicate.

[TheNutcracker]

74. More will be given pot instead, stopping the creation of addicts who'll do anything to get the pills

[BaggersRDumb]

82. But pot cant mask pain the way opiates can, pot can help but for pain opiates are the best

The new law means we are regressing and not progressing as a society.

Showing that we must be treated like children, even physicians have to be treated like children, they cant be trust to do the right thing, etc.

sign, when we grow up drugs will be legal and available and rehabs for addiction will be as common as ATM's

just like WOMEN's health clinics should be and would be (as common as ATM's) if men had babies

[DesertFlower]

132. i tried medical pot and it made my pain worse.

it also made me anxious, raised my BP and kept me awake till 4 am.

back in the day (late 70s) when i occasionally smoked pot it put me to sleep.

[TransitJohn]

87. Well that sucks.

More pain in the service of ideology.

[Benton D Struckcheon]

89. Asked my wife re this,

she's a doc. There's a whole bunch of painkillers that make her antennae go up. This is one of them.
She prescribes this VERY rarely, and only if the person has gone to see her. She's a GP, though. Her logic is that if you're in that much pain after she's done whatever it is she's previously done for you, you need to see a specialist.
And if this needs to be prescribed by a specialist, that should mean being seen by that specialist, so as to make sure you still have whatever the condition is this was prescribed for in the first place. Seems reasonable.

[lululu]

175. yes, of course, Benton

If I have a nerve going nuts, I want to make an appointment at a pain center an hour from here three months from now in the hopes they'll give me a prescription. You and your wife have no conception of what devastating pain is like and the debilitating impact it has on one's life.

[wordpix]

93. rush limpballs must be upset at this news

[mpcamb]

136. Hah! Right!

[christx30]

94. Stupid idea that'll fuel

black market drugs. People are going to get what they need, the government be damned. The people that don't have the connections are the law abiding people that are going to suffer. The addicts are going to be slightly inconvienced.

[onecent]

104. I totally agree with you...I am a senior and if I get a debilitating disease

and need pain killers...I WILL FIND THEM. What about the people that have cancer, and the older people who cannot get to a doctor and then to a pharmacy. America is getting to many god damn rules...and laws..... AND TAXES. They won't make pot legal I'm 69 and I would use it if necessary...but big pharma is getting to god damn big for their pants.

[Skarbrowe]

100. I'm having a very hard time getting Vicodin....

I have a kidney disease that doesn't allow me to take any kind of anti-inflammatory medications. No aspirin, Advil, anything that reduces inflammation and actually eases my pain. I have a few other diseases other than the Stage V kidney failure. Before they took Darvocet off the market back in 2010, I had been able to get them from my specialists and doctors with no problem. I took them for over 10 years.

Right now, Vicodin, which I hate btw, is the only thing that helps me do some dishes or walk around a grocery store. All my health care is through the VA and they have been so good to me about everything but this. During my last kidney doctor appointment just a couple of weeks ago, the Nephrologist finally said I HAD to have pain killers. Now, I have to wait and see if the Primary doc will go along with this. It's her decision. She's not very brave, so I expect her to not to fight for me to get these pills. I've been around pain killers for years with the Darvocet and I never abused them. I usually didn't even come close to taking what was prescribed. But, you are immediately thought of as a drug addict, or soon to become one, if you ask for this type of pain killer.

I've been wiped out by pain since 2011. I have had the occasional prescription of Vicodin that I try to stretch for weeks and months. Now I'm being worked up for dialysis and I'm still fighting for some relief from HUGE cysts on both kidneys. That along with arthritis, gout, and the ever baffling fibromyalgia, have gotten me so screwed up I can barely type. Please excuse the tons of mistakes. I don't post much anymore.

Just saw this post and thought, geez, now my Primary will really say "no way".

[Divernan]

102. So sorry to read of your situation - hope your doc comes through for you

with some pain relief. Sending a very gentle hug from a little old lady in Pennsylvania.

[Skarbrowe]

159. Thank-you...Oops

Last edited Sun Aug 24, 2014, 06:14 PM - Edit history (1)

Double post!!

