#NoMorePain Bill, Limiting the Prescription of Opioids

[Anonymous]

Anonymous wrote:I don't know if that's the answer, but doctors really do need to limit their prescriptions.
I had minor surgery last week. No significant pain at the hospital (I was asked about a million times) They gave me prescription strength ibuprofin just in case, which made sense and for which I was grateful. They sent me home with two prescriptions - one for 24 of the prescription ibuprofin and one for TEN pills of oxycodone. Keep in mind that not only did I not request that, but that I specifically said I wasn't in pain and that the ibuprofin was doing a fine job of managing it.

I didn't end up taking any of the oxycodone and turned it in this weekend at the drug take back events (good timing). But why in the world did I get it at all? And why did I get 10 of them instead of just one or two? My doc had told me before surgery that I'd probably be able to go back to work the next day, so it's not like I had some kind of miraculous recovery.

The whole thing was really startling to me.

You had surgery. Frequently the medication you get at the hospital is stronger than you think and when it wears off at home you are caught off guard. 10 oxy (at I assume like 5 or 10 mg?) is enough for like...2 and a half days tops. It is what I was given after leaving the hospital after a c section and they wouldn't refill it when it was through. No one is getting hooked on oxy in 10 pills unless you already have a problem and surgery is (IMO) a legit reason to provide a patient a couple days worth of decent pain relief that they can use on their own time and not have to come back to the doctor to get.

[Anonymous]

Anonymous wrote:This is nuts. People who legitimately need these meds should not have to jump through hoops. Criminal druggies popping the pills for fun and killing themselves in no way, shape, or form justifies taking drugs away from those that actually need them.

Exactly, this crap of one solution fits all is stupid and negligent.

[Anonymous]

One of my siblings is a surgeon at a top practice in a large American city. The older, middle-age, and young doctors in her practice discuss their experiences and have noted that as diagnosis, tools, and treatment has become more targeted, more precise, and less intrusive, the pain medications have - somewhat paradoxically - become even stronger.

Patients born before 1980 seem to be okay with being prescribed old-fashioned Advil, Bayer, Motrin, or even Tylenol for outpatient use and recovery, perhaps because they developed a stronger tolerance for pain. Those born after about 1980 seem to prefer a prescription for the opioids because they equate stronger with better.

The physicians in her surgical group, and at her hospital, are now generally of the consensus that stronger is not better, and that the destruction caused by opioid abuse far outweighs their medical benefits overall. They have adopted a new, wholistic, and more "natural" approach to pain management that encourages less strong forms of chemical intervention, and alternative therapies like cognitive behavior exercises and meditation. The practice is thriving and their patients approve of the new approach.

[Anonymous]

Do we want government in our healthcare?

[Anonymous]

Anonymous wrote:

Anonymous wrote:#NoMorePain or #StopthePain.

Congressional Legislators with morality and strength of character need to introduce the #NoMorePain Bill immediately. The No More Pain Bill would mandate that opioids cannot be prescribed for more than a 10-day supply. After that, any re-prescribing of opioids to the same person within a two-year period, must be administered at the physician's office and under physician supervision on a daily basis.

A universal pharmaceutical records patient database can be established and maintained for opioids only, in order to check that one patient does not repeatedly obtain a single prescription via multiple doctors. And the obligation that a physician administer any subsequent prescriptions on a daily basis, takes away a physician's argument that they just did not know.

The medical profession has already accepted as standard practice the recent, professionally-recommended, and voluntary limits on the over-prescription of antibiotics in order to prevent patient overuse and the subsequent development of antibiotic-resistant bacteria.

The medical profession needs to similarly accept new, legally-imposed limits on the over-prescription of opioids to prevent patient overuse and the subsequent development of drug addictions.

Exceptions should be introduced for Cancer treatment, and End-of-Life care, though many of those pain treatments are currently administered in a hospital or hospice settings and under medical supervision in any case.

I would amend the proposed Bill so that a physician can order a second 10-day prescription with just a simple office visit, but that a third 10-day represcription within a one-year period is entered into the opioid prescription database, and is subject to review by an independent physician.

The professionally-recommended limits on the prescription of antibiotics has resulted in cases of serious complications or even death where antibiotics should have been prescribed earlier, but were withheld for fear of antibiotic resistance. However, generally speaking it is viewed as a positive thing for the population at large.

Similarly, there will be examples of persons inconvenienced by the withholding and greater restrictions on opioids, but for the population at large it will be a positive thing. Just take a moment to talk to the millions of Americans whose lives have been forever and indelibly impacted by the scourge of addiction.

