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Sun Nov 18, 2012, 08:06 AM

Maine doctors requiring random drug tests before writing prescriptions for pain pills

Source: BDN

In an effort to combat Maine’s high rate of prescription drug addiction, doctors are asking patients to sign a controlled-substances agreement that, in part, allows the doctor to ask for a blood or urine sample at any time to ensure patients are taking their pills, rather than selling them, and are taking those pills only.

Patients who don’t sign likely won’t get prescriptions. And those who fail the test will have some explaining to do.

“Everybody is under pressure to have policies that do everything they can to tighten up the prescribing of opiates,” said Gordon Smith, executive vice president of the Maine Medical Association.

Maine has had a prescription drug problem for years. The state has the highest per-capita rate of opiate addiction in the nation, and more Mainers are seeking treatment for painkillers than for alcohol. The number of babies born with opiate withdrawal symptoms has skyrocketed. And this week Maine had its 50th pharmacy robbery of 2012, a crime that experts say is directly tied to prescription drug addiction. Maine had half that number of robberies in 2011; not long ago it had none.

Read more: http://bangordailynews.com/2012/11/18/health/maine-doctors-requiring-random-drug-tests-before-writing-prescriptions-for-pain-pills/

98 replies, 13385 views

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Reply Maine doctors requiring random drug tests before writing prescriptions for pain pills (Original post)
Maine-ah Nov 2012 OP
JDPriestly Nov 2012 #1
obamanut2012 Nov 2012 #5
slackmaster Nov 2012 #27
JDPriestly Nov 2012 #36
magical thyme Nov 2012 #58
lbrtbell Nov 2012 #77
slackmaster Nov 2012 #81
happyslug Nov 2012 #88
movonne Nov 2012 #74
magical thyme Nov 2012 #2
Maine-ah Nov 2012 #7
Ilsa Nov 2012 #25
hexola Nov 2012 #26
CBGLuthier Nov 2012 #3
dotymed Nov 2012 #28
valerief Nov 2012 #57
zanana1 Nov 2012 #60
obamanut2012 Nov 2012 #4
Bluenorthwest Nov 2012 #16
obamanut2012 Nov 2012 #29
Bluenorthwest Nov 2012 #43
Proletariatprincess Nov 2012 #67
groundloop Nov 2012 #6
Laelth Nov 2012 #55
Occulus Nov 2012 #89
sulphurdunn Nov 2012 #8
elias7 Nov 2012 #14
sulphurdunn Nov 2012 #17
dixiegrrrrl Nov 2012 #82
kickysnana Nov 2012 #19
sulphurdunn Nov 2012 #39
kickysnana Nov 2012 #9
dflprincess Nov 2012 #83
Cobalt Violet Nov 2012 #10
Proletariatprincess Nov 2012 #18
Cobalt Violet Nov 2012 #47
Hoyt Nov 2012 #11
cali Nov 2012 #12
Maine-ah Nov 2012 #13
ozone82 Nov 2012 #15
madokie Nov 2012 #20
Marrah_G Nov 2012 #24
madokie Nov 2012 #32
Marrah_G Nov 2012 #38
Proletariatprincess Nov 2012 #35
Ashgrey77 Nov 2012 #72
Proletariatprincess Nov 2012 #21
Marrah_G Nov 2012 #23
obamanut2012 Nov 2012 #30
Bluenorthwest Nov 2012 #37
Marrah_G Nov 2012 #41
Bluenorthwest Nov 2012 #44
Marrah_G Nov 2012 #52
Occulus Nov 2012 #96
Marrah_G Nov 2012 #98
Proletariatprincess Nov 2012 #45
Bluenorthwest Nov 2012 #46
Proletariatprincess Nov 2012 #66
Cobalt Violet Nov 2012 #48
madrchsod Nov 2012 #65
Ashgrey77 Nov 2012 #73
Cobalt Violet Nov 2012 #75
Comrade Grumpy Nov 2012 #61
magical thyme Nov 2012 #49
Proletariatprincess Nov 2012 #68
magical thyme Nov 2012 #87
Occulus Nov 2012 #90
magical thyme Nov 2012 #92
Occulus Nov 2012 #93
magical thyme Nov 2012 #97
Marrah_G Nov 2012 #22
hobbit709 Nov 2012 #31
Marrah_G Nov 2012 #40
hobbit709 Nov 2012 #42
Marrah_G Nov 2012 #53
Occulus Nov 2012 #91
MI Buckeye Nov 2012 #33
WooWooWoo Nov 2012 #34
Dustlawyer Nov 2012 #50
Marrah_G Nov 2012 #56
Dustlawyer Nov 2012 #84
Marrah_G Nov 2012 #85
Laelth Nov 2012 #51
Marrah_G Nov 2012 #54
magical thyme Nov 2012 #59
fasttense Nov 2012 #62
ck4829 Nov 2012 #63
Buzz Clik Nov 2012 #64
SkyDaddy7 Nov 2012 #69
Cobalt Violet Nov 2012 #76
Coyote_Bandit Nov 2012 #70
justice1 Nov 2012 #71
Kennah Nov 2012 #78
luv_mykatz Nov 2012 #79
randome Nov 2012 #86
Ash_F Nov 2012 #80
aquart Nov 2012 #94
Ash_F Nov 2012 #95

Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:21 AM

1. This could easily become common practice around the country.

I would not be surprised. And it would, in my opinion, be a cheaper and more compassionate way to deal with addictions to opiates.

