Prop fda petition

[painfullife]

OMG- has anyone seen the fda petition by "Physicians for Responsible Opioid Prescribing"? These jokers are asking the FDA to change the labels on how doctors prescribe narcotics for pain by limiting the dosing to 100mg a day (morphine equivalent) and to limit prescribing to 3 months. This will kill doctors prescribing for chronic pain since many states are passing laws restricting doctors anyway and my insurance company will not allow my pain medications to be prescribed except as exactly in the labeling.

[Mark N]

I haven't seen this and I sure hope it isn't true except for acute pain patients. I hope there are people speaking up for CPers as these restrictions are ridiculous and make many of us suffer needlessly.

[Pharmacist.steve]

The state of Washington has already implemented a 120 mg/day Morphine - or equivalent - unless the patient is being supervised by a pain specialists

[Eva 14]

I am familiar with the Washington law, which is pretty ridiculous. The government should NOT be putting limits on opioid dosing---especially such low limits.

I recently heard something about a law in Florida and wondered if it is true.

My hairdresser has a friend who lives in Florida who suffers from chronic pain. My hairdresser told me that the State of Florida has strict limits as to how much pain medication a person can be prescribed. She even said they have limits on how many anti-depressants can be prescribed.

My hairdresser knows a lot of people and hears a lot of stories, so I want to believe that she just got this one mixed up. I know Florida is infamous for the "Pill Mill" problem, but if this law is for real, it's the worst thing I've heard of in years!

I do know that in Florida pharmacists often will refuse to fill a script for pain meds if the doctor is located further than a half hour from your home. I don't know if this is the law, but pharmacists do it all the time in Florida. Crazy---because driving an hour or more to see a good pain specialist is far from uncommon.

I told my hairdresser I'm glad I live in California, but I really feel sorry for people in Florida. And who knows how long before these insane laws blanket every state in the nation? It is so scary. Why don't the political candidates EVER talk about people with chronic pain? I suppose they're afraid people would think they're pro-drug or something.

There are ENOUGH laws on the books re: opiods. We do not need any more restrictions. I don't want to get into the gun issue here, but even after these horrible shooting rampages by a few sick individuals, politicians are not putting restrictions on guns. Which is more dangerous, meds or guns? By the way, I support the Second Amendment. I just thought is was an interesting comparison. Not trying to get off-topic, here.

Eva

[tortoisegirl]

Yeah I saw that...I don't think it'll change anything, at least not quickly. I have a feeling that their point wasn't as much focused on the dose/time limit in that article, but to ask that the long acting meds only be marketed for severe pain (instead of moderate to severe), and that there be increased physician training on when is appropriate to prescribe these meds. They wouldn't be able to pass a ruling like this unless they were to at least provide provision of what to do with all the patients on these doses...which 70% of Oxycontin patients and 90% of Opana patients surpass (per the article). As much as I think restrictions hurt patients like us, I also see the need to do something different than is being done now, as the abuse rate is steadily rising, even taking into account the rise in overall prescriptions. Seems like they have some good tools (like pain contracts and UAs) which aren't fully being utilized. I'd actually agree that long acting meds should only be marketed for severe pain, but I also think that pain can be severe without someone being bed bound for example. How the patient defines their pain is very subjective.

I live in WA and there is still a lot of doctor and pharmacist confusion on that new law. They are interpreting it in very different ways. My primary doctor was prescribing me more than that without plans to refer me to a pain specialist, but I had plans to see one myself (and do currently). I'm now realizing how poorly my primary doctor had been managing my pain. I had been asking for a couple years to see a specialist, but he didn't have ideas so I had to do it on my own. I see no reason there should ever be a dose limit as folks have tolerance...you could take 10 times the dose as someone else but get 10% of the relief they get. The pain clinic I go to doesn't write scripts for over 200 pills as they say those get flagged by the DEA. So for those of us on meds like methadone which only come in 10mg pills, there are some folks which will need more than one script a month. A hassle, but doable.

I hate to be reading stuff like this just when I am finally getting my pain back under control again, but I have to have hope that they can't do a lot of change at one time, and not very fast. I agree a limit on how far a doctor is from your home is ridiculous...I get that they may want to prevent folks driving several states over and getting ridiculous amounts of pills, but a half hour limit excludes a lot of folks. I think the states need to work together to pass laws that find abusers while not excluding legitimate patients. Its hard to know if what we hear second or third hand is true. Best wishes.

[Mark N]

Kate, you have more faith in our lawmakers than I do. We have people passing these laws that have no experience or knowledge about CP. I agree that something different needs to be down as people get scripts for Oxy from dentist which is not the purpose of long lasting meds. I would feel better if there were a provision for chronic pain patients as lawmakers have gotten the message that cancer patients need more pain meds but not that we need more pain meds that they have legislated at this point. I hope it gets worked out without impacting those of us that have been on our meds for years.

[Eva 14]

I really think all that we need is a nationwide prescription drug database. The State of California has an excellent statewide drug database, and that's why California has a fairly low rate of prescription Oxycontin abuse, as opposed to some other states (this was talked about in congressional hearings).

Soon all 50 states will have online drug databases that any doctor or pharmacist can check. Then they can see whether or not someone is "doctor shopping". It's all ONLINE, in real time. No more having to wait a week for the DEA to get a
report from Sacramento (or whichever state capitol) on a given patient.

So unless people are somehow using phony names/dates of birth, it would be pretty hard for "drug seekers" to get multiple prescriptions.

It really seems to me like this should be enough to solve the problem of "doctor shoppers".

Any additional restrictions will just adversely affect chronic pain patients, IMO.

Eva

[painfullife]

The petition may be read at http://www.citizen.org/documents/2048.pdf . You may submit your response to the FDA at http://www.regulations.gov/#!submitC...12-P-0818-0001
It appears the group "Prop" believes they are only preaching to the manufacturers to get them to stop marketing to physicians outside of this groups arbitrary and capricious limits on time and dosage, but they don't get it. My doctor said that if this goes into effect, he will be obligated to stop treating all people with chronic pain because of fear that the DEA will pull his license if he goes outside the prescribing labels. So these guys are very dangerous to the entire chronic pain population.

[becky50]

Hi, I just joined the group, and I saw your Post on the PROP Petition..We, Arachnoiditis sufferers and chronic pain Patients... Have created a Petition on Change.org objecting to this PROP Petition, would like anyone with Chronic Pain to Please sign this, we are going to have to battle for our rights...Here is the URL
http://www.change.org/petitions/prop-s-petition
We are up to over 200 signatures...Please help us fight this Petition!

[becky50]

I believe the data base thing is called VISTA? Someone I know told me about it..Any Dr. can log in and see what scripts they're patients are filling and when.