Mrs. cbelt3 suffers from chronic pain- spinal spondylitis, spinal defects, rheumatoid arthritis, and fibromyalgia. She has been going to the same pain management doc for a decade. BUT.. with the changes in the law to 'protect against opiate addiction', her doc now has huge audit hoops he has to jump through.

Several years ago one of our daughter's friends was stealing her Vicodin and replacing them with Tylenol. So on a random test, she tested 'nope, not taking her pills'. No comment was made.

Then last year she had some poppy seed strudel at Christmas. Tested positive a day later for Morphine (poppy seeds). She and the doc talked about it, and all was well.

Then two weeks ago she had the stomach flu. Took her time released vicodin, promptly threw it up. Then went in for a random test. "NOpe, not taking her pills".

And under Ohio's new "Three strikes" law, her pain management doctor had to 'fire' her.

She is devastated. Not only is she in deep pain, but now has been told she is 'unfit' and 'an addict'. And has to go request 'approval' from a new pain management doctor. Or be told she cannot receive ANY sort of pain relief.

That's right. The law says that people in pain.. really aren't.

I'm enraged. This is a bureaucratic nightmare. Aaaargghhh.

Jeebus! That really sucks. And I mean REALLY SUCKS!

Then went in for a random test. "NOpe, not taking her pills".

what does this mean? The can call you on random and test to prove that you actually take the medicine they give you?

Sorry to hear of your wife's medical problems. I hope you can find a solution to this travesty.

There are too many idiots out there taking pain meds that shouldn't be. It causes major problems with the folks that truly need relief.

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space-time
Then went in for a random test. "NOpe, not taking her pills".

what does this mean? The can call you on random and test to prove that you actually take the medicine they give you?

It varies, but yes. My partner and her Dr keeps her doseages just below the threshold. Her mom needs more, and gets pee tested every 90 days.

Now, one of the big issues is elders (or others) selling their opiods because they need the cash. That's why they test those prescribed above a threshold.

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cbelt3
Mrs. cbelt3 suffers from chronic pain- spinal spondylitis, spinal defects, rheumatoid arthritis, and fibromyalgia. She has been going to the same pain management doc for a decade. BUT.. with the changes in the law to 'protect against opiate addiction', her doc now has huge audit hoops he has to jump through.

Several years ago one of our daughter's friends was stealing her Vicodin and replacing them with Tylenol. So on a random test, she tested 'nope, not taking her pills'. No comment was made.

Then last year she had some poppy seed strudel at Christmas. Tested positive a day later for Morphine (poppy seeds). She and the doc talked about it, and all was well.

Then two weeks ago she had the stomach flu. Took her time released vicodin, promptly threw it up. Then went in for a random test. "NOpe, not taking her pills".

And under Ohio's new "Three strikes" law, her pain management doctor had to 'fire' her.

She is devastated. Not only is she in deep pain, but now has been told she is 'unfit' and 'an addict'. And has to go request 'approval' from a new pain management doctor. Or be told she cannot receive ANY sort of pain relief.

That's right. The law says that people in pain.. really aren't.

I'm enraged. This is a bureaucratic nightmare. Aaaargghhh.

I'm all for tighter restrictions on these drugs, but you have to treat people who need treatment. I'd call every local news outlet in ohio and tell them your story. Also learn all about shame tweeting and target people who can actually do something for you.

It's bad enough this woman has to live with you... she should at least be able to ease her pain.

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Rick-o
Sorry to hear of your wife's medical problems. I hope you can find a solution to this travesty.

There are too many idiots out there taking pain meds that shouldn't be. It causes major problems with the folks that truly need relief.

and selling them instead of taking them.

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How does NOT taking a pill demonstrate addiction?

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Onamuji
How does NOT taking a pill demonstrate addiction?

that's what I didn't understand.

It's one of those "prove a negative" things. In this case they are not proving an addiction, they are testing to see if the drug was taken, with a negative test "proving" the patient might be selling it instead.

Hal,

cbelt, I have about the exact same pain messyou mention, even to the fibromyalgia, which I call The Mess©. And I'm under VA care. VA doc took away one of my pain meds about a year ago. Then another one about 4 months ago. Gave me gabapentin, which I cannot take, mess makes me nervous as a long tailed cat in a room full of rocking chairs. Our system is a real mess!!

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Call the news, call your state and federal reps, tweet your predicament and seek asylum in a civilized nation... Keep fighting for what's right. People shouldn't have to suffer on account of the stupidity and shortsighted selfishness of others.

Let us know if there's anything we can do.
g=

Unfair to your wife. I hope you find a solution.

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Ohio does not have a 3-strikes law in regards to pain management or opiate prescribing or the like. The state medical board does recommend pain management contracts, and from what you said your wife's situation no longer met the terms of that contract. This seems to be a practice rule, and either you misunderstood what they told you, or they are falling back on a general authority to fire a patient.

Any doctor in any specialty is generally permitted to "fire" a patient for any legally valid (i.e., non discriminatory) reason with the provision of appropriate notice including reasonable time to locate an alternate. Most provide 30 days.

