New Methadone Restriction Question

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 12/18/2007 11:42 PM (GMT -7)   
As of the 1st of january pain doctors will not be able to perscribe methadone 40mg wafers anymore.

http://www.deadiversion.usdoj.gov/pu...e_advisory.htm

Hi, I am currently perscribed to 4 - 40mg methadone wafers a day which is 160mg's a day. I get this medication for treatment of severe chronic pain. This has been a miracle medication for me and has given me my life back.

I have a question and did some reasearch and couldnt find an answer to. I know 40's are being taken off the market. The 10's will still be available. Will I be able to get 12 - 10mg methadone's a day, which would be a perscription for 360 a month or is there a law or somethingsaying you can only get so many a month?

Ive been trying to find presctiption limitations as far as how many of a medication a doctor can perscribe a month or is it unlimited and the doctor can write it for whatever as long as its justified?

Please Help, Shawn

TinaK
Regular Member


Date Joined Mar 2003
Total Posts : 396
   Posted 12/19/2007 5:55 AM (GMT -7)   
hi Shawn,
I don't take methadone now but when I did, I was prescribed 12 10mg a day. So yes, my doctor gave me a prescription for 360 a month. I was on that amount for about a year up until 6 months ago. Hope that helps.
Tina


Chutz
Veteran Member


Date Joined Jan 2005
Total Posts : 9090
   Posted 12/19/2007 9:32 AM (GMT -7)   
Shawn,

And welcome! Sounds like Tina answered your question. You can also ask any pharmacist about this. They'll know since they dispense it.

Good luck,
Chutz
Co-Mod Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, collapsed disk, dermatitis herpetiformus, osteo arthritis in spine and other locations.
***************

The only difference between genius and stupidity is that genius has it's limits. Albert Einstein: (1879-1955)


Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 12/19/2007 11:25 AM (GMT -7)   
Thank you so much for the reply. This was on my mind the past few days and you help ease my transition. I will be losing 40mg a day, but I think I should be able to handle that. Thanx again for the reply. My doctor is a real good guy and has gone out of his way many times to to help me out, since I dont have insurance. So im not to worried, because to date he is the best doctor I have every had.
 
Thanx Again,
Shawn

ReactiveConstellationNE
Regular Member


Date Joined Dec 2005
Total Posts : 256
   Posted 12/20/2007 11:40 AM (GMT -7)   
The link in the first post doesn't work; it has "....." in place of some of the URL. :(

I am a very nervous EXTREMELY SEVERE, progressive chronic pain sufferer who has an appointment with his doc in about 45mins. that may determine whether or not I have to try to keep getting by with Teva generic Oxycodone ER (440mg per day) and generic Mallinkart hydromorphone (32mg per day; if nothing else is changed, I will beg my doc for more of this, even though I know it will be like pulling teeth because he is brutally minimalist with the breakthrough/IR meds).....

....or if I will be able to try switching to methadone. MaineCare won't pay for any more Oxycodone, and the Teva stuff has an extremely poor nausea/vomiting-to-relief ratio compared to the Brand or the Watson/ABG exact-brand-clone generic which is now off the market.....MaineCare also won't pay for Fentora or Opana at this time, the latter isn't even in their PDL at all(!)

The problem this news presents for me, is that after the initial switch to say, about 120mg of methadone, I may need to titrate up to 160-200mg in order to truly control my present pain levels properly. This is of even greater importance than usual, because we have a two year old son and another child on the way in 3 months and I am currently in NO shape to help support my wife through her labor and the early weeks of baby care! :(

I am nervous at the prospect of having to ask my doctor for 480-600(!!!) tabs per month.....obviously this is a serious problem.
Conditions: Chronic Pelvic Pain, Severe Lesioning of the Spermatic Cord, Reiter Syndrome (Reactive Arthritis and Myalgias along with a slew of other symptoms), Sacroiliitis, Costochondritis, widespread Tendonitis, and on and on. Typical daily pain levels exceed 8.5.

Medications: Oxycodone, Dilaudid, Lidoderm (lidocaine) Patches, Flexeril, Soma, Testred (testosterone capsules); many herbs & supplements.


