Florida's "pill mills"

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cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 2/23/2011 10:12 PM (GMT -6)   
There have been a few discussion threads addressing the "pill mills" in Florida and the consequences for legitimate patients, including the extreme shortages of oxycodone in some parts of the state.

So, here's a news story that may interest folks:

http://www.nytimes.com/2011/02/24/us/24drugs.html?emc=eta1

Excerpt: " Mr. Trouville said that since the operation began a year ago, a task force had taken action against 66 doctors at 83 locations and seized more than $25 million worth of property. "

Mrs. Dani
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Date Joined Jun 2009
Total Posts : 2787
   Posted 2/24/2011 11:13 AM (GMT -6)   

Link to article ~~>

http://www.nytimes.com/2011/02/24/us/24drugs.html?_r=1&emc=eta1

Perscription Monitoring article ~~>

http://drugcontrol.flgov.com/pdmp/index.html

Full Law (s. 893.055 and the accompanying Public Records law s. 893.0551) ~~>

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0893/0893.html

"Pill Mill" Article~~>

http://www.time.com/time/nation/article/0,8599,1981582,00.html

Full Law (SB 2272) ~~>

http://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=43950


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momtofourangels
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Date Joined Apr 2010
Total Posts : 2261
   Posted 2/25/2011 1:11 AM (GMT -6)   
Thank you for sharing this info with us. I just read the artlicle and it's horrible that they clinics are giving drugs like this. It's just making it harder for those of us with cp to get our legitimate medications. It makes me sick.

Dani
thank you for sharing even more information. wow. they have long laws or whatever they are i can't remember, don't they? This is so serious.

people are dying and i'm sure these pill mills couldn't give a crap.

love and hugs
Loretta

desert
Regular Member


Date Joined Feb 2011
Total Posts : 93
   Posted 2/25/2011 7:43 AM (GMT -6)   
I've never understood people who do this kind of thing. Even if they didn't have a problem with the abuse of the drugs themselves, they have to know that there are supply problems leaving people in really bad pain and that people are dying from what they are doing. I have never met a person who could do that kind of thing before. It's just so strange to me that a person could put their own money ahead of everyone else so selfishly. Wait, I think I'm glad that I don't know anybody like that.

-Jeff

ohthepain
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Date Joined Mar 2005
Total Posts : 353
   Posted 2/25/2011 7:54 PM (GMT -6)   
These pill mills make it harder for us legitimate pain patients...but I think we need to go after the crooked docs rather than punishing the patients. I don't want any of my meds in a database with our government...not my psych meds, not my thyroid meds and not my pain meds. We've seen how well our government can protect it's classified info, how well are they gonna protect my classified info? Something needs to be done here in Florida b/c it's bad. But the fact of the matter is that people who want to abuse drugs are going to do so and if we take the pills away they will jsut find something else. We need to help the drug addicts get off drugs and close the pain management clinics that hand this stuff out like skittles but I don't want "Big Brother" knowing what I consider my personal business.
 
Just my 2 cents as a Florida resident who has had my pain management care impacted by this issue.
 
Also, our govoner recently decided he wasn't going to support the database with gov't funding.
~ Carina~

Fibromyalgia, Bulging Discs (L4, L5-S1), DDD, Spinal Stenosis, Facet Joint Disease (Overgrowth), Osteoarthritis, Acid Reflux, Hypothyroidism, ADD, TMJ, Migraines, Depression and Anxiety.

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Boxerlover
Regular Member


Date Joined Dec 2006
Total Posts : 275
   Posted 2/25/2011 11:59 PM (GMT -6)   
I am also a Florida resident although it is not too bad where I am. I feel sorry for the true pain patients who go to these places and go to their next appointment to find the doors locked. Our new govenor rejected the state wide monitoring system which at least would have helped to a degree.
 
I hate the idea of it all being monitored to that degree but if it helps weed out the drug seekers even a little it may be worth it.  Although I agree that the drug seekers will just come up with other ways which is why they NEED to deal with the actual problem!

momtofourangels
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Date Joined Apr 2010
Total Posts : 2261
   Posted 2/26/2011 12:13 AM (GMT -6)   
I agree. I don't want my "personal business" on the government database either. I don't trust them on bit. Who knows what would happen it that came to fruition (sp?) It's scary. They do need to take care of the people that are addicted like that so we can have peace that we can get our meds and not have to worry about it.

love and hugs
Loretta

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 2/26/2011 9:11 AM (GMT -6)   

I posted this on another thread here, but thought it might be better suited in this spot as well.

