Pain Meds and the DEA guidelines

What specific rule? Could you provide a little more detail?

Edit: oops,,, didn't realize this was the Stage IV when I answered. I'm a pharmacist, so if you don't mind me posting here, and if you can provide some more detail, I'll try to answer.

Mzmerz: These guidelines that you linked are meant for non-cancer chronic pain. The first line says it all:

Summary

This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.

Chronic pain OUTSIDE of active cancer treatment,, which I believe you fall under. I am sad that your doctors are treating you this way. They should be more proactive in helping you obtain your meds. And they should be prescribing you better drugs too. #60 Tylenol 3 to last 30 days. That is nuts. That is only 2 tabs a day for a med that only lasts 4-6 hours in duration,,, obviously not enough to get you thru the whole day. And Tylenol 3 is a crap pain med. (If it works for you, forgive me for saying that! But it is not the best choice)

As for the pharmacy: I would print that guideline and highlight that line that says OUTSIDE of active cancer treatment and let them know you are in treatment and you need your meds.

Many medical professionals are so afraid of the DEA that they allow their patients to suffer for fear of what might happen to their license. With proper documentation in your records explaining why you need the pain meds, it would not be an issue in case of an audit.

I hope you can find the relief that you need.

glennie

Nothing against Tylenol 3,, if it works for you! It is just not usually first option. And definitely you need more than 2 a day. Minimum you should be "allowed" is 4 to 6 a day. Best of luck with the doctor.

In response to the increasing hesitancy to adequately medicate cancer patients for pain, the American Society of Clinical Oncology (ASCO) issued the "ASCO Policy Statement on Opioid Therapy: Protecting Access to Treatment for Cancer-Related Pain," in May 2016.The statement provides principles to balance public health concerns regarding the abuse and misuse of prescription opioids with the need to ensure access to appropriate pain management for cancer patients and survivors: The policy states, "Cancer Patients Are a Special Population - ASCO believes that cancer patients should be largely exempt from regulations restricting access to or limiting doses of prescription opioids in recognition of the unique nature of their disease, its treatment, and potentially life-long adverse health effects from having had cancer." From:http://www.asco.org/advocacy-policy/asco-in-action/asco-releases-principles-balancing-appropriate-patient-access?et_cid=37861275&et_rid=1396253832&linkid=ASCO+Releases+Policy+Statement+on+Opioid+Therapy:+Protecting+Access+to+Treatment+for+Cancer-Related+Pain_btn

wow. I agree giving Tylenol 3 twice a day is crazy. Cancer pain is totally not on the same guidelines. Shame on to your dr for making you wait.

My Mo is very generous with pain meds we have tried many many different meds and strengths. Refills for him is never a problem and hospital stays he always gives me a demerol pain pump to control my own pain. His nurse says he is like this with all patients. Just doesn't seem right to have cancer patients living in constant pain. My problem is the insurance. Not the pharmacist fault. Insurance is extremely strict about refills. They only allow a refill 1 day before prescription ends. One pain med is for 30 days and 1 is for 27 ( the insurance allows a max qty written at one time ) so I have to go pharmacy twice in one week. Grr. Once a year they allow an early refill of 3 days for vacation. There is also 1 hospitalists who always tries to limit my pain meds at hospital but thankfully my Mo over rides his order.