Hello There, Guest! Login Register
Index    |     Search    |     Members    |     Help

Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
DEA to reduce painkiller Rx by 20%...
#1
https://www.dea.gov/divisions/hq/2017/hq080417.shtml
In response to the wide spread opioid abuse by physicians and Drug firms the DEA is proposing a reduction in the availability of painkiller meds in the U S by 20% next year.

For information on how The public can submit written and electronic comments about this proposal go here:
https://www.federalregister.gov/document...essment-of
Or here
https://www.deadiversion.usdoj.gov/fed_r...fr0804.htm
 
Reply
#2
(08-05-2017, 08:52 AM)1171 Wrote: https://www.dea.gov/divisions/hq/2017/hq080417.shtml
DEA is proposing a reduction in the availability of painkiller meds in the U S by 20% next year.

For information on how The public can submit written and electronic comments about this proposal go here:
https://www.federalregister.gov/document...essment-of
Or here
https://www.deadiversion.usdoj.gov/fed_r...fr0804.htm

I wonder if this will drive up prices.

The DEA relying on FDA data? OK good luck with that.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
Reply
#3
street prices may increase sooner; formularies are much slower to change.
I suspect demand is high world wide and the manufacturers will just re-allocate production to other growing unregulated markets.
this just confirms the narrative from patients: previous levels of painkillers are/will be more difficult to obtain.
generally other forms of self-medication will replace them; hopefully more benign and less expensive (probably/maybe cannabis).

I wonder how long before marijuana will be a covered substitute. i believe the opioid problems lead to change medical reluctance and acceptance of its legalization.
 
Reply
#4
(08-05-2017, 01:11 PM)1171 Wrote: street prices may increase sooner; formularies are much slower to change.
I suspect demand is high world wide and the manufacturers will just re-allocate production to other growing unregulated markets.
this just confirms the narrative from patients: previous levels of painkillers are/will be more difficult to obtain.
generally other forms of self-medication will replace them; hopefully more benign and less expensive (probably/maybe cannabis).

I wonder how long before marijuana will be a covered substitute. i believe the opioid problems lead to change medical reluctance and acceptance of its legalization.

It appears like it may be moving in that direction.

I am REALLY worried about the plight of CA IW's. There are caps on other treatments that can relieve pain and increase function, such as physical therapy, aqua therapy, message, chiro...and things like yoga are VERY difficult to get approvals. I understand this was due to the physicians who were taking advantage, however patients are suffering.

As you have read on this site some injured workers are getting cut off of medications by UR and/or IMR cold turkey or in dangerous ways. I try to offer guidance to injured workers, however both the CA WC request and appeals process is complex. It is not complex to just send in the IMR as many injured workers and attorney's are doing without providing anything else in hope doing this action will lead to an occasional overturned decision. This system is complex in the sense of what is now needed to be included, medical treatments guidelines, relevant medical records, and a knowledge of how to overcome the reasoning used to deny the request, or the foresight and knowledge to know and anticipate the boilerplate denials being used and include rational so they cannot be used. It is too much for most WC physicians to do for every patient and every request. They would go bankrupt. Many MPN physicians do not have the skillset or knowledge.

In makes my heart hurt to read the stories of injured workers who are on limited income such as SSDI, and who are paying for pain medications out of pocket. In a recent post the IW stated they get refills when they can afford it. I can ONLY imagine what that is like going off and on medication, and the resulting possible withdrawals that may occur as a result.

I am also very aware that there is an overprescribing of Opioids which also causes harm to patients. With pain being subjective, and having limited other alternatives for treatment I can also see the dilemma physicians face in the CA WC system. I do not have an answer, but I am well aware of the dangers of cutting off patients cold turkey.

There was a case in CA WC that was attempting to hold the UR physician responsible for his actions on a UR determination caused the patient harm. I have not kept up on the status of this case. Do you know 1171?
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
Reply
#5
No I haven't followed the case.
They do need to open up restrictions on non-opioids if they are going to omit the meds; shouldn't shut it all down. But cost conscious employers and big business have more clout these days. Options are becoming fewer.
Maybe it will inspire more workers across the country to start voting for their own interests?
 
Reply
#6
(08-05-2017, 06:28 PM)1171 Wrote: No I haven't followed the case.
They do need to open up restrictions on non-opioids if they are going to omit the meds; shouldn't shut it all down. But cost conscious employers and big business have more clout these days. Options are becoming fewer.
Maybe it will inspire more workers across the country to start voting for their own interests?

