Yes I am in chronic pain back,neck,leg,from serveral operations on back I can not find a pain center that take's medicaid, need oxycontin I've been in pain since 1989 when the dump truck I was driving hit a 18 wheeler head on,percocet is not killing the pain,my father who is dieing from cancer gave me some 80 mg of oxycontin my God what a relief!!! the best few day's of my life since 1989, this is a miracle drug!! I had heard awful story's of this drug,and I'm sure some of them are true,but some people do not ask for bad thing's to happen to them that they can not control,it's a sad day when I served in the army for this great country,and I can not get the treatment I deserve( I am not a drug addiict,and I don't drink alcohol) So if any one no's of a doctor in Columbus,Ga who take's medicaid,and will go that extra mile for his,or her patient's and will write this perception please let me no, or if you no how to get this free from the manufacturer let me no..Thank you very much Bookoo12201955, P.S. This is a great web site even if I can't find the help that I so desperately need,what a way to ease one's mind of the stress,and to no I'm not alone!!!
Q: I'm on medicaid need script for oxycontin,need doc,or free from company chronic pain
I'm not surprised Percocet is no longer working as it is a short-acting oxycodone with acetaminophen, not meant to be used long-term for chronic pain. You would need an extended release medication for round-the-clock pain treatment. I'm also not surprised that 80 mg of OxyContin brought such good pain relief since that is the highest oral dosage made. I seriously doubt that most doctors would prescribe that dosage for long-term use. (The PDR recommends starting patients on 10 mg.)
As you look for a doctor to help you with pain relief, I feel I need to caution you about a few things. Doctors are usually very hesitant to prescribe opioid medications like OcyContin on a long-term basis. Because these drugs are so often abused, the DEA monitors them closely. Physicians who prescribe them too freely or who prescribe them to people who turn out to be selling them are often prosecuted. Therefore, most doctors are cautious about prescribing them and are always on the lookout for potential abuse. For that reason, I wouldn't recommend telling a doctor that you took your father's 80 mg OcyContin. Taking someone else's prescription medication is illegal and they may tag you as someone who cannot be trusted to take the medication as prescribed. And, contrary to the previous answerer's advice, making a scene in the emergency room will most likely get you labeled as a drug seeker. Once you have that label, no reputable doctor will prescribe opioids for you.
One other thing you didn't mention but I'd like to warn you about just in case – do not ever cut an OxyContin tablet in half for any reason. Because they are extended release medications, this could result in an unintended overdose, which could be fatal.
As for finding a doctor who takes Medicaid, try contacting your local Medicaid office to see if they have a list of area physicians who accept Medicaid. If they don't, the only other thing I know is to sit down with the phonebook, start calling all of the local doctors and ask. I wish I had a simpler answer for you on this.
I wish you the best in your search for a doctor and the appropriate medication.
Karen
Philip,
Thank you for your input on this question. You are correct in saying there is no ceiling on prescribing opioids. In this case, however, I was concerned that the person asking the question had gone from taking Percocet (of which the highest single dose available contains 10 mg of oxycodone) to taking 80 mg of someone else's OxyContin. That big of an increase can be extremely dangerous. While there is no ceiling on the amount of oxycodone that can be taken, it's essential that the patient be titrated up slowly to avoid overdose.
Currently in the U.S., the highest dosage of oxycodone available in a single tablet is 80 mg. We used to have a 160 mg tablet, but that has been discontinued. I didn't mean to imply that 80 mg was the most that could be taken in a day or even at one time – just that that is the largest single-tablet dosage available. I wanted to impress upon the person asking the question how dangerous it was to suddenly take that strong of a dosage that hadn't been prescribed for him.
As for my statement that it is difficult to find doctors who will prescribe large doses of OxyContin for long-term use, I stand by that. Most general practitioners in the U.S. will not prescribe anything stronger than hydrocodone on a long-term basis because of their fear of the DEA. Many refuse to prescribe any kind of opioid for any reason. Sadly, even many pain management specialists are hesitant to prescribe high dosages of opioids because they know they're being watched. Unfortunately, the FDA is currently considering putting even more restrictions on the use of opioids, so I don't expect the situation to improve any time soon.
You were fortunate to have a PCP in the U.S. that was willing to work with you and provide the pain relief you needed. If you could read my mail each day, you would see that your experience was the exception rather than the rule. For every one person who has found a doctor willing to help them, I hear from more than a hundred that can't find anyone who will help.
I'm also very happy to hear you have a good doctor in the UK and you don't have to worry about the DEA there. Although the percentage of people who abuse opioids compared to the number of people who need them for real pain problems is fairly low, here in the U.S., the attention seems to be on preventing the abuse rather than helping those in pain. Sad but true.
Thanks again for your contribution to this question and this site! – Karen
Dear Karen,
Thank you for this clarification. I agree with you entirely that it is dangerous and irresponsible for any person to switch from oxycodone 10 mg to OxyContin 80 mg without doing so under careful medical supervision, and without careful titration of the dose in a proper clinical context.
I read recently that an FDA advisory panel has just recommended banning all compound analgesics that combine acetaminophen (APAP) with low-potency opioids and opiates such as hydrocodone, codeine, dihydrocodeine, etc., ostensibly because too many patients are taking too much APAP by stepping up their intake of these combination analgesics. The stated goal of the advisory panel is to reduce the unnecessary intake of APAP by patients suffering from chronic pain. If the FDA acts on the recommendations of its own advisory panel, it will effectively ban almost all of the Schedule III drugs that currently act as at least partial remedies for those patients suffering from chronic pain, whose doctors are either opiophobic or whose doctors live in fear of being prosecuted by the D.E.A. (or by state health departments) for prescribing "too many" Schedule II drugs. If the FDA follows the advice of its own panel, then drugs such as Tylenol with Codeine #3, Tylenol with Codeine #4, Norco 10 / 325, Vicodin, etc. will all be banned.
Is this what you referred to when you stated that the FDA was considering placing even tighter restrictions on the prescription of opioids?