[Skarbrowe]

160. Thank you...oops

I almost called you by the name of this really, very nice lady I know that lives in Pennsylvania. When some of us get older, all hell breaks loose on the body. I don't have it nearly as bad as a lot of people. Thanks for the hug, too. Always appreciated and needed.

Just an example of the brain problems. I've tried to reply to you three times and I keep messing it up. sheesh

[WinkyDink]

152. {{Skarbrowe}}

[Skarbrowe]

161. Thank you, WinkyDink....

I had a good friend in high school that liked the nic-name Dink. Thanks for your kindness ( HUGS!) and the walk down memory lane.

Now, I really have to read all the post in this thread because I didn't have the energy last night.

[WinkyDink]

166. You're welcome. As a Boomer, I was quite taken with the TV character WinkyDink, the first inter-

active one!

&index=2&list=PLVtA6C0Gj3p-L3KyyIfoNRSti-qOqXifa

[olddad56]

101. I had a former girlfriend that died from liver failure caused by long time abuse of Vicodin.

This was long after we were together and I didn't know about it until after she passed. She had chronic pain and became addicted to Vicodin. By the time she died, she had, over a period of time, taken all of the equity out of her house, and spent it on Vicodin. She had a prescription through her doctor, but she had built up a big tolerance to them and was getting them from an online pharmacy, probably from Canada. She had a habit that was so out of control that she was up to over 50 pills a day. It was a very sad story.

[UglyGreed]

109. Sorry for your loss

the liver damage was most likely caused by the acetaminophen, which is why I stopped using it years ago.

[olddad56]

122. thanks

[bravenak]

111. People NEED painkillers!

We do NOT want them ending up in back alleys buying heroin. Or even having it delivered.

[GeorgeGist]

112. If only we were sophisticated enough as a society ...

to have a systematic approach to health care. Instead of this hodge podge of cottage industries all needing their fix of pie.

DEA needs to die.

[C Moon]

120. I'd heard that when patients cannot get it from their doctors (after becoming addicted)...

it can lead to the patient hitting the streets for heroin.

[quadrature]

123. the issue is money and political donations

more doctor-office visits
more money for doctors
more donations

[kickysnana]

124. For those cheerleading leaving millions in agony A.T.E.T.Y.D.T.T.T.C.B.T.Yx3

For those who will die of the pain.
For those who will not be able to live with the pain.
For those who's life will be reduced to agony, who cannot work, cannot parent,
For the overwhelming of the overwhelmed medical system, hospitals, doctors, clinics,
pharmacies
For the idiots at the FDA and DEA

[NaturalHigh]

126. Not exactly a surprise. These are the head "drug warriors" after all.

I don't agree with this decision, but it's definitely not a surprise. The DEA needs to keep opening new fronts in the drug war to maintain the illusion that we actually need all those agents cracking down on people.

[DesertFlower]

129. it doesn't say anything about refills.

my doc doesn't phone in my vicodin, but he does allow me 2 refills. i can't imagine having to drive 44 miles round trip every month for a new prescription.

i'm 73.

just found this:

http://www.usatoday.com/story/news/nation/2014/08/21/us-restricts-hydrocodone-painkillers/14387867/

i can still get my refills. thank goodness. he's a primary care doc and i'm lucky to have him. most primaries won't write for vicodin. you have to go to a pain center.

[Laelth]

156. I expect better from a Democratic administration.

This move validates all right-wing arguments about government overreach and intrusion into the lives of the people.

-Laelth

[wordpix]

164. you won't get it from O admin. I've been dealing with fed health agencies for months

also with my Dem. members of Congress re: medical billing practices (providers just make up numbers that are extremely high and fantastical), med marijuana and human trials (no trials for CBD mm, although proven effective for many cancers in animal studies), and pesticides known to cause all kinds of health problems (cancer and neuromuscular disorders to name just two categories).

