Big Pharma's Lockdown On Legitimate Chronic Pain Patients
Is narcotic pain medicine becoming a thing of the past?
Why are doctors across America phasing out the practice of prescribing effective pain medication?
Will big pharmaceutical companies ever truly understand what it's like to face the other side of the coin?
Lately there's been a musty scent in the air surrounding the use of prescribed narcotic pain medication. Many doctors appear to be running scared as the DEA scours through fields of medical records, inspecting prescribing pads like a mouse scavenges for food in a dimly lit cellar.
Should the day come when doctors recommend Ibuprofen to a feeble man who's been involved in a terrible car accident (breaking several bones / requiring extensive surgery), is this doctor at risk of malpractice when there are more effective options available that they choose not to pick, out of fear? Fear of what? Doing the right thing? No, I don't think this is the reason... Somewhere along the line, in the not too distant past, doctors were loosely prescribing narcotic pain medication as if it would never go out of style. Nowadays, the harsh penalty of potentially losing their license for writing any unknown number of opiate prescriptions over so many calendar days or some other form of strict criteria, has been enough to prevent many physicians from taking even subtle "risks" with patients who are expressing obvious signs of pain and discomfort.
The unfortunately unique problem with pain is that it's not a physical object and in order for others to detect it, they'd have to rely solely on the backbone of our body language using their intuition - something that's gone missing in western practice. If more doctors took the time and really got to know their patients front to back, then they will be their own best judge of deciding what the right thing to do is, regardless of what the DEA thinks about their decision or what their drug representative wants out of the deal. Sadly, until patients are put before profits, the foundation of America's healthcare system remains in jeopardy like an iceberg affected by global warming.
While I believe that the vast majority of human beings in their right mind would choose to do the right thing, we must all work together to become the change we wish to see within every aspect of our lives; and knowing that by doing so, it will shine light on those crossing our path that need it most.
In the meantime, some patients may have to find another way to manage their pain without putting their life or health at risk. Others are turning to natural alternatives such as kratom, cannabis, turmeric and/or implementing various lifestyle changes into their daily regime... But the key is to never give up hope.
What will you do?
Warm regards to all who face life's challenges head on.
I was hurt in a boating cc some 40 years ago. For about the last 20 years I've been seeing one pain Dr. & taking Oxycodone 30 mg. Well all of the sudden the Dr. just flat shut me off & stopped seeing me. I have talked with several other patients & it seems it's happening to lots & lots of people... I've seen the news shows & I can understand why they're doing this!!!! My question is, what are we (the people that take them correctly like myself) suppose to do? Cant their blood be checked for this & if you DON'T PASS you're OUT, no more? That's what I think should happen! Taking meds that WORK & make your life in general livable from people that Do NOT abuse them is just inhumane. I went from a productive active person (bicycle rider long distance) to being bed bound. I've gained over 100 Lbs. Can't work now, nonproductive 60 year old man now... WHAT ARE WE TO DO? Lay here in massive pain & wait to die? Something needs to be done!!!!
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I agree with you completely and that is my fear. I am due for a refill in a few days and am afraid that my insurance company will reject it or put me on it for 5 days then that's it. Did you go thru withdrawal? I hope you are ok, please let us know what's going on now, have you tried to fight it?
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Goat c Says:
The federal government is taking the place of your doctor. They are doing this to so many people what they don't realize that this is creating a black market for more dangerous synthetic pain killers that are causing more deaths. As far this goes they need to stay out of my drs practice of medicine.
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This is a 3 issue problem. The first obvious issue is the faker, the people that cry wolf about their pain when really they just wanna feel high and find the greedy doctor that just takes the money and hands out either drugs or scripts... the failure of the justice system to hand out harsh enough penalties to these people to curb the activity let it blow up the practice like a cloud engulfing everything in sight - (if these doctors were given jail time of that equivalent to most other drug dealers this would have been curbed years ago)....
The fda also is a contributing factor with the 20% rule which allows generic drugs a 20% variance in the effective narcotic that is in the medications prescribed say you get 80mg oxycontin this means that the range of opioid content can range from 64mg to 96mg.... that is a 32 mg swing so if you get the higher 96 content med the drug store changes suppliers to the 64s the normal patient will take more to make up the difference because the dr can not increase the number as they used to, the patient runs short but tries riding it out, but it happens over and over so now the patient is listed as an abuser, thus they get ridiculed and start looking on the street. But now the drug store switches back to the 96s and the patient has found some street drugs and takes multiple 96s thinking they are 64s and since they've been in pain now with no relief and are stressed out from ridicule and being treated like a criminal (not because they were but because the fda allowed the 20% variance) and they just want complete relief, they add some street drug with the two 96s they took and end up as an od in the hospital again multiplying the problem.