Shortly a new law will come into effect here in KS, if it hasn't already. It is a syestem called K-Tracks or something like that, as to where the Dr's will have to report to the state what Class II, III, and IV meds are being scripted to who and how much. The Pharmacy's will also be under this new law, and will have to report on a daily basis, of who got what and how much. It will all be monitored by the state of KS. Dr's, PM's and Pharmacy's will all be on the same system.

 
    My Dr, is against it, and does not believe that the state needs their noses in it. However if it will help us in the long run for those of us who need these med's, then I'm for it. As with all new progerams or laws, I'm sure there are Pro's and Con's on this issue.
 
 SE

stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 2/26/2011 10:16 AM (GMT -6)   
Just FYI,  MN already tracks how many narcotics physician's write RX for and if they are suspicious they are investigated.  Thus physicians are leary of writing scripts for pain meds.
 
Kitt

jeanneac
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Date Joined Feb 2009
Total Posts : 1915
   Posted 2/26/2011 9:21 PM (GMT -6)   
I usually hang out on the crohn's forum but since I am in a lot of pain anymore with my joints, I thought I'd have a look see here. I live in SouthEast Georgia and some clinics have even popped up here. While I totally sympathize with people who are in pain and think some of us live in pain b/c our docs are too conservative with pain pill because of the epidemic of addiction. I suspect a lot of people who live in pain are forced to go underground for pain meds and have to go to the pain clinics.
However, someone told me they were in a drug store the other day and they announced their shipment of oxycontin was late. They witnessed a ton of people leaving the store and getting on their cell phones. They took this to mean a lot of them had "customers" out there to call. It's really a shame. I've only taken hydrocodone on occasion for pain and never got high from it. Not sure why people would take it for that purpose. It's a shame we don't have better ways to control pain. I for one, could use some relief!!!
d 1/09 with colitis sigmoid colon with some diverticular disease as well, IBS, Colon resection Nov. 2010, now in remission
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Scarred_for_life
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Date Joined Jul 2008
Total Posts : 1560
   Posted 2/27/2011 5:55 AM (GMT -6)   
I agree with each and every poster on this topic. It's hard enough being a pain patient without all the crap that is out there. I've witnessed so much horror in my years of being a pain patient and it scares me that people are out there doing this.

I've seen deals going down in parking lots, had my son stealing my medications and witnessed people in full withdrawls mode cause they can't control their urges to steal pain meds and get "high". Out of all of it....only one really got to me....my youngest was a senior in hs and got hooked, via one of his friends, on my pain medications. I don't know how long he had been stealing from me and I really didn't want to know. But, when I did find out it scared the hell out of me and I can honestly say that I feared for the kids life.

I had mixed emotions at that point. I was furios, scared to death, felt like I had been stabbed in the heart and totally depressed. Of course he had the gaul to deny everything, but I had him red handed and told him I would let this one slide. Kicked him out of the house and told him that if he ever stoled from me again I would turn him into the police.

Anyway, my point is.....that for some unknown reason my son was drawn to this. I don't understand it but I don't have to watch while he ruined his life either. These people are the worst of the worst.

Anyway, hard to trust him again.

Hugs

Scarred
I live to "Tame My Pain!"

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/9/2011 11:52 AM (GMT -6)   
Hi,
@Scarred, You wrote, "Anyway, my point is.....that for some unknown reason my son was drawn to this. I don't understand it but I don't have to watch while he ruined his life either. These people are the worst of the worst."

I can't help but think the media is partly at fault. They went on and on about Oxycontin and how people were using it to get high. Well, kids hear this and they start to wonder what all the hype is about. And then there is the peer pressure. Even if he wasn't interested someone else might be.

My younger sister was talking to someone about my chronic pain issues and difficulty in getting my medications (partly due to the laws, partly due to the fact that nothing serious shows up on an MRI for me and some of my DX's are idiopathic.)

Anyway, her friend said he would sure like to get some Oxycontin. She looked at him and said, " You are part of the problem for her!"

I've talked to my (previous) doctor about the stigma surrounding oxycontin and he said he thought the media was largely to blame. I respect this doctor with all my heart so when he says something I listen. He is very conservative, etc.

Anyway, just my 2 cents on that part of the topic.

Imme

Draka
Regular Member


Date Joined Jun 2009
Total Posts : 256
   Posted 10/9/2011 2:46 PM (GMT -6)   

Thanks for the articles.... I am a south FL resident and I always have had a problem filling my scripts....

Just last week my primary Dr. put my back on Oxycodone.... I got the script drove right to the pharmacy handed them the script and was told they couldn't take the script... because.... the date was not spelled out... the date was on there but was like this: 10/6/11.... the word October was not spelled out...

