Maybe this is why my ignorant Dr Creepo decided to go into pain management!!! He maybe knew this was coming and decided to jump on the money bandwagon!!!! However, He is currently the joke of town! My obgyn commented on it, my former dr commented on it and the nurse and dr at the actual Pain Management clinic said they have heard tons of bad things about him lately!!! They said "Yea, we've heard he thinks he's running a full fleged pain management practice out there when in fact he doesn't have a clue what he's doing!" I couldn't agree more!!!!

Lord, if this is taking place in Idaho too this isn't a good time for me at all! I am reassured by a letter my obgyn wrote to the pain management doc though! It is very informative and very much in support of my needing long term pain managment! He even makes reference to how terrible my current doc is treating me and how he agrees Im in desperate need of a caring doc! I just re-read the letter again and actually know now everything wrong inside which is nice! I only knew of part of it and actually didn't know how bad it really was til reading thru the copies of my entire medical chart from my ob! He is the one that did my adhesion lysis last May and no wonder Im still in pain, his surgical notes say he couldn't remove over 80% of the adhesive disesased area!

Grrrrr, I really hope that this isn't true nationwide! Well, I guess I really hope the pain management clinic accepts me as one of the chosen few to remain a permenant patient at their office. I've been told several times that the only thing they do is make reccomendations, get me on a stable dose and proper cocktail of meds to manage my pain and then I must have a PCP to return to who is willing to continue to rx what the PM office has me on!!!

We all need to be writing our congressmen!!! Or, move to Florida to join Tipper!!!! lol Hell ... what a life we lead! Everyday another piece of bad news that makes ya wanna just give up!!! Sometimes I think that is really wasn't that bad living without pain meds, it seems that my stress levels are extremely higher then ever while continuing to battle just to get the damn things!!!

Well, all we can do is pray and prepare! My appt with the actual PM office here is wednesday and God willing, he'll hear my cry and accept me permenantly into their office. I can't imagine doing this all over again a few months down the road!!!!

Prayers for all of us,
Riss

Hey LFH...where did you get this information and do you know what the Law is called.

I am very curious to know what the meds are and at what amounts. I am (hopefully) going to be moved up to a stronger med.....but I don't want to start something that I cannot continue on later....my PCP is going to start my meds. At this point in time, I refuse to see a PMD because they only want to guinea pig me.

I will start research and see what I can find....thanks for any further info and for this original info!

WE see our pain doc every two months religiously. Thank you for this useful info. Hopefully everyone will check to see if the laws in their state have changed.

I heard of this proposal and I think it sucks. More hoops are exactly what people in pain don't need. Only the fakers will have the energy!

My spine doc went from having a PM guy in his office once a week to hiring a doctor full time as part of the practice. They also have an MRI machine and xray machine so I'm not sure it means anything about NY. With my case being under W/C I see both of them every month still.

I'm not on any routine chronic pain meds at this time, but I'd be interested in finding out more about this too. I'm an NP so can prescribe narcotics. I don't deal with chronic pain management in the practice I work for, other providers do, but we are not a pain mgmt clinic (we are primary care). So that will impact on a lot of our patients. I'm going to see if I can find some info on this tomorrow when i go to work (I work in MA)

Thanks for the heads up though!!

This applies to WA state only:

http://www.blueridgenow.com/article/20100729/ZNYT04/7293012?Title=Move-to-Restrict-Pain-Killers-Puts-Onus-on-Doctors

Oh good grief. None of the pain management clinics in my area prescribe ANY drugs of ANY kind NOW. I have no idea what I'm going to do. I'm not exaggerating when I say that I CANNOT walk without the pain meds.

Lord, what are we supposed to do??? This really stinks.

My FNP manages all my meds including pain meds in order to save me $. P.M. clinic co-pay $60, FNP co-pay $25 and I only have to see her every 2 or 3 months. Other months just go by her office and pick up scripts $0 co-pay. She is wonderful and more effective that any MD or specialist I've ever seen except my Hep C doc. I pray they don't mess things up here in NC

Hmmm... this part could be worrisome.

"The panel is expected to require that, among other things, doctors refer patients to a pain specialist for review when their daily medication increases to a specified dosage level and they do not show improvement. The specialist can then determine whether to continue the drug, reduce it or use other treatments like physical therapy....
Pain specialists and regulators in Washington State said they thought the requirements were essential because doctors were giving high daily dosages of powerful drugs for ailments like back pain for far too long without evidence that the drugs worked."

While I agree if a med doesn't work after increasing it a few times it should be stopped but that doesn't mean another drug shouldn't be tried. PT, I am so sick of PT. There is just so much PT can do in many cases. I believe quite a few of us have plateaued out of PT or it has made things worse. Insurance companies know that, that's why they limit the number of visits they will pay for. It seems based on the article, if a med doesn't work then it's PT for you.

Since most of us are seeing PMDs, I don't think it will effect many CPs. Just have to wonder how many on this committee either are themselves PMDs or have connections to the PM industry and are just looking to make everybody get another doctor = the big bucks for them, higher copays to us.