So many people vote against their best interest. I do not know if that will ever change.

For many CA IW's they are successfully shutting down all treatment or most treatment. It depends upon the carrier, but it is happening. For some it has made a recoverable injury into a lifetime disability.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
Reply
#7
(08-05-2017, 02:01 PM)California_Help Wrote:
(08-05-2017, 01:11 PM)1171 Wrote: street prices may increase sooner; formularies are much slower to change.
I suspect demand is high world wide and the manufacturers will just re-allocate production to other growing unregulated markets.
this just confirms the narrative from patients: previous levels of painkillers are/will be more difficult to obtain.
generally other forms of self-medication will replace them; hopefully more benign and less expensive (probably/maybe cannabis).

I wonder how long before marijuana will be a covered substitute. i believe the opioid problems lead to change medical reluctance and acceptance of its legalization.

It appears like it may be moving in that direction.

I am REALLY worried about the plight of CA IW's. There are caps on other treatments that can relieve pain and increase function, such as physical therapy, aqua therapy, message, chiro...and things like yoga are VERY difficult to get approvals. I understand this was due to the physicians who were taking advantage, however patients are suffering.

As you have read on this site some injured workers are getting cut off of medications by UR and/or IMR cold turkey or in dangerous ways. I try to offer guidance to injured workers, however both the CA WC request and appeals process is complex. It is not complex to just send in the IMR as many injured workers and attorney's are doing without providing anything else in hope doing this action will lead to an occasional overturned decision. This system is complex in the sense of what is now needed to be included, medical treatments guidelines, relevant medical records, and a knowledge of how to overcome the reasoning used to deny the request, or the foresight and knowledge to know and anticipate the boilerplate denials being used and include rational so they cannot be used. It is too much for most WC physicians to do for every patient and every request. They would go bankrupt. Many MPN physicians do not have the skillset or knowledge.

In makes my heart hurt to read the stories of injured workers who are on limited income such as SSDI, and who are paying for pain medications out of pocket. In a recent post the IW stated they get refills when they can afford it. I can ONLY imagine what that is like going off and on medication, and the resulting possible withdrawals that may occur as a result.

I am also very aware that there is an overprescribing of Opioids which also causes harm to patients. With pain being subjective, and having limited other alternatives for treatment I can also see the dilemma physicians face in the CA WC system. I do not have an answer, but I am well aware of the dangers of cutting off patients cold turkey.

There was a case in CA WC that was attempting to hold the UR physician responsible for his actions on a UR determination caused the patient harm. I have not kept up on the status of this case. Do you know 1171?
Work comp is doing just that, sending me letters stating "patient has two weeks of medication and no further medication will be approved". I was not given any "weaning guidelines" as stipulated in the denial letter... my pain mgmt nurse practitioner never offered me a guideline/schedule.  I just did it on my own. It took 3 months to feel normal. what I experienced was: an emergency room visit due to heart  fluctuation, heart palpitations, uncontrollable shaking in the middle of the night for no reason... I'm currently not on any pain medication. Recently after a severe flare up I was given half of a norco 5/350. I felt sick to my stomach.  
There are many people I know who are unable to afford medication and are quietly suffering in pain, I for one am one of those people. There are times that pain medication is too expensive $163 for 30 tab of norco and 30 tabs of zanaflex. 
What gets me so upset is the fact, going to an ER for pain flare ups only to be told "your a chronic pain mgmt patient... the ER is not for you! Get your pain doctor to give you a prescription the emergency is for people who are in immediate pain or injured or sick... this is your warning and we will be marking your chart as well!"  Imagine sitting on a gurney, crying in pain, and the doctor is reprimanding you in front of nurses and other patients and my son.  The government has no right in telling my doctor what he can and cannot prescribe for a patient.  Ok that's my two cents.
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#8
Put your opinion in writing in the public comment section of the proposal. It's your government too; you have a say in what happens.
You can also file a complaint with the medical board
http://www.mbc.ca.gov/Consumers/Complaints/
And the DWC
http://www.dir.ca.gov/dwc/DWC_FilingAComplaint.htm
 
Reply
#9
(08-12-2017, 03:19 AM)Babebahn Wrote:
(08-05-2017, 02:01 PM)California_Help Wrote:
(08-05-2017, 01:11 PM)1171 Wrote: street prices may increase sooner; formularies are much slower to change.
I suspect demand is high world wide and the manufacturers will just re-allocate production to other growing unregulated markets.
this just confirms the narrative from patients: previous levels of painkillers are/will be more difficult to obtain.
generally other forms of self-medication will replace them; hopefully more benign and less expensive (probably/maybe cannabis).