The right thing to do always involves sacrifice by some individuals for the greater good of the many, and it will be hard.

I lean toward an approach that marries a more restricted ability to prescribe (open and unrestricted prescriptions for a 21-day supply), and more medical tracking and oversight for cases of prescriptions beyond those three weeks, with exemptions for aggressive Cancers and late-term care. A medical expert on opioids who appeared on a recent NPR show, said that prescribed opioid use beyond three weeks, is where one starts to see problems with abuse and addiction.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:#NoMorePain or #StopthePain.

Congressional Legislators with morality and strength of character need to introduce the #NoMorePain Bill immediately. The No More Pain Bill would mandate that opioids cannot be prescribed for more than a 10-day supply. After that, any re-prescribing of opioids to the same person within a two-year period, must be administered at the physician's office and under physician supervision on a daily basis.

A universal pharmaceutical records patient database can be established and maintained for opioids only, in order to check that one patient does not repeatedly obtain a single prescription via multiple doctors. And the obligation that a physician administer any subsequent prescriptions on a daily basis, takes away a physician's argument that they just did not know.

The medical profession has already accepted as standard practice the recent, professionally-recommended, and voluntary limits on the over-prescription of antibiotics in order to prevent patient overuse and the subsequent development of antibiotic-resistant bacteria.

The medical profession needs to similarly accept new, legally-imposed limits on the over-prescription of opioids to prevent patient overuse and the subsequent development of drug addictions.

Exceptions should be introduced for Cancer treatment, and End-of-Life care, though many of those pain treatments are currently administered in a hospital or hospice settings and under medical supervision in any case.

I would amend the proposed Bill so that a physician can order a second 10-day prescription with just a simple office visit, but that a third 10-day represcription within a one-year period is entered into the opioid prescription database, and is subject to review by an independent physician.

The professionally-recommended limits on the prescription of antibiotics has resulted in cases of serious complications or even death where antibiotics should have been prescribed earlier, but were withheld for fear of antibiotic resistance. However, generally speaking it is viewed as a positive thing for the population at large.

Similarly, there will be examples of persons inconvenienced by the withholding and greater restrictions on opioids, but for the population at large it will be a positive thing. Just take a moment to talk to the millions of Americans whose lives have been forever and indelibly impacted by the scourge of addiction.

The right thing to do always involves sacrifice by some individuals for the greater good of the many, and it will be hard.

I lean toward an approach that marries a more restricted ability to prescribe (open and unrestricted prescriptions for a 21-day supply), and more medical tracking and oversight for cases of prescriptions beyond those three weeks, with exemptions for aggressive Cancers and late-term care. A medical expert on opioids who appeared on a recent NPR show, said that prescribed opioid use beyond three weeks, is where one starts to see problems with abuse and addiction.

I hate to say this, but 21 days is long enough to get addicted and build a chemical dependence, especially for stronger dosages.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:#NoMorePain or #StopthePain.

Congressional Legislators with morality and strength of character need to introduce the #NoMorePain Bill immediately. The No More Pain Bill would mandate that opioids cannot be prescribed for more than a 10-day supply. After that, any re-prescribing of opioids to the same person within a two-year period, must be administered at the physician's office and under physician supervision on a daily basis.

A universal pharmaceutical records patient database can be established and maintained for opioids only, in order to check that one patient does not repeatedly obtain a single prescription via multiple doctors. And the obligation that a physician administer any subsequent prescriptions on a daily basis, takes away a physician's argument that they just did not know.

The medical profession has already accepted as standard practice the recent, professionally-recommended, and voluntary limits on the over-prescription of antibiotics in order to prevent patient overuse and the subsequent development of antibiotic-resistant bacteria.

The medical profession needs to similarly accept new, legally-imposed limits on the over-prescription of opioids to prevent patient overuse and the subsequent development of drug addictions.

Exceptions should be introduced for Cancer treatment, and End-of-Life care, though many of those pain treatments are currently administered in a hospital or hospice settings and under medical supervision in any case.

I would amend the proposed Bill so that a physician can order a second 10-day prescription with just a simple office visit, but that a third 10-day represcription within a one-year period is entered into the opioid prescription database, and is subject to review by an independent physician.

The professionally-recommended limits on the prescription of antibiotics has resulted in cases of serious complications or even death where antibiotics should have been prescribed earlier, but were withheld for fear of antibiotic resistance. However, generally speaking it is viewed as a positive thing for the population at large.

