I had a conversation with a chronic pain pt .. who I had suggested that the pt get a copy of the definition of palliative care and a copy of the new CDC opiate prescribing guidelines .. specifically the section that exempts those who have cancer, terminal or under palliative care from the daily limits of morphine equivalent limits.
The pt took these two pieces of information, highlighted the appropriate context and showed to the prescriber. Apparently bringing this information to the prescriber apparently caused a little bit of a “commotion” by most of the clinic’s staff.
The pt was interested in getting their opiate dosage increased. Apparently this particular prescriber and/or the clinic that the prescriber worked in… did not care if there is an “exception” to the “cookie cutter rule” of a max of 90 mgs of Morphine equivalents for pts… Which in the first place are “GUIDELINES” and do not bear the weight of law.
So it would appear that some prescribers… are treating GUIDELINES as RULES/LAWS and then will “slice/dice” the GUIDELINES as to which parts they elect to follow and what is appropriate pt care… is of little concern.. and avoiding any potential harm to the prescriber’s license/lifestyle dominates the prescriber’s pt care protocol.
Filed under: General Problems
This patient must have the same doctor that I do. My doctor has repeatedly told me that it would be against the law for her to do anything more than she is already doing for me. I even pointed out that the state she practices in has GUIDELINES of their own that state that if she, the provider, feels that going over the 90mg MED is NECESSARY, that she may do so by requesting an exemption. She told me she had no idea what I was talking about (even though the website that I read that on was a STATE website) and blew me off. I have been fighting this since before the gov put their guidelines out. She had me on a much higher dose and I had another medication that was supposedly for pain and was actually causing more pain due to the fact that my body reacts very strangely to a whole lot of medications. I told her that the other medication was actually causing me harm and she reluctantly took me off of it, but only after she cut down my pain meds. Guess what? Elimination of the offending medication brought some of the pain down, but the drop in my pain meds was repeated by the pain management that I subsequently saw and I have had other pain causing issues arise since then. NO ONE and I mean no one, wants to do any diagnostic testing on me. I believe that is because if they were to find something, it would substantiate my “claim” of being in more pain. So here I sit, on just barely enough pain medication to get me out of bed. I sit in my chair for 14 hours a day and have told my doc that, but she is terrified of losing her license, so she declines, no REFUSES, to help me. I am only 37 and the thought of “living” this way until the day I die TERRIFIES ME. As long as she has her license, it doesn’t matter if I exist this way until I die, I guess. I spoke with her about dosage adjustment so that I could attempt to work, originally. She shot me down so here comes foreclosure. She apparently does not care that my children will have nowhere to live with winter coming on either. Chronic pain affects the ENTIRE FAMILY. Those whom we are supposed to trust, literally, with our lives, could care less as long as they keep their licenses. This world has gone bat poo crazy.
Brokesoul ….I sorry for your pain issues. I also sit in so much pain but I’m in Palliative Care in Olympia, WA . They keep you in pain so it is so hard to get around. Oh yes this is Palliative Care in Washington state I am afraid to see Hospice care here. They may been worried a drug addict will sneak in on them. The problem is they wouldn’t know a drug addict if they seen one. They are the only ones getting help with medication. I’m sorry but I’m so angry about what this government has done to me. I really don’t think we have a human being in office.
One thing I have thought about is where is the polititicans families getting their medications. You know they have family members who are older and have chronic pain issues. This would be very good to know. It could open things up for chronic pain community . I have always wondered .i would like it on equal ground.
BINGO,,, dead on,,,this article is,,,mary
This has been going on since the CDC guideline have been out. In fact doctors who have prescribe to a patient for years have taken it upon themselves to just cut patients completely off. Many times with no taper even though the CDC states in the guidelines that the taper should be slow and for some who have been on opiate for years and/or a large may take many months or even up to a year to taper down. In fact, in some state’s the politicians have taken it upon themselves to come up with laws that have even worse limits for those who depend on opiates to help manage there chronic pain. Doctors and politicians have decided that the way to deal with the increase of addiction and deaths from OD’s is to not do what will work (and unfortunately cost more at least short term) but to view it as if we get rid of the drug so will the problem. Anyone who knows anything about addiction knows the drug or substance is just part of the picture. Without education, long term treatment, and treating addiction as a disease instead of a moral issues that cause many to think it’s all their fault those death will continue. Unfortunately I doubt there is a way to save everyone because some have such denial (part of the disease) that they can be on deaths door and still think they do not have a addiction problem.