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Fda Requires F2F + Monthly Paper Rx!?


Poppyseed123

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Look at today's paper re: stepping up Hydro meds to Scheule II www.newyorktimes.com

 

Where does that put us CP

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I noticed that proposal on the NBC Nightly news recently. Until now only pure hi~dro required a written Rx. So far it's only a proposal, I'm sure the lobbyists in DC will do their best to keep it from actually happening. At least one local doc had his C 2 privileges revoked and had to put patients on hi~dro, if that proposal passes even 5/500 Lore tabs will be on the same level as more~feen. Big med makers are sure to fight hard to prevent the change. If they did put them on the same level there would be too few docs willing and able to write scripts for people needing something as simple as a the C 3 stuff. But what I recall was they could write a 4 month supply, not the monthly script needed for todays C 2. Still the change would devastate todays patients because so few docs are will or able to write C 2 already. I just don't see it passing myself.   

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Hi @Popyseed123 and @HighTide,

 

Are you referring to the article http://www.nytimes.com/2013/10/25/business/fda-seeks-tighter-control-on-prescriptions-for-class-of-painkillers.html?ref=health&_r=0 ?

 

I have seen signs in the local Du@ne Reades in the US and mom-n-pops clearly stating that any med containing hydro requires a new r x each month - this as early as a month or two ago, no more refills at all.  I thought the regulations had already changed. I have always thought that from an abuse perspective hydro was a bit loosely controlled in the many cough syrups and tablets such as hyc0d@n (was CIII I think) which contain no APAP just some homatropine, so  I suspected it was just a matter of time.   Also from an abuse perspective, however, this only addresses hydro meds that contain other substances such as APAP or ibuprophen, and in a sense, maybe that's a good thing because also epidemic worldwide is the liver failure and stomach ulceration caused by such abuse or self-medication. 

 

Unfortunately IMHO this just hurts those who need it most, forcing those who are not mobile to see the doctor more often.  I don't think it will make the kind of difference they think it will but it should force chronic pain sufferers dependent on op!ate therapy to the right tool for the job.  I am not an expert but shouldn't chronic pain sufferers who are on op!ate therapy be on meds w/o APAP anyway and if APAP or other OTC analgesics are needed (I understand that the combination of certain op!ates and an appropriate dose of APAP or ibuprophen can create a synergy to help with chronic inflammation or just the symptoms associated with taking higher doses of op!ate themselves).

 

Interesting subject and great post.

 

PR

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Guest ZeroZia

Packrat, regarding medication combinations.  I see your point on the subject, but I think it is important to remember that the vast majority of people who are getting pain prescriptions aren't getting them for long term pain management.  The drugs that are out there for long term pain management do exist in pure forms.

 

It is much easier for a doctor to say to a patient with short term pain issues, "Take this pill." Instead of, "Take this pill and some Tylenol or Motrin."  People, in general, aren't that bright.  Especially when it comes to their own health.  Hell, look at the average American diet or physical activity level.  People aren't any good at taking care of themselves in general.  So simplifying things makes it a hell of a lot easier.

 

Regarding a monthly face to face with a doctor.  This action doesn't surprise me in the least.  People have shown time and time again that they can't be trusted to take their medications correctly.  So a monthly check-in at this point is to be expected.  Frankly considering the measures that are taken to prevent the abuse of prescription opiates.  I'm surprised it hasn't happened sooner than this. 

 

There is a culture of prescription drug abuse in the United States.  It's everywhere and at every level of our society.  Sometimes it's openly addressed and some times it's not even considered abuse.  I'm sure everyone can think of the person who takes a couple of Xanax to sleep or a couple of Vicodin for a mild headache.  The degree of control being shown here is trying to stem, in my opinion, the overt and blatant abuse of S2 and S3 opiates that is so common.

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ZeroZia - what an asset you are to the forum! I'd like so much to get some background on your statement: "most chronic pain patients are getting meds in pure form".  Wow, really? Educate me, please! I have NEVER been offered pure form of anything I get from my qualified LT Pain Management Practitioner. Should I ask my doctor of many years to cut out the Tylenol? Will/does that typically raise a fuss? Do you have experience in this? This is such good news, to me, and perhaps others on this forum; so please, expand on this!