The results of such a ban will almost certainly be grotesque, and may well lead to a surge in the number of suicides caused by inadequately controlled chronic pain. I do not make this statement lightly - many patients in the US who are unable to obtain adequate pain relief turn to suicide in their efforts to alleviate the pain. At the present time, doctors who treat patients suffering from chronic pain have at their disposal a number of at least partially effective drugs that combine low-potency opioids / opiates with APAP. These drugs are inadequate in the context of chronic, severe pain, but they are better than nothing at all. Almost all of the Schedule III analgesics will be banned should this recommendation be implemented.
Unless the FDA issues clear, unambiguous guidelines, made binding on the D.E.A. and on state regulatory agencies, recommending that doctors be given a much freer hand in prescribing Schedule II painkillers to patients suffering from chronic pain, without having to worry about being harassed by the D.E.A. and / or by state regulatory agencies, this proposal is a recipe for utter disaster, and human suffering and misery on an appalling scale (made socially acceptable because it would be "legal").
This is an object lesson in the shambles that invariably results when the US government declares a "war" on something (whether that something be drugs, terrorism, etc.). Whenever America declares a "war" on something, the result is invariably human misery on a massive scale. This misery is invariably made even more grotesque by another American tendency, which is the refusal of politicians (and many of the people who they represent) to recognize and to acknowledge when such as "war" has failed. To this day, many politicians continue to insist that the "war on drugs" is working, despite the fact that most illegal drugs are cheap, easy to obtain, and freely available.
It is working, all right. It is working to ensure the continued and irreversible erosion of rights and liberties that we once took for granted - particularly in the realm of Fourth Amendment jurisprudence. Searches and seizures that were considered by state and federal reviewing courts to be utterly impermissible just 20 or 30 years ago are now considered to be perfectly acceptable - and citizens who protest are frequently harassed and branded as "trouble-makers". A generalized "drug exception" to the US Constitution (and to state constitutions) now exists, just as a generalized "gay exception" to the US Constitution existed right up until June 2003 (when the US Supreme Court handed down Lawrence v. Texas, 539 U.S. 558 (2003), thereby explicitly and bluntly overturning an earlier decision (Bowers v. Hardwick, 478 U.S. 186 (1986)) that permitted the states to criminalize gay sex even when this occurred in entirely private contexts in the homes of gay persons). The "war on drugs" makes it acceptable for state and federal government officials to fly over the homes of law-abiding citizens at low altitudes to determine whether or not the occupants of those homes are growing marijuana (see Florida v. Riley, 488 U.S. 445 (1989), in which case the dissent invoked George Orwell's dystopian novel "1984" by hoping that "...it will be a matter of concern to my colleagues that the police surveillance methods they would sanction were among those described forty years ago in George Orwell's dread vision of life in the 1980's:
"The black-mustachio'd face gazed down from every commanding corner. There was one on the house front immediately opposite. BIG BROTHER IS WATCHING YOU, the caption said. . . . In the far distance, a helicopter skimmed down between the roofs, hovered for an instant like a bluebottle, and darted away again with a curving flight. It was the Police Patrol, snooping into people's windows."). The "war on drugs" is also working to gut the Eighth Amendment, with its prohibition against cruel and unusual punishment (the Rockefeller drug laws in the State of New York mandate grossly disproportionate, lengthy terms of incarceration for both users and sellers of illegal drugs). The "war on drugs" is also working to gut the Fifth and Fourteenth Amendments' guarantees of due process of law (see United States v. Salerno, 481 U.S. 739 (1987), in which case the US Supreme Court upheld the so-called Bail Reform Act of 1984 in the face of a due process challenge; this statute provides for the incarceration prior to trial of persons charged with certain offenses on very broad and shaky grounds of potential dangerousness to the community. In short, the "war on drugs" has taken a wrecking ball to the constitutional structure of checks and balances that exists to protect the individual from the (virtually limitless) resources of the state.
There is a shocking tendency in America to confuse a procedure or medication with its abuse. The furore that surrounded the abuse of a particular, very effective and useful sleeping pill is instructive in this regard.
I was born and raised in South Africa. When the sleeping problems plagued me as a young adult, my doctor in private practice in Johannesburg prescribed a sleeping pill marketed as Rohypnol (its generic name is flunitrazepam).
May readers will recognize this drug. It has acquired a reputation as a "date-rape" drug, because it has been used to spike the drinks of women (and sometimes men), in order to render them powerless to resist sexual assault. However, flunitrazepam is an extremely effective sleeping pill - I know this from personal experience. I took flunitrazepam for about two years, before immigrating to the US, and it gave me solid, uninterrupted sleep every night without fail. However, when young men in states such as Florida imported this drug and started using it to sedate and sexually assault women, common sense flew out the window here in the US. Whereas other nations (including South Africa) opted to impose tighter controls over this drug (it was moved from Schedule 5 in South Africa to Schedule 6 (there are a total of eight schedules in South Africa, with Schedule 8 representing illegal drugs)), the US government is currently trying to ban this drug outright! Again, we see a tendency to confuse abuse of a drug with its entirely legitimate usage - current efforts to move flunitrazepam to Schedule I under US drug laws fly in the face of reason and definition - Schedule I drugs are by definition drugs that have no accepted medical usage and that are highly addictive. In fact, flunitrazepam continues to enjoy usage as a powerful sleeping pill all over the world, and it is no more addictive than diazepam, lorazepam, temazepam, or any of the other benzodiazepines (I now take lorazepam for panic attacks and insomnia).
If the FDA follows the recommendations of its own advisory panel, patients who now obtain partial relief from pain may find themselves utterly without remedy.
I am glad that I no longer live in the US. As you mentioned, my doctor in New York City was unusual in that he did not hesitate to prescribe OxyContin 80 mg and Norco 10 / 325 in generous quantities for me. When I moved to Chicago on assignment, I found a pain management specialist who agreed to continue the regimen - but I realize that I was lucky, and that many people who suffer from chronic pain are left without medications, to suffer and to lead lives of genuine misery.
