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Author Topic: Pain network survey on changes to prescribing practice.  (Read 2516 times)

Offline nick (OP)

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Re: Pain network survey on changes to prescribing practice.
« Reply #1 on: August 15, 2016, 12:28:30 AM »
That's brutal. Surely adequate pain management is the top priority? Apparently not.
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Re: Pain network survey on changes to prescribing practice.
« Reply #2 on: August 15, 2016, 04:03:33 AM »
Thats fucked,. Well the done clinic is at least an option for them.  Id think thatd be best for around the clock pain anyways.  I knew a guy that got hit by a ups type truck 15 years ago, crushed his legs, been in a chair since.  Dude was never gonna get better, definitely someone who deserved his opanas.  I mean so what if he sold a few each month to a friend.  Ive always done the same with my subs mainly just to help one or two friends out when it was needed.

Weve already found out what the non cpps did when they cut off the oxys and opanas,. Will they ever learn that people wont just stop. Theyre gonna go to done or the streets to get their shit if they get cut off

Offline candy

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Re: Pain network survey on changes to prescribing practice.
« Reply #3 on: August 15, 2016, 06:25:05 AM »

No one with chronic pain should have to worry about having their pain meds decreased or taken away.
No point in treating someone's pain because their is no cure for their disease or disorder. That is just cruel.

“My doctor said he is afraid of the DEA and CDC,” said one patient. I have heard the same shit as I try to navigate the fucking healthcare system
dealing with a chronic illness and pain.

If you are on the up and up as a physician, don't over prescribe or prescribe for conditions that don't require opioids for severe pain, then you have nothing to worry about. I don't know how many times I have heard some doctor tell me that prescribing opiates is not within his/her scope of practice.

Because the DEA is both a regulatory and and law enforcement agency, doctors are afraid to prescribe and therefor allow their patients to suffer needlessly. 
As I pointed out, unless you are on the DEA radar and have prescribed illegally in the past, then do your fucking job and help those living with chronic pain.

I have been living with chronic pain now for quite some time and I am growing tired of the same bullshit excuses given by these doctors who are afraid the DEA is going to come and raid their office.
You do feel desperate. I don't want to lose my methadone take homes. Sure, I could go the clinic everyday if I had to, but dealing with the clinic because I test positive for other opiates I am not prescribed is not something I want to do yet.

I am not quite ready to give up the fight for my rights to appropriate medical care/pain management.

It took me months just to get a script for Gabapentin, 300 mg, 2X a day and that doesn't cut it, but I will play along and just continue to get it increased.
If you as a physician are more concerned about the DEA then the quality of life for your patient, you need to be in a different profession and have no business having a license as an M.D.
Doing procedures all day that don't treat the patients pain or only provide temporary relief is just another way to increase profit.
My physician charges $1,200 dollars cash for an injection in the neck that is supposed to help with pain, treat PTSD, anxiety, and a list of about 20 other conditions.
Pure profit done right in the office. $1,200 dollars made in less than 15 minutes. The same procedure posted on a half dozen flyers, each claiming to treat a something different.

I guess the only way we will get pain medication we desperately need is when we can be cured and for many that cure equals death to those in the medical profession.
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Re: Pain network survey on changes to prescribing practice.
« Reply #4 on: August 15, 2016, 06:59:37 AM »
Yes, it isn't just Opiates.

At my appointment before last with my Psychiatrist she asked me to only refill my Xanax every 30 days (a day before here and there was alright she said) where before I was doing it every 28 days which my insurance will pay for. The next sentence out of her mouth was that she trusts me [and I believe her] but that the DEA will "ask her questions" if it continues.

So this isn't just C-III and C-II meds, it's C-IV as well as crazy as that is.

If they think the increase in suicide rates are only because those in pain are not being treated properly than they haven't examined those with severe anxiety issues that make you feel as though you can't breathe and are having a heart attack every day/other day/sometimes more then once a day.

The DEA is the best thing that ever happened to the Cartels and the RC market and the worst thing that ever happened to those of us who legitimately are seeking honest help!

Offline Opi-ette

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Re: Pain network survey on changes to prescribing practice.
« Reply #5 on: August 15, 2016, 08:04:24 AM »
My PM Doc dropped me down from 120 Oxy/mo to 80/mo just randomly out of the blue a couple years ago.
It made no sense to me as it seemed such a random drop but of course I kept my mouth shut and kept up with my injections. (Which quite honestly the injections only last about 3 days max, and I refuse epidurals so 3 days is better than none). About a year in, I asked him, can't you at least make it 90? An even 3 pills a day? He hemmed and hawed and said "Opi-ette I have to keep you on a tight leash". Part of me believes its for my own good and part of me knows he has to cover his own ass. He did up me to 90 and I never broached the subject again.

Is my pain adequately managed? No. Dare I ask for an increase? No. Me, the rock and the hard place have gotten to know each other quite well.

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Re: Pain network survey on changes to prescribing practice.
« Reply #6 on: August 15, 2016, 12:11:59 PM »
It is quite ridiculous, as you guys may have seen me post before my doc hands scripts out like candy, but towards me has been quite stingy after seeing him a few months, but almost everyone I know or hear that goes in there gets opiates for things that they don't need them for. I checked him out on that site(EDIT: Propublica) that I can't remember the name of right now that shows the doctors in your state prescribing practices like what are his most prescribed meds how many of his patients receive c2 meds etc and most of his are sch 2 and 3.