Previous medications: Opana ER (12 hour time releasd Oxymorphone, Endo Pharm.), Fentanyl patches (two 100mcg/hr patches worn simultaneously, changed every two days; Mylan generic solid polymer patches), Cymbalta, Lyrica, Neurontin, Amitryptyline, every NSAID known to man, Prednisone, and many more.


Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 12/24/2007 11:23 AM (GMT -7)   
ExitWound,
I would like to know what happened at your doctor appointment. I dont mean to intrude I am just interested if you got switched over to methadone or not? If you did, did the doctor give you the 10mg tablets? Did he give you 480-600 a month?

Happy Holidays,
Shawn

Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 1/14/2008 9:51 PM (GMT -7)   
UPDATE!!!!

Well I went in to the doctor and almost cried! I have been on methadone 40mg 4x daily for 2+ years now. That is equilivlant to 160mg a day. This was a perfect dose for me! It really helped my pain an allowed me to manage my pain with my life. I was able to finally start working again thanx to this medication.

Well the 40mg methadone wafers were taken off the market on the 1st but the 5 and 10mg tablets were still avaiable for pain management. So I figured that I would get 12-16 methadone 10mg tablets a day which would be the same dose I was taking with the methadone 40mg wafers.
WRONG! At first the doctor was only going to give me 4 methadone 10mg a day! I flipped out, he would be cutting 120mg a day in one MONTH! Methadone is a drug that needs to be tapered slowly. I eventually got him to give me 8 methadone 10mg tablets a day which is still HALF of what I have been getting for 2+ years.

I am in so so so much pain that I can't even work. I lost my job and am now bed/coach ridden again. WHAT DO I DO? I am thinking about maybe looking for a new doctor. Any advice would be helpful at this moment. I would have posted what happened earlier but I've been in so much pain I dont even want to go on the internet.

Shawn<!-- google_ad_section_end -->

Circa1988
Regular Member


Date Joined Aug 2007
Total Posts : 90
   Posted 1/15/2008 3:23 AM (GMT -7)   
Have you gone back to your doctor and told him what it has been like since the decrease. I honestly do not see how he can justify cutting your dose in half because the strength of pill you were taking was discontinued. BTW no there is NO limit to how many pills they can prescribe to a person, they just need to be able to defend why they had to prescribe that many if they are investigated (this is no doubt your doctors fear, that prescribing that many pills a month will draw unwanted attention).

Excuse my language but this is another in a long line of crapty things the DEA has done to "reduce diversion" at the expense of patients. They are so single minded about trying to stop drug use that they trample everyone else in the attempt. And all for something that is: 1. A completely and utterly hopeless goal (stopping drug use) and 2. Is on fairly questionable moral grounds. Some feel it is not the government's job to stop people from taking drugs in the first place, and that jailing them for it is puritanical because it is punishing them for their different moral beliefs. Not to mention the fact even more people feel that often the laws do more damage than the drug use itself. An editorial once put it very well: Bill Clinton, George Bush, and Barack Obama all are known to have used drugs, and this apparently is not a problem in the eye of the public (given their political success). However had any one of them ever been arrested for drugs they would have never had a chance at becoming as successful as they are due the fact that they would have a criminal record. And to top it off, 'The War on Drugs' forgotten casualties are the patients who are receiving inadequate care due any number of ridiculous attempts to stem drug use. Here is one of my favorite examples:

