WA state faces law suit for 2007 Opiate RX law

Hello Betty,

                Just wanted to drop in and let you know that I read the article, Which I found very interesting! I think all states are cutting back on the pain medicines that doctors are prescribing. I believe that this is not right, and people should stand up and speak out! I would love to hear from you, my email address is maddolphinsue@hotmail.com feel free to email me! 

                                                                 Sue

I am in constant pain due to Arthroscopic being botched twice.  Now I need a new knee and can't afford the surgery or the time off work.  At first, my doctor said, very sympathtically, that he would make sure I was comfortable.  Now, he wants to see me in his office monthly and keeps changing the medications to some that don't work at all.  I don't want to be dependant on pills, but, I have to be able to get through each day and not wish for it all to be over.  Where do these doctors and lawyers get off acting like "God"?  I wish it would all go away, but it won't.  Some days are easier than others, but they all are painful.

I am a resident of Washington State. I remember when they did this and found myself wondering where it would stop. Feelgood laws such as these never just stop with the targeted issue, in this case Morphine. It will undoubtably continue on and target all Opiate based drugs. Lets get to the real issue. Doctors are afraid to be sued and worried that there practice insurance premiums will skyrocket if ther insurance company's find out if they are prscribing pain meds on a regular bases. Hense the "drug contracts" that we as patients are forced to sign.

I suffered from repetative Knee dislocations starting at age 10. By the time I was 17 I had 2 staples in each knee and significant bone and ligament damage. I am now 45. And in need of 2 knee replacements. In 2001 I was awarded full dissability. However it wasnt much so I still couldnt afford Medicare. I have been denied 2 times for state insurance because I get to much money form SSD.

I have always had pain. But over the last few years it has become unberable. A year ago I started seeking a doctor who would offer me some releif. I was reduced to going to community clinics because of no insurance. I was shocked when I was told they would only give me Tylenal III. I have exhausted all my resources. I am now completely bed ridden on most days. I have resorted to turning to the streets to get pain pills. When I do have them I can function for the most part.

DigDog I know exactly how you feel. I just want it all to end!!

I would like to add my Email address. If anyone would like to contact me and share info, story's, or chat you can contact me at robertmoore63@hotmail.com

Thank you

Aloha Betty,  Thanks to your work I was able to read both the lawsuit and the original law of 1996.

Reading a lawsuit is so very biased (I don't trust any lawyer who seeks 33% or more of a lawsuit), that I took the time to read the 36 pages of the Washington law.  These are guidelines, not restrictions and bring up some very good ways for a physician to help separate drug abusers from drug dependant users.  The law is quite sympathetic in dealing with patients who have chronic pain.  The key to staying within this law is keeping open and truthful communication between doctor and patient. 

One of the replies to your original statement states that he/she resents having to follow up with the doctor on a monthly basis.  This person, I feel, is wrong.  I was a health care provider until I became 100% disabled with fibromyalgia and arthritis.  I actually see two internists each month and they have learned to trust me implicitly, but they still want to see me to keep re-evaluating the pain, treatments, and meds.  They share all my information from each visit. (I signed a paper for open communication with each doctor.)

It only makes sense.  I suffer greatly from pain to the point of daily suicidal ideation, but my doctors have kept the edge off the severe pain and I have learned new ways of coping with the pain.  It has taken me 40 years to get to this stage.  There are times that I wish I could just get unlimited opiates and never have to see a doctor again...but I have learned that is not the way to deal with chronic pain.

Again, the law is a set of guidelines.  Don't get all your information from a lawsuit.

You really have no idea what it is like to prescribe medications only to have a patient suicide within a few days.  That death was (and is still) crushing for me and that sad family.  I wish that I had these guidelines when I first started out in health care 35 years ago.

This law will not keep a patient with severe pain from getting needed relief.