This is a national tragedy.
Only when those people who suffer from chronic pain mobilize politically and apply pressure to their political representatives will anything change. Prior to this FDA advisory panel recommendation, it appeared that the US was slowly relenting and acknowledging the seriousness of chronic pain. Now this has happened.
God help those ordinary men and women who are left to fend for themselves and to suffer.
PHILIP
I couldn't agree with you more, Philip. Our government here gives lip service to wanting to help pain patients, but then does everything in their power to make it more difficult for us to get adequate pain relief. And you're right – the "war on drugs" has been a catastrophic disaster. It's done little to nothing to reduce drug abuse but has created a multi-billion dollar bureaucracy that we can't seem to get rid of.
Actually, when I mentioned that the FDA is considering placing even tighter restrictions on the prescription of opioids, I wasn't thinking of the possibility of removing drugs with acetaminophen in them – although that is certainly a serious concern. But an even greater concern to me is the fact that they are developing "Risk Evaluation and Mitigation Strategies" to try to put tighter controls on the use of opioids. Here's an article I wrote about it: URGENT: FDA May Remove or Limit Access to Opioid Pain Medications
As you'll see when you read the article, this could be a disaster for chronic pain patients. If they follow through with these ideas, I'm afraid we'll see a significant increase in suicides as you mentioned. What is sad is that these kinds of restrictions never seem to deter those who are determined to abuse drugs. They just make life miserable for honest people who are in pain and just trying to have some quality of life.
I'll be interested to hear your thoughts on this.
Karen
Dear Karen,
I read the proposed FDA changes with a growing mixture of disbelief, horror, and revulsion.
Patients suffering from chronic pain already have terrible difficulty obtaining access to opioids and opiates that they need in order to function. The proposed changes could make it impossible for the majority of doctors who currently prescribe such medications from doing so in the future. Already, the state health departments and the D.E.A. point a loaded gun to the heads of doctors who prescribe Schedule II narcotics -- now, they would seek to make it virtually impossible for these doctors to prescribe these drugs.
I had hoped that the proposed elimination of the compound analgesics would be accompanied by a loosening of the restrictions currently imposed on doctors in terms of their abilities to prescribe Schedule II narcotics -- how incredibly naive I was in thinking that the US government would act in a manner that would help its vulnerable and suffering citizens. It is almost as though our politicians are TRYING to make persons who suffer from chronic pain live in utter misery.
When the FDA was slow and reluctant to approve AZT (now known as zidovudine) to persons suffering from HIV infection, activists literally shut down the FDA building, barricaded the offices of prominent lawmakers, and resorted to illegal activities to force the issue. Ultimately, these activists succeeded -- the FDA listened, adopted a fast-track process for the approval of anti-retroviral drugs, and made these drugs available to those patients who needed them. I am now beginning to think that the only way of making it clear to the US government that patients suffering from chronic pain need their opiates and opioids is to resort to such illegal activities.
I am very, very glad that I no longer live in the US, and have no plans to return to the US. I have watched those who oppose President Obama's plans to implement a universal health care package that would ensure that all Americans have access to healthcare describe the President's proposal as "socialized medicine", and I have seen some protestors actually display placards depicting President Obama as Adolph Hitler, complete with a small moustache. These bastards seem to think that merely using the phrase "socialized medicine", and portraying President Obama as Hitler, somehow makes the problem of 50 million uninsured Americans go away. There is a reflexive response to the phrase "socialized medicine" that shows just how ignorant those who use this phrase really are. I now rely on the British NHS to help me deal with chronic pain, numerous medical complications of Marfan syndrome, physiotherapy, MRIs, CT scans, echocardiograms, etc. - and I am both appalled and disgusted by the American attacks on the NHS - attacks that utterly misrepresent the NHS, using scare tactics invoking the spectre of healthcare rationing - completely overlooking the fact that healthcare is already rationed in the US, and that only those who are either independently wealthy or who have very generous health insurance actually have access to healthcare. America may indeed have the best medical technology in the world, but it most certainly does NOT have the best healthcare system in the world, and those ignorant fools who keep banging the drum and insisting that America has the best healthcare system in the world are utterly misguided and utterly misinformed. Commercials in the US currently defame the NHS, grossly and criminally misrepresenting the NHS and indoctrinating the American people with horror stories about long waiting lists and substandard medical care. I have relied on the NHS for several years now, and have nothing but praise for a system that has taken care of me and addressed all of my medical needs without my having to pay a single penny - yes, I pay taxes, but my taxes in the UK are substantially lower than the taxes I used to pay in the US.
If the NHS represents "socialized medicine", then LET'S HEAR IT FOR SOCIALIZED MEDICINE!
Should the FDA succeed in forcing these two changes upon the American people, I foresee a growing trend in which people suffering from chronic pain will turn to fraud and misrepresentation to obtain their medications, probably by travelling to Canada and / or Mexico to obtain their medications. I would personally support these patients without hesitation. Nobody should be forced to suffer from excruciating pain, day in and day out, because a nation has lost its way with respect to the "war on drugs", which has increasingly turned into a war on people.
I watch those who oppose President Obama demonize the NHS, and it makes me sick to my stomach to watch these false and ugly misrepresentations. The visceral hatred that so many conservatives harbour for President Obama is unlike anything I have ever seen before in American politics - clearly, the neoconservatives cannot stomach the fact that THEY LOST, and lost BIG TIME! The American people voted for a man named Barack Hussein Obama over the neoconservatives - something that the latter group cannot deal with and simply cannot handle. THEY LOST, to a black man (horror!), whose name sounds like Osama! - and they cannot deal with this loss!
Karen, I can only say that I am deeply saddened, but am not in least surprised, by the materials to which you referred me. Now, we have to decide how to respond to this. If persons with HIV were able to obtain AZT and other much-needed drugs by resorting to civil disobedience, then person suffering from chronic pain may wish to resort to the same tactics. When persons who suffer from chronic pain appear in court, as defendants, and tell juries about the excruciating suffering and pain to which their governments have condemned them, without due process and without an adequate reason, they may well receive sympathetic hearings (and equally sympathetic verdicts).
