What suggestions would you give to the DEA?

umm....you dont need to bump a thread 15 minutes after you posted it just to keep it on top....

as for the suggestion to the DEA.....i think their methods are a little flawed.  Opiates are deffinitely usefull for somepeople but I know a lot of people who let opiates ruin their lives. There are deffinitely docs who are too liberal in their prescribing  with giving out IR meds but for the most part for someone with chronic pain extended release meds are necessary and i dont think they should be banned just because a small percentage gets diverted. and I am really starting to get sick of the governments war on just oxycontin...first off oxycontin is just one oxycodone formulation and second....every single opiate is abusive and addictive....not just oxycontin. It makes me sick how the dea and government makes it appear that the only problem is oxycontin when there are quite a few different very potent opiates that are abused on a normal basis. 

seems like more of a war on Oxycontin is turning into .war on all schedule II opiates not just Oxycontin...and to some it seems it is scaring the doctors outta properly treating pain....its amazing that the invention of one brand of pill can have soo much effect to the pharmaceutical industry/ chronic pain population...heck wee feel bad enough for being in pain don't make us feel bad for needing the meds we need... and in some cases afraid of telling people what we need to take for being frowned upon..... I LOVE THE USA

Nascar #88 GO JR!!

I just read your post about roxies 30mg being removed? That is my BT meds and received some two weeks ago in Chicago Il from the pharmacy. Where did you get this info from? Thanks

The DEA's official policy recognizes and supports the need for treatment of chronic pain as does my states medical board.  I have never had a problem with the DEA or the State Board of Medicine.  There are well publicized guideline to help physicians stay on the side of the angels when manageing pain patients. 

Managing chronic pain patients is difficult and time consuming and not everyone wants to do it.   Doctors who manage pain also have a responsibility to diagnose and detect addiction and diversion which is also time consuming and difficult.  Pain patients often do not appreciate the problems that they cause when they are non-compliant. 

Pain patients often refuse more appropriate treatments or are not open to tying adjuvant medications.  Just read the comments on this site about how worthless lyrica or neurontin are or how dangerous facet joint injections are.  These are proven and effective therapies for some people, but rather than discussing the potential risks and benefits some posters just dismiss them as dangerous and ineffective instead of encouraging other chronic pain sufferers to try them and see if they might work for them.  Pain patients frequently have unrealistic demands and expectations for how their condition is managed.  Many people on this site seem to think the best way to manage pain is to allow pain patients unlimited access to as much narcotic pain medication as they want.  

Oxycodone and hydrocodone are difficult drugs because they are immensely popular as drugs of abuse. Some addiction patients have told me they prefer it to all other narcotics.  The vast majority of patients I have found to be getting large quantities of drugs from multiple doctors have asked for oxycodone or hydrocodone preparations.  Why?  I don't know.  I think it is primarily that these drugs have excellent brand recognition on the street and are in higher demand and command higher prices. 

As I have posted before, I perscribe very little oxycontin (one patient right now).  I see no clinical advantages for this drug, more risk because of variable metabolism, and because it seems to be a favorite of people who are likely abuseing or diverting it.     

I certainly wonder why hydrocodone is a medication that is wanted by addicts unless it is like Tussinex or hycodan tablet's. It might be very well becauses many doctor's are concerned about RX'ing Sch 2 narcotics. Amphetimines are also very addictive and there are many like Adderal, desoxyn, dexidrine  and other amphetimines that are very easily obtained from high schools. I know this from family members that are still in high schools and I wonder why the DEA is not concerned about this. I understand everyone has their job's to do

Flyer 1976

I think the DEA has got oxy om their mind because of the extremely large quanity sold. And About half is resold by the patients for a profit. I know people who sell their whole scrip.

Sammy

that about half of all oxy rxs are resold by pts for profit?

That really makes me mad that people make statements like this just because they know a few dishonest people that sell their rxs...People like that only make it hard for true pain sufferers to get treated. That's why some docs won't rx oxy at all.

My Doc told me that the DEA shut down the AIMDE pharmacy because there were 72,000 unaccounted pills. However there are now a lighter blue with an "M" on one side 30 on the other and the 15's are also lighter green with the 15 on the other side. There are also white ones made by EITHEX which arent as effective as the new lighter blue ones. I pray that they wont faze them all out. I wont be able able to function these people should try living with deabilitating pain.