I had to drive 20 minutes back to my Dr's office to have the problem corrected... she was angry.... apparently there is yet another law that the date must be spelled out and the # of pills must be written out and also in # form....

It should be: sixty and 60.

So crazy... but again... it's always something!


C3 through C7 right open door laminoplasty, C2 through C10 hemilaminectomies, C2 through C7 right forminotomy, and left C5 through C7 foraminotomies, C3-C5 structural rib allograft and local vertebral autograft & C7 with the same allograft & local verterbral autograft & Vertex instrumentation C3-C5

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/9/2011 6:55 PM (GMT -6)   
Thanks for the heads up, as it wouldn't be a first for me either that a script wasn't written "correctly", though I'm getting better at looking at my prescriptions before I leave the doctors office. And since it's almost a 2 hour drive one way for me now, I'd hate to have to do that drive all over again just for something as silly as that!

When I first moved here I still had a script from my previous doctor in another state. Well, he never writes his DEA number on them because it's not a law and he says it helps keep abusers from submitting fake scripts.

I went to two pharmacies before one would even tell my why they wouldn't fill it. They just said "No.". When I talked to my doctor's about it he explained that he had had to call every pharmacy his patients see to explain how they would not get in trouble for filling a script without a DEA number.

Just to clarify I have no idea if the laws in Florida are the same as where I used to live. Seems like I moved to another country, not just a different state! But it sure upset me the first time the pharmacy said "No".

Imme

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 10/10/2011 1:35 AM (GMT -6)   
Honestly, part of the solution is research into safer narcotics and ofcourse to make existing narcotics less abusable through other means outside of adding APAP to it (or other substances that can cause real damage to the body).

The biggest issue with safer narcotics is that sometimes the "safety" mechanism cause them to work improperly when following the tradtional prescribing profile. For example, there was a morphine pill that was supposed to be tamper resistant but there were complaints it did not digest and break down properly in the system. Hopefully, that ones been fixed.

The second idea is more research into safer new narcotics. The thing is the opioid pathway remains one of the most effective ways to treat pain. As science is discovering over time, there are several sets of receptors. More recent medications use multiple pathways, which can have opioid sparing effects. Bustran is a pretty good example of this, as its not new in existance, but new for chronic pain management, and its method of delivery makes it difficult to abuse. Like Tramadol and Tapentadol, it also works on the norephedrine system for addition pain relief action.

Demoral was one of the first to have multiple mechanisms of action. However it was toxic and too short lasting, but for nuero pain it worked very well. I think science has realized multi action medications which could utilize weaker opioids IF properly adjuvanted is the best path forward. However, it took years to see the Bustran patch, 25 years to advance from tramadol to tapentadol, and there were newer medications talked about that have yet to make it into phase III trails. Also, to have less addictive medications like Bustran patch (enter as Schedule III) and tapentadol (enter as Schedule II) really hurt the industry since tramadol was unschedule (and still is federally) and marketed as less addictive. All evidence indicates that thought tramadol can be abused and is, its still less abused and addictive than other opioids. That has to be partially attributed to its multiple mechanisms of action and it seems we've hit a stumbling block here with anti depressants being now labelled addictive by some within the medical community. Hopefully anti depressants will surive the scrutiny.
 
The DEAs current policies are well supported by politicians on both sides of the spectrum. Those policies are in need of revamping, but unfortunately the conservatives feel this is an area where big government is needed and liberals feel everything must be regulated (generalizations, no offense to anyone :)  Until politicians on both sides can realize that government protection/regulation is just as important as proper health treatment in society and can balance the 2 out, the DEA regulation will remain unchanged. This is sad because the DEA is for the benefit of Americans not the disbenefit, and therefore a system with disbenefit like this isn't properly serving the government or people of the unites states :/
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.

Post Edited (grainofsalt) : 10/10/2011 12:41:26 AM (GMT-6)


sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/10/2011 7:56 AM (GMT -6)   
Hi!
I read a very interesting though disheartening article by the Cato Institute that explained *why* doctors in general are being scrutinized so horribly, even the good ones.

The major points I took away from that article is that the pain management society wants to take all rights from physicians to prescribe opioids, and that the government is now blaming the failed war on drugs on doctors. Doctors have become the scapegoat for the failed war on drugs.

I will find that article again and post it here as it was a real eye opener and actually quite scary in how the government has given the DEA too much lee-way to go after doctors and patients. The DEA and the government are using the pill mills as an excuse to take away any rights that patients and doctors have to pain control. But again it's really about the failed war on drugs. It's no different than prohibition and how well did that go?