Try to imagine a world without Tylenol #3 with codeine, without Vicodin, without Norco, without Darvocet, without Percocet, and without generic versions of these drugs. Then try to imagine a world in which almost no doctors would be authorized to prescribe drugs such as OxyIR, OxyNorm, OxyContin, Morphine Sulphate, MS-Contin, hydromorphone, oxymorphone, dipipanone, and the other Schedule II narcotics. Then try to imagine suffering from chronic, unremitting pain of the severity that causes people to kill themselves. This is indeed a form of legalized torture, made possible by another American "war on" something - in this case, drugs.
Let us both keep our ears to the ground and report back to each other on whatever we hear. My email address is philipchandler domain earthlink dot net.
I look forward to hearing form you.
PHILIP CHANDLER
HONESTLY SIR I AM ONLY 28 AND I WAS ADDICTED TO OXYCONTIN WITHIN A WEEK AND IT WAS SO HARD TO GET OFF OF IT! I MEAN IT FELT LIKE I WAS LITERALLY DYING INSIDE AND OUT, NOT TO MENTION THE DEPRESSION PART OF IT BUT IF YOU ARE HAVING PAIN LIKE THIS GO TO A PAIN DOCTOR AND ASK THEM IF THEY KNOW OF ANYBODY BECAUSE I KNOW OUT HERE IN BOLINGBROOK, ILLINOIS THEY HAVE TONS THAT TAKE MEDICAID AND THEY PRESCRIBE IT FREELY BUT LIKE I SAID THEY CALL IT "HILLBILLY HEROIN" OUT ON THE STREET AND THAT CAN'T BE A GOOD THING RIGHT? BUT I MEAN IF YOU ARE IN THAT MUCH PAIN GO TO THE EMERGENCY ROOM AND SEE WHAT THEY WILL HELP YOU WITH IF YOU HAVE TO MAKE A SCENE AND THEN I AM SURE THEY WILL HELP YOU ;) GOOD LUCK!! HOPE YOU FEEL BETTER!
I suffer from an inherited syndrome named Marfan syndrome that is highly lethal if left untreated. Marfan syndrome is a connective tissue disorder caused by a faulty gene named FBN1 located on the 15th chromosome pair; the defective version of FBN1 causes the body to create an insufficiently elastic version of a key protein named fibrillin-1, which is an essential component of connective tissue. Marfan syndrome also causes overactivity of a hormone named Transforming Growth Factor beta (TGF-beta); the results of this are that organs throughout the body suffer structural defects, and persons with Marfan syndrome frequently present with unusual height, high myopia, highly arched palates, "crowded mouth" problems, skeletal abnormalities, sinus hypertrophy, and other problems that cannot be attributed to the defective version of fibrillin-1 coded for by the damaged version of FBN1 alone. Marfan syndrome is autosomal dominant -- if one parent has this syndrome, each of that parent's children has a 50% chance of inheriting the syndrome; if both parents have this syndrome, each of that couple's children will definitely inherit the syndrome.
The most serious, life-threatening complication of this syndrome with which I present is an ascending aortic aneurysm; the aorta is the largest artery in the body, and an aortic aneurysm is a weak spot in the wall of the aorta that can disintegrate ("dissect") over a period ranging from a few seconds to several days. It can also rupture abruptly as opposed to dissecting; when this happens, the patient is usually dead within seconds. Very few people survive aortic dissection or rupture without surgery. When the weak spot reaches a size with which the cardiologists and other doctors are no longer comfortable, the standard of care consists of surgery to section the damaged aorta and to replace the aortic valves (if necessary) with artificial valves, or valves from the heart of a pig. The latter valves wear out and have to be replaced after a number of years, whereas artificial valves last a lifetime.
Up until recently, there was not much that patients could do other than take beta blockers (which act indirectly, by reducing the pressure applied to the wall of the aorta with every heartbeat) and carefully monitoring the size of the aortic aneurysm. Recently, however, Dr. Harry Dietz (of Johns Hopkins) established that overactivity of TGF-beta is also at the heart of pathogenesis of this syndrome. Commonly prescribed drugs named angiotensin-II receptor blockers (or antagonists) (ARBs) can reverse the effect of TGF-beta, and administration of ARBs such as losartan, candesartan, and irbesartan has been shown to reverse aortic wall damage in pediatric cases (clinical trials with adults are yielding very promising results too). Consequently, I now take losartan 200 mg daily in divided doses of 100 mg; this finding has revolutionized the treatment of Marfan syndrome, and it is entirely possible that my aortic aneurysm will never require surgical correction.
Unfortunately, there is nothing that can be done about the severe and permanent damage to my spine and joints that has already occurred. I suffer from levoscoliosis, facet joint arthropathy, disc compression, multilevel annular bulges, prominent spur formation, prominent Schmorl's nodes, disc desiccation, bone marrow signal changes, prominent osteophyte formation, marrow edema, and other indicia of severe degenerative changes; and I present with bone infarcts above and below each of my knees. I also suffer from osteoarthritis, which causes me severe and unremitting pain when not appropriately medicated. I also suffer from osteoporosis, which renders me an unsuitable candidate for treatment with rods inserted into my spine (as has been done in the case of many other patients suffering from osteoarthritis).
In 1995, my primary care physician (PCP) in New York City prescribed OxyContin. We titrated the dose until I obtained excellent pain relief at 80 mg twice daily (total dose of 160 mg every 24 hours). This dose remained effective for many years; I have been lucky in that I have developed tolerance relatively slowly. My PCP also prescribed Norco 10 / 325 for breakthrough pain; Norco 10 / 325 consists of 10 mg hydrocodone mixed with 325 mg acetaminophen. My PCP was very generous, and I received 240 Norco tablets every month; in addition, my Norco prescriptions were almost always written with five refills.
