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Pain med regulation

I’ve been a little out of touch this past week, as I’ve been dealing with a large kidney stone, which was finally removed by laser last night. I really don’t recommend having a kidney stone.

I got a little lesson about the problems of over-regulating drugs this week. One of the common pain meds prescribed by doctors is Hydrocodone/Acetaminophen 5/325. Now, realize that this is already set up to prevent abuse of Hydrocodone — because the Acetaminophen will kill you if you take enough to abuse the Hydrocodone. But on October 6, Hydrocodone combinations were moved by the DEA from Schedule III to Schedule II, over the objections of much of the medical community. What this means is that doctors can no longer phone a prescription to your pharmacy — you have to take a physical signed piece of paper — and there can be no refills.

As several doctors told me this week, this concerns them because patients have to come in more often, and may be stuck without pain medication when they need it. They also indicated that the practical result is that they’ll end up prescribing larger amounts, just to be sure, resulting in lots more leftover drugs.

More stupidity by the feds.

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22 comments to Pain med regulation

  • darkcycle

    Ugh. I truly sympathize. My stone had to be broken up by the lithotripter. It’s like sitting in a tin wash tub full of water and having a friend beat on the sides with a baseball bat.
    Feel better fast. It doesn’t really take long, you’ll be reassured to hear.

  • divadab

    At least the DEA is being consistent with their mission by making hydrocodone harder to get hold of. But the dreaded merrywanna is still deemed more dangerous than vicoden, which will addict you if it doesn’t destroy your liver. In fact, in my State, in order to be able to use medicinal cannabis, my medical professional needs to show that I don;t tolerate opiates! To use a much safer medication!

    And here’s the capper – my doctor prescribed vicoden for my back injury – under ObamaCare, it cost me $5.67 for 40 pills. How many more opiate addicts is the ACA creating? And continuing to suppress and oppress cannabis?

    • NorCalNative

      divadab, which state requires you to prove you can’t tolerate opiates before you can get a recommendation to use cannabis?

      • divadab

        Washington. Check out the code. For pain- all standard pain remedies must be exhausted for cannabis to be available.

    • Windy

      Wow,diva, my hubby is on hydrocodone, and we are on Medicare with a supplemental, he gets 120 per month and it only costs us a $6 co-pay. Obamacare is obviously proving to NOT be the solution to the high cost of medical care and prescriptions it was advertized to be.

  • NorCalNative

    Pete, as someone who has had a kidney stone I can really empathize with what you experienced. It’s NOT much fun.

    I call bullshit on your physicians and their complaints.

    Here’s why.

    It’s as simple as your physician writing 3 individual prescriptions dated one-month apart that can’t be filled until the date on the prescription. This is how my Schedule II meds were managed for years.

    There is absolutely NO NEED to have a patient make monthly visits OR the need to prescribe large quantities. I know from experience that this works.

    It takes a few extra minutes to complete 3 prescriptions versus 1, but if it helps manage prescription drug abuse I’m all for it. Patients NEVER have an over abundance of pills to store or protect from theft using this method.

    As someone with a comprehensive history of poly-substance abuse I’m thrilled that the FEDS made this move because it makes it harder for people to obtain a drug of abuse.

    Finally, the use of fast-acting opiates like vicodin really have little place managing “CHRONIC” pain. However, in an Emergency situation like kidney stone pain they are absolutely appropriate.

    My understanding is that the U.S. uses 80% of the world’s supply of hydrocodone products. Why?

    • darkcycle

      NorCal, the DEA expressly forbids that practice now. One script per visit for pain meds is the rule.

      • NorCalNative

        My bad, bullshit on me!

        I still believe that despite the additional hassle for patients and physicians that hydrocodone belongs in Schedule II based on abuse potential.

        If physicians respond by prescribing larger amounts then Pete is absolutely right that this is a recipe for future disaster.

        Hopefully that down arrow is from Pete, because I deserve it for not doing my homework.

        That the option for backdated scripts is bye-bye suggests a real distrust of M.D.s as “gate-keepers” of narcotic prescription medicine.

  • gravyrug

    NCN, my daughter got hit with this when trying to refill her meds for her back injury. Apparently the back-dated prescription deal is expressly forbidden. Her doc went with ordering twice the dosage, so she only has to go back after two months, instead of one. The other weirdness is that hydrocodone is now listed the same as oxycontin, so why not just prescribe that, instead? It’s a stupid move by the DEA, but that pretty well describes their every policy move.