Similarly, there will be examples of persons inconvenienced by the withholding and greater restrictions on opioids, but for the population at large it will be a positive thing. Just take a moment to talk to the millions of Americans whose lives have been forever and indelibly impacted by the scourge of addiction.

The right thing to do always involves sacrifice by some individuals for the greater good of the many, and it will be hard.

I lean toward an approach that marries a more restricted ability to prescribe (open and unrestricted prescriptions for a 21-day supply), and more medical tracking and oversight for cases of prescriptions beyond those three weeks, with exemptions for aggressive Cancers and late-term care. A medical expert on opioids who appeared on a recent NPR show, said that prescribed opioid use beyond three weeks, is where one starts to see problems with abuse and addiction.

I hate to say this, but 21 days is long enough to get addicted and build a chemical dependence, especially for stronger dosages.

I agree with you, which is why I think that only a two-week (14-day) supply should be allowed to be prescribed without oversight or restrictions, but with registry onto an opioid prescription database. Patients with aggressive and late-stage Cancers, and End-of-Life care can be exempted from the 14-day rule, and allowed a 30-day prescription for their outpatient or hospice care.

After the initial 14-day or 30-day opioid prescription is consumed, a patient would have to been seen by a physician in order to obtain any more opioids. Physicians would be encouraged to transition their patients to OTC pain medication at that point, including Aspirin, Advil, Motrin, or Tylenol. If the physician decides that another opioid prescription is warranted, that prescription can only be extended week-by-week (with a physician's visit required for each extension), the order would have to be entered into the opioid prescription database, and it would have to be approved by an independent medical reviewer.

The incredible pain relief of an opioid versus and OTC painkiller for each additional week of a prescription, is vastly outweighed by the incredible pain caused by the likelihood of addiction of using an opioid verus an OTC painkiller for each additional week.

Restrictive opioid reform legislation will be VERY opposed by the pharmaceutical companies who earn incredible corporate profits on such opioids, but the personal costs of opioid addiction to Americans is too high to bear any longer.

[Anonymous]

Stupid question: why do we need to control it? Let the people who wants to OD die. The smart person would never ever become addict. People who become addicts are worthless for the society anyway. I think it is so much better for the country overall to get rid of them (or rather let them kill themselves). What is the point of treating them? Do we have any recovered addict who made some significant contribution to this society?

[Anonymous]

Anonymous wrote:

Anonymous wrote:#NoMorePain or #StopthePain.

Congressional Legislators with morality and strength of character need to introduce the #NoMorePain Bill immediately. The No More Pain Bill would mandate that opioids cannot be prescribed for more than a 10-day supply. After that, any re-prescribing of opioids to the same person within a two-year period, must be administered at the physician's office and under physician supervision on a daily basis.

A universal pharmaceutical records patient database can be established and maintained for opioids only, in order to check that one patient does not repeatedly obtain a single prescription via multiple doctors. And the obligation that a physician administer any subsequent prescriptions on a daily basis, takes away a physician's argument that they just did not know.

The medical profession has already accepted as standard practice the recent, professionally-recommended, and voluntary limits on the over-prescription of antibiotics in order to prevent patient overuse and the subsequent development of antibiotic-resistant bacteria.

The medical profession needs to similarly accept new, legally-imposed limits on the over-prescription of opioids to prevent patient overuse and the subsequent development of drug addictions.

Exceptions should be introduced for Cancer treatment, and End-of-Life care, though many of those pain treatments are currently administered in a hospital or hospice settings and under medical supervision in any case.

I would amend the proposed Bill so that a physician can order a second 10-day prescription with just a simple office visit, but that a third 10-day represcription within a one-year period is entered into the opioid prescription database, and is subject to review by an independent physician.

The professionally-recommended limits on the prescription of antibiotics has resulted in cases of serious complications or even death where antibiotics should have been prescribed earlier, but were withheld for fear of antibiotic resistance. However, generally speaking it is viewed as a positive thing for the population at large.

Similarly, there will be examples of persons inconvenienced by the withholding and greater restrictions on opioids, but for the population at large it will be a positive thing. Just take a moment to talk to the millions of Americans whose lives have been forever and indelibly impacted by the scourge of addiction.

The right thing to do always involves sacrifice by some individuals for the greater good of the many, and it will be hard.

