Pain meds - more restrictions now than previous?

[martymoose, BSN, RN]

Hello- Have you noticed that the MD's are very leary of prescribing narcotics to new pain patients? Is this something as of recent?

I can give an example if anyone is interested.

[brownbook]

I have heard this has been an issue for many years. I don't have any facts or details. Just the general idea (from reliable sources) that doctors who prescribe a lot of narcotics may be investigated by state or federal agencies.

It makes no differences to the bureaucracy that these doctors are seeing legitimate patients with chronic long term pain issues who sure may be "addicted" but who at the same time need these narcotics for real pain.

I am sure there are a few rare doctors who abuse the system, give out narcotic prescriptions like candy, then ruin it for legitimate doctors and legitimate patients.

[tewdles, RN]

There are a number of published articles that detail the opiate aversion that some HCPs demonstrate. The studies show that reluctance, misunderstanding, and ignorance of prescribing principles adversely affect the pain management of a variety of patients...even in oncology where pain is anticipated.

[salvadordolly]

I live in the Midwest and the DEA has investigated MD's that prescribe pain meds, making them all paranoid to prescribe. A lot of docs say if they need a narcotic, they give a pain clinic referral. It seems to be getting bad for people with chronic pain. the clinics have to do a lot of paperwork to prove compliance and non-abuse, and their rules are getting tighter. My previous "pain doctor" was a physical medicine and rehab MD and was burnt out on all the inappropriate referrals. He moved out of state.

[sharpeimom]

My husband had foot and ankle surgery in late 2010 that did not go as expected and he has been on a variety of pain meds since. Some were narcotic and some weren't and all were ordered by a pain specialist at a pain clinic. Those meds were ordered with two refills and that worked well until the pain clinic lost its funding and the specialists left.

Now he still takes his Tramadol q6 hours, but our PCP said he is only allowed to order it a month at a time. He doesn't see him monthly but my husband calls for a new script and reports on his pain level monthly. Works so far.