  • Shelley Neth

    I have an ailment that causes chronic pain and have therefore been on a steady prescription of pain meds for sometime. My doctor writes a prescription for 6 refills, which I fill once a month. This has worked without a gitch for years. Until now. Now i must treck to another town every month to pick up a written prescription, which is a pain in itself for him and for me. Also, the insurance company has also seemingly been heavied into changing its policy so that the doctor now also must fill out a pre-authorization each time for the amount. And Medicaid has now put a cap on how many pills they will pay for mking people with chronic pain, and therefore a larger prescription, pay for what is over the cap out of pocket. All these rules are doing is making it harder on legitimate pain patients.

  • I’m really sorry to hear about your kidney stone. I used to be an ER nurse, and I saw a fair number of kidney stone sufferers. The pain was often compared to a gunshot.

    You’re right about the hydrocodone–it’s absolute stupidity. They’re bent out of shape about deaths from Oxycontin (schedule 2), so they move hydrocodone to schedule 2. If the schedule made that much difference, they wouldn’t be having a problem with Oxycontin to begin with. Most Docs, NPs and most staff nurses know what a goofball move this is. That’s what happens when you let cops practice medicine.

    • darkcycle

      Got that right. Cops are barely smart enough to be cops. Service boots with zippers on the side were specifically designed with them in mind.

  • CJ

    Hydrocodone has always been a favorite. If I’m totally honest, I actually prefer it to almost anything. It is different from heroin in my experience. I think we’re all physically different. The thing is though everyone I have spoken to kind of agrees. Hydrocodone is this beautiful intermixed feeling of energy and euphoria. Heroin, especially IV and especially long term use, it’s not quite like that. The rush has a euphoric feeling and no doubt good quality heroin will feel that way in the afterglow (the legs) but I’ve always had a strong sedative effect with heroin. Oxycodone has always seemed to me very, very close to heroin but hydrocodone, no not at all except in exceptionally high break through amounts perhaps. I used to love Roxicodone, 30 mgs of Hydrocodone. When the formula was such that they could be snorted or injected successfully (and easily). But the reformulation that makes them oral only limits them but something is different about them to. To me, the pre tampered formula of those 30mg hydrocodone pills (instant release) that was drug perfection and just so not dangerous and just so good for someone, especially someone with crippling psychological problems, PTSD, handicap enducing depression. The problem was cost. 10$ a bag of heroin is already a nightmare but those pills could run you atleast 20$ but I know it’s gone up to 1$ per mg and even higher. It’s impossible. But there was a time and I will say it was, in my opinion, equal to like really high quality E that just doesn’t overwhelm you and make you incapable.

  • jean valjean

    I am astonished to learn that the highly addictive drug hydrocodone should ever have been schedule 3, while totally non-addictive cannabis is schedule 1. Obviously massive lobbying by Big Pharma has created this absurd state of affairs while the DEA has revealed itself to be utterly biased and incompetant in its farcical scheduling.

  • This is all about PAIN MANAGEMENT.

    Anyone suffering from pain should be able to obtain a remedy to said pain.

    If one needs to drink to do so, the only limitation is one’s access to monies…and if you’re a sweet chick, or a devilishly handsome rogue, one can get free drinks.

    How can anyone responsibly manage someone else’s pain threshold?

  • NorCalNative

    At Strayan, Fanta? Seriously?

    Whiskey Tango Foxtrot?

  • NorCalNative

    At Strayan, ABUSE POTENTIAL DEFINED.

    From FDA.gov website.

    Abuse potential refers to a drug that is used in nonmedical situations, repeatedly or sporadically, for the positive psychoactive effects it produces. These drugs are characterized by their central nervous system (CNS) activity.

    Examples of the psychoactive effects they produce include sedation, euphoria, perceptual and other cognitive distortions, hallucinations, and mood changes. Drugs with ABUSE POTENTIAL often (but not always) produce psychic or physical dependence and may lead to the disorder of ADDICTION.

    Addiction is defined as a chronic, neurobiological disorder with genetic, psychosocial and environmental aspects, characterized by one of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.