#NoMorePain Bill, Limiting the Prescription of Opioids

[Anonymous]

#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.

[Anonymous]

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.

On a daily basis? Uh no. As a former cancer patient I needed my powerful opioids for weeks until the cancer meds started winning. I could not function without the opioids and I am genuinely worried about this crackdown. Especially with a cancer is under control now, but will return, this idea really worries me.

[Anonymous]

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.

[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.

On a daily basis? Uh no. As a former cancer patient I needed my powerful opioids for weeks until the cancer meds started winning. I could not function without the opioids and I am genuinely worried about this crackdown. Especially with a cancer is under control now, but will return, this idea really worries me.

I may be mistaken, but I think cancer patients are exempt from most of the opiod control regulations.

[Anonymous]

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.

No thanks. I have chronic migraines. I get 15 of the lowest strength Vicodin (take 1-2 every 6 hours) a month. I have taken this dose for 20 years and the use has not escalated. As it is, I have to go to the doctors office every month to get a prescription. They see me, ask if anything has changed. Write a prescription. I leave. 5 minutes, except the half hour to and from, and the wait. Huge PITA. They cannot call a prescription in. They cannot do refills. They have to do random urine screenings. I have to keep a prescription of Narcan on hand. For enough Vicodin to treat sever migraines about 3 times a month. And I also do Botox. Nerve ablutions. Take preventative. Use Imitrex. Etc. Legit, above board headaches.

So now you want me to drive a half hour each way and sit in a doctors office to be handed the pills. And go back in 6 hours for a second dose if I need it. Should I drive with a migraine? Should I drive on Vicodin? Should my husband take off work once a week and drive me?

Come on. There are a lot of legitimate pain patients out there managing chronic pain. The opioid epidemic is serious. But sometime I can go two weeks without needing a Vicodin. I am not the opioid epidemic. Enough already.

[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.

I'm in health care, and can tell you that. Back in the old days, I could give someone a prescription for ibuprofen and maybe tylenol#3, and know that if those meds didn't control pain, I could call in a different medication. The DEA etc decided a few years ago that oxycodone, vicodin, percocet etc could no longer be called in to pharmacies, but required a written rx. So if a patient calls me at 9 pm at night, in pain, my recourse now is to sent them to the ER or urgent care, where they incur extra costs. I'm not going in to the empty office at 9pm to give a patient a physical prescription; that's not safe for me. I may tell the patient to hold on to the prescription paper for the opioid until they figure if they need it or not. I also tell them that those prescriptions expire, which they do. So the DEA's effort to limit prescriptions actually leads me to write more opioids than I used to. SAD but true

[Anonymous]

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.

that's ridiculous for a ton of reasons
just a few
1. cost to patients if they have to travel to a medical office daily, missing work
2. cost to patients for the added services /employees needed to dispense meds. That task isn't going to be delegated to a medical assistant, so the office will have to employ nurses or physician assistants
3. Medical offices will become targets for robbery if drugs are routinely stored on the premises
4. physicians may need to register with the board of pharmacy and pay to enhance security if they're storing narcotics inhouse

[Anonymous]

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.

[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.

I'm in health care, and can tell you that. Back in the old days, I could give someone a prescription for ibuprofen and maybe tylenol#3, and know that if those meds didn't control pain, I could call in a different medication. The DEA etc decided a few years ago that oxycodone, vicodin, percocet etc could no longer be called in to pharmacies, but required a written rx. So if a patient calls me at 9 pm at night, in pain, my recourse now is to sent them to the ER or urgent care, where they incur extra costs. I'm not going in to the empty office at 9pm to give a patient a physical prescription; that's not safe for me. I may tell the patient to hold on to the prescription paper for the opioid until they figure if they need it or not. I also tell them that those prescriptions expire, which they do. So the DEA's effort to limit prescriptions actually leads me to write more opioids than I used to. SAD but true

Wow.
On a related story, DD had serious surgery on both legs and was prescribed oxycodone for one week, which she needed to be able to tolerate the pain and the movements she needed to do afterwards. On about Day 5 one leg swelled out of control and she had to be brought to the ER unable to walk due to the pain. In consulation with her surgery team and the ER doctors, they treated and released her. She asked whether she should extend her prescription at the ER because she had to restart her recovery. The ER offered to do it because she was in such bad shape. Her surgery team said not to worry about the script they would extend it later. She decided to just wait - of course she was drugged up in the ER. Two days later, she called the surgery team and they told her they would extend it, but then called her back and said state law prohibited them from prescribing it even if they saw her again. Her only option was to go back to the ER and have them prescribe it. She still couldn't walk. What did she do? She got some more off the street through friends. She never took them, but just having them helped calm her down. She toughed it out using non-opioids, but that delayed her recovery and PT because she wasn't able to push the legs far enough. The doctors felt bad for her, but there was nothing they could do. How about we trust the doctors with these decisions - especially in small amounts less than a week for obviously acute conditions.

