Thank you.

I have been dealing with my son's Godfather the past six months.: Naval Academy grad, former Navy Pilot, business owner; a very successful man, who is suffering from late stage Crones and other accompanying maladies,

He was on opiods for the real and transcendent pain he has been dealing with. Now they want him off. No explanation, little recourse, deal with it. He can prove he never violated amounts, scheduling, etc.

So, the people who enabled him now can't find the courage to make sure his landing is soft.

I get abuse of substances, trust me. Laws have, as we know, unattended consequences...Steve is one.

No one should be denied legitimate pain management meds....best of luck, get a second, third, fourth opinion from a PM specialist imo. Is MJ an option? Best to you daepp and to your pal Paul...that sucks. It's being taken seriously now...and still no end in sight :(.

My wife recently had laser eye surgery, in the recovery room they went over the paper work with us and said just take Advil for the pain.

I kept asking are you sure?

The nurse kept saying yes, just take advil. I said but you said her blood pressure is so high from the pain, isn't high blood pressure bad? Just take advil.

My wife went back a couple of days later for a follow up, they said they made a mistake and should have given her something more for the pain - and gave her a prescription.

On the other hand, in the CBS video, one of the people that had their life ruined after getting hooked because of pain from a dirt motorcycle accident said the CEO should try taking a couple of his own pills (OxyContin) for two weeks and see for himself how easily it is to get hooked.

If you had your shoulder hurt back on October 27th, you would for sure be an addict by now on OxyContin. Then you would have two big problems instead of one. Three months?

Addicts hurt a lot more people than themselves, one of the many ways is people who really need pain medication and now can not get it.
Addicts are not victims, until they own up to it and take responsibility for their choices they will not get better.

No one made an addict start, they made that choice.
No one can make an addict stop, they have to make that choice.

To say other wise does a disservice to the addicts and every one around them and enables addicts to maintain their self destructive path and continue to hurt themselves and others.

I am on it, KC. The PM specialists are the most afraid and I go in with him to plead his case. Thank god for pot, I kid you not. He has a card...saved his life, placebo or not.

Steve is my friend and Jack's GF. I see him three times a week and have watched the de-evolution of his life, from a recent request from his wife for divorce, to tending to this once Titans recycling...cleaning his house.

His eyes still have the pierce, the depth: We make each other laugh.

Opiods are an issue. Don't forget those that were hooked when they were legal. Let them down easy.

Sorry for the rant but I don't give up on friends.

Best.

This is being dictated by the federal government. Threaten the doctor's livelihood if they fail to toe the line. A lot of these patients are not going to get better, they are on narcotics for chronic problems. Give them narcotics to dull the pain and they have a life. Take that away and all they have is misery.

End result will be a lot of people going on the street to get relief and then they will die. Fixin' to go from bad to worse in a big way.

All great and dandy, except the patients (not addicts yet), doctors and medical community/staff were not properly notified of just how quickly addictive some of these medications are.

For example:

MAY 10, 2007
In Guilty Plea, OxyContin Maker to Pay $600 Million
https://www.nytimes.com/2007/05/10/business/11drug-web.html?module=inline
And these settlements as large and as quickly resolved as they appear to be on the surface, are not always what they are cracked up to be.

Opinion
Opioid Makers Are the Big Winners in Lawsuit Settlements
State and local governments are giving up opportunities to hold the drug industry accountable for Americans’ overdose deaths.
https://www.nytimes.com/2018/12/26/opinion/opioids-lawsuits-purdue-pharma.html

For so many, it is no different than any other illegal drug, or completely legal, alcohol and now cannabis. They want a high, and they will get it.

I understand everyone is different. I have always felt so many "victims" want to feel no pain, and take the dose so high they are numb and like that feeling. Some no doubt just have an addictive personality.

For someone like Paul's friend's problems, addiction is not the issue, it is real pain. I watched my Uncle screaming in agony from cancer when he was moved enough to change the sheets and he was on morphine. He "lived" like that for three weeks.

The doctors have a hard line to walk. I recently had oral surgery. Very painful procedure, and I was prescribed just a few Oxycotins. I only took one. I would rather hurt for a while than feel like the Oxy made me feel.

I do see the problem, and have seen it from various angles. I typically don't use medications, or even visit doctors. Recently injured myself pretty badly, so went to see the doc to get some internal pics and make sure I hadn't broken anything. Was there with the doc maybe 2 minutes and she set me up for x-rays and prescribed pain meds (opioids). Told her I didn't want the meds.

Really good friend of mine has been using opioids for a very long time. Told him years ago he was an addict (jokingly, at first). With the new laws, he's coming off the meds, but it's hard for him. And he does still have the pain that got him the first prescription...so what does he do about that?

That is me to a tee...even after hip replacement surgery the Oxy stayed in the drawer.

Exactly. Steve's point to me is that he is dying; he knows it, we all know it and he is in pain, lots of it, consuming.

We have tried everything, folks, from patches to electronic stimulus to booze.

Pot helps, opiods rule. Let this man die with pain as an aside.

