Opiate Pain Medication

Posted by lisacm @lisacm, Apr 17, 2022

My husband suffers from severe chronic abdominal pain and has been for last 9 years. He is on very high doses of opiates. We currently live in California but would like to move out of his state. His pain doctor is concerned if he moves to another state, he will not be able to be prescribed the meds he is currently on because now they are only prescribed for patients with terminal cancer. Has anyone heard of this or had any experience with something like this? Personally I don't think this makes sense because he's been on these meds for years so I'm trying to understand why this would be an issue.

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I think his pain doctor has a valid point. There are states that require drugs mailed into them to satisfy all state requirements for those drugs. And states that very strictly regulate pain meds and don't want people bypassing state law by ordering them to be shipped interstate. That's analogous to how many states treat medical or recreational marijuana if it's not legal in that state. Add the issue of sending anything into a state where it would be prohibited and Federal mail-fraud laws can come into play.

We went through this when moving to another state that had yet to accept prescriptions filled by, of all things, a nationally-recognized veterinary compounding pharmacy. For the first several months, the meds were shipped to a friend in a nearby state and picked up from there. Sounds silly but state drug laws vary widely so you might have to research the state you're moving to. IF the prescription can be filled in that state, and a national pharmacy will fill it, the California doctor can prescribe it in California and your husband can just pick up the drug locally just as if he were on vacation or business trip in that state. That way the pharmacy may consider the regs of the prescribing state, not dispensing state.

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If you are planning a move one of the things to do right away is to find a pain management practice or physician and make an appointment to see them via telehealth appt if possible. It's helpful to have your current Dr write an introductory note detailing what you are currently taking. Make copies and speak to the DRs, not the nurses or PAs. Getting pain medications isn't easy at all. As mentioned each state has their laws and guidelines. Never assume medical practices are the same... You may also need to find a pharmacy in your new area and speak to them about pitfalls concerning drug dispensing. In my state, the pharmacy has more oversight and control over when you get your medication than I think it should. There are seven licenced druggists and several techs. Each pharmacist can decide whether or not you get your meds that are controlled substances every 30 days or maybe 28 or 29 days. The insurance companies won't pay for certain medications if they aren't documented excessively. There are all sorts of issues that can happen. Never again will we be able to roll in with a prescription and get it when we want it. Rules and guidelines are now set in stone. Woe unto the person who pisses their pharmacist off. They have more authority than you think and sometimes throw a wrench in the machine if they feel something is off.

So really all I'm saying is never expect consistency whilst dealing with pain meds, DRs, pharmacists, and insurance companies.

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Another consideration would be who will carry/manage his health insurance. Insurance policies and rules are managed by each state, unless you are a Federal or Military retiree who has chosen to carry your national coverage (like BCBS Fed) into retirement.

You say "but I am on Medicare..." Yes, but the supplements and/or Advantage plans vary widely by state as well. You need to get a copy of the policy you would have in your new location and read all of the fine print. In the case of opiates and other medications, you need to read everything about their drug coverage and who is their Pharmacy Benefits Manager (PMB.)

I know people who had to go through "step" therapy - trying each drug from A to X on the PMB list when they changed coverage - even if they had a long history & good records to show they had already been through it.

Crazy insurance rules are why several of my Winter Texan neighbors maintain their residency in other states after retirement. It is also why I continue to pay a higher premium for my BCBS Fed plus Medicare B. Watching friends struggle with stupid insurance rules and high copays, forgoing necessary meds, and being miserable has taught me where to economize.
Sue

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Is there any drup opiate or not that will help podendal nerve pain. Surgery didn't work And think every day that that only way out is death

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There is and has been a shortage of pain docs in the U.S. for sometime and it will get worse as are other specialties in medicine. I’m on the east coast and have lived in major metro areas my whole life and I’ve never had any difficulty with pain meds after going on Medicare. I see my pain doc every 3-6 months and my meds are renewed monthly without issue. If your pain control is a major concern for your spouse I suggest you stay near large metro centers with big medical institutions to get the best care.

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Not an issue in Missori, except because of increasing government managementt of medical care and negative effects that may come of it. It seems many MDs are reluctant to prescribe narcotics.

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Once again the congress and other decision makers take a issue and blow it out of proportion. Most of the opioid deaths are a result of fentanyl and heroine. The others are simply people who simply want to get high and don’t know what not too take when your on them. I don’t think there are many of any that die when taking the doctors recommended amounts. I don’t have the answer because right now our Government is no longer working.

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Hydrocodone 10/325 about 8 years now. The only relief I’ve had with 30 yr journey with ME/CFS. Tried many other things holistic to medical marijuana. No help for me. It can be a lonely place. If those great decision makers in politics decide we can’t have it…. Not sure what I would do. Take care💙

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@sueinmn

Another consideration would be who will carry/manage his health insurance. Insurance policies and rules are managed by each state, unless you are a Federal or Military retiree who has chosen to carry your national coverage (like BCBS Fed) into retirement.

You say "but I am on Medicare..." Yes, but the supplements and/or Advantage plans vary widely by state as well. You need to get a copy of the policy you would have in your new location and read all of the fine print. In the case of opiates and other medications, you need to read everything about their drug coverage and who is their Pharmacy Benefits Manager (PMB.)

I know people who had to go through "step" therapy - trying each drug from A to X on the PMB list when they changed coverage - even if they had a long history & good records to show they had already been through it.

Crazy insurance rules are why several of my Winter Texan neighbors maintain their residency in other states after retirement. It is also why I continue to pay a higher premium for my BCBS Fed plus Medicare B. Watching friends struggle with stupid insurance rules and high copays, forgoing necessary meds, and being miserable has taught me where to economize.
Sue

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I too am on medicare. When it came time to pay for A+B I was aghast at the deductable for D. $6200-$10.000 on top of the $289. Monthly premium. All because I am on hydrocodone. I take 10mg 3x a day. And still in agony. But for those handful of hours of relief I'm not too sure I would still be here. So I said NO to advantage as well as D. The deductable would never be met. So why pay back to the government what I had paid to them already. On the chicken shit dr.s? Who would rather watch you in agony than treat you like a person and not a criminal? IS IMO, SHAMEFULLY CRIMINAL! BTW, I have CES. Cauda Equina Syndrome. But my name is Tesse. Glad to meet ya

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@lanalc

Hydrocodone 10/325 about 8 years now. The only relief I’ve had with 30 yr journey with ME/CFS. Tried many other things holistic to medical marijuana. No help for me. It can be a lonely place. If those great decision makers in politics decide we can’t have it…. Not sure what I would do. Take care💙

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Unfortunately a lot of people are forced to find alternative ways to get what they need on the streets. This is of course very dangerous and is why some people overdose and is opposite of what the government wants. So why not through MRIs and other test’s find out where the pain is and allow doctors to do there jobs.

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