He hasn't ever talked about the dea, losing his license, or ask me to wait 30 day to refill meds, or any of that shit. I think if doctors were like candy said then they have nothing to worry about, I doubt that many doctors who aren't pill mills, have gotten any real warnings at most maybe a few inquiries to make sure they aren't over prescribing or that a patient has a legitimate need. More than likely a few doctors got those inquiries and puckered up and forced a lot of patients to deal with unnecessary pain because of all the crap they hear about losing their license.

I just don't see how even the crooks at the dea would go around revoking medical licenses for people who were prescribing compassionately and legitimately. Most doctors are rich and it's hard to bring legal troubles to a rich person so I think most of the stories of docs losing their licenses have been highly exaggerated and for legit reasons. I think they all are so(understandably) scared of losing their paycheck that they don't and aren't willing to put a patients needs first.

Every single doc that I have heard about who has lost his license or gotten a warning has been massively over prescribing and has rates 5x the normal doctors. I think those docs who go through that make a big deal acting like they were not doing anything wrong and that the dea is just going after all docs who prescribe any opiates and put a scare through the whole medical community.

I understand there was a problem with overprescribing, and one of the last thing drs need to do is give everyone and their dog a script but being compassionate and helping people with legitimate needs is important and those are the people who are suffering. It has gotten worse and worse for cpp's and the laws continue to go downhill making it harder for them, and that is what is causing most of the problems, when they cut people off then they goto the streets and now they are another addict adding to the "epidemic".

It just seems that it's an easy solution to just let doctors use their discretion when it comes to a persons medical needs and regulate when it gets to the point where they are a pill mill and not actually helping people. If it were up to me, anyone should be able to get them and the people who are medicating for mental pain are as important to care for as the people who need it for physical pain but right now they need to take care of the people who are in physical pain because they aren't.

It does kind of piss me off when people who are on opiates blast people who take them for anything besides what they are taking them for if you know what I mean. They come off holier then thou, and like everyone else is a junkie and they are the only ones who need them. I completely understand that they want to be able to get them and people who are taking them for illegitimate needs jeopardize that and being pissed off about that, but to me they should be more pissed at the people who are allowing patients to suffer because someone used them illegitimately instead of the "junkies" who don't need them to be able to move. I understand it but it just kind of irks me when they hate on opiate users who don't have as severe problems and call them junkies.



EDIT: here is that site to check out doc's prescribing practices I was trying to think of earlier. https://projects.propublica.org/checkup/drugs/2954

**EDIT: INFO below is about Propublica that doesn't have to do with the thread just wanted to share it to people who don't know what it is.**


The site I couldn't think of earlier in my post was propublica and if you haven't looked at it you should it's very interesting it shows all the docs in the states prescribing practices and you can look at which docs prescribe the most opana, or xanax, or whatever drug and see which ones are close to you and what kind of docs they are to get a better look at what their prescribing practices are really like.

Obviously it's a doctor shopping drug seekers dream site but it has a lot of legit uses and is very interesting to me to see how some docs really prescribe and how many prescription drugs people take it's insane.

You can look at a lot of stuff on the site you can look up by individual doctor, by city or state, by what kind of doctor it is, by drug, by medicare claims, by what percentage of schedule 2 drugs their patients are on, and a bunch of other stuff. Like the link I put up was the top prescribers for oxycodone in Colorado and it shows all the doctors in my state in order of who prescribes it the most to the least, and you can do that with any drug and can see the top 20 drugs that your doc prescribes and how it compares to the state average.

You can also see who prescribes the most in the country and what percent of their patients take it and other drugs and how much of each drug they prescribe compares to the average amount that the drug is usually prescribed in that state. For example here is some of the stuff it shows you

Like the doctor I goto as my primary care doc, 21% of his patients take sch. 2 medications the avg. amount of each doctors patients in CO who get sch. 2 is 8%. 15% take sch. 3 drugs the avg. is 9%, 19 is the number of prescriptions per patient the avg. is 15 and 71% of his patients are over 65 years old. Oxycodone HCL is his 4th most prescribed drug, on average in CO oxy is the 35 most prescribed drug doctors in his specialty prescribe. 21 of his patients take Oxy HCL, and 30 out of the 109 prescriptions he wrote for it were for people 65 and up.

Compared to last year he has a lot less benzos and opiates on his top 20 list the only other opiates are hydrocodone which is 7th most prescribed drug compared to it being the 6th most prescribed drug by other drs in CO with his specialty. The only other pain med on his list is tramadol. There are no benzos, Ambien is his 10th most prescribed drug compared to 18th being the avg in CO. Last year there were a lot more opiates and benzos, I know for a fact both xanax and valium were on his top 20 as well as one other opiate I can't remember what it was though either fent or morphine but its no longer on his top 20.

So for whatever reason he has prescribes a lot less scheduled drugs this year compared to last, I would be interested how many other doctors are that way, and if any doctors are prescribing more then they did the year prior. The site is really cool I think, like 24,000 people take oxy in CO compared to 78,000 people being prescribed it in PA. 

https://projects.propublica.org/checkup/providers/1730252289 This doc, prescribes more oxy then any other Family Medicine doctor in the US. Only one of the top 10 drugs this doc prescribes is not a benzo or sch. 2 drug its carisoprodol which is number 7 on his list. I would assume this dude is a pill mill just by looking at his prescribing history, and if that guy can go without getting caught I don't know why any doc prescribing legit would need to worry.
« Last Edit: August 15, 2016, 12:56:57 PM by Griffin »

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