I live in NM but i see more and more everyday of pain management doc's not being able to give what their pt's need for pain control.Remember when about 10 yrs ago or so in EVERY doctors office there was a sign stating "No pt will be in pain" "NO pain zone",if you haven't noticed these signs are in very few places anymore.I truly feel the reason being,not because there were what 32 deaths from opitate related accidents 1996 to what 2002,no it is cuz too many people abused this "rule",they were not in pain,or very little,but since the signs were there hey let's get some for mama,papa,sister,the neighbor,and cousin joe.Then we'll say we're in so much pain we'll get some extra to sell to the drug addict down the road.These people are the one's that ruined pain control for all of us.The poor souls that died in that time period may have been suicidal,and i am sorry but if a person is truly suicidal they do not tell anyone,usually,they find a way and do it,this may or may not have been the case.The fact that they lost their lives is very sad,no matter if intentional or not,and i feel very sorry for their families to have to live after their loved one's are gone,but the number of people that have had to go on disability or work in so much pain that they themselves want to die far outweighs the 32 folks that did die.I have had a wonderful pain mangement doc since 2004,she is the FIRST person to fully address my pain issues,and many others.This June 2008,she informed all of her pt's that as of Sept 2008 she will no longer be doing pain mangement.The DEA has chased her around the tree so many times she has choked and has to give up her practice.I am sure that she has had a few pt's "get over on her" to get pain meds to share with all but over all she is very diligent in who and what she gives to people in pain.She does not just say "Here take these and go away" you have to see her every month,she does ROM,myofascial therapy and will send you out for further evaluation from other professionals.I saw the writing on the wall and had the foresight to have an implanted pain pump installed into my body,yes it is surgery,yes it is there forever,but i was waiting to show up for my appt at pain doc and nobody be home.I am sorry to see her go,i am sorry for all of her pt's that have no other avenue,i am sorry that so many people either lost their lives or got over on these doc's and abused the situation.Maybe someday soon there will be a blood test to "show" pain,wouldn't that be great,no more fooling the doc's.OK i am going to shut up,i am glad that that i have the pump,it is still in the process of getting situated but so far so good.Good luck to all.

Just about the time my wife became essentially bedridden with end-stage COPD with nem God help her, as her only help of any kind, the VA lied to me and had me do a "consult" with a "Board Certified Pain Management Specialist".  It turned out he was no such thing - just had some experience with pain patients and lots of (incorrect) opinions.  He announced at our first meeting that he was taking over my pain care, and my PCP could no longer prescribe for my pain.  I am disabled after 6 back ops and lots of nerve damage and pain.  Instead of raising my opiate dose slightly due to much increased activities, he trashed the entire regimen.  He stopped ALL of one opiate, refused me the most helpful and least dangerous adjivant leaving me Valium, which I hate becuase it leaves me exhausted, cut the MS IR to under 1/2 of what it was, and then tried to cut the fentanyl in half with the plan of cutting it entirely and forcing me onto methadone, SSRI's, Gabapentin and tricyclics, all of which have caused me problems.  He played dominance games, never examined me, didn't listen to me, and demanded my presence whenI could not afford to get there so often or to leae my wife alone for so long.

When I asked for the standard he was using, I was presented with a copy of the Washington Guidelines, and told I had been on far too high a dose of opiates.  I've been fighting this for almost a year now.  For the first time in 23 years, I've had to consider suicide.  My wife was looking into the DEath With Dignity Act (oh - we're in Oregon), and I knew it was because she hated seeing me tear myself apart trying to take care of her and the house.  After talking it over, we decided it would be better to die together, in each others arms in a beautiful place we loved rather than lie there in an increasingly toxic house, sick, intoo much pain to help ourselves or each other, rather than tolerate the intolerable situation being "justified" with these guidlines based on fear, propaganda and fantasy - and the absolute power of a doctor over his patients.  Had it not been for some almost-good-enough help from a local doctor, we would likely have been dead by now. What will happen in the long term, I have no idea.

There are other vets who are also being pulled off of their regimens that had been working, and being returned to their beds, couches and wheelchairs.  These guideliones are not just abusive - they are DEADLY.

Ian MacLeod

Hello All

I would really like to Thank all of you for your input, thoughts and experiences.

Since many of you mentioned having serious thoughts of suicide, I would also like to add that I am a member of the American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?fuseaction=home.viewPage&page_id=1   I'm the mother & a survivor of a suicide victim and I now also participate in educating the public & helping those who feel that suicide is their only way out.  As a Chronic Pain patient myself, I also understand how that severe chronic Pain and especially For those who are severely undertreated, how they could come to the conclusion to just end this all.  For the first few years of my pain, I too was severely undertreated and could barely make it through the day and fought very hard to continue working.  It was not until about 4 years ago when I was fianlly sent to a Pain Mgt clinic that sent me through a pain mgt course, that my eyes were opened and I knew that I was defineately not suffering alone.  There was alot more to pain, patients & management than I had even dreamed of.  I'm one of the fortunate ones that has two very remarkable doctors, one that taught me exactly what she expected of me as a patient and another who listens to me and offers support, advice and is willing to step outside these guidelines and make certain that every month like clockwork, my rx's are ready as needed.  NOT EVERYONE HAS IT LIKE THIS!

