Sorry, I think it's only for C2's that you can't ever get a script
from a non PM/oncologist. Shorter acting does not mean less addictive, though. Often the shorter acting ones create addiction the quickest (take fentanyl for example, which is ultra-short acting). They do cover up to a month or so of Vicoden and for about
6 months of Ultram before you're off to the PM's office, but yeah, basically everything will eventually land you in the PM's office. Our local hospitals now have PM's on staff to write for post-op meds when a C2 is needed b/c some of the insurance companies won't even cover those without a script
from a PM (i.e., percocets must be written by a PM or at least an anesthesiologist, even if it's post-op -- NS's script
s are not always covered). Some people go to see a PM pre-op so there can be a paper script
waiting for them to pick-up at the hospital after surgery. The PM's are happy to oblige, but I guarantee you that this would not have been their first choice on how cover getting script
s for pain meds.
Obviously the possible FDA rule would start affecting those who don't have insurance or who have medicare/medicaid. Right now in IL, those people have their choice of where they go to be treated. Honestly, some crazy fools are jealous of the Medi patients b/c of that. I think that's nuts. Medi is the worst b/c then people only get to see their PM once a month no matter how horrible condition they are in. I can't figure how I would have gotten through some of the really tough times if I wouldn't have been able to go in for extra injections mid-month. Unfortunately, our pain does not follow a 30-day calendar, it just invites itself over whenever it darn well pleases.
lol Next time I will stamp it with a forwarding address of the FDA so it can go & bother them for a change. (jk, mostly I like the FDA they save us from evil peanuts & spinach and such, but it does seem this particular regulation would pose an extreme hardship on people like you)
I know it will be tough for a lot of people, including you, PA if this goes through. Please don't think I am against PCP's or such writing for narcs as long as they do so responsibly. The PM's (not the pseudo-PMs, the real ones :) in my area have really rallied as late, but until recently the PCP's and specialists didn't really consider them much more than glorified drug dealers & they definitely would not write script
s for much of anything. The PM's have been great about
putting on lectures & classes and such about
how to identify addiction and as a result have been exposed to a lot of questions from the rest of the medical community. The best thing to come out of it is that now regular docs are starting to see pain control as a medical treatment. No one would ever say that a patient should be denied narcs during major surgery b/c it would be both cruel & dangerous. And yet somehow they fail to translate that the same benefits (controlling heart rate, bp, breathing rate, etc.) apply to people in severe chronic pain. I've been really glad to see that some of the PCP's & ER people & the like are starting to defer to PM's on issues of pain control whenever they themselves don't feel comfortable enough treating. My PCP has started actually looking at vitals both on & off narcs and can see that there is a measurable benefit to my overall health to be on these medications. And for that I'm really glad. I know I wouldn't trust my own PCP to handle writing narcs for me even if insurance covered it & she was agreeable b/c she doesn't understand conversions, standard titrations or typical dosing for a given size & weight. But I certainly don't take any issue with non-PM docs who know what they're doing writing legitimate script
s for their pain patients. If I can help in your battle, I will gladly join-up.
But I fear that like what often happens that our voices will go unheard in favor of some uninformed neurotic with a loud voice. We have hands-free cell laws here in Chicago now even though every international study ever done (& there have been many) has shown that it makes the roads less safe b/c it gives people a false sense of safety. The insurance companies even lobbied against it b/c it is talking, not holding the phone that causes accidents. Nonetheless, some poor uninformed soul who, tragically, lost his daughter in an auto accident by someone holding a cell phone told the legislators that this was going to save countless lives & thus was able to get the law on the books. It is situations like that where some influential person tells some tragic story about
someone dying that end up creating laws that negatively impact us all. That is why I think that education is the key. Properly prescribed narcs save far more lives than they destroy.
But perhaps we should follow others' lead and write our own sob stories (has anyone lost a family member due to not being able to take them to their local doctor's office for treatment/pain meds?). The sorrier the better. And make sure you mention anything that would involve endangerment of life or limb. Barring that, I think it will actually take a lost life in order to prompt people to do the right thing. So sad, but that's just the way things go these days. :(
let me know if you find out about
PS-- What doctor would be against pain contracts? We already have to sign a basic contract with them stating we won't be late, will pay our bills, will take meds as prescribed, etc. What's the harm in adding a few lines about
not selling script
s, abusing meds or doctor shopping?