People who are truly addicted to opiates need to have medical supervision. Many people really have chronic pain for which they need medication, but that does not mean that they have to also suffer the debilitation that comes from a severe addiction.

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Response to JDPriestly (Reply #1)

Sun Nov 18, 2012, 08:26 AM

5. +1

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Response to JDPriestly (Reply #1)

Sun Nov 18, 2012, 09:40 AM

27. It seems like a major hassle. Doctors are smart enough to detect drug-seeking behavior...

 

...and people who ask for narcotics but don't have a condition that merits their use.

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Response to slackmaster (Reply #27)

Sun Nov 18, 2012, 09:57 AM

36. Doctors would probably just enforce their contract if and when a patient

appeared to them to be drug-seeking. Doctors I know are just appalled at the problems of dealing with drug-seekers. Yes, doctors detect drug-seeking behavior, but then what do they do? Simply prescribe a small amount of whatever drug and hope the person doesn't harm him- or herself. Waste a lot of time that could be spent helping sick people on a drug-seeker who may have other complicated psychological problems that need treatment? I think the idea of getting a contract signed that places some responsibility on the drug-seeker is great. It eliminates the need for random drug-testing on populations that are not addicted. Great idea. Sometimes addicts need to seek alternative solutions rather than ruin themselves with drugs.

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Response to slackmaster (Reply #27)

Sun Nov 18, 2012, 12:12 PM

58. doctors are "allowed" to spend how much time with their patients?

And patients aren't capable of exaggerating the pain they're in, to keep the supply going? Or of "doctor shopping" until they find a doctor who will give them what they want for whatever reason?

Here in rural Maine, a lot of people work physical labor jobs: fishing, clamming, lobstering, ship building, etc. which are prone to muscle and tendon injuries. Those kinds of injuries are notorious hard to pin down pain levels. (For example, horses can have ligament tears that still show up on ultrasound, but the horse will no longer show any signs of pain or injury. How easy is it to fake the pain and lameness, backed up by U/S that shows damage?)

Yes, in the small villages everybody knows everybody, so families get reputations for certain problems. But the small villages are being slowly changed with an influx of transplants, including new doctors who *don't* know the local peculiarities and are trying to set up new businesses in a somewhat hostile (to transplants) to newcomers, giving unexpected challenges. Plus a summer influx of vacationers. It's an environment that makes "doctor shopping" very easy...

Plus, people who are manipulators tend to know how to work systems quite well. For example, when I worked in a call center, I noticed a pattern: people who wanted to get us to break rules would call 5-10 minutes before closing on Friday evenings, knowing full well we would be 1. most tired, so less alert and more prone to mistakes, and 2. anxious to get them off the phone as soon as possible so we could get home for the weekend.

It's just not as easy to be a human gatekeeper as some people would make it.

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Response to slackmaster (Reply #27)

Sun Nov 18, 2012, 08:35 PM

77. Doctors miss things a LOT

I could write an entire book about how my life was ruined by dozens of doctors who completely missed the mark with my diagnoses. It took me a full decade to be diagnosed with fibromyalgia.

We need the testing. Doctors make too many mistakes to be reliable.

And that's precisely why I'm adamant against doctors determining whether a woman's life is in danger when she's pregnant. They are wrong far too often.

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Response to lbrtbell (Reply #77)

Sun Nov 18, 2012, 10:33 PM

81. I always fire them when they miss things or try to sell me treatments that I don't need

 

I recommend it.

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Response to lbrtbell (Reply #77)

Mon Nov 19, 2012, 03:42 PM

88. fibromyalgia is a disease determined by the lack of evidence of anything else.

I do Social Security work and fibromyalgia comes up every so often, if you look up how
fibromyalgia is diagnosed, you quickly see it is based on a series of failing tests for other problems, but the treating doctor still thinks something is wrong (i.e. the patient is NOT faking the pain).
f

Fibromyalgia has been recognized as a diagnosable disorder by the US National Institutes of Health and the American College of Rheumatology. Fibromyalgia, a central nervous system disorder, is described as a 'central sensitization syndrome' caused by neurobiological abnormalities which act to produce physiological pain and cognitive impairments as well as neuro-psychological symptomatology. Despite this, some health care providers remain skeptical about fibromyalgia as a disease because of a lack of abnormalities on physical examination and the absence of objective diagnostic tests.]

http://en.wikipedia.org/wiki/Fibromyalgia

Thus fibromyalgia is more a disease determined when all other possible causes are eliminated, as opposed to a disease Doctor determines by test results that shows you have the disease. Thus it often take years before someone is diagnose with fibromyalgia (and even then it is often disputed). Just comment that sometime it is not the Doctor's fault, when the diagnoses is wrong.