I also have doctors who encourage patient involvment and support all my research & work on the internet.  They encourge my online support activities and also my interaction with so many others in pain.  I spend hours a day involved with research, study and talking & supporting other pain patients.  Trying to teach and help them too to receive proper treatment, how to talk with their physicians, what behaviors can be construed as drug seeking behavior (which nearly every person in pain can exibit at one time or another, due to desperation for relief & treatment) but that's for a whole new discussion.  I help to instruct them on how to keep a pain diary, where to find printable materials for one and where they can find an online one that prints out your diary that looks very professional and easy to understand graphs, notes, meds, exercise, etc.  So their doctors can see that they are very serious about receiving treatment and are not just seeking drugs to get high.  They are in pain and would like to live a life with the best possible comfort they are allowed.

I don't know or understand why some of us do receive treatment and why others have to suffer so much before or if they ever find a doctor who will listen to them and is not bound by some state guidlines that they have taken clear past the guidline stage and used as an excuse to denie treatment to suffering humans.  Yes, I feel blessed to be one of the treated ones, but because I am blessed, I feel it necessary for me to also join in on pain advocacy and help the best I can to continue to try to support, educate and help in any way possible those who suffer in silence and many are afraid to speak out, I'm not!

Our sociey seems to disregard the weaker ones or those they would like to place labels on as drug seeker or o just get over it and get out of bed, they're lazy and just don't want to work or what ever those who have never really felt what real pain is and because our needs come with a little bit of speculation, there's not a test, how can we trust these people, they just want to be legal drug addicts and all the rest.  They need help and I know that I'm no better than any of them and they should be allowed the same treatment as any of the rest of us.

For anyone to imply or insinuate that I've only gained my information about this topic from a law suit is like a direct slap in the face. 

I've spent many, many hours on the internet, phone and through personal support listening and not only listening, but actually hearing what the under or un treated pain patients have to say.  Do we need guidelines, most certainly.  Do we all have to follow some rules and regulations to keep us and others safe with our treatments. most definately. 

But when I hear someone say that they have a difficult time making it to an apt once a month, I don't automatically think they are being lazy or fighting the system.  I know that they are trying despeately to hang onto a job, one that quite possibly, they've been forced through pain flare times to have to miss work and they might not be able to afford to miss another day.  For me personally, I have telephone apts with my PM doc and can also request them with my primary care, not all have this opportunity and not all are able to miss one more day, afternoon or morning of work.  I don't judge these people and try my best to understand their circumstances.  They need for the medical community to listen too.

Pain Care is in desperate need of guidlines that set up between doctors and patients.  Not ones that a group of beaurocrats sit around a table and create, just so they can say they are working hard on the drug war.  Especially when not one of them have the slightest clue as to what a pain patient is in need of and what it's like to be a chronic pain patient.

Once again, I thank all of you for your input, I'd love to hear more from you all and anyone who would like to contact me, your welcome to click on my name beside my post and send me a private message.  I don't share my email in an open forum, but would be glad to send it to any of you in a private message.

God Bless you all and if you'd like to see some follow up articles on this subject?  Here is a link that you can find all kinds of discussion and alot more info.  http://www.painreliefnetwork.org/forum/viewtopic.php?id=1937

Gentle Hug to all

Betty

Good iam glad they are trying to do something about thisas alot of problems because of the fear of to many pills.While we who are in pain and iam not talking a broken bone pain .Iam talking pain we have to suffer it sucks.

I recently moved to Cleveland, Ga. My husband and I bought some land several years ago for our retirement home that we are almost ready to move in. The joy in seeing our dream come true has turned into a nightmare for me. I have been on a low dose of Vicodin for about 10 years now and have been taking one 5/500 vicodin twice a day. Imagine my abosolute disbelief when I checked with four doctors in this area and was told that they do not prescribe pain medication at all. One doctor told me that they had to sign a form stating that they would not write prescriptions for pain meds before they could practice medicine at that clinic. I then called a pain management clinic in Gainesville and made an appointment only to be told that they do not prescribe pain meds. I made an appointment with an orthropedic doctor to get shots in my knees to relieve the pain and inflamation only to be told they do not give pain meds. After ten years , I was terrified because I had no idea how my body would react or if I would go thru withdrawal systems and I was out. I asked all of these doctors to tell me who would help me and their answers were all the same, I don't know. I was fortunate that the dose I had been taking was low and all I had were a few aches and pains. 

Thank you for posting the article with the links.  I had found the "guidelines" before reading the newpaper article because I am being bounced around to pain management groups and physicians.  Most of the physicians that I have been referred to are specifically L & I physicans.  No one yet has an understanding of what I have and that it can only be managed.  I relocated to WA from TX in 2003.  The new "guidelines" have my physician running scared.