The DEA seizes any assets a doctor has *before* he goes to trial or convicted of anything. Also those assets are distributed to law enforcement, the DEA and one other organization that I can't remember now. But can you imagine? It sounds like something out of a movie!

The doctor without assets has no recourse to fight said charges except to plea bargain for a lessor crime. It can take years to be absolved from said crimes even when not guilty. By then the doctor has lost everything; his practice, and all he or she owns.

The DEA has way too much power now.

Imme

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/10/2011 8:05 AM (GMT -6)   
Re-hi, I think the New York Times article confirms the Cato Institute article in one paragraph here: “This is a completely profit-driven operation that has no medical regard for anyone,” Mark R. Trouville, the special agent in charge of the Miami field office for the D.E.A., said in an interview. “These clinics have nothing to do with the welfare of the community.”

Imme

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 10/12/2011 4:07 AM (GMT -6)   
I truly sympathize for those in Florida. In Maryland, this issue of going after pain clinics is not a widespread issue. Most pain clinics in this state are affiated with hospitals or larger healthcare groups and I think the stregnth in numbers idealism for our system has helped to keep MD from becoming a DEA raid haven.

With that being said, the pain clinics in MD are slightly more conservative with their prescriptions, but the trade off is some relief vs no relief. For me personally, I'm prescribed tapentadol (a schedule II) which is effective for moderate to moderate severe pain, but isn't very effective for breakthrough pain. Instead of prescribing breakthrough pain medication (such as 15 hydromorphones per month), I was prescribe an adjuvant, Soma - a non schedule muscle relaxant, to take as an assist and it does help somewhat. That's pretty much my trade off, assurance my pain will be effectively treated most of the time, and knowing that I'll have to endure more severe pain part of the time. However, for me that trade off is a welcome change from the treatment I got years ago at the VA.

My current doctor (whose part of a larger hospital group) requested an MRI immediately and was willing to prescribe a temporal script until the results came back to show the injury. However, when I was at the VA, they refused to even do an MRI. They labelled me as a "seeker" for trying to get prescribed Tylenol #3 to ease the pain. The head doctor at the VA's hospital in Baltimore told me my injury was all in my head and that I needed mental help.

Still to this day I have the fear that one day I'll walk into my doctors office and something like that will happen even after the MRI results (despite having an excellent relationship with them). Calling someone a seeker causes irrepairable damage, and causes a world of self doubt.
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.

Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/12/2011 8:40 PM (GMT -6)   
I think the government/dea intervention is rediculous.

I have very liberterian views though. If someone decides to use hard drugs, then ruins their lives and their families lives. Then so be it. Moral and drug issues should not be the governments business. I'm ok with using some tax dollars for real drug education as opposed to the bullcrap propoganda they've been using since the 70's but that is as far as they should go with my money. Create jobs, fix infrastructure and leave the morals or lack there of to parents. Some people just turn out bad regardless. Such is life. A Utopia will not be created, our rights wil just be lost trying. Rant over :)
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 10/13/2011 12:19 AM (GMT -6)   
I tend to be authoritarian (albiet a more center left one), but DEA regulation is one of those areas I would lean more towards libertarianism than authoritarianism.

Authoritarianism for matters of national security is completely different than drug regulation.

Just my view ;)
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/13/2011 7:00 AM (GMT -6)   
I don't think the AMA, the DEA, and the FDA are doing this to reduce drug related deaths. That's just what they say in order to do what they do. It's about money as always. The profits law enforcement reaps from arresting medical professionals is nothing to sneeze at. I don't just mean pill mills but rather medical professionals as a whole. And there's nothing wrong in my book with doctors who actually do make money as long as it's legal.

But what is wrong is that law enforcement organizations divide all profits, (assets) they seize *during* arrest and not after conviction between their organizations. That way doctors have no resources to defend themselves in court, and end up plea bargaining down to a lessor crime and or jail time. That's why all anyone reads in the news that so and so doctor was found guilty of "x".

It blows my mind that this kind of thing is even happening in America. But it's all on the Internet for people to read, they just need to dig just a little deeper than front page news and or Fox TV. Of course the people who need to know these things won't be bothered, it's so much easier to point the finger and blame someone else for our societies problems.

Google Dr. Scott Fishman for one example. You may already know of him for his relentless advocacy of quality pain care and compassionate treatment of chronic pain patients.

Dr. Fishman was arrested and had to move back home to live with his parents because all of his assets were seized at the time of arrest. But he would not plea bargain and 5 years later all charges against him were dropped. He lost everything he had worked for. I found this information by going to the Cato Institute website.

One more thing that really disturbs me is that Florida law now states that the DEA must be allowed access to all patient records if requested, no warrant is needed.