I moved to the UK about two years ago, and over the course of this timeframe, my doctor here in the UK increased my dose from OxyContin 120 mg twice daily to my current dose of 200 mg twice daily (total dose of 400 mg every 24 hours). This is definitely a high dose - I am receiving high dose opioid therapy. I cannot overemphasize the fact that I do not abuse my medications. My doctor here in the UK trusts me with an eight-week supply of my medications, which means that I take home a total of 224 OxyContin 80 mg tablets and 112 OxyContin 40 mg tablets every eight weeks. She also prescribes OxyNorm (named OxyIR in the US) 10 mg and 20 mg capsules for breakthrough pain, and gives me a total of 168 OxyNorm 10 mg capsules and 168 OxyNorm 20 mg capsules every eight weeks. In addition to this, she prescribes the UK equivalent of Tylenol #3 with codeine; I receive a total of 448 Co-codamol tablets every eight weeks. When the breakthrough pain is relatively mild, I take the Co-codamol tablets; on the other hand, when the breakthrough pain is severe, I take the OxyNorm 10 mg and OxyNorm 20 mg capsules.
If these quantities sound excessive, it is because doctors in the US are notorious for UNDERTREATING chronic pain. This is not news; several studies have confirmed that there is an appalling tendency on the part of doctors in the US to avoid prescribing opioids and opiates, even in those cases where the prescription of such drugs is clearly indicated. The terms "opiophobia" has been coined to describe the shocking tendency of so many doctors in the US to avoid prescribing drugs from this class; about 20% of family practice physicians do not even bother to order the triplicate prescription blanks that are required in the US for the prescription of drugs from this class! Doctors in the US wrongly assume that addiction and physical dependence are the same thing; they are NOT the same thing, and the fact that doctors, of all people, fall into this trap is testament to the ignorance that plagues so many doctors with respect to pain management and the prescription of drugs from this class.
This is not entirely the fault of the doctors. The "war on drugs" has been conflated with the legitimate prescription of powerful analgesics from the opioid and opiate classes of drugs, and many doctors feel under constant threat of being audited by the respective state boards of health and by the Drug Enforcement Administration (D.E.A.) whenever they contemplate prescribing opioids and opiates. This situation is both ludicrous and tragic; politicians and petty bureaucrats, uninhibited by wisdom, knowledge, or experience, make decisions as to what constitutes the "excessive" prescription of opioids and opiates, and then impose these determinations on medical professionals who have spent seven years or more obtaining hard-earned professional qualifications. It is little wonder that so few doctors are willing to prescribe as many Schedule II painkillers as they deem necessary.
(Schedule II painkillers include pure codeine, pure dihydrocodeine, pure hydrocodone, pure oxycodone, and other opiates and opioids that are not compounded with acetaminophen. Schedule III painkillers include many of the weaker opioids and opiates compounded with acetaminophen. For example, pure codeine is a Schedule II medication, whereas Tylenol with Codeine #3 is a Schedule III medication. Schedule II prescriptions may not be issued with refills; every time the patient needs another month's supply of the medication concerned, the doctor has to issue an entirely new prescription. Schedule III prescriptions, on the other hand, may be issued with up to five refills. Schedule II prescriptions have to be written up on triplicate prescription blanks - one copy of the prescription is retained by the doctor, one copy is retained by the pharmacy, and one copy is retained by the state department of health. Schedule III prescriptions, on the other hand, may be written up on ordinary prescription blanks. There is therefore an understandable, but very unfortunate, tendency on the part of doctors in the US to prescribe large quantities of weak opioids and weak opiates compounded with acetaminophen, as opposed to prescribing more powerful opioids and opiates unadulterated with acetaminophen; the result is that a large number of patients end up taking large quantities of acetaminophen that, at best, are useless to them, and at worst, are damaging to their livers.)
When prominent personalities such as Rush Limbaugh and (possibly) Michael Jackson are found to have abused OxyContin, they do an incalculable disservice to those men and women who are in genuine need of this particular medication, as well as to concerned friends and relatives of patients who take this medication. Following Michael Jackson's death, and the questions raised about OxyContin (including newspaper articles describing OxyContin as "hillbilly heroin" and articles describing the "struggle" that various persons have had trying to wean themselves from OxyContin), well-meaning members of my immediate family badgered me for weeks, trying to get me to stop taking OxyContin, and describing the articles that they had read about the bad press that OxyContin has received, and the "chokehold" that OxyContin has had on the lives of other men and women. THANK YOU, I GET THE POINT - when an irresponsible fool abuses a drug such as OxyContin, the results are bound to be tragic and unfortunate. When Sonny Bono skiid into a tree at high speed whilst in a Vicodin-induced stupor, his wife insisted that Vicodin (hydrocodone mixed with acetaminophen) was a "dangerous" drug that "robbed people of their thought process" - without regard to the fact that the dumb fool should never have been performing high-speed physical exertions whist under the influence of hydrocodone in the first place!
But I reserve unfettered, open contempt for Rush Limbaugh - an abusive, vicious bully, who had repeatedly and savagely mocked people suffering from substance-abuse problems, and who had attacked the Americans with Disabilities Act (ADA) precisely because this Act protects people whom Limbaugh refers to as "defectives" (his word to describe people addicted to drugs). This mealy-mouthed hypocrite had the effrontery to seek refuge in a drug rehabilitation center when news of his dalliance with OxyContin and hydrocodone preparations hit the fan. Instead of accepting personal responsibility for his behaviour (bullying his housekeeper, Wilma Kline, into diverting her husband's post-operative Vicodin prescription), Limbaugh actually blamed OxyContin and Vicodin for his downfall, insisting that there was something inherently dangerous about these particular drugs that forced him to abuse them. This variant of "the Devil made me do it" is particularly stomach-turning when it is uttered by moralistic bigots who hurl accusations against gay Americans (for example).