Diacytlemorphine is a pain medication that is proven to be more effective at a lower dose and with fewer side effects than many other strong opioids for treating very severe pain for lot of people. This is especially true of end stage cancer patients. One very large advantage it has is that for some people who have end stage cancer this med is less sedating and allows them to communicate with their families and be more aware in their last days than other opioids. This drug is available for prescription in England and widely used there, as well as in other European nations. It is not however, available for prescription in the U.S. because it is a Schedule I drug and 'has no accepted medical value.' It is not prescribed, because, in the opinion of the DEA it is too addictive and should not be prescribed. The only issue is that this medication is available in every city in the US and is sold on street corners throughout the country, anyone who wants to buy this medication can. Diacytlemorphine is also known as Herion. Now shall we analyze who suffers from this arrangement. Despite the fact that there is no legal source for herion in US (because it cannot be prescribed), it is extremely easy to get for anyone who wants it, that is, for drug users. However, cancer patients and other sufferers of extreme pain who might benefit from another option to try for pain relief (might I add one with many benefits for some people) generally stay within the medical establishment for their pain-relief, and do not go to illicit sources. Drug users however have no qualms buying their drugs from outside the system. So it is obvious this situation really only detriments legitimate patients (and getting back on topic), just like the change in methadone pills affecting Pains. They only detriment legitimate patients because what the Gov't is too short-sighted to see is that all of addicts will simply find another source, because they are not confined to legal methods. Not having herion available for prescription is simply based on the strong stigma surrounding herion just the same way that because methadone has been getting all this bad press lately the DEA has to do something about. Both are completely irrational. If the government made drugs illegal because they are addictive than they would certainly have to make Hydromorphone (Dilaudid) and Oxymorphone (Opana), both of which numerous studies show that addicts actually prefer OVER herion. And to show how irrational the change with the methadone tabs is, well, they are continuing to give them out for Methadone Maintenance (to recovering drug addicts), just not pain patients. This seems fine, however, the vast majority of methadone deaths were with methadone from a Methadone clinic. Many of the addicts, it turns out, die taking benzos or other drugs on their methadone, or sell their methadone to people, some of whom overdose and die with that methadone dispensed from the Methadone Clinic. It is merely an act so the DEA can say it is fighting 'The War on Methadone.' Well they are winning the war on pain patients.

I hope that my post is not too long and off topic for people. I could go on and on there is just so much wrong with 'The War on Drugs,' from screwing up foreign policy, to empowering gangs, to the racist drug laws (not being melodramatic look up the 100-1 discrepancy between powder cocaine and crack cocaine). It is just infuriating to me what the Gov't does because they are trying to rid the world of drugs, a goal that is in my mind absurd in its futility. Though I do not propose to know the answers to the drug-abuse problems, after 80 years of trying the current policy, with only rising drug-use rates, I think it is obvious that filling our jails with drug offenders is not the solution and that it is time for SOME kind of new direction. I dont really care what, just something different.

I hope everything works out for you Pains. Like I said, call the doc again and see what he says. I dont think that another doctor would raise your dose that high, especially now that you are down again. But maybe.

Good luck.

Post Edited (Circa1988) : 1/15/2008 4:17:20 AM (GMT-7)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13451
   Posted 1/15/2008 9:40 PM (GMT -7)   
I think I would be finding myself a new pain mgt dr. The odds of this guy ever treating your pain properly is slim to none. He is more afraid of the DEA coming down on him for doing his job, when in fact he is not. To cut your medication that way is wrong no matter how you cut it. Get busy and find a new dr. Be honest with the new one and tell him what happened with the old one. Susie


Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 1/23/2008 11:08 AM (GMT -7)   
Well I called the office and managed to get in to see the doc again on monday the 28th. I went on the 5th this month so the doctor is seeing me early. I also have another appointment set up with a new doctor on Feb 8th.  I am going to take in my perscription histroy, my MRI files, and doctor notes from past doctors. I have a feeling that my doctor i see on monday will be once again lowering my dose! It happened to my friend so i figure it will happen to me. I will probally get lowered another 2 pills a day so I will be on 60mg a methadone a day, when little over a month ago i was on 160mgs a day.
 
I am going to tell this new doctor how much pain I have been in. That I lost my job because I couldnt perform at work because my pain was not managed right this past month. For so long my life felt somewhat normal meaning I started to enjoy the great things about life because my pain was managed so well with the dose I was on. I eventaully found a job and started working again, i am doing family activities, and even going out and about with friends alot more and enjoying life. Since my drop in dose I think I left the house once. I have no appetite, lost my job, pretty much bed/couch ridden, grumpy, and not active at all anymore.
 
My life has done a complete turn around for the worse. I feel better today hence the reason I am writing back because after I called to make an appointment to see my doc again and they let me come in early, I took 80mgs this morning which is my normal dose and will probally take another 40mg tonight. I think I could get by on 120mgs a day and be allright, but for some reason my doctor wants to get all his methadone patients down to 60mg no matter what dose they were on before.
 
