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Medicare- Opioids and Benzodiazepines

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Posted 10/16/2016 7:29 PM (GMT 0)
I ran across this and thought some of you might be interested.

Concurrent Use of Opioids and Benzodiazepines in a Medicare Part D Population-
/www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/Concurrent-Use-of-Opioids-and-Benzodiazepines-in-a-Medicare-Part-D-Population-CY-2015.pdf
Posted 10/17/2016 10:41 AM (GMT 0)
Hey M&G.This is a topic that shakes me to the core.

I've been taking 3 mg of Xanax a day for 13 years.Really bad things happen to me without it.

If I have to choose between the 2 I'll have to choose Xanax.

I feel that I would die without it.

Maybe I'll learn how to grow Opium Poppies...Just Kidding..

Take care.

Rick
Posted 10/17/2016 5:27 PM (GMT 0)
M&G, I read about this a while back. From what I understood they are headed towards making people make a choice of which medication they need the most. The only way both would be rx'd is for a very short term. For some reason I couldn't get the above link to load. Most likely it was me.
Posted 10/17/2016 8:05 PM (GMT 0)
straydog, It's not just you. I can't get to it either, if I try and use the link I posted, but I can get to it from my Bookmarks. I sincerely apologize for the confusion. Anyone else that the link doesn't work for, please let me know.

I have posted another link below, it is on page 214. This info is much shorter that what is in the link I originally posted, but it says basically the same thing. There are seven pages at the link I first posted, so it is too long to copy and paste due to what it would cost HealingWell.

Go to page 214-215-

/www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf
Posted 10/18/2016 12:10 AM (GMT 0)
There was an extra dash included in the original post.

/www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/Concurrent-Use-of-Opioids-and-Benzodiazepines-in-a-Medicare-Part-D-Population-CY-2015.pdf

It happened when I posted it also. I can't get it to go away. But if you copy from the bottom right, up to but not including the initial dash, and paste it, the website will come up right.

Post Edited (Alcie) : 10/17/2016 6:19:50 PM (GMT-6)

Posted 10/18/2016 12:25 AM (GMT 0)
I'm hoping this doesn't mushroom into a ban on prescribing benzos and opioids together for everyone. I'm battling severe pain but also nighttime severe spasms and have had no results with anything but Valium, and that doesn't even completely stop them.
Posted 10/18/2016 4:30 AM (GMT 0)
Alcie the article I read not long ago said they will be stopping the two together & they indicated a 2 week limit would be placed on the 2 together.
Posted 10/20/2016 8:36 PM (GMT 0)
I think this pertains to when the same doctor prescribes both and the benzos are prescribed for a condition related to the chronic pain the opiates are being prescribed for.

I know several people that go to doctors that will not prescribe opiates and benzos. But, they are prescribed a benzo for a mental health impairment or seizures and they have not had any problems getting their prescriptions written for opiates or benzos.
Posted 10/20/2016 11:06 PM (GMT 0)
Susie, or anyone who knows, I'd love to read more about this. I'll happily read an article if anyone can find a link.

M&G, do you have any more info?

I had a better night last night with my screaming spasms after taking a small dose of lorazepam.
Posted 10/20/2016 11:38 PM (GMT 0)
Alcie, I don't have any more info at this time. If/when I come across anything else I will post it. I did anticipate it with the FDA adding the Box Warnings to these meds.

I have not run across anything that states a doctor Cannot prescribe an opiate and benzo together or for longer than a short time frame. It is still up to each doctor to prescribe for each patient according to their professional judgement. I do think that many doctors have stopped prescribing these meds together. But that is their choice. If a pain doctor or pcp prescribes an opiate and a psychiatrist, neurologist, etc prescribes a benzo for an condition unrelated to pain, chances are there won't be a problem. Of course it is still up to each of those doctors what they prescribe.
Posted 10/21/2016 12:39 AM (GMT 0)
Alcie, you may want to look in the link above that M&G posted for us & see if you can find anything in there. From what the article said it was geared towards CP patients having to make a decision of which medication they wanted long term. They did the usual citing a bunch of garbage about the deaths related to the two drugs combined. They will target this as they have in treatment of CP.
Posted 10/24/2016 10:07 AM (GMT 0)
My PCP prescribes my Xanax.My PMD prescribes the Pain Med I take.

Hopefully that covers me.

If not,well,goodbye cruel world.

Take care.

Rick
Posted 10/24/2016 9:50 PM (GMT 0)
Rick, I think some pcp's will refer patients to psychiatrists if the patient needs anti anxiety meds long term. It seems like that is the direction this is all going in. A pain management doctor is not trained in treating mental health issues nor is a pcp. The training they get touches on mental health issues. Their training doesn't concentrate on it like psychiatrist's and psychologsit's does. Things like anxiety are a mental health issue, even if it stems from chronic pain.
Posted 10/25/2016 3:05 AM (GMT 0)
Remember that sometimes the medications we are on produce anxiety, and in that case a psychiatrist is not indicated since it's not a mental health issue at all. For instance, give me too much Prednisone and I definitely need my Xanax!
Posted 10/25/2016 9:51 AM (GMT 0)
That would be fine with me.I have no problem going that route.My PCP knows I can't be taken off Xanax.We've never discussed it,but if I know it,I'm assuming that he does.

Take care.

Rick
Posted 10/25/2016 5:12 PM (GMT 0)
Rick, I learned a long tiime ago to not assume anything. I also learned that sometimes a doctor does things because of pressure from colleagues. It may not happen often, but it does happen. It doesn't happen as often when a doctor is in a sole practice as it does when a doctor is a member of a group practice.
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