med advice?

Actiq is fentnyl and if she's not going for the patch she's not going for that . Although it may be a approved med it's usually approved only for cancer patients so you would be out of pocket and it's costs would far exceed the oxy. The few we have on it are in a constant battle with insurance companies and waiting months for a decision approval for off label prescribing.

If Opana worked to some degree I would try to get her to calculate the dosing closer to the correct one. I did the conversion in the other post using pain management conversion table and the dose previously was somewhat low. She's either guessing or just didn't want to give you the higher dose right out the door and many drs are like that, they start on the lowest end and titrate up as needed. Switching meds every few months is not helping your pain. It takesa good several mmonths to just get steady serum levels.

Have you tried the patient assistance program for the OxyC?

Vickie and BTL .
I have to disagree when you say that fentanyl ER, the patch, is like Actiq which is Fentanyl trans-mucosal, the sucker. I have been on both and they are very different in effect. You can hardly tell that you have the patch on while when using Actiq or Fentora, that tablet, the effect of pain relief and wooziness is immediate. I definitely would not drive a car or suchlike while sucking on an Actiq. . . Q

I get you there, I'm just so hard wired on the dangers of Fentora and Actiq that I automatically warn people if they think it's going to be like fentanyl with no dizzy side effects. I like to be lying in bed when I take my Fentora, that way I can sort of direct the pain relief to where I want/need it the most. It's strong stuff . . . Q

Do you meet the criteria for Actiq ? Click on Transmucosal Fentanyl Products at the link below and see page 31 on that page.


TennCare Preferred Drug List (PDL) Effective September 15, 2014-
/tenncare.magellanhealth.com/static/docs/Preferred_Drug_List_and_Drug_Criteria/TennCare_PDL.pdf

i only said something about the actiq bc i was using it years ago, for surgery/stoma/nerve/scar pain, and migraines(that was before all these warnings, regulations and such. didn't know it was just for cancer now. Thanks.

I just don't know what to say to PM other than, can I try the opana again, but at a higher dose since my tolerance is so high....tellig your PM you have a high tolerance just scares me, even though she should know that knowing i've been on meds so long. But she is my newest PM so i guess she has to start at low dose and go up.

I didn't know of any other options either. Seems like its either morphine, opana, or paying $$$ for oxycontin...but the opnana made me sick, and morphine doesn't work at all-ever..

just tired of the pain....

Post Edited (AngMichelle) : 9/22/2014 3:19:13 PM (GMT-6)

I don't understand your statement mercy&grace?

AngMichelle, I was making a comment on what the general public believes Medicaid is and does. In my state it will not pay for Chronic Pain Management. You can't even find a pain management dr who will accept Medicaid. And to pay for it yourself is often more than most people can do on low income.

Those who receive Medcaid are Thankful for what it does pay. I'm just saying that reality and perception aren't the same. I didn't mean anything negative towards Medicaid receipents.

Talk to your doctor using very neutral terms and don't be anxious about it. "I don't feel my pain relief is adequate" or "My pain gets out of control sometimes and I can't manage it with my normal coping mechanisms" (which hopefully you have, outside of pills). Talk about what has worked and what hasn't worked and for me it's better if I write it down because I'll get anxious in the situation and not be able to speak about it in the detail I should to help my doctor figure out what might work for me.

Hopefully you have a doctor who is aware of the chemical make-up of the pain meds and will be able to pinpoint one that may work better based on the ones that don't work. I've mentioned before that I have a psychiatrist who is a chemical mastermind and she is always able to adjust doses and make suggestions based on how each different med works for me. I did very well on Opana too, except for the fact that I was RXed 2 per day and the last few hours before I could take the next one were sometimes pretty dreadful :(

Have you talked to your doctor about the Butrans patch? That has a lot of 'anti-abuse' properties. I've been on it for a little over a month and am at the highest dose (20 mcg/hour) now. Along with my BT meds and my other coping mechanisms, most days I can keep my pain under control. That's MOST days - I still have one-two super bad days a week, but then again I have 4 or 5 decent ones. I know it hasn't worked for a lot of people long-term (the butrans patch) but it might be worth a shot. I really like not having to keep track of two pills (an ER and an IR).

And as far as prescribing 2 per day for rescue meds, that's stingy, but it will help the rescue meds work better when you DO take them, at least in my experience. The more I take, the more I need ...

Ang...I'm sorry for what you are going through.  I want to tell you that you are not alone in your struggles.  I don't really have the answers.  I'm in a similar boat.  I don't have prescription coverage any more since my health insurance "downsized".  I am heartsick as I remember the many years that I had excellent health, dental, eye and prescription coverage.  I only had a small co-pay for all of the aforementioned, so I suppose I was clueless to the true "cost" of prescriptions.

I've had a bee-otch slap of reality since starting PM in January with no script coverage.  My PM doctor even gets frustrated with me when I tell him I can't afford the "big gun" meds I need.  He wants me on Fentanyl or OxyContin or Zohydro, but I can't BEGIN to afford those meds.  I have applied for PA, but I'm told I do not qualify due to income.  They don't take into consideration the amount of income is spent monthly for maintenance meds (alone) for my husband's HBP/AFIB and my AD, AA, Arthritis meds, Anti-spasmodic meds, etc.  WHO CAN AFFORD these crazy high prices without assistance?

I hope you find answers, but hope is not a plan.  The suggestion to research a drug comparison chart is a good one=)

Hugs~~Dixie

AngMichelle, there is another aspect for Medicaid Providers. The politicians have demanded that the high prescribers of pain meds and certain other meds to Medicaid Receipents be disciplined. And they want to be kept informed of what each state is doing to these high prescribers. Also it use to be that if a Medicaid Providers wasn't allowed to participate in Medicaid, that was it. Now, it will also affect their ability to be paid by Medicare. Medicare pays much more than Medicaid, so they choose Medicare. Although, Medicare is beginning to also tighten down on "overutilization."

The only alternative for someone on SSI who receives only Medicaid, is to pay out of pocket for pain management. And with the max federal amount, with no other income, being $721, saying the choice is difficult is a gross understatement.