Hopefully this new doctor can keep me managed at 120-160mgs a day and I can get my life back. I wont be able to get my job back because I left on bad terms, My boss doesnt fully understand what kind of pain I deal with everyday and the whole situation.
 
Any advice on what I should tell this new doctor would be helpful.
 
Shawn

Mochiah
Regular Member


Date Joined Dec 2007
Total Posts : 450
   Posted 1/23/2008 4:21 PM (GMT -7)   
Pains - I think Gramps is right (as usual). On top of what he pointed out, both insurance companies and pharmacies have their own rules and restrictions. By that I mean an insurance company may allow a refill every 25 days, but just because they allow it at 25 days, the pharmacy's policy may be every 28 days so your stuck without meds until the pharmacist says okay OR the pharmacist gets the okay from your doctor. Please be careful, I would hate to see you without meds for even a day...even the lower dose is better than none at all.
Mochiah/a.k.a. Sue
cervical fusion 2006, with great result
L4-5 surgery with cages, plates, and screws in 2005, I have continued pain 
MEDS:  Fentanyl patch, Norco, Celexa, trazodone, and Parafon Forte
 
Im going to smile like nothing is wrong, act like everything is perfect, and pretend its not hurting me.


Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 1/27/2008 6:06 PM (GMT -7)   
Okay, you'all got to understand that at my last visit with the doctor he informed me that he was cutting all methadone patients back. This clinic is a crazy clinic and they get patients on a daily basis coming in early for there meds, saying they lost there meds, or saying there meds were stolen. I have been seeing this doctor for over 2 years and have never came in early. I have been a good patient since day 1. They know my situation this month as I have kept them informed. The doctor wanted to get my dose down, and in less then 30 days I managed to get my dose down to half of what is was. I went from 160mgs a day to 80mgs a day in 20 days.

My doctor is a very understanding person and knows what kind of pain I deal with everyday. I dont have insurance and pay cash for my doctor visit and medication every month. This is an extreme situation and some exceptions probally will be made. At my last visit I even asked the doctor if it was okay to start the month taking my normal dose and slowly taper and he said that would be the best way to go. I am pretty sure he will see that I am trying my best.

As far as seeing a new doc, you got to understand my situation. My pain was managed perfectly at my dose of 160mgs a day. I managed to get my life back on track and obtain a job again. Since the taper everything has gone down hill. Hopefully the new doctor will understand that. If not I will not get any meds from the new doc and stay with the doctor I am with now. There is nothing wrong IMO to seek professional advice from another doctor.

Mochiah
Regular Member


Date Joined Dec 2007
Total Posts : 450
   Posted 1/27/2008 8:39 PM (GMT -7)   
I just don't get it...when a patient's pain is managed just fine, why in the world do they decide to cut every patient down to 60 mg (other than DEA fear). If it didn't work on your (and his other patients) taper up, then it sure as heck isn't going to work to cut everyone down. You would think he would offer other medications to bridge the gap.

Pains, I am so sorry you and his other patients are going through this. I know you don't want to rock the boat there, but I would be demanding more answers than "everyone is being cut." That totally goes against the do no harm that the doctor swore to. I am glad that he had said it was okay for you to taper, but, as you already know, that is just too huge of a taper for someone to handle that quickly.
Mochiah/a.k.a. Sue
cervical fusion 2006, with great result
L4-5 surgery with cages, plates, and screws in 2005, I have continued pain 
MEDS:  Fentanyl patch, Norco, Celexa, trazodone, and Parafon Forte
 
To handle yourself, use your head...to handle others, use your heart
 
I'm going to smile like nothing is wrong, act like everything is perfect, and pretend its not hurting me.


Pains
New Member


Date Joined Dec 2007
Total Posts : 10
   Posted 1/28/2008 1:24 PM (GMT -7)   
Well i went to see my regular doctor today and once again I was dropped down to 6 methadone 10s a day. To think i was on 160mgs a day for 2+ years and get dropped down to 60mgs a day in less then 45days is insane. If someone told me that would happen I would of never believed them. I go see this new doctor in 11 days. I am just going to explain to this new doctor what my life has been since the cruel drop in meds.