Then you have the Gestapo pharmacist that treat pain patients like criminals... patients that follow the rules only use 1 dr and dr dates refill and it is that date and the insurance company says yes it's time to refill but pharmacist refuses to fill the script even tho you been filling it they every month... this then creates stress which increases the effects of the pain thus possibly leading to some of the previously mentioned things to happen... pharmacist should keep eye on some things but should not refuse filling script if they think something is an issue they should contact the dr and discuss it. The pharmacist has computer listing of each narcotic prescription filled for each patient at their finger tips with the govt required data base... I guess i will stop here, seems i got a bit involved but i have been going thru this for over 15 years and tho i have not abused my meds and refused med increases i can see how things can happen... pain is the circuit breaker of the body if you block it to much you will burn out your body just like if you block the circuit breaker in your house you could burn your house down.
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You can thank Johny Knoxville and his documentary The Wild and Wonderful Whites of West Virginia for the crackdown on opioids in 2010. Mr Knoxville made fun of a family abusing & selling opioids along with marijuana & alcohol. This falls on him for ppl that are truly in pain and can't get the medicine needed for chronic pain. If you haven't seen it, you should. Thanks to Johny Knoxville, a known drug abuser made things hard on ppl that have needed pain medicine for accidents, cancer, birth defects, etc...
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I agree with you. I broke my hip when I was twenty four and am now seventy. I have had five surgeries on my hip including two artificial hips. My pain has been almost unbearable at times and the pain medicine kept me going. I don't know what t future holds for those of us who really need narcotics but I feel like a criminal when I get my prescription filled. I am now taking three 8mg Subutex a day and it does help but not like the oxicodone I was taking. I have heard that it is harder to get off of these and it frightens me because withdrawal is a horrible experience. Why can't they make something that will help that isnt addictive? Having to live with pain is bad enough and if we can't get pain releif, I don't know what will happen. I think doctors should ban together and fight this thing. Without them we would all be in trouble. There are god doctors and bad doctors just like in every walk of life. The government needs to let the doctors treat their patients and do their own job. They can't catch the real culprits so they pick one ones who are most vulnerable so they can look like they are doing their job. Any comments?
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Yeah. They can't stop the Heroin, Fentanyl and Carfentynyl. So let's pick on the pain community and make them suffer!! Without meds I suffer. But I can walk out my door and buy Heroin!! Which is NOT going to happen. What now!!
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Goat c Says:
There are also people who sell their pills for profit and these people get them from Medicaid. This is a total disgrace to the people who are in pain and do the right thing by going by the book. I get minimal pain medications. My pain is just lowered, not gone, and i have further fractures of my thoracic spine and my dr won't raise my level. This is not what they meant by the words 'do no harm'. They are doing harm everyday to the patients that have pain that is intolerable.
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Please go to change.org and sign a petition being sent to Congress and all the states Governors proposing Special Schedule II Narcotic pain card to be used by chronic pain sufferers. 1) This card would be issued by the individual states. 2) limited to chronic pain pts suffering from a defined list of debilitating illnesses with supporting documentation of diagnosis and insurance coverage. 3) Approval via a Board Certified oncologist, hospice physician, pain anesthesiologist or pain management physician etc. Each month should not bring a fresh struggle to source the pain medications that make life bearable for chronic pain sufferers. We can help ease patient suffering while safeguarding against prescription opioid abuse and death. This petition was started by Dan Egelton of Brownstown, Michigan. 27,268 supporters have signed it. Please sign to help us all!!!
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I agree with so much of what all of you are saying. It is an absolute travesty what all of us chronic pain sufferers have to go through now just to try and have some semblance of an active, productive life.
That being said I have to address what one user stated about the variances in generic vs brand name medication. There is absolutely no law from the FDA that allows for a 20% variance in the active ingredient in any medication. The law that is most often referred to is the Hatch-Waxman act of 1984. The law states that all generic drugs must contain 100% the same active ingredient. The only difference allowed is in the non active ingerdients. The reason some generics don't work as well as others is everyone's body may react differently to the non active ingredients and may experience less efficacy in the bio availability. This is where the variance of 10-20% comes into play. A person may experience up to 20% difference in the bio availability of one brand over another and may have one brand work better than the other, but the active ingredient again must be 100% the same.
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You are absolutely incorrect! The 20% rule is not for api or active ingredient such as Oxycodone. The 20% rule deals with the bio-equivalency of a generic drug compared to the name or innovator. You should not spread false information if you do not know what you are talking about!