I’m not sure I agree with “inconveniencing” people with legitimate pain, peole with serious injuries, people severe, chronic pain, and my 90 year old grandmother who has an opioid prescription and who can’t drive and needs to take an oxygen tank with her when she leave the house, but is not end of life, for the greater good of addicts. I’m all for treating addiction, not jailing people. But I don’t think they should take priority over people legitimately using opioids responsibly.

[Anonymous]

I broke my neck last year and the opioids were a life saver. Perhaps literally. It was a month before the cord swelling went down enough so they could surgically repair it. It was very painful. I feel like I would just be collateral damage to the people wanting the government to set medical procedures. I had a good doctor and now am in great shape. Glad it happened before you people “fixed” the problem

[Anonymous]

Ok you Naysayers,

How exactly would you propose to address the opioid epidemic?

[Anonymous]

Anonymous wrote:
Ok you Naysayers,

How exactly would you propose to address the opioid epidemic?

Hold the abusive prescribers criminally responsible.

The way our medical system is set up makes it a disincentive to actually spend time with a patient. They need to move patients in and out as fast as possible. So it's easier to just prescribe pain killers and walk them out the door, instead of spending time counseling and educating each patient. Build something into the system to encourage prescribers to provide this counseling.

Doctors should be educated on addiction the same way they are educated on pain management. They need to more precisely prescribe the estimated amount to cover the need, and not overprescribe.

Patients need to be counseled on what to do with the drugs if they don't use them all. Physician offices, pharmacies, and other medical facilities should be set up to take back unused medications and dispose of them properly.

Invest in addiction treatment with proven results. Not just a 7 day detox program, but inpatient treatment to help truly resolve the addition. And that's going to take some $$$ unfortunately.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Ok you Naysayers,

How exactly would you propose to address the opioid epidemic?

Hold the abusive prescribers criminally responsible.

The way our medical system is set up makes it a disincentive to actually spend time with a patient. They need to move patients in and out as fast as possible. So it's easier to just prescribe pain killers and walk them out the door, instead of spending time counseling and educating each patient. Build something into the system to encourage prescribers to provide this counseling.

Doctors should be educated on addiction the same way they are educated on pain management. They need to more precisely prescribe the estimated amount to cover the need, and not overprescribe.

Patients need to be counseled on what to do with the drugs if they don't use them all. Physician offices, pharmacies, and other medical facilities should be set up to take back unused medications and dispose of them properly.

Invest in addiction treatment with proven results. Not just a 7 day detox program, but inpatient treatment to help truly resolve the addition. And that's going to take some $$$ unfortunately.

They should never be allowed to participate in Medicare, Medicaid, VA, or any other government health system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don't know if that's the answer, but doctors really do need to limit their prescriptions.
I had minor surgery last week. No significant pain at the hospital (I was asked about a million times) They gave me prescription strength ibuprofin just in case, which made sense and for which I was grateful. They sent me home with two prescriptions - one for 24 of the prescription ibuprofin and one for TEN pills of oxycodone. Keep in mind that not only did I not request that, but that I specifically said I wasn't in pain and that the ibuprofin was doing a fine job of managing it.

I didn't end up taking any of the oxycodone and turned it in this weekend at the drug take back events (good timing). But why in the world did I get it at all? And why did I get 10 of them instead of just one or two? My doc had told me before surgery that I'd probably be able to go back to work the next day, so it's not like I had some kind of miraculous recovery.

The whole thing was really startling to me.

You had surgery. Frequently the medication you get at the hospital is stronger than you think and when it wears off at home you are caught off guard. 10 oxy (at I assume like 5 or 10 mg?) is enough for like...2 and a half days tops. It is what I was given after leaving the hospital after a c section and they wouldn't refill it when it was through. No one is getting hooked on oxy in 10 pills unless you already have a problem and surgery is (IMO) a legit reason to provide a patient a couple days worth of decent pain relief that they can use on their own time and not have to come back to the doctor to get.

My DH was given a 6 week supply of oxy when he had Lyme disease. The pharmacist escourted me to my car because of the street value. DH didn’t get addicted either. Not sure how much one would need to take to get addicted.

[Anonymous]

Anonymous wrote:Stupid question: why do we need to control it? Let the people who wants to OD die. The smart person would never ever become addict. People who become addicts are worthless for the society anyway. I think it is so much better for the country overall to get rid of them (or rather let them kill themselves). What is the point of treating them? Do we have any recovered addict who made some significant contribution to this society?

While in some ways I feel we should just do mass incarceration like we did during the crack epidemic, the cost to our society is far greater than the cost of prevention.