@helenfrances @sears
Recently, taking benzodiazepines and opioids together has become a red flag for the state pain control commission here in Oregon. It means, for now at least, getting prior authorization approval through my doctor. I just started last week taking Cymbalta for neuropathy, and it required prior authorization approval. So, now I have to go through the process for 2 medications. I got approved for Cymbalta through the end of 2021, but Morphine approval is only good until the end of 2020 (hoping that when I have to go through the approval next month will be good for a year).
I've been taking clonazepam 1mg for 15 years, and mscontin for 7, and never had to get approval until this summer. Something has changed to make me get approval all of a sudden. Initially, I was prescribed Clonazepam for anxiety,, but along the way I found that it also has treated my restless leg syndrome. My wife is happy that I don't kick in my sleep anymore.
You said that you were taking 4-5 pills. Was that 1mg pills? Tapering off Clonazepam is a really, really long, slow process. I would anticipate it taking longer than a year, and from what I've read from others, the final low dose is the hardest, and takes an even slower taper.
For now, I depend on Clonazepam to do its job. Dependence is not the same as addiction. I depend on Meloxicam and voltaren cream to reduce the arthritis pain, especially in my hands, enough so I can write and play the piano without awful pain. So, I am dependent on them to make it possible for me to function. Diabetics are dependent on insulin. People with OAB depend on Myrbetric. So, being dependent on a medication is nothing to be ashamed of, or afraid of. Renee, who's a pharmacist, @faithwalker007 has explained the differences very well, and I've found her to be a great resource on this whole issue.
So, where are you in the titration process? I'll be interested in hearing how it goes for you.
Jim
To not require pre-approval by your insurance providers for your clonazepam especially since you’re taking MS Contin before now would be called a miracle in pharmacy circles. Lol
It’s been required in Wyoming-serviced insurance providers and Medicaid for at least 5 years of not longer. In fact I had to have my Ambien pre-authorized many years ago and I wasn’t even on opioids at the time. Us pharmacists are actually more leery of benzodiazepines than almost any other class of drug other than MAO inhibitors.
I stopped by Ambien almost as quick as I started it. I’m more content to not sleep at all than deal with the side effects that crap gives me.
Anyhoo— the reason you see the crackdown on benzodiazepines especially with poly-pharmacy and co-medication with opioids is the high risk of sedation, increased comorbidity and mortality rates of accidental overdosing or death due to respiratory depression and suicide.
The alarming increase in suicide and depression due to Covid-19 has insurance companies and providers hypervigilant to be on the offense instead of landing in court with malpractice suits.