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Politics of Pain
I have chronic pain and have had since I lost my leg and injured my back in Vietnam in 1968. Now nearly 50 years later it has gotten worst with advanced age. In the last few years I started using strong pain medicine and now the powers that be want to shut it off unless your a cancer suffer. Even though many opioid users who follow their doctors advise do well and lead near normal lives. So I would like to open up discussion on the politics of pain if it is allowed?
I just received a notice from the pain news network (Painnewsnetwork.org) that the CMS (Centers for Medicare and Medicaid Services) is about to close public comment for citizens on payment for opioid type medicine through Medicare and Medicaid. If their proposal is approved they will restrict payment for pain medicine (opioid) to a small amount that needs to be renewed every few days. The Comments close March 6th and any citizen or concerned person may submit their comments.
For more detailed information please check the Pain News Network (painnewsnetwork.org) February 19, 2018 a post written by Richard Lawhern who provides a lot more information than I can.
You can write direct to regulations.gov (www.regulation.gov) look for Docket ID: CMS-2017-0163 . In the search box at the top of the page fill in the docket ID which should take you to the page with two requests for comment. I believe the one calling for payment is most important but you can comment on both. IMPORTANT make comments by the end of March 5, 2018. Just tell them how this will effect you or your family, of course family and friends can comment also. In addition contact you elected officials on the federal level and state level. Their office address and phone number is in the phone book or you can Google them and send an email. I did an internship in a congressional office and I know that they give more weight to letters sent through the mail but all comments make an impact so phone, email or write to make an impact. The pain news network article provides a direct link to make comments.
There are many sites that have formed to provide information about pain so if you wish to do something I recommend you get in contact with them to find out more information on opioid regulations.
I realize that most people come to this site for support, but if you would like to do more to lobby for change to opioid regulation then maybe we can bring up information on this site also. One of the things that counselors and Social Workers do is advocate for people, so as a Social Worker I have done some of this. 19lin
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I agree Jeff Sessions doesn't know what pain is.I'd like to jump in here to let you know I live in Calif. And my Dr told me they have allowed opioid prescriptions now to just be faxed over to pharmacy before like you,'ll I had to get a script every month you may want to explore this with your Dr.all states are different though.
you still have to hand carry a hard copy of Minnesota
https://www.painnewsnetwork.org/stories/2018/4/2/medicare-finalizes-plan-to-reduce-high-dose-opioids This article from Pain News Network indicates that the government will put new rules into effect on January 1,2019 that will limit those on medicare and medicaid from receiving over 90 mg of morphine equivalent units in 7 days with certain exceptions. We will have to wait and see, but the loss of pain medicine will hurt a lot of people. 19lin
It has recently been documented that only 1% of the opioid overdoses result from doctors prescription pads. The rest come from sales of drugs on the street. Many "street" versions of drugs like Oxycontin actually contain Fentanyl which is at least 100 times stronger than the active ingredient in Oxycontin and other prescription pain killers, The problem is, the government needs to be seen to be doing "something" about the problem. There are too many small drug dealers to catch them all. Arrest one and two pop up in their place. Big drug dealers are smart, too smart for most cops. really big drug dealers are really smart and they pay off authorities so they can stay in business. They don't care how many retail dealers get popped, they know more are just waiting to get their start.
We, the people who really need these drugs, and the doctors who are willing to take care of us, who obey their Hippocratic oath, to first do no harm, like the harm they know arises from unabated pain, are the low hanging fruit. Our addresses, our phone numbers, our medical records and the information about our doctors and pharmacies take no effort to obtain. By harassing doctors, and blaming patients they appear before the news cameras as the great saviors of society. If these methods worked, overdose death would decrease, not continue to increase as they are. Law enforcement is great at busting users and street dealers. Law enforcement is completely impotent when it come to keeping heroin out of our country, from shutting down the illegal labs that are producing the fentanyl that is being mixed with the heroin and other drugs on our streets. So the news media stays focused on us and our doctors and they live in fear and we live in pain. Meanwhile the death rate from opiate overdoses continues to rise. Anyone like me who has been taking these drugs for years and will be taking them for the rest of our lives can tell you that obtaining the necessary prescriptions to get our meds has always been like pulling teeth. You are scrutinized, doubted, looked at as if you are scum and even accused of being "drug seekers" by both doctors and nurses. This in spite of the first thing they are told in school about pain is that they or anyone else can know what another individuals pain feels like or how bad it is. They also know that the more control a patient has over the level of drugs they use the lower those levels are. (This is due to the fact that getting that control greatly lowers their level of anxiety and therefore lessens and eases their experience of pain.)
I don't see any improvement of this situation anywhere on the horizon. My advice is if you can get a pain pump, do it. It's obvious that no drug abuser is going to trade 250 mg. of narcotics a day for 2.75 mg. of narcotics a day. Oh yea, it works a lot better too.
Love and Blessings to all my fellow travelers Don't let them shame you, don't let them demand your silence. Call them out on their failure when they don't help you with your pain. This is the worst failure of the medical establishment since the use of leeches and the practice of "bleeding".
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1 ReactionCongress is now taking up Opioid issues with a bunch of new bills. https://www.medpagetoday.com/washington-watch/washington-watch/72588 This article gives some information on what is happening so now is the time to write your Representatives and Senators again.
President Trump has indicated he will back the new requirements of limiting Medicare and Medicaid from paying for 90 mg of morphine equivalent units for 7 days. Over that the pharmacists must call the doctor to talk about the patient and their real needs.
In my opinion this is just undue harassment of all involved. I know pharmacists will call doctors anytime they feel something is out of order with a prescription they do not need to be ordered to do so and doctors have a lot more to do than be on the phone with the pharmacists. All this means is that pain patients will loose. 19lin
Add on: another good article on doctors and pain is located here: https://theconversation.com/why-its-so-hard-for-doctors-to-understand-your-pain-93526
It not only shows how red heads react to pain meds (Yes I am or was a red head, its now gray) it also discusses some of what doctors are up against when working with pain patients. 19lin