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Politics of Pain

Chronic Pain | Last Active: Apr 30, 2018 | Replies (56)

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@stfnwtl89

@wsh66, @19lin thank you both for the posts and website info provided. I too have been researching this very topic in an attempt to help with a family member. This is going to snowball and yet again, it happens over and over people who follow the rules and really need help and rely on prescriptions to make it through the day will be punished for those who are out there abusing the system. And for a senator to use a platform such as this for political gain makes me sick. In the last 3-4 months I have really had to become active in the care of my mom even more so with the dr. and pain management clinic she is being treated by. It's taken me a full month to put the pieces together as to why her treatment has changed so drastically. Around November, December 2017 he seriously began changing her medication, rather than treating her pain. She has been diagnosed with facial neuralgia and has suffered greatly due to a dental procedure gone wrong about 15 years ago. Sometime in 2016 she was assigned to a new pain clinic and I have a feeling her PCP was unable to assist in pain mgt. Things seemed as though we might have a turn around and someone might actually understand and put in some time to find a combination of meds to help ease the day to day pain. Then mid 2017 the attitude of the Dr. shifted - rather than mgt. of pain, the focus seemed to be reduction of medication, as I listened to my mom for months tell me each time she left the Dr. she felt he wasn't listening. By December 2017 the reduction of her medication was so apparent in her ability to function on a daily basis, I begged for help and began calling her PCP and her pain mgt. Dr. We have made several trips to the ER and now are on an every 7 to 14 dr. visit to the pain clinic because the reduction of medication has been too great and she is in a physical and emotional state like I have never seen before. After 2 trips to the ER she is now terrified to go to a hospital to seek help, it was a nightmare for her and for myself and my dad. So I started researching why the change in her care all of sudden.... Since the CARA bill was signed by President OBAMA in July 22, 2016 it took time for it to be implemented and put in place and for the public to actually see the effects. In addition to the funding that has been provided https://www.samhsa.gov provides grant funding for the "opiod crisis" by state and has other interesting information as well. It also came to my attention my state has received a huge grant dedicated to this very purpose and it outlines goals set forth by medical community within your state. I also read within the CARA bill opiod is defined as any drug with highly addictive tendancies and when you research further the answer to reduction of opiods is to replace with narcotics, go figure. Now the DEA is involved and telling Dr.s what they can and can't do with their patients and I realize this was in an attempt to rid the medical community of the those who write prescriptions to those who abuse them and are dealing them out on the streets. Yes I get it, with that being said it has scared Dr.'s and changed the mind set from being in the best interest of their patient to being reduction of medication and keeping my clinic off of DEA's radar. Now I ask who within the DEA has taken the medical doctors Hippocratic oath and/or where would we find the american medical associations code of ethics within the realm of the DEA and on the HILL? FDA should be slapped and pharmaceutical companies should have stricter testing and analyzing I personally have people within my immediate family who were saved in a drug trial at MD Anderson so I am all for new drugs etc...., what I am having a problem with is the polictics that has creeped its way into the dr's office and hospitals across America. If you look on the DEA's website at the most wanted in America I ask you to find a Dr. or patient with chronic pain condition listed with posession or intent to distribute, the majority are hispanic and the drugs listed are cocaine and marijuana, their is 1 Asian and the drug is heroin, there is 1 fellow from Louisiana and the drug is meth. All of which are not manufactured in a pharmaceutical lab well with the exception of marijuana which I personally would like to see legalized in all states, as the benefits would far out weigh the risks. Now I feel as though I am having to take time away from the care of my mom in order to research this new law and CRISIS that has been deemed as EPEDEMIC in order to get her somewhere else for treatment but where?
Below is the current version of the medical oath for dr.'s, I think a bill should be passed to reinforce the oath below.
American Medical Association Code of Ethics (post- 1980)

Preamble: The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility not only to patients, but also to society, to other health professionals, and to self. The following Principles adopted by the [AMA] are not laws, but standards of conduct which define the essentials of honorable behavior for the physician. II. A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.

III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

IV. A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.

V. A physician shall continue to study, apply and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.

VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services. VII. A physician shall recognize a responsibility to participate in activities contributing to an improved community.

I am left with the overwhelming fear of not being able to make a difference and sub par medical care for those who actually need it. The CARA 2.0 which is now being pushed by 8 senators who have really made this their mission really scares me as to what effects it will have for medical care. I came to this website and joined in an attempt to help find answers but all I am seeing is other people who are frustrated and their pain is not being managed either. Very disheartened

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Replies to "@wsh66, @19lin thank you both for the posts and website info provided. I too have been..."

@stfnwtl89 I agree with your statement. I can understand that for those in the medical profession their license is their bread ticket and they need to protect it for their sake and that of their family as well as future patients that they may help, therefore they may give in to gov whims rather than endanger a good living. Still the people who sit on these agency boards that make the rules that will in effect kill Medicare and Medicaid funding for opioid medication for long term chronic pain patients they are in a sense practicing medicine without ever examining the patient. If they pass the rule it will make it nearly impossible for some pain patients to continue. I have grave reservations my self about if I can afford this medicine or if I can still take any. Now at 70 my pain has gotten worst and comes from more sources as my body breaks down with age. I really do not know what I will do? Fortunately my children are in college and their funding is paid partly through my military service so whether I am here or not is not that important although I would like to be there to see them graduate. My wife is a nurse and has a good job and she can help with their extra funding needs better than I can on a fixed income. 19lin

@19lin well we just can't give up without a fight. I am sure your family would miss you terribly. I pray for anyone who suffers from a disorder that causes chronic pain I have watched some I love suffer for years and it affects everyone involved in some way.

No question about that, but there can be positives also. I know I have looked for a dozen years for a reason and I know that in that time I have grown to be a better Christian and person because I have a humility that usually only comes with being knocked down pretty hard and I appreciate that. Doesn't mean I don't get angry about it from time-to-time, but I have a little wisdom now and not sure I had anything but knowledge before.

@19lin

I gather from reading the regulation being considered that the discussion is addressing post op pain, hence the 3-day limit, and allowance is made for doctors to order a refill. It doesn't have language that applies to treatment of chronic pain with opioids.

Jim

Jim The way it is stated any recommendation would be to limit Medicare and Medicaid payment or allow it to the insurance people to decide. I went to the gov site and it was not clear but the article in Pain News Network I referred to was much better written so please check there. It sounded like they were going to reduce payment for long term pain medicine. I would be happy to be wrong. 19lin

@19lin

I hope it's only addressing post op prescriptions. Having to get a fresh prescription every month is a real inconvenience to me. Any more frequently would be a problem, living in the country, and what in the world would we do if we were to go on a trip out of state? Two years ago, my wife and I took a 5 week road trip to visit our kids in New Hampshire and Indiana. It's basically impossible to fill an opioid prescription in many states when you're from out of state.

I did read the link to the Pain News Network.

Jim