Tramadol now a "controlled substance" in NY

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Myrne
Regular Member


Date Joined Jun 2009
Total Posts : 451
   Posted 3/29/2013 4:53 PM (GMT -6)   
HI all - I usually post in the Crohn's section, but had a question pertaining to the pain medication I take and thought you all may have some more info.  I am on Remicade every 4 weeks and take tramadol as needed for Crohn's.  My prescription is only for 2/day (50mg) as needed, and my doctor usually writes me a script of 60.  I usually call for a refill every 2 months or so, as I don't take it daily, mostly on the weekends when I have plans to be out and about or before work on bad mornings.
 
So I called for a refill last week and my doctor's nurse called back and said that my doctor was on vacation and she could no longer send in the refill request because NY state has recently classified Tramadol as a "Controlled Substance".  She said she could have the nurse practitioner from his other office write out the script and mail it to my pharmacy.  I was a little confused, but agreed.  A few days later I went to pick up the medicine and the pharmasist informed me that my prescription was changed from 2/day to 1/day and there were 30 pills instead of 60.  I am wondering if my doctor's office is less comfortable prescribing this now that it is a "controlled substance" (whatever that means).  I am slightly worried because it is kind of my back up for bad days and I am afraid I will have nothing now. 
 
I plan on talking to my doctor about it at my next appointment.  I respect his decision if he is no longer comfortable prescribing this medicine, but I am also wondering if there is anything else to take for pain?  A lot of people on the CD forum have stronger meds (narcotics) for pain, but I don't think that is for me at this point in my disease or life.  Do you think a change in the med classification can really change how a doctor prescribes things (considering he was very conservative to begin with)? 

Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 3/29/2013 5:16 PM (GMT -6)   
This is from the DEA website re: tramadol:

Tramadol is not currently controlled under the CSA. Arkansas, Illinois, Kentucky, Mississippi, New Mexico,
New York, North Dakota, Ohio, Oklahoma, Tennessee, West Virginia and Wyoming have designated tramadol as a schedule IV drug under state law. Louisiana passed legislation that identifies tramadol as a drug of abuse; demonstrating potential for abuse.

Myrne - Who knows about doctors and why it was changed. I personally would be irritated that it was changed the way it was. It would be one thing if he had told you about the change in person - and you both mutually agreed upon it.

I think you can only answer what to do next about this. Was the tramadol helping? Do you need the 2x a day dose? If so - then you need to let your doctor know this. If he's agreeable - that's great. If not - I would seek out a different doctor. To me - it's important that your pain needs be listened to.... and, really, tramadol is one of the weaker meds out there. I think it's completely appropriate to be asking for that.

Good luck figuring this out.... let us know.

--Tina
Moderator - Chronic Pain Forum

My faith and family sustain me - even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to e-mail me or ask on the board. Thanks!

sjkly
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Date Joined Dec 2007
Total Posts : 2113
   Posted 3/29/2013 5:32 PM (GMT -6)   
The practice may also have a lower limit for nurse practioners writing out the script and when your doctor comes back from vacation your script may go back to normal.

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 3/29/2013 5:57 PM (GMT -6)   
As Tina showed, Tramadol has moved to a Schedule IV med in a few states. Even in mine which is VA...they have changed the prescribing habits even without it being a law. My dog is on Tramadol and it has the stickers/warnings everywhere that it is a controlled substance even though I use the Vet Pharmacy.

I even let my PM know that my dog is prescribed this because the prescription is in my name and with the Prescription Monitoring Program, I didn't want them to see this and wonder about it.

Since you say that you would fill the 60 pills every 2 months...it sounds like you still average just the one a day, is this correct?

I definitely would speak with your Dr. when he gets back from vacation and see what you can work out together.

Good luck..
SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

Myrne
Regular Member


Date Joined Jun 2009
Total Posts : 451
   Posted 4/1/2013 7:40 AM (GMT -6)   
Thanks for the replies. Snowbunny - I would say that I probably "average" 1/day. Although on days I feel I need one, I usually need another towards the end of the day - so it's more like 2 one day, none the next. I am not sure how terribly effective they are. I have been prescribed percoset in the past, which were much more noticeably effective, but they made me sleepy, so I was unable to take them during the day. The one thing that I do notice is that it slows my digestive tract down and calms the spasms. I am hoping to talk to my doctor to see if he recommends something else that can do the same. I have heard some people with Crohn's taking Wellbutrin with some success. My only reluctance there is that I would have to take it every day. Thanks again for your help.
29 year old female with a husband and son.
Diagnosed with CD in January of 2005.
Currently on Remicade.

quincy17
Veteran Member


Date Joined Feb 2013
Total Posts : 952
   Posted 4/1/2013 1:00 PM (GMT -6)   
There have been a lot of changes in the classifications and dosage limits all across the country since Jan.1. NM just limiter Oxycodone Rx's to 120 per script. as this is one third of my former dose I will be talking to my oncologist about what to do today. I can't take any of the ER drugs, I've tried them all without success so it will be an interesting talk. I'm on this board for my cancer caused pain and have found the advice here to be very reliable . . . Q
Age 52 at time of Dx, PSA 511, Gleason 9, tumor inoperable, and HT advised for maintenance.
Current age 58, PSA 2.5 and still on HT . . . Lupron 30mg every 4months with accompanying blood work including fresh PSA, 50 mg Casodex daily. CP drugs are #30 Cymbalta90mg 1/d, #120 Oxycodone IR 1 every 4 hours, #120 Fentora 600mcg 4/d

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 4/1/2013 1:06 PM (GMT -6)   
My guess would be that it is the nurse practitioner who is/was uncomfortable with prescribing you 60 pills. Either that or the nurse who called the NP gave the wrong information or it was taken down wrong by the receptionist at the other office.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 4/1/2013 1:10 PM (GMT -6)   
As a little side commentary I find the term "controlled substance" somewhat funny as it is used to described "narcotics". The reason it is funny is that in all actuality all prescribtion medications are controlled substances and due to problems with meth production and "designer drugs" a lot of OTC medications have become controlled since their sale have become regulated.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 4845
   Posted 4/1/2013 11:08 PM (GMT -6)   
I tend to agree that it was most likely the NP that was not comfortable with writing the 60. They have limits to what and how much they can prescribe in some states and controlled even more so by individual Drs they work for. His own policy may limit her if you dont see them but see the Dr instead each time.

It most likely will get defined when he returns.

Lol Jim you right and I have wondered how this term got associated with narcotics. You could say all meds that are not OTC are controlled since they have to be written by a Dr,nurse practioner,or PA,require you to get them a pharmacy and sign for them like the sudaphed.
" The best thing to hold onto in life is
each other"

Disabled since 1998 on SSD
DX: lft knee TKR. 6 rt knee surgeries for meniscus repair. Pars defect L-5 ,ddd at L3-4 S1. disc collapse at L-3 with nerve impingement. legally deaf,rt shoulder repair 06. post encephalitis/migraines
MEDS: methadone,lyrica,zantac,maxide,K+,lasix,prempro,flexeril,indocin
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