Imme

sunrisedusk
Regular Member


Date Joined Oct 2011
Total Posts : 23
   Posted 10/13/2011 7:07 AM (GMT -6)   
I guess what really worries me is that once a law is put into effect it's darn near impossible to reverse. That's why you can still find laws dating back from 1850.

Imme
Since 2001 I've been DX'd by many specialists: Fibromyalgia, Small Fiber Neuropathy, CRPS (right foot), Tarsal Tunnel Syndrome, DDD, Arthritis, Chronic Fatigue Syndrome, Myleopathic pain due to spinal cord compression, & Central Pain Syndrome. Compression Fracture L1 2003ish. MVA years ago, sustained a compound fracture Lumbar area.

Medicalkid2
Regular Member


Date Joined Oct 2010
Total Posts : 147
   Posted 10/13/2011 4:29 PM (GMT -6)   
I used to and still do volunteer in local law enforcement and have gone on quite a few traffic stops. Its disgusting the amount of narcotics officers pull of people of EVERY age. I'm serious too. Its a pretty wealthy area too with plenty of respectable physicians. But when I was in high school the given was talk about ADHD stimulants as I think about %70 of kids had a valid script...I would go into the nurses office and they had a cabinet chalked full of bottles labeled "CONTROLLED SUBSTANCE". Then I would hear tons of talk about OxyContin, Vicodin, etc. Most kids didn't know much about it but boy allot of people seamed to have it and use it. It always bothered me because kids would get stupid large amounts of it. (Edited for language) One girl about 17 had a 20mg 2x a day OxyContin script for fibromyalgia she had for a year...she was started on OxyContin from the start and even admitted she didn't need it but it was "like her antidepressants" in a semi-sarcastic tone. Only reason I know the details is because she came in pissed one day when her new doctor refused to write for it and wanted to switch her to Tylenol #3. Then of course allot of football players would talk about Vicodin and what not but thats a given if you look at the entire NFL's narcotics use statistics. I heard about a few kids with pain problems but becoming addicted and having there parents basically lock there pain killers away and manage the whole issue. There were also allot of the druggies who would take Vicodin in really unsafe amounts not understanding that 2000mg of tylenol at once is not good for you.

Over all I can't comment on "pill mills" but I can say doctors need to (Edited for language) learn how to manage pain. I do not think everyone needs to go to a pain specialist; I mean come on an Internist; the type of doctor allot of people see as their primary s job is "to diagnose, treat and manage chronic diseases and ailments of the body with a focus on general medicine". I think once you have a diagnoses and a pain specialist has ruled out other treatments there should be no issues with an Internist or whoever you see as a primary, prescribing opiates should not be an issue if the doctor has any sense of good judgement...anyways that's just my opinion.


(Edited for language)
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Post Edited By Moderator (Screaming Eagle) : 10/13/2011 4:04:20 PM (GMT-6)


Sick_N_Tired
New Member


Date Joined Oct 2011
Total Posts : 14
   Posted 10/13/2011 7:57 PM (GMT -6)   
Imme hit the nail on the head as far as I'm concerned. It's all about the money. The DEA and other agencies have to maintain or increase their budget, it can never go the other way. Money from arrests, and legal/court/disciplinary fees. Lobbyists for privatized prisons and their private suppliers of food, blankets, ect...Our lives are driven by others quest for the almighty dollar at any expense.

You are also right in that once a law is on the books, it doesn't matter if it infinges on your rights as human being or takes away your freedom as an american, you will most likely never see the law removed.

Of course these are just my opinions, and do not intend on offending anyone. I just prefer freedom over a Nanny State. I don't want any government making my personal decisions or anyone else's. Even if my decision kills me, it's my decision.

Besides, if your always trying to protect people from themselves, you offset natural selection and breed stupity. Darwin was a smart guy :)
29 years old. Disc bulges at C3-C4, C4-C5, C5-C6, C6-C7, T3-T4, L3-L4, L4-L5, and L5-S1. Also, Cervical Sponylosis, and Disc Desiccation or DDD. Migraine headaches when cervical pain not managed.

4 x 10.5/325 vicodin daily (at most)

2(sometimes 3) x 350mg Soma daily (at most) (having difficulty obtaining this prescription at the moment)

sore42long
Regular Member


Date Joined Apr 2011
Total Posts : 235
   Posted 10/13/2011 9:20 PM (GMT -6)   
I'm in canada ,and its much the same here !I wish there was a patch to wear that would kill the pain .I try to be so careful with meds as narcotics are not good for the body ,yet so necessary for helping ease CP.I too blame the media for the hype. Its sad the abuse of pain meds and people making money from illegal sales and not caring about consequences.
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