To those persons who have become addicted to OxyContin - you have my sincere sympathy. However, please do not make the assumption that all people who take OxyContin will necessarily become addicted to this drug. I have encountered this mentality with depressing frequency, and it is frankly both arrogant and ignorant.
PHILIP CHANDLER
all i need to say to this long article is: I AGREE WITH EVERY SINGLE WORD as a prescribed oxycontin patient trying to postpone a major potentially paralyzing if they screw up, SURGERY because i'm only 35 with little kids, I AGREE, i don't even know what else to day, you nailed it.
I agree with you 100% on what you say I have been on oxycotinte 6o mg 3 times daily and oxycodone 4to6 times daily after 5years of being dianosed wit fibromiagia and I currently lost my job and got on medicade and no one will help me I dont drink or do any drugs but when I go to the emergency room they treat me like I am a drug addict and it makes me mad and sad and I tell them Idident ask for this pain or did I ask for the prescriptions that they put me on just not rite thanks
I am sorry for your trouble and agree with your assessment of American Physicians. I have hideous pain following extensive surgery as treatment for cancer. Nerves and tissue damaged and pulled in a mess. For the first several months surgeon would shake head and give script for a few percocet. Finally my Oncologist referred me to a Doc who specialized in, well, people like me. It has been great, except one catch. Had I received the correct treatment from the start, my pain would have been totally more successful. The surgeon was too busy both arrogant about his own good work and ignorant about pain treatment.
I hope this helps you. I am on medicaid also and in n.y. state you can get it w/ a prior auth. Also, I was getting them bfore I got the medicaid. call purdue phamacuticals and ask about their program they have. you have to go through this other co. 1st called EZ meds and pay like $59.00per/mo. and then send purdue $25.00per/mo. for as many brand name oxycontain that your Dr. perscribes a mo. So, it ends up costing you approx. $84.00per/mo. for your medication. you get your script send it to them and they overnight them to you every mo. you may even be able to bypass ez meds thats why I told you to call purdue 1st. Ask 1 800 555 1212 for a toll free # for purdue pharmacuticals or purdue labratories not sure which. there's some paper work initially but once you've done that your home free. Good luck and if you need anymore help let me know. hope all goes well cause I know the pain you're in I had almost the same injuries and then some so I know what you're going through!!
I fully understand the need for correct medication when dealing with chronic pain. I myself am a breast cancer survivor and I have been on oxycontin for the past 8 years now. Things are starting to get better though. I understand that docs are not prescribing hardly anything anymore, thanks to all the junkies out there, but for anyone, inlcuding you, who might need any help. I do have many leftover tablets that I am hoping to get rid of. I have been helping many pain sufferers online lately who just cant get what they need. Email me and we can discuss it further. I am only trying to help, seeing as how high prices are and everything else in the system..
Best Wishes to all,
Margie email - Makerswalk10@hushmail.com
Margie!!!! Don't ever sell or give your meds to anyone! That is a felony. Even if you have good intentions you are seen in the eyes of the courts as a trafficker of narcotics.
Don't do it!!!
And to anyone considering trying to purchase these drugs. Don't be crazy!!! See keep seeking a physician who can help. If your condition is real, don't give up! Someone will help you, just be honest with the doctor. Maybe ask friends if they are acquainted with a physician who is good.
You do not want to start down the road of seeking medication that you need illegally. You will destroy your reputation and any chance of actually getting the help you need. You will not only be in horrible pain, you will also be in prison.
Please stay on the honest path, even though it can be very hard to see at times.
Best wishes to all of you. I hope you get the help you need from a physician that you can trust.
- Berman Tchavensky
Oxycontin is wonderful drug for those in constant pain. I have two sides of the stories. 1. My mom has fibromyalgia and in constant pain, she takes Oxycontin and Oxcodone (Percocet). 2. My husband became severely addicted to Oxycontin (OC's) and is now in recovery (7-1/2 months clean) while taking Suboxone. For someone in your situation who will more than likely spend the rest of your life in agonising pain, I would suggest calling Medicaid to get a Provider listing for your area. You could also try their website. You will probably always need pain medication so dependence in enevitable but addiction is a different subject totally. I am from South Carolina and am currently in Pain Management myself. Just remember over time your body does build tolerence for opiod pain relievers. So there is no where to go but up as far as strength is concerned. I hope that you find the doctor you need. Good luck!
I was in the same situation. I had a Pain Management Doc who didn't take it etiher.
They were great when I was working and had great insurance but when the pain after 3 surgerys and a blood clot on my spine....and too many other issues to count left me with no job and no insurance...they werent so great anymore.
Most hospitals offer a Pain Clinic. Mine does. And if it is in a hospital medicaid should cover it.
The problem is that medicaid doesn't cover oxycontin. So your Doctor would have to try you on a few other things I believe before they would cover it. In fact that is why Im here Im looking to see if anyone knows the process before my doc appt next week.
I have been on 4 different things and nothing controled the pain like oxycontin.
Do not listen to naysayers who number 1 do not understand what it is like to live with chronic pain...#2 Have no clue the differnece in dependence versus addiction. Of course if you are on a med for a long time and stop taking it you will feel withdrawl but so would someont with another illness who stoped taking insulin....If you take it as prescribed you are fine and the doctor will ween you off when you dont need it anymore.
Chronic pain is horrendous! Some people actually cant take it anymore and take their own lives becasue their whole life changes. You cant do anything well anymore and you cant forcus on ANYTHING except your pain. That is Y these medications are out there.
PEople get addicted to EATING are we gonna take away food....or sex....
Im so tired of people thinking averybody is Michaeil Jackson! Good Luck!
I too have been a long-time pain patient, due a bad fall resulting in to two spinal surgeries on six separate levels on my neck --as well as what is referred to as a syrnx (an inoperable cyst situated inside of my spinal cord).
Because the syrnx cannot be removed or cut into without, most likey, leaving me a quadrolepic, my doctor opted instead for a shunt to drain the syrinx and pain therapy for, most likely, the remainder of my life.