Seriously, Dr. L, you have NO IDEA why a reader here might think you are biased? Simply re-read your post. It alludes to "unrealistic expectations" of pain patients, and they "do not appreciate the problems" they cause with their "non-compliance", potential for addiction and diversion, and "time consuming and difficult."

Not ONE REFERENCE TO or DESCRIPTION OF a SINGLE pain patient as compliant, flexible, reasonable, willing to try adjuvant drugs, nor a single reference to anything like "satisfaction clinicians enjoy when they enable a close to normal life for a patient so miserable before treatment he or she wishes to just die" nor any reference to the fact, which I believe you will agree with, that the overwhelming majority of patients taking opioids for pain chronically do not become addicted --- in short, you offer not a sole mention of any positive, reasonable characteristic of so much as one pain patient nor, despite much intimating that pain patients are unreasonable, self-centered folks, any mention that successful treatment of a patient in severe chronic pain should make the clinician feel satisfied he or she has given the patient "his or her life back" when properly treated for pain.

Of course, it needs to be said that perusal of your other posts does not reveal the image, supra, of an uncaring, biased doctor such as the instant post casts. Rather, I know from reading many of your posts that you are, in fact, an empathetic and reasonable clinician. I guess the question that pops into my mind, and that you might want to ask yourself and which I would hope your colleagues would ask themselves, is why these positive traits that we know you have and express, are completely missing when you have to give an "off the cuff" description of the pain patient?

The upshot? When a doc we know to be reasonable and caring comes across as so negative when describing pain patients, we begin to see the invidious but pervasive biases -- some of which are not even conscious, I am sure -- against people with chronic pain. Imagine what would be posted by a physician who does not possess the relatively exquisite empathy that you radiate? This is the kind of near institutional, albeit probably not intentional, bias against pain patients that we who suffer from it must live with [and in some cases, die from:(].

I mean, come on -- even our reports of our pain or our poor experiences with meds like Lyrica, et alia, are met with initial skepticism, as per your post and many other expressions of the medical profession's disdain for us because we don't fit easily into the existing medical system and because our conditions can be frustrating -- and NOT just to clinicians -- but to all, as we who suffer it know all too well.

And, please, this is not any kind of attack on Dr. L. She is one of "our angels", IMHO; rather, this is an attempt to illustrate the systematic kind of prejudice we must overcome, to the point where even "our angels" are little frustrated and biased.

Best to all,

M

hydrocodone is usually sought after because doctors are more liberal in prescribing a schedule III than a schedule II and also to many people that I knw it gives a more enjoyable energetic "high" than other ones which would makes you drowsy. 

as for the stimulants....even though they are schedule II the doctors still hand them out to tons of highschool and college kids who walk in and say they have trouble paying attention in class. I guarantee you it would be easier to scam a doctor into giving you adderal, dexedrine, or methylphenidate compared to if you were to try to scam a doctor to get tylenol 3 or codeine. I can guarantee it because i know someone who used to go around doctor shopping and scamming doctors just to turn around and sell the medications. She was going around getting opiate, benzo, and amphetamine scripts and she never once got turned down when trying to get adhd medications like the stimulants talked about above 

And per the comment someone made to dr lois about being cruel to the 17 year old girl....I agree completely with doctor lois. That person was experiencing chronic pain because she overdosed and gave herself that condition and then is not open to any adjunct therapies and just wants higher dosed narcotics. That just shows addictive behavior. I think dr lois's comments were justifiable completely and this is coming from an addict(myself). 

my doctor only give me a certain amount of vic. low dose with a hernated disk and bone spur into my nerve. witch is very painfull as you can see i can only be on my computer 15 min.s  a day with out crying my eyes out witch is bad.. 

I'M HAVEING SURGURY THE 16THS ON THIS MONTH AND I'M SCARED..

I am sure this is not news but CIII narcotic abuse is popular in my area because they are one of three parts of a "cocktail" that the druggies party on. They actually like Lorcet the best because it has more APAP. I know a person who is caught up in this and several who have died doing these "cocktails".

I wish the DEA would focus soley on diversion. The best way to do it would be to monitor pharmacies that have a high volume or CII and CIII narcotics going out. Everytime you see a vehicle with more than two people in it who have identicle RX's you know what's up. I see carloads in Houston. Four people with the same RX's in the same car from the same clinic, none of whom seem to be in pain. I know you can't tell by looking but it seems strange to me.