 

Thank you and welcome

Poppyseed

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@ PR - I read the article and it seems like the same news I recall from NBC. One thing I think may have changed that I'm not aware of, but I thought cough meds were see four, but it's been a long time since I've gotten any so it could be different now. It always struck me as strange that it was lesser controlled when it was actually less damaging, (i.e., not having apap) than pks. The Nor~co and other stuff containing less than 500 of apap was an immediate success because Drs knew it was less damaging that the 500, but 325 is considered the least effective dose, so it's as low as they could go and still be on a see 3 level.

 

@ Poppyseed - IDK what your situation is, whether you get something like P3rks, that is a see 2 or what. Unfortunately, if it is the case, I would suggest asking the Dr to change you to a 5 or 10 mg of 0xie eye are. I'm not sure if they even offer 10 mg, last time my Dr wrote me that they only gave me 5 mg because 10s were not sold. IDK why they couldn't give instructions to take 2 x 5s, but it's been a long time so I'm not sure if they are sold now or not. But if you are already getting a see 2, I would tell the Dr you are worried about the damage apap causes and ask about changing you. It can't hurt, it least I wouldn't think it would cause a Dr to see it as bad for you to inquire. Without knowing more about your situation I can't really offer any other advice.

 

Best wishes, H~T

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ZeroZia - what an asset you are to the forum! I'd like so much to get some background on your statement: "most chronic pain patients are getting meds in pure form".  Wow, really? Educate me, please! I have NEVER been offered pure form of anything I get from my qualified LT Pain Management Practitioner. Should I ask my doctor of many years to cut out the Tylenol? Will/does that typically raise a fuss? Do you have experience in this? This is such good news, to me, and perhaps others on this forum; so please, expand on this!

 

Thank you and welcome

Poppyseed

Poppyseed,

Firstly thank you for the compliment, I was referring to drugs like OxyContin and Opana and Diluadid which are not adulterated with Acetophetimine. Tylenol (ApAp) is highly hepatotoxic as well as toxic on other systems if your doses are high enough I would address this with your pain doctor. I cannot speak to it raising a fuss, but if you're taking more than 3 grams of APAP daily you're taking too much. It's hard on so many body systems and some doctors choose not to acknowledge current research. I am not a chronic pain patient, per se, so I cannot tell you if it will cause you problems. I might just say that you were concerned about the long term implications of taking APAP long term in large doses.

If you're curious about where my qualifications in making this statement lie I hold an advanced degree in pharmacology and toxicology. I don't take APAP/Tylenol EVER. It's terrible for you. The only reason why it's still an available and widely used drug is because it's effectively been grandfathered in and the people who produce it lobby the AMA and FDA. If you can avoid it, I would urge you to do so.

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This is a new law that is scheduled to go in effect sometime in 2014.  However, it is not the law now.

 

My PM doc was able to give me a scrip for 10/325s with 2 refills and called it in.  No paper at all.  (Right before I had to get off all PKs.)

 

But ... different states have gotten tougher with their own rules and laws.  Florida in particular has really stepped it up due to Florida's rampant pain "clinics."

 

Keep an eye out on the news.  Some time this year the new restrictions will go into effect.

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There hasn't been a 100% hydro until the recent approval of a product. It is being launched by a Pharma company in March 14'. It is a SII as required by the FDA for approval. It is also a long acting formulation of hydro. This specific products approval process really started the ball rolling for the rescheduling of the entire class.

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Later this year my Psych said Hi-dro will be a C-II.  It will probally be fall he said, it was off topic, but I just had heard this last week. That's really all I know. Again it was off-topic & I don't get or use them. BUt given the news as others have stated it's become nearly as dirty a word as Oh -I see's & X-x IMO Opiated-

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Aunt Pitty Pat

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My doc says it's not for sure cII but is likely. He told me don't worry about it. He'd just write 4 separate scripts post dated for each month so I can still just see him 4x/year.

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My doc says it's not for sure cII but is likely. He told me don't worry about it. He'd just write 4 separate scripts post dated for each month so I can still just see him 4x/year.

Auntie how I wish I knew your doctor!!

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That illegal But very nice of him

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It's not illegal at all. I have a real doc. Not a pill mill guy. He wojlsnt do it if it were illegal. Psych also writes 3scripts for ADHD meds.

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It's not illegal at all. I have a real doc. Not a pill mill guy. He wojlsnt do it if it were illegal. Psych also writes 3scripts for ADHD meds.

 

Actually this is not specifically "legal" for C-II medications.

Your doctor can write two future refills on the same prescription if they are dated 30 days apart.

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