When I was on 160mgs a day, everything was all good and I started slowly but surely getting my life back. My pain was managed greatly. I was actually able to go out and get a job and work like a normal human. I was able to live a somewhat normal lifestyle by being able to go to the movies, or hang out with friends and family and due things that normal people would do. I would still be in pain but it was managed perfectly to the point where I could do those things.

Since the drop I have lost my job because I couldnt perform up to par because of pain. I am a very iritable person. My family cant even stand me. Because when I am in great pain I am a monster. I am rude, not nice, almost unbearable. I left the house all but 2 times this month. I stayed home when family went out to eat or to the movies because of my pain. I was even able to take small walks before and now I dont even want to get up in the morning or get off the couch. The pain is so bad, it shoots down my left buttox and down my left leg. Feels like someone actually took a sharp knife and is stabbing my butt and cutting it all the way down to my leg.

I hope this new doctor understands that my pain was managed really good at a dose from 120-160mg of methadone a day, and that I could live a somewhat normal lifestyle at that dose. Wish me luck and I will keep you all informed of what happens on the 8th.

I want to personally thank everyone here who has given me advice and helped me threw this process. So... THANK YOU

Shawn

Mochiah
Regular Member


Date Joined Dec 2007
Total Posts : 450
   Posted 1/28/2008 4:43 PM (GMT -7)   
Shawn - I am really upset and definitely feel for you for what you are going through. After all, isnt' that what we are all after, to feel somewhat normal. People (including the doctors) take for granted jumping in their car and leaving home, going for a walk, going to the gym, shoot even just standing long enough to prepare dinner. We are in the fight of our lives just clawing our way through each day.

I can definitely relate to your isolation, and I am sure many others here do too. I leave the house once a week to go replenish the house with food and supplies. I have always been a very independent person, never asking for help, but now I feel mentally small when I have to ask someone to help load rabbit food or dog food onto my cart, sometimes even a few gallons of milk. When I hurt badly, as I have the last week or so, I even isolate myself from my family....I have found myself staying up later at night, even until around 5 a.m. so I am going to bed when they are getting up just so they don't have to see me gimping around and sometimes crying. There is nothing they can do anyway so I have to just work through it in my own way and in my own time. It is going on 8 years that I have dealt with this, so they are tired of hearing "I hurt," so I just avoid them. I don't even call my mother (who I usually speak with every other day) just because I know she is going to ask "so how are you."

I have to say that HW is the absolute best place I have ever come to for support. Chutz and the other mods readily welcome everyone into the family and I actually feel somewhat normal when I come and post here or even read. That's all I want, to feel more normal in the world, like I fit in...and here I do. We are all in this together. I have gone to other chronic pain sites only to find they are places where everyone is exchanging information on how to purchase online medications on top of what their doctor is giving, or some with no insurance. At any rate, I got the feeling from many of them that they were purchasing from MANY places, just by their questions of "which pharmacy does this OP use, which doctor does that OP use....it is sad that people have to resort to that because of the opoid phobia, but I didn't feel I fit in there. I have a doctor who prescribes and my morals tell me it is wrong to go elsewhere since I have found a doctor willing to treat the pain....if the OP gets busted (which I was reading happening almost daily) then 1. they are out their money and their refills. 2. your name is in the DEA hands and if they find your name on multiple lists then their busted...plus their doctor would probably be informed and they would be SOL. Anyway, that is in a different direction...my point is just that I just didn't feel I fit in there.
Mochiah/a.k.a. Sue
cervical fusion 2006, with great result
L4-5 surgery with cages, plates, and screws in 2005, I have continued pain 
MEDS:  Fentanyl patch, Norco, Celexa, trazodone, and Parafon Forte
 
To handle yourself, use your head...to handle others, use your heart
 
I'm going to smile like nothing is wrong, act like everything is perfect, and pretend its not hurting me.

New Topic Post Reply Printable Version
Forum Information
Currently it is Monday, December 05, 2016 1:24 AM (GMT -7)
There are a total of 2,732,865 posts in 301,064 threads.
View Active Threads


Who's Online
This forum has 151217 registered members. Please welcome our newest member, antknight.
209 Guest(s), 3 Registered Member(s) are currently online.  Details
Nick_69, Stanislav, celebrate life


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2016 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer