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Old 11-08-2015, 12:07 AM   #1 (permalink)
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Join Date: Sep 2003
Location: brooklyn, new york
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Pain Management Patients Suffer Due To DEA Regulations

On August 27th, 2014, the Drug Enforcement Administration passed new guidelines regarding the dispensing and prescribing of Schedule II medications such as Oxycontin, MS-Contin, morphine, methadone, hydrocodone and fentanyl. While federal FDA guidelines apply to all states, my own experience as a Pain Management patient has been exclusive to New York City.

I am prescribed 150 mg of methadone per day, which adds up to 450 10 mg pills per month. In September of 2014, the Head Pharmacist of the drugstore which has been carrying my medicinal needs for over 12 years, informed me that the DEA threatened them with closure since they dispensed a huge volume of Schedule II medications. This pharmacy happens to be the one closest to a huge urban Medical Hospital and is one of the finest drugstores I've worked with. The staff knows you, treats you with respect, and provides the best in products and services.

Several area pharmacists had told me that Oxycontin, Oxycodone 30 mg IR, MS Contiin, and Lortab were generally the narcotics which the DEA had focused on in the past and that the actual number of these "infamous" medications would have their unit numbers significantly reduced or in some cases, no longer will be carried by the store. My pharmacist told me that methadone would have a strict limit or quota on how many pills would be dispensed. He explained that a DEA official had visited the pharmacy and audited their records on the number of CII opiates and opiods. I immediately asked him about the methadone restriction and he said, "I don't know exactly, but it will effect you. We were initially told that the limit would be 120 pills per month."

Why would methadone be considered a hazardous drug when it is one of the least abused, cheapest ($7.84 for 450 pills versus $1,685.00, which had been the cash cost of Oxycontin) and most potent long acting pain medication used as both a heroin substitute and, more recently, as a powerful analgesic preferred by many pain management physicians? Methadone has had an extremely high rate of success with heroin addicts enrolled in specialized medically supervised clinics which are licensed to dispense the medicine which is as strong as heroin but doesn't possess the euphoric effect of the latter (Drugs Of Abuse I 2015 Edition: A DEA Resource Guide). In addition, methadone was shown to curtail the criminal activity associated with procuring heroin. As a CII medication manufactured by licensed pharmaceutical companies such as Roxanne, methadone did not need to be "cut" with other substances to lesson its potency. Addiction Treatment Programs in Manhattan appealed to those individuals who wanted to improve their lives by avoiding dirty needles, receiving a medicine which was free of impurities and significantly decreasing the insidious craving for heroin and virtually stopped the endless ritual of "all day" "hunts" for low grade product.

However, it soon became clear that these stricter DEA regulations would severely compromise the care and legitimate need for the narcotics that pain management patients were receiving in New York City. Since the DEA guidelines have been in effect, my pain management doctor needed to decrease his new patients* dosages of methadone. (*This was based on those patients who exclusively used the sanctioned pharmacy which worked with him ). I was petrified over what would happen to me and I had to make an appointment just to review the plan for my care. I've been through two methadone withdrawals and could not believe that some government agency was going to interfere in the care of all of us. When my appointment date arrived, the head pharmacist of my pharmacy was meeting with my doctor in order to fully explain why his pharmacy was sanctioned and how pain management patients would be "treated". I was invited to join this meeting based on my longevity as a*pain management patient of this practice as well as the fact that all of my prescriptions had been filled by this pharmacy for almost 16 years. In New York City, the DEA set forth a mandate that pharmacies which were based inside hospitals or had an affiliation with a hospital and were dispensing high quantities of Schedule II Controlled opiate/opiod pain medications would have to adhere to new quotas.

Based on the number of dispensed CII prescriptions per month, my pharmacy received an extremely harsh monthly quota. This meant that I would receive, at the most, 180 10 MG methadone tablets per month which represented an immediate dose reduction from 150 mg per day to 60 mg per day! My doctor knew that I was floored by this news and told me not to worry. I looked at him as if he had three heads and asked him how would I be able to tolerate a 90 mg dosage reduction? Any pain management physician and patient who had been on this high of a dose of methadone, knew that this drug had one of the harshest withdrawal effect on the human body when lowered this rapidly. Both my PM MD and the pharmacist stated that abrupt discontinuation of methadone can result in severe hypertension, seizures and even death. My doctor told me to trust him. I told him that I would.

One would think that methadone was one of the most expensive, dangerous or most abused of CII narcotics by looking at the numbers of deaths attributed to these medicines in its class. Nothing can be further from the truth, and if anything, methadone remains one of the cheapest as well as safest CII Pain Medications ever used. Methadone remains the medication of choice for Treatment Programs which Specialize in Heroin Abuse to Abstinence. In addition, methadone is an extremely potent pain medication which has been shown to not have an ever-growing need to be increased in order to maintain its efficacy as an analgesic. Methadone acts as a "barrier" to other drugs in that drugs like morphine; heroin, hydromorphone, oxycontin, Opana, or any other euphoric inducing pain medication from binding to that receptor in the individual's brain—which causes rapid onset of tolerance, euphoria, and increased need for the MD to prescribe higher doses of these drugs to pain patients. Methadone's potency—it is as strong as heroin but does not provide the person with the euphoria associated with heroin, oxycodone, morphine sulphate or Dilaudid.

Finally, methadone is very, very cheap. My monthly dose of 450 pills costs under $7.84. I used to be on 240 MG per day of Oxycontin= 90 pills a month. This medication cost $1675.00 per month.

All I can say is to contact the DEA, the FDA, and the pharmaceutical companies which manufacturer the Pain Management medications and inform them of what is happening in New York City or your own state or city since methadone, if sanctioned, will not only result in astronomical costs to pain management patients since pain management doctors will be forced to prescribe these other, more expensive medications, but will also cause addicts to return to heroin. This means that inner city crime will surge and your parents or children won't be safe due to diversion, huge increased in street purchases of oxycodone, Oxycontin, MS Contin, etc. Methadone Maintenance Treatment Programs cannot be closed or compromised in any way as HIV/AIDS rates will soar based on the increase of folks sharing dirty needles.

Pain Management patients in New York are suffering much more pain due to these guidelines which limit pharmacies to how much one can get per month. My insurance covers the cost of 450 methadone pills with a co-pay of $2.67, but I cannot locate a pharmacy in Brooklyn or Manhattan who stocks methadone or is willing to dispense it for this low of a co-pay. I pay $300.00 for this medication, which is the only one which treats the intractable pain I've sustained due to pancreatic and colon cancer, nueropathy in my feet, and back injuries which occurred in 1996

God Bless And Thank You For Reading My Post!

"If Enough people Call You A Duck, You Better Start Quacking."
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Old 05-16-2016, 03:25 PM   #2 (permalink)
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diversion of scheduled ii medication , pain management , patient need for medicines

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