I wonder how long before marijuana will be a covered substitute. i believe the opioid problems lead to change medical reluctance and acceptance of its legalization.

It appears like it may be moving in that direction.

I am REALLY worried about the plight of CA IW's. There are caps on other treatments that can relieve pain and increase function, such as physical therapy, aqua therapy, message, chiro...and things like yoga are VERY difficult to get approvals. I understand this was due to the physicians who were taking advantage, however patients are suffering.

As you have read on this site some injured workers are getting cut off of medications by UR and/or IMR cold turkey or in dangerous ways. I try to offer guidance to injured workers, however both the CA WC request and appeals process is complex. It is not complex to just send in the IMR as many injured workers and attorney's are doing without providing anything else in hope doing this action will lead to an occasional overturned decision. This system is complex in the sense of what is now needed to be included, medical treatments guidelines, relevant medical records, and a knowledge of how to overcome the reasoning used to deny the request, or the foresight and knowledge to know and anticipate the boilerplate denials being used and include rational so they cannot be used. It is too much for most WC physicians to do for every patient and every request. They would go bankrupt. Many MPN physicians do not have the skillset or knowledge.

In makes my heart hurt to read the stories of injured workers who are on limited income such as SSDI, and who are paying for pain medications out of pocket. In a recent post the IW stated they get refills when they can afford it. I can ONLY imagine what that is like going off and on medication, and the resulting possible withdrawals that may occur as a result.

I am also very aware that there is an overprescribing of Opioids which also causes harm to patients. With pain being subjective, and having limited other alternatives for treatment I can also see the dilemma physicians face in the CA WC system. I do not have an answer, but I am well aware of the dangers of cutting off patients cold turkey.

There was a case in CA WC that was attempting to hold the UR physician responsible for his actions on a UR determination caused the patient harm. I have not kept up on the status of this case. Do you know 1171?
Work comp is doing just that, sending me letters stating "patient has two weeks of medication and no further medication will be approved". I was not given any "weaning guidelines" as stipulated in the denial letter... my pain mgmt nurse practitioner never offered me a guideline/schedule.  I just did it on my own. It took 3 months to feel normal. what I experienced was: an emergency room visit due to heart  fluctuation, heart palpitations, uncontrollable shaking in the middle of the night for no reason... I'm currently not on any pain medication. Recently after a severe flare up I was given half of a norco 5/350. I felt sick to my stomach.  
There are many people I know who are unable to afford medication and are quietly suffering in pain, I for one am one of those people. There are times that pain medication is too expensive $163 for 30 tab of norco and 30 tabs of zanaflex. 
What gets me so upset is the fact, going to an ER for pain flare ups only to be told "your a chronic pain mgmt patient... the ER is not for you! Get your pain doctor to give you a prescription the emergency is for people who are in immediate pain or injured or sick... this is your warning and we will be marking your chart as well!"  Imagine sitting on a gurney, crying in pain, and the doctor is reprimanding you in front of nurses and other patients and my son.  The government has no right in telling my doctor what he can and cannot prescribe for a patient.  Ok that's my two cents.

If you want to change doctors you can. I recommend getting a pain management doctor (MD).

I am curious what medical malpractice attorney's would think about the actions of the emergency room and what resulted. (unknown) If this happened to me I would request any and all records from the hospital.

I do not know the status of a case where an attorney is trying to hold a CA WC UR doctor civilly responsible for their actions regarding cutting off several medications cold turkey. The patient lived however like you had to go to the ER due to severe withdrawals.

I hope to God these irresponsible UR and IMR people (not sure if actual doctors write all of the denials, will discuss this another time) do not kill a patient by putting them into withdrawal.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
Reply
#10
I'm in NYS and I have seen my pain management doctor for 6 years and have tried multiple injections and have decided to go with the permanent SCS for my lower back. During a consultation with my doctor 3 weeks ago he said that his office will be getting out of writing scripts for narcotics all together. I have neck and shoulder injuries that the SCS won't help and will still need pain meds from here on out. Seems we are running out of options as far as doctors for these meds that we drastically need to live day to day
 
Reply
  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Why is there going to be a hearing to reduce my earnings? kitty 3 2,335 03-29-2008, 08:46 PM
Last Post: kitty

Forum Jump:


Browsing: 1 Guest(s)