@Leeall, what do you mean the PM clinics don't prescribe? What do they do?

I apologize... I didnt mean to worry anyone. I got home late, was tired and had been to my doctor. I was SO upset that I was about in tears and SPITTIN' NAILS! I came here and posted first, before I checked into it a little more. I wasnt sure whether or not it was going to be the same in any other states but just in case...I wanted everyone to have this information WAY AHEAD OF TIME and have adequate time to get plans in place! Nothing is set to happen anywhere else right now so those NOT in Washington State- can rest easy. Its really nice to know that alot LESS people will be affected by this!

Everything about this pisses me off! One Dr. basically states that he believes that anyone with cancer deserves ALL the pain relief that they need. (well OF COURSE they do) but so does ANYONE in pain!
I also think that there is a HUGE conflict of interest to have an advisor of this change, also working closely with the addiction community! Talk about one sided opinions!

Ok..mad and tired again - off to bed.

Thanks Chronic for the article!!

darn i live in WA state and my pain doc dosn't rx my meds, he makes suggestions for med changes to my primary and my primary rx'es my meds. this may make it more difficult when my primary eventually takes over my care or my pain clinic may have to start actually rx'ing meds

I pray this doesn't affect me as I finally found an Internal Medicine doctor and am considered by my 1st pm doctor ever to be a "medication management only patient" that he said after 11yrs I no longer belonged in pm and needed a doctor to take care of all my health needs including pm.
He would take me back and I respect him however I finally have a doctor that spends a lot of time with me, is looking at all aspects of my health as RSD can affect people internally and she is trained to do pm as she took some anesthesiology classes in Med School so she could understand pain patients better.
I have a pain contract with her just as I would with a pm doctor. My meds changed but is being controlled very well.
Please give us any info you can & thank you for letting us know

All, please keep in mind that this a proposal. It is not final, as far as I know. Write letters to your newspaper editor, legislators, and the medical committees who are considering this. You can influence people! I agree that it is screwed up. We have to get our meds from whoever has the courage to Rx them, because many docs don't. There are some "pain docs" who only do procedures. I suffered through one of them at the beginning of my journey... It also angers me how some are biased toward only treating specific diseases. Cancer is scary and painful, but it is not the only thing that is scary and painful. All who suffer deserve professional and caring help.

Peace to all!

Alas, the states can implement more restrictive rules than the federal government. The federal rules governing the prescibing of controlled substances are very basic (and the DEA determines what medication is classified as a scheduled medication, not the FDA, despite their desperate desire to have this authority themselves...and then most everything would be scheduled and they'd implement special training for every level of medication and we'd never get anything, even aspirin or blood pressure medication because heck, even that can cause physical dependence!). Those state requirements can be much stricter than the federal rules (and most have some level of additional requirements for providers, pharmacists, etc.). The state rules often lag behind the federal rule making (most state rules/laws have to go through their state Congressional process and not all states actually meet every year, nor for more than a few months of the year, so getting things done at a state level often takes much longer than getting things done at a federal level at times).

For example, last year, the DEA changed the rules (through an open rules-making process) to allow doctors to write up to 3 prescriptions for a Schedule II medication at one time for an established patient: one to be filled immediately, one to be filled no earlier than 30 days from now, and one to be filled no earlier than 60 days from now (each script has to be dated the day it is written with an annotion of fill no earlier than XX date as appropriate). This was done to make it easier on both the patient and the doctor, reducing the need for those monthly visits to the doctor, as well as the extra time and expense, especially in light of why many patients need the Schedule II medications to begin with (to make the appointment and actually get there safely and then on to the pharmacy can take hours or even days depending on availability of transportation, physical condition, etc. (not to mention the ridiculous added expense of a medical visit for the purpose of getting a script only). And more recently, that 3 script process has been extended to electronic prescribing, although not all systems are designed to accept this type of prescribing because it's NOT a refill, it's a new script each time (and not all systems accept a script to be filled no earlier than 30 days from now).

But that's the federal rule; the states can make it more restrictive (and/or they haven't caught up to the federal rules or they prefer to be more restrictive). So as patients we need to know the federal rules, state rules, and in some cases, city/county rules as well.

It's important to understand that the DEA (federal) is not out there targeting patients or doctors who are obeying the law; they have much too much on their plate than to single out individuals for entrapment (which is illegal) or surveillance. So the next time your doctor, any doctor, blames the DEA for not being able to do something, ask them to show you where in the rules it says so--in writing! If they're so in touch with how the rules work, they should have the handbook in their office and be able to provide you chapter and verse for why they can't do something reasonable. Force them to do the same when they claim that oxycodone in any form is being discontinued (it's not; it's just a convenient excuse for being lazy) or there is no equivalency chart for OxyContin to Morphine (there are infinite equivalency charts, especially as all narcotics are measured in morphine equivalent doses!).

I wish everyone a pain-free day! :)