It sounds like Mrs. CB's provider considers the contract broken and that is the reason she is being told to look elsewhere for medical support. Presumably the office has provided confirmation of the specific reasons she is being asked to locate a new provider. If the 3 "strikes" you state are at issue are the ones that led to the office's decision, I believe you never filed a police report on the stolen meds (replaced with vitamins not Tylenol I thought), but EMS was called for the kid in medical distress. If the practice is willing to accept an appeal, perhaps they would accept a copy of the report for that callout as validation of the reason Mrs. CB had not had her meds.

It does appear though that the bridges have been burned with this office, and even if they are willing to take her back on, she probably wants to look long-term at other options. And as a user of controlled substances on an ongoing basis, to protect herself in the future she will want to thoroughly understand the terms of any pain contract as well as what may cause issues with it.

Well this sucks!

So I guess this means that going forward, every time she gets sick enough to throw up, you need to take a video of her puking and save a sample of the results for testing. Or else visit the doctor for every little thing to make sure there is documentation of the reason why the vicodin did not make it into her blood stream.




This style of "enforcement" is doubly maddening. It penalizes people in physical pain for the ordinary vagaries of human illness and metabolism, and it penalizes the addicts who self-medicate for emotional pain without offering them any viable alternative.



Edited 1 time(s). Last edit at 05/05/2017 06:57AM by Janit.

cbelt3,

Make sure you document this in detail and send a copy to your reps in the state and federal governments. Your wife can't be the only one suffering like this.

You might want to consider legal class action against the governing body that created the law.

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Ed (modelamac)

I think I will just put an OUT OF ORDER
sticker on my head and call it a day.

hal....

TL... her contract is 10 years old. I suspect that he is working from his own rules based on state audits and reporting and his insurer. The state has targeted every pain management practice, and put a huge onus on them.

I'm preparing documents for her to apply to a new practice. Apparently this happens all the time. Again.. Ohio sucks.

Oh, and the doc said "well, if you only need medication occasionally your primary care doctor can prescribe them." BUT that is no longer true. 7 days supply only.

So she's pretty much doomed to having to see a doctor every week.

I HATE over-reacting politicians.

Primary care can prescribe, from a legal perspective, more than 7 day supplies at a time. Any given doctor may elect not to, sounds like that her primary care's policy not law. There are proposals to limit acute opioid prescriptions to 7 day supplies however this has not been fully approved .

Currently Ohio law permits opioids analgesics up to 90 day supply per rx, with rx valid for 14 days of issue date or future 'dispense after'' specified on the rx. The DEA allows future full dates up to 90 days after issue date.
Given Mrs CB's primary apparently won't write for more than 7 days at a time, this might be something she can ask about.

It's important however to understand how practice policy and laws align and differ so you and Mrs CB can fully advocate for yourselves.

I live in Ohio too, I know what's happening here. It ain't pretty. The situation in Ohio really isn't that different from Kentucky, Florida, and a host of other states. These are serious drugs with great potential for abuse including overuse or diversion. The contracts are developed to help cover the prescriber, and also to help ensure the patient understands the risks of use and consequences surrounding any deviation from the care plan.

TL-
Good points. It's quite possible that her (now previous) PM doc was being overly aggressive. The stuff he 'dinged' her on was NOT on the contract. She's been very compliant to the contractual terms.

I do expect that Ohio regulators have also been very aggressive, the news has at least one 'pill mill' shut down every few weeks. I can't help but think that some of these folks are legitimate medical practices that ran afoul of auditing and record keeping. The ladies in his office painted it as a zero defect environment. ONE mistake on paperwork gets them fired.

In Washington, my partner's doc will write a 1 month supply, and 2 more dated one and two months in the future. Sounds like a federal law is applying.

Maybe she should develop a taste for single malt scotch... ?

Actually, just wishing for some good luck on finding a new doc for her. One that understands what the real needs and solutions are. When my PM guy was contemplating retirement several years back, I checked into some other options, and it was an eye opener. My PM guy's wife had been sick for awhile, and after she passed away, he kinda perked up after about a year or so, and now he'll probably keep working as long as he's able. The thought of finding a replacement in the current environment is daunting.
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cbelt you know that really sucks.

I think many of you know that I had failed spinal fusion and still have spondylitis, degenerative disc disease,
arthritis of the spine and two more bulging discs. I tried everything before surgery, 3 months of intense
physical therapy, 2 pain specialists(one having done the max. number of injections), tried a chiropractor
that was highly regarded by others. I tried just about every type of pain med there was even tried pure
morphine at one point. While I was on most of these drugs family couldn't deal with me. I became an
@#$%&hole. When I told the pain specialist I was through with meds, he was through with me. He wanted me
to try an implanted spinal cord stimulator but after talking with one person with a 3 lead stimulator and
doing some research I decided against it. Now I my routine is prescription strength ibuprofen, 2 hours
every morning in my recliner with a heating pad and many days multiple treatments with a portable TENs
Unit and my hot tub. I make do but it's not the life I would like to be living but I'm narcotic free except
when I need valium to get me Meniere's under control. Right now I'm having a lot new back pain and really
don't want to go to the Dr. for fear of them wanting to operate again but I really need to find out if I have
more than just those bulging discs. My el cheapo TENs Unit has been my savior on many days.

I wish her luck in finding some relief. I know what she's dealing with and it's no fun. Glad she has an understanding husband.

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Grateful11