I have been on a combination of pain meds (Oxycontin and Methadone together) for the past four years now. For me,together, they work better than the 12-hour dosage of Oxycodone alone. Ask your pain specialist about this commonly used combination of drugs. Methadone removes pain without any woozy side-effects at all. And along with the Oxycontin every four hours, my pain has been bareably stablized over these years. Hope this helps.
R. Casper
P.S. The bad news is, though, that with pain such as yours or mine--due to a combination of surgery scar tissue, irreversable neurological damage and of course the continuing situation that exists in your back, neck and leg, you must come to terms with living with pain, to some degree always. Truth be told, the mantra of all pain specialists is: you can never expect complete and total pain removal after such an ordeal as yours or mine.
Now the good news, see if your doctor will consider altering your meds and trying a different combination to control the pain. If he refuses to, it's time to shop for another pain specialist. Also, just a tidbit that works for me, Relaxing from stress is key and helps greatly. I can't stress that enough.
Before this physical nightmare I was a very busy lady with a warp-speed career, that I loved. Now, with my career and much of my life on the back-burner, there are many new roads to walk down and discover.
I wish you the best with your challenge. But remember: doctors work for you; you do not work for them. Shop around to get satisfaction and a less pain-filled existence from the best specialist you can find. Interview them as you would someone applying for a job. I have a feeling you're going to be fine.Good luck and God bless.
Gosh i know exactly how you feel i just recently moved to Florida from NY where my doctor was sure to keep me pain free. I had everything transfered to a doctor here in Florida including my MRI results i have also had new Florida MRI done and my doctor tells me he cant write the medications i have been on for years despite my awful MRI results d/t the state regulations which i know nothing about he said i have to goto a pain clinic and has given me refural except not ONE will accept medicate i hate who ever has ruined it for ppl in real pain and i Hate Floridas dumb rules if i leave its because in NY you have one doctor and no problems the doctors in NY do not le their patients suffer!!!! EVER
This is a question for justkathy11. I'm hoping that u can help me, I'm from Long Island, NY. You say that you had no problem getting the proper pain meds from doctors here. Well, I really hope you can give me a name of a doctor or pain managment doctor who would be willing to prescribe the proper medication and dosage needed. I have been in pain for 7 1/2 years now. I see a neurologist and an afflilate neurologist pain mgt doctor. Besides having MS for 10 yrs and my largest lesion affects sensory, Im overly sensitive to pain, touch, hearing, etc. It's a long story how I ended up with all the problems I currently have but will tell u what I do have now..6 herniations in my thorcic spine, 4 bulges in my cervical spine, with 1 affecting the spinal cord. I have facet arthritis down my entire spine, and my L5 has antheosis (not sure if right name) but is the vertabre not in position my is pushing back. I have bulging in L1 and L2, SSI Joint, coccydynia and this list goes on..with severe spasms in my upper and mid back..Im unable to sit for anylonger than 10 mins have to constantly switch positions. I am unable to work anylonger and applying for SS disb.I was on fentayl patch for 4 years, with Vicodin 750 4 times a day for breakthru pain...I was switched from the fentayl to oxycontin when I started PT in a heated pool, the patch wasn't working properly. Pain Mgmt doctor started me on 20 mgs 3 tices a day with vicodin...I kept complaining that I needed more mgs for the oxys, so he put me on 30mgs morn..20 mgs afternoon, and 30 mgs nite...I called several times crying bc I needed moree mediction, and also when he went up 10 mgs mornng and nite, he totally cut me off of the vicodins 4 times a day.I couldn't bear the pain so a few times I took extra oxys 40/40/40 and this worked alot better and gave me some quality of life....he will not give me any meds for breakthru pain and will not give me any addl mgs..which I think is awful, being he is there to help to make me as pain free and functional as possible...I want to find another doctor to go to who is willing to keep me from this awful pain and was wondering if you can give me names of doctors who willl prescibe the right dosage..I have all my MRI's and written reports to brring to a new doctor so can you posssibe give me any names of doctors u know that would help me and I would switch from my current pain managmet doctor bc he's not even trying to help me...thank you Donna
I am from LI now in Florida but i moved here from upstate NY which Doctors actually care bout their patients and needs the drug abusers and seekers are making life living hell for those of us suffering.. If you were upstate i could help you with doctors.... I am having a hell of a time here in Florida :( if i go back to NY the reason would be is for the doctors i am suffering big time and now doctors here will only prescribe percocet and only twice a day d/t abusers and other doctors who are in trouble for the way they have prescribed to people who were abusing and must i say Florida medicaid suckssss you need to be seen in a pain clinic to be able to get the meds you need and of course they dont take medicaid.... The cash price for one visit is like $500.00 then 200.00 every visit after to get a refill on your scrips... How can doctors get away with letting their patients suffer their should be a way to fight this i dont know i am at a loss in this god forsaken state!!!!!!!!!!!!!!!
I am sorry for what you are going through. I couln't find a doctor either. I fired my old doctor after being in pain for four years and more symptoms of joint pain, he still couldn't find out what was wrong with me. I got a new doctor and because my old doctor had me on 8 vicodine a day for years she accused me of just wanting pain pills. She fired me after she ordered mri's of my shoulder and hip but before I even had them done. And I know it is so hard to find a doctor that will take chronic pain with all this pain med issues going on. I am going to the state medical board. This is not fair I dont do drugs or drink either, I am a mother of 5 and don't have time for that. I had to take a leave from work but I have had the same job for 11 years. It really upsets me that I was called a narcotic abuser for no reason just because I was in pain. I recommend that you call your insurance. I have anxiety from doctors now and I am having my medicade call to find me a doctor. Good luck to you.
hi my name is brandi and my mother mary gilbert has the same problem as u do she has authoritis and alot more health problems.. and it seem like she cant get any help and it makes me wanna cry because i cant help or tak the pain away from her and the pain is sooo bad for her she somtimes feel like givin up abd takin her own life and it really sad cause u can tell the doctors whats goin on and its like they dont care they have no compasion and i didnt know it was suppose to be like that and now that medicaid dont pay for oxycontin it is a shame because who has money to pay for this drug that does work mircles for you and people like my mother if they can t afford it...its just a shame and it is also a shame for people to be able to get it and theres nothing wrong with them cause when it comes to people that need the medcine they have to go threw hell and back to get what they need soo if anybody can help us please reply.