Careful there Paul, you sound like Harvey Rose.

Has Steve been to a methadone clinic Paul? Most go to these for PM...best to you both....it just sucks.

Last year I somehow blew 1 IV disc in my neck and 4 in my lower back. It took months to get properly diagnosed and 2 surgeries done. I'm still not 100%, more like 75%, but I can at least walk without screaming now. Still trying to convince the neurosurgeon that I need 1 more lower back surgery.

Dr.s are VERY stingy with pain meds, even 5 mg Vicodin or Percoset, so I live on massive doses of Excedrin and Tylenol. I hate to think what I'm doing to my liver, but if I don't take them, the pain in my legs keeps me from sleeping, and I still have to go to work 5 days a week.

Once again, a few people ruin something useful for the rest of us.

I'm sorry, but CBS, and for that matter anything you "watch" on TV is just bull$hit AFAIC.

That would be a fascinating experiment.

My sibling is an MD. Says you are completely effed if you think you are solely capable of just saying no if you get hooked.

Intervention is required.

Is two weeks enough to hook? Don't know.

I haven't read the whole thread [ducking] but a couple recent posts have mentioned how it's harder to get narcotics for legitimate pain recently. Each state is going to be different, but now that we have this "opioid epidemic," we now have all sorts of regulatory agencies looking over our shoulders--both as patients and as doctors. The end result being that it's more difficult now to get any narcotics.

California has CURES. It's a state database for all narcotic prescriptions. Before a provider prescribe a narcotic, the provider is supposed to check with CURES to see what other narcotics (if any) the patient has been receiving over the past 12 months. Don't do it, and the provider risks having the medical board revoke their license. So big brother is watching both patients and providers.

On a weekly basis, I get letters from insurance companies regarding a narcotic prescription I wrote for a patient, and reminding me about this opioid epidemic. I get letters from insurance companies asking me to justify the need for opioids for patients. Weird, as I don't get it for every patient--seems hit or miss which insurance companies (adjusters?) care and which don't. [Of course, if they took the time to read the notes/dictations/records I include with every prescription, they'd have their answers. But heck, it's easier to send out a form letter to ask a question, than it is to look for the answer.] Once in awhile I get mandates from insurance companies instructing me to sign patients up for "pain contracts" and to do toxicology tests.

Just this past month, California has changed the requirements for prescription pads, due to this opioid epidemic. The safety features (to prevent forgeries) have been updated. This is causing some degree of mass confusion amongst providers and pharmacists, as we were informed of this via email--get this--the week between Christmas and New Years. For a new set of rules that went into effect on Jan 1st. Of course no one had the new prescriptions ready to go with only 3 days' notice. There are also regulations that limit the number of narcotic pills that can be prescribed in any one prescription.

The frustrating part of all this is that we go from one knee jerk reaction to another. Instead of using best judgment, the focus is on compliance with regulations. Unfortunately, when you try to apply one set of rules (formed by bureaucracy) to all situations, you find that there are often people who get left out.

The prescription pad thing really chapped my ass because of the zero notice element. That, and the prescription pads can only be ordered from "approved" printers. They did something similar like 2 or 3 years ago. The changes will do NOTHING to address the problem, of course. CURES, that website is pretty GD lame too.

Each state is a little different, but my understanding is this crap is originating at the federal level. I have spoken to physicians in different states, and a ton of crap has been going down all over the country.

Here's one for a datapoint.

As a dentist, I have a DEA number.

When I get home at night, I check onto PPOT and my email (In no particular order).

In addition to TABS's pimp daddy pics, on my email I get a custom printout of what I prescribed.


http://forums.pelicanparts.com/uploa...1548467000.JPG
http://forums.pelicanparts.com/uploa...1548467000.JPG

I think these are interesting, in that in average to ordinary dentists, I am prescribing more than the other guys, but, I am also doing a lot more oral surgery than the average folk. This feedback is also interesting that it references cross prescriptions with other doctors.

I think it also shows another trend, regardless of what I treat, and how I treat it, the average practitioner has cut way back on prescriptions. The average dentist is prescribing just two a month, that is how much this has been curtailed.

Also, in our continuing education, we are mandated now to dedicate a certain amount of CE time dedicated to this issue.


So guess what... Tomorrow I will log onto PPOT, check out TABS's latest fly daddy pics, and then take a 3 hour CE course on this subject (not TABS- narcotics...).

I am sharing this to provide some insight into what is being done at a provider level to address this issue.

edit... I am agreeing this stuff is interesting, but the people enforcing this aren't in the real world....

Agreed. Super irritating. And also reflective that the people forcing these rules on us are totally out-of-touch with and/or don't GAF about how things work in the real world.

There's supposed to be some sort of 6-month grace period, but tell that to the patient with a narcotic prescription for post-op pain who is standing in front of a pharmacist who refuses to fill the prescription because it's not on one of the new scripts.

I have like 3 or 4 iterations of controlled Rx pads, sort of a lot for the last two, because neither lasted very long.

Should have bought an interest in a secure prescription pad printing company, damn.