These agencies are infiltrated with the revolving door compatriots of drug and chemical corporations. They do not want mm trials or anything else interfering with their toxic pollution of food, water, air or our bodies b/c they're making billion$ per year on this stuff. If they can make billions on old drugs/old chemicals, they don't have to develop new or contend with mm that will eat into their profit$$$.

That's what this is all about.

[steelsmith]

162. Damn it, This crap is disgusting.

I cannot afford to go to the doctor once a month, my prescriptions eat up all available money. Don't these idiots think before they pass these laws? Which party put these idiots in charge? I'm devastated now, pain management is not a joke, when you need meds, you shouldn't have to deal with this type of insanity.
I will now go from a relatively active life to curled up in a corner writhing in pain. Just fucking great...

[deafskeptic]

165. I'm dismayed at this. yes, this can be be addictive

but people with chronic pain need relief from it. Only a small percentage get addicted to it.

For a long time, I had a problem with chronic and severe pain due to a chronic ulcer caused by both diabetes and pvd. For quite awhile I was afraid I'd get addicted to it so I was very careful not to get hooked on it. I didn't want to go with out it either. The chronic pain sufferers have a very difficult time getting pain relief.

Doctors are reluctant to prescribe pain meds like vicodin because they can lose their licences if their patients become addicted to it. That's quite a dilemma here. Neither doctors or patients benefit from this.

[SoFlaJet]

171. Here comes another big wave of heroin overdoses

Happens every time they make it harder for people to get their pills, heroin becomes more easy to get, stronger, and cheaper. It's been happening down here in Florida since they started closing down the pill mills and throwing doctors in jail for decades at a time sentences.

[lululu]

174. bad news for people with pain issues

I used to have a doctor who knew I was careful about Vicodin. Then I moved to another state, and the new doctor doesn't prescribe it unless there's a visible injury (I fell badly onto concrete a few months ago and it was prescribed when I hadn't even asked for it.) But when I had previously asked for it for a chronic pain issue I got No, even though I'd been carefully taking it for years an dmy old doctor vouched for me.

This is the sort of thing that sends people out into the streets to buy it. Not that I would, because God knows what I'd be sold, something poisonous maybe.

Yet another example of the idiocy and the harm done by the War on Drugs. Everyone who had a hand in the new regulations should suffer from pain and not get anything to relieve it.

[Prophet 451]

179. I find this questionable at best

I'm an addict. I take large quantities of dihydrocodeine to cope with chronic arthritic pain. I should be on much stronger painkillers according to my doctor but most of them have really nasty interactions with the four psychotropics meds I take daily. I was also a semi-pro wrestler and wrestling is a business that's awash with prescription painkillers (the abuse of which is, in my experience, even more of a problem than the steroids people associate with wrestling). At least these days, my addiction is monitored and controlled and I'm on a dozen pills a day, not 30 or so from a guy in the locker room and washed down with whiskey. I've known painkiller addicts. Addiction is a problem with the opoids and one that's often overlooked.

That said, I live in a country where my doctor visits and my drugs are paid for by the NHS and I already see my doctor every couple of weeks (because my file has "SUICIDE RISK" in big red letters at the top). In a country where you still have to pay for doctor visits, all this is likely to do is force chronic pain sufferers to endure their pain longer or get their pills from some shady online pharmacy. It's going to require extra doctor visits. For me, in a country with decent and cheap public transport, that's not a problem. But in a country where your doctor might be thirty or forty miles away and with (forgive me) shitty public transport, that visit might be either impossible to make or more than you can afford. A lot of people in poverty or old people don't drive and they can't afford a taxi.

[MissB]

180. Dh take one a day.

His primary card dr prescribes it. He used to have to argue the dr a bit for it, until about three years ago.

His dr decided to update his X-rays of Dh's back to see how far Dh's ankylosing spondylitis had progressed.

Now he kindly writes a prescription for 30 days worth, no arguments. It's that bad.

[lululu]

183. yeah, it's amazing

If they can see it, they treat it, but if it isn't visible, obviously the patient, like me, an old woman who's never touched even marijuana I am so boring, is a crazed drug addict and just gets to suffer.