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Hello, I'm not willing this on anyone, but what if a conscientious DEA officer has a bad shootout with someone and needs quite a bit of narcotics. Maybe this has to happen before they see the real importance of having pain medication around.
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Unfortunately we the "text book" patients are being discriminated against and are being brushed with the same stokes as those that are abusing their pain medication. And because Oxy's, Fentanyl and other opioids are becoming increasingly available on the street we are getting cut off because the Government is saying that we don't need that high of a dose, but unfortunately some do. I was on Gabapentin, Oxys and the Fentanyl patch and just switched over my opioid meds to Kadian. It's also a morphine pill but not as prevalent on the streets, yet. Unfortunately some may have to start using Marijuana or other street drugs to keep their pain in check because Drs aren't doing their job and caring for their patients. They are supposed to "Do NO Harm" to their patients but they certainly don't have our backs when it comes to pain management. These hard drugs will create a whole new problem because at least on the opioids, you are somewhat functional and may be able to work. Now all you will have are people on Disability and not able to work and possibly addicted to the illegal drugs too! It's a nightmare and I'm not sure why the Doctors aren't listening. I get that they don't want to lose their license but then put in place better screening processes to keep patients in check. Just my thoughts.
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It’s true that the PK values are required to fall between 80% and 125% of the reference value in these randomized, crossover trials. More importantly, however, the entire 90% confidence interval (CI) of the observed PK value must also fall between 80% and 125%.
As a general reminder, CIs are ranges of values we can be confident the true result falls, which in this case is 90% of the time. from article in pharmacy times
To explain bioequivalence with an example, imagine that a brand-name product was shown to have an AUC of 100 units in a crossover study. In the same study, let’s say the generic product was shown to have an observed mean AUC of 93 with a calculated 90% CI of 84-110. Because the FDA requires the mean AUC of the generic product as well as its entire 90% CI must fall between 80 and 125 units, this would meet the bioequivalence requirement.
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bioequivalence does not mean the same example you have 4 pieces of fruit 2 apples 2 oranges 0r 1 apple and 3 oranges or 4 bananas or 2 grapes and 2 blueberries
every example is the bioequivalent of 4 pieces of fruit but they are no where near the same in intake to the body
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Anais Goodacre Says:
I live in Canada; Drs here use a special Triplicate RX pad for prescribing opiates. The patient's name, MSP number (Medical Services Plan aka Insurance Number), nominal and spelled amount, dosing times and signatures of DR, patient and pharmacist required. Scripts are valid for 5 days from writing, and repeats are not allowed. Chronic Pain patients managed by narcotics are required to use only one drugstore, and sign a contract with their Dr. It works well most of the time. I've been on narcotics for chronic pain for 10 years, and periodically reassess with my Dr and pharmacist to decrease or increase my dosage. 80% of cost for my meds is paid for through our Government Insurance Socialized Medicine. This is working well for me.
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I'm sorry but that entire paragraph addressing variances in generic vs brand name products should be removed. The example of an 80mg OxyContin ranging anywhere between 64-96mgs is completely inaccurate information! Please whoever comes across this post do not base any decisions or discussions you have with your providers or pharmacists on this information.
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It's not just narcotics. They are after benzo's too. Somehow, someway, people will find a way to kill themselves which makes all the innocents that take exactly as prescribed pay the penalty. Case in point, the husband of a friend I used to know. He could not get enough so he cut off a finger to get more and finally, in the very end, he got the high he wanted and was DEAD. She had enabled him and was left a widow that didn't know how to set an alarm clock or write a check. He had also taken out a credit card she knew zero about and she lost her house too to pay for that debt. Those people are the problem. Not those of us who never have an early refill.
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I totally agree! People are dying from illegal drugs... If people want to die, they will find a way... People who actually have chronic pain and take Norco, are being put in this same group. I've had migraines for 20+ years and until migraines are eliminated in another lifetime, pain meds like Norco are a lifesaver until a migraine drug like Amerge can kick in. You can only take so many Amerge or that does bad things to your kidneys, liver or heart. So eliminate legal pain meds and every time you get a horrific migraine you have to go to the ER. Cost of Norco is cents compared to an ER visit which is a thousand or more. People will try to feel high on smoking stinky socks if it works... It's not the drugs used for pain, it's the *****s who abuse anything to feel high, not just pain meds or opiates, but illegal drugs or whatever they can come up with. I'm sure there are bad doctors who sell illegally and so forth, but those bad apples need to be dealt with just like malpractice situations. Legally used pain meds are not the problem, people are the problem!
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Maybe DEA and government should put that kind of effort into getting rid of street drug users, manufacture's and pusher's where the real problem is. That is where the problem lies quite trying to divert your failures.