[Anonymous]

Nothing nearly as extreme as cancer, but my mother had surgery and needed strong pain killers (in ever decreasing amounts) for a couple of months afterwards.

Really, why don’t we go the other direction and just legalize/stop restricting drugs? It’s hard to imagine the addiction problem getting worse, destigmatizing it could make it easier to addicts to get help, and those who genuinely need them medically would have access.

[Anonymous]

So we want legitimate pain patients to go in every single day. To see a doctor or PA. To hand them pills and charge insurance $200 for an office visit.

And no one can figure out why the cost of healthcare is through the roof in this county.

[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.

On a daily basis? Uh no. As a former cancer patient I needed my powerful opioids for weeks until the cancer meds started winning. I could not function without the opioids and I am genuinely worried about this crackdown. Especially with a cancer is under control now, but will return, this idea really worries me.

Agreed. I'm the caregiver now to my husband, who just suffered a traumatic brain injury a week ago. He's on Tramadol for really bad pain. I can barely move him to the bathroom to pee, much less get him to a doctor's office daily for the meds.

I can see prohibiting mail order. And I can see tightening pharmacy computer systems so that they don't allow multiple prescriptions. I can even deal with picking up a week's supply at the doctor's office instead of a pharmacy. Lord knows I've been all over this county getting records and forms signed for him already. I'll drive. But daily med dispensing at a doctor's office? No way.

[Anonymous]

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.

[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.

I'm in health care, and can tell you that. Back in the old days, I could give someone a prescription for ibuprofen and maybe tylenol#3, and know that if those meds didn't control pain, I could call in a different medication. The DEA etc decided a few years ago that oxycodone, vicodin, percocet etc could no longer be called in to pharmacies, but required a written rx. So if a patient calls me at 9 pm at night, in pain, my recourse now is to sent them to the ER or urgent care, where they incur extra costs. I'm not going in to the empty office at 9pm to give a patient a physical prescription; that's not safe for me. I may tell the patient to hold on to the prescription paper for the opioid until they figure if they need it or not. I also tell them that those prescriptions expire, which they do. So the DEA's effort to limit prescriptions actually leads me to write more opioids than I used to. SAD but true

I'm that poster. Thanks so much for responding and for giving that insight. It definitely makes sense from your point of view - an important demonstration that sometimes the most well intentioned policies actually backfire.
I'm not sure what the answer is. I really don't think it was appropriate for me to be given that many opioids (and I will mention it to my doctor at the follow up) but I definitely see the conundrum now and understand why it happened.

[Anonymous]

Anonymous wrote:

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.

I'm in health care, and can tell you that. Back in the old days, I could give someone a prescription for ibuprofen and maybe tylenol#3, and know that if those meds didn't control pain, I could call in a different medication. The DEA etc decided a few years ago that oxycodone, vicodin, percocet etc could no longer be called in to pharmacies, but required a written rx. So if a patient calls me at 9 pm at night, in pain, my recourse now is to sent them to the ER or urgent care, where they incur extra costs. I'm not going in to the empty office at 9pm to give a patient a physical prescription; that's not safe for me. I may tell the patient to hold on to the prescription paper for the opioid until they figure if they need it or not. I also tell them that those prescriptions expire, which they do. So the DEA's effort to limit prescriptions actually leads me to write more opioids than I used to. SAD but true

I'm that poster. Thanks so much for responding and for giving that insight. It definitely makes sense from your point of view - an important demonstration that sometimes the most well intentioned policies actually backfire.
I'm not sure what the answer is. I really don't think it was appropriate for me to be given that many opioids (and I will mention it to my doctor at the follow up) but I definitely see the conundrum now and understand why it happened.

Earlier poster back again. I forgot to add that failure to relieve pain can leave you open, as a practitioner, to board inquiry, for patient abandonment or other complaints. If most people would take opioids after the surgery you had, I don't want to be explaining to peer review why I omitted giving some to you