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You need your family doctor or back doctor to refer you to a pain clinic. Mine is associated with my hospital. I don't think you can go to the pain clinic without being refered. Also if you are a veteran, try calling the veterans administration and see if they can help you.
Philip is lucky that the oxycotin really helps him. As I said, I can't take the oxycotin or oxycodone, it gives me bad headaches, and doesn't help that much on pain. I am on percocette 20mg four times daily and my pain level is still way to much to have even an ok day. Every day is bad and some are worse.
If anyone at this site that has been on oxycotin, oxycodone or percocette for any length of time and doesn't feel that they are addicted because they use the meds as prescribed and only for pain, they are fooling themselves. I have been on my pain meds for 8 years and ALWAYS take them as directed and I am still at a pretty low dose. I don't drink. I went off these pills 3 different times because of family or doctors making me feel guilty. The withdrawal is terrible. I never suffered from the pain of my condition during withdrawal because the pain of withdrawal over rides the condition because it is so much worse. After about two to three days its out of your system, but the pain of my condition was terrible. I thought the pain doctor would be pleased with me, but he knew I had no choice but to be on pain pills. The pain I have gives me no quality of life at all.
Any one suffering from chronic pain should also consider taking an antidepressant. It's very hard not to be depressed living in pain every minute of the day.
One last word to all of you out there........PLEASE don't go purchasing pills from anyone on line that says they have extra pills and would be glad to help you. You don't know what your getting and you could always make your condition worse. None of us need more pain to deal with.
God give all of you out there (and me) the strength to keep searching for some relief and a better quality of life.
I am having the same issue. I was going to a pain clinic in Joliet Il then we lost ins and I could still go but I have to pay 150 a visit to get my scrip then medicade pays for the pills but sometimes I just cant afford the $150 visit. If anyone does find a medicade pain dr please let me know. I nurt all the time and have no meds at the p[resent time.
Thanks
Christy
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Karen,
You state that very few doctors would prescribe 80 mg OxyContin for sustained, long-term use. I must interject here. I have written, above, about my condition in considerable detail -- but what is relevant to your reply is that I am currently taking 200 mg OxyContin every 12 hours (a total of 400 mg every 24 hours). This is actually the British National Formulary's recommended maximum daily dose -- but it is essential to mention that there is no upper ceiling associated with opiates and opioids. Many people -- including doctors -- do not know this. The fact is that a person on high-dose opioid therapy can take massive doses -- doses that would kill an opioid-naive patient -- without any ill effects whatsoever. It is not unusual to read about patients taking OxyContin 800 mg daily -- in fact, I think that this is the maximum amount that Medicaid will pay for.
You state that very few doctors would prescribe 80 mg OxyContin for sustained, long-term use. Respectfully, I must interject and strongly disagree here. I have written, above, about my condition (Marfan syndrome) in considerable detail -- but what is relevant to your reply is that I am currently taking 200 mg OxyContin every 12 hours (a total of 400 mg every 24 hours). This is actually the British National Formulary's (BNF's) recommended maximum daily dose -- but it is essential to bear in mind that there is NO UPPER CEILING associated with pure opiates and opioids. Many people -- including doctors -- do not know this. The fact is that a person on high-dose opioid therapy can take massive doses -- doses that would literally kill an opioid-naive patient -- without any ill effects whatsoever. It is not unusual to read about patients taking OxyContin 800 mg daily -- in fact, I think that this is the maximum amount that Medicaid will pay for in some states. I refer you to http://www.gao.gov/new.items/d04110.pdf, where it is stated (about OxyContin) that "Like all pure opioid agonist analgesics, with increasing doses there is increasing analgesia, unlike with mixed agonist/antagonists or non-opioid analgesics, where there is a limit to the analgesic effect with increasing doses. With pure opioid agonist analgesics, there is no defined maximum dose; the ceiling to analgesic effectiveness is imposed only by side effects, the more serious of which may include somnolence and respiratory depression."
Back in 1995, I started on OxyContin 80 mg twice daily (a total of 160 mg OxyContin every 24 hours), with hydrocodone / APAP 10 / 325 for breakthrough pain. I developed tolerance very slowly (gradually increasing to 200 mg twice daily over a period of 14 years). When I moved from the US to the UK, I started taking OxyNorm for breakthrough pain (hydrocodone is not available in the UK), so in addition to the OxyContin 200 mg twice daily, I also take OxyNorm 10 mg and OxyNorm 20 mg as needed for breakthrough pain.
You state that it will do a person no good to make a scene at a hospital ER, and I completely agree with you. There have been times when I have suffered such excruciating pain that I have gone to the ER -- and by asking for an injection of diclofenac (which is a particularly painful and unpleasant injection), I have obtained more appropriate pain relief with a fentanyl patch or with an injection of meperidine -- by asking for a non-opioid injection, I have established my good faith intentions with the hospital staff, and have obtained more appropriate pain relief. That is truly perverse. This was NOT a ploy on my part; I go through utter hell when my back acts up (please see my above message about Marfan syndrome)...
I have written above about the problem with the D.E.A. -- doctors in the UK are much, much more willing to prescribe powerful opiates / opioids than are doctors in the US, precisely because they do not have to worry about a Sword of Damocles hanging over their heads every time they write out prescriptions for drugs such as OxyContin. I have NEVER abused my prescriptions and have NEVER sold them -- this would be such shabby treatment of my doctor here in the UK, who is a kind and decent person who has bent over backwards to help me, and who is a wonderful clinician; I am shocked and upset when I learn of patients who sell their doctors down the river like that...
Thank you,
PHILIP