New FDA restrictions on hydrocodone?

I know there was a similar thread posted, but I wanted to flesh some things out here, with my own thoughts. Not so much a rant, keeping the invective in check, but a reasoned, thought out statement.

What's been recommended by the FDA Panel is changing hydrocodone, and the meds that contain it, to the same schedule as morphine, oxycontin, and methadone.

What this effectively does is require more office visits, increase costs to the patient, give more latitude to pharmacies to not fill a prescription if they feel it is not legit, and stigmatizes those who uses these meds - lumping them in with those who would seek to fill false or stolen prescriptions.

The problem here is not that "If you are doing everything right, you have nothing to worry about." There are dozens of threads, and I have run into it myself, of a patient, legitimately trying to fill a proper prescription (that in many cases was hard enough to get in the first place), and getting treated badly, ie; as a drug addict, by pharmacy staff, whether at a chain, or even mom and pop type pharmacies.

The problem here is that the FDA is trying to put the genie back in the bottle. We all know that prescription drug abuse exists. We all know that because of that, it's tougher for those of us in long-term pain to even find a pain management physician in some cases who is willing to see us. And those that are willing to see us are generally less willing to prescribe amounts or dosages or even medications that even have an effect on out daily lives.

It seems that one of the central figures in this, Dr. Andrew Kolodny, head of the "Physicians for Responsible Opioid Prescribing" is a psychiatrist. He is quoted in some of the news stories surrounding this, and had been, apparently, a long time advocate of this type of action. This group has a very interesting series of videos on YouTube, which I do recommend watching. They seem to be pretty professionally made.

The central argument of this group seems to be that there are no long term tests on the effects of opioids on the bodies of those who get them prescribed. Most studies are 12-16 weeks. This much is true. And there are side effects to these medications. We are all familiar with these.

But, on many occasions during those videos, Dr Kolodny, who I am assuming is behind the camera, and his colleagues have said that there needs to be a comprehensive study done. Fine. Do the study. He is a department head of a hospital. Find someone to run the study, and quantify your colloquial evidence that states that "non-malignant long-term pain is not well suited for opioids." Where the questions come in, and they are raised in the videos, is increase in mobility and useful motion. A properly trained Pain Management Doctor will do more than just prescribe the pills. There will be at a minimum flexibility and strength exercises, or physical therapy, depending on the starting point, and the injury or condition the patient is trying to recover from.

Ah, but here's the other issue. Money, again. Insurance, or whatever healthcare you have backing you up may or may not cover physical therapy, and if they do, it's for a limited time. This issue, of combining the medication with actual physical movement, was not brought up in the videos that I watched, to my recollection. But the FDA does not regulate physical therapy.

In the end, and though this was a panel that passed the measure, the full FDA usually complies with the panels, a psychiatrist who cannot write a pain prescription has managed to change the way pain is treated. And who catches the fallout from people who will have more emotional problems from withdrawal or other issues with a drop in pain meds and an increase in pain levels and change in body identity from re-increased pain? And who will counsel the spouses and children of those who will have really bad reactions to this?

this news story troubled me when I first heard it today, but not too concerned, yet. my pain meds are being prescribed by my oncologist, who is treating me for advanced metastatic prostate cancer. many cancer patients are dealing with CP, so I hope they don't start targeting oncologists too. Pain control is central and crucial to anyone dealing with a serious cancer issue.

david

The most upsetting part about this to me, is not fact that the FDA is trying to interviene into peoples lives even further than they already are; I think this has been coming for a long time. It's the idea that there is no amount of regulation on the side of patients (my opinion only), that will prevent or deter what's already going on with the side that are actually abusing the prescriptions. They just put into our local paper the other day that one of the teachers at the local highschool here was cited for being in possession of 10/325 oxycodone, without a prescription. The local PD showed up, wrote the teacher a ticket, and the teacher was allowed to finish the school day... They didn't say whether or not the teacher was under the influence or not, I'm guessing not, since they didn't perform an arrest. If that's all that's going to happen, how do they expect the abuse to stop?

Well what gets me is we keep hearing about them not knowing the long term effects of opiates,well we don't really know anymore about the long term effects of any other class of meds either.

The studies on all meds are pretty much done in the same control numbers with same variables.

They want long term effects? Take a look at Cpers,some of us have been on these meds much longer then their test groups.

I get tired of it all,just want to live what I have left as comfortable as possible and without all the headache the DEA wants to create for me.

Vickie

Its like when they blow up a bridge during highway upgrades. They put up a new one, all the approaches are built, and the new bridge is fully tested before you drop the old one into the drink.

This time, it kinda looks like they are considering running the det cord out and rigging the plastic explosives before new bridge has even been designed.

And I think a closer look at who is behind that push may prove interesting. Let the word get around anymore that grandma's arthritis medicine is going to be affected (maybe) and some ears may perk up.

I invite people who may not have heard my story to check out some of my other threads/rants & raves about dealing with an already broken system, and just trying to get xrays for a condition that had already been diagnosed 10 years ago, but I was unable to get the previous medical records. I'm still trying to get a diagnosis back.

C, the problem is they are not acting out of malice for those obtaining it illegally, at least not obviously. They are saying that there is no solid evidence that opioid based medications work for long term treatment of pain. (not shouting, just saying.) That's the hilarity (because you have to laugh) of it all. Because neither the drug manufacturers, who's patents expired long ago most of the time, would not spend money on them, nor would anyone else fund a study on this. It's anecdotal evidence. From the admittedly little that I've seen, and I'm not a lawyer, but I would have a hard time believing this would be admissible in court. Yet it could lead to a wholesale change in drug laws, which are convoluted enough already.

Yes we who suffer, and those who prescribe it know the effects, dangers, and side effects. It's been documented to death. But the aim of this group is not to ease suffering, as I see it, it is to at least reduce the amount given. Which is not a bad thing, altogether, but who suffers most? What are the other options? And who benefits most?

Again I submit that the president of this "Physicians for Responsible Opioid Prescribing" group is a psychiatrist. Now what medical professional would a person who has been on opiods somewhat successfully long term, who has had their medication level altered turn to for help in dealing with that?