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Response to JDPriestly (Reply #1)

Sun Nov 18, 2012, 05:50 PM

74. Do you mean Rush...he should be in jail now...and

also make to take a drug tests...

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:21 AM

2. I get majorly pissed off

When we get urine tox screens that come back positive for newborns. We had 2 in one day a few weeks ago. This is a small rural hospital with not a lot of newborns in a given day...

Our tiny local pharmacy had a big robbery with oxycontin stolen a couple years ago.

Good on them. This is a good thing.

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Response to magical thyme (Reply #2)

Sun Nov 18, 2012, 08:33 AM

7. I agree, MT....so sad.

Rx abuse is huge up here - My MIL and FIL are both pharmacists, and my FIL has been robbed three times now. :/ I hate the invasion of drug tests, but this seems pretty logical to do at this point -

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Response to Maine-ah (Reply #7)

Sun Nov 18, 2012, 09:38 AM

25. My pharmacist (local company) had to stop carrying

Certain medications for dentists because he couldn't afford the break-ins any more. He lost business. I guess the dentists started using the hospital pharmacy to get meds for oral surgery.

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Response to magical thyme (Reply #2)

Sun Nov 18, 2012, 09:40 AM

26. Yep - just saw this up close...co-worker...and Suboxone is just as bad.

There doesnt seem to be any real therapy with Suboxone prescriptions...just give it to them and let them take it...and give them more.

I thought the idea was to get off drugs?...now all I see are lots of people fucked up on Suboxone.

A co-workers girlfriend was taking it all through her pregnancy...that baby was hospitalized for over a month.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:22 AM

3. The only people I know who get treated like this are actual former addicts.

Oh well, the new america we are all guilty of all crimes and must all pay for it.

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Response to CBGLuthier (Reply #3)

Sun Nov 18, 2012, 09:43 AM

28. I have one problem with this.

If your drug screen shows that you have smoked a joint, then you are a drug addict and are cut-off from your prescribed pain meds. I have major health problems which include herniated disc's (7) and a sciatic nerve that is literally gone. If I smoke a joint to help relieve the pain (i try not to take too much prescribed meds. because I don't want to be a zombie). Marijuana is the drug they mainly (in most states) check for in addition to ensure that you are taking your meds. It is not a one size fits all solution. Luckily, in In. I had Dr.'s who understood. In Tn. it is a different story. They all want you to see a pain (meds) Dr. I told my family Dr. upfront that if he could not prescribe my pain meds in addition to my other meds, then I would find a different dr.. They have tried in the past to put me on stronger meds and I have refused. I refuse to have multiple surgeries on my spine. I have known 2 Dr.'s, my mother and several carpenter friends who have had more pain and disability, permanently after their spine surgeries..

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Response to dotymed (Reply #28)

Sun Nov 18, 2012, 12:12 PM

57. Can't you see the pain med doc, get the script, and just not fill the script? nt

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Response to CBGLuthier (Reply #3)

Sun Nov 18, 2012, 12:33 PM

60. I'm not a former addict and I get drug tested...

It isn't done to insult the patient, it's just that sometimes a patient with chronic pain just doesn't know when they're taking too much medication. After three or four years of daily meds, their effect can become dulled and the patient doesn't realize when he's taking one "extra". I don't mind it; I wouldn't be able to function without pain medication.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:25 AM

4. Most addicts are addicted to script drugs

But yet, the media and government seems to focus on weed and coke and meth.

I don't think this is a bad idea, because of doctor shopping.

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Response to obamanut2012 (Reply #4)

Sun Nov 18, 2012, 09:08 AM

16. I recommend that you research the studies that address how many chronic pain

patients who use opiates wind up with addiction problems. It is remarkablly low, particularly among those with no prior drug abuse history (under 4%), but also dang low among those who do have such a history (about 19%).
Most abused kids are abused by their parents, therefore all parents should be subject to unnanounced random home visits from child services, even those who have no indications of and no history of abusing anyone.. The stats for parental child abuse are far higher than for chronic pain patients becoming addicts. Combine just phsyical and sexual abuse, 26.8% of American kids. Average number of child abuse caused deaths in the US- about 5 each day. That's 1825 a year. Dead.
The abuse parade that is American parenting is not a new thing. What steps do you recommend to stem that tide? Or is that the sort of issue that is off limits because there are so many 'good parents'? Of course, there are more chronic pain patients who are not addicts than there are parents who do not hit or sexually abuse their kids, percentage wise. Which makes me say hmmmmmm.

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Response to Bluenorthwest (Reply #16)

Sun Nov 18, 2012, 09:44 AM

29. I don't need to research it

I have seen it in my own family.

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Response to obamanut2012 (Reply #29)

Sun Nov 18, 2012, 10:12 AM

43. Child abuse or drug abuse?

I note you do not address any of what I wrote, you just say 'facts don't matter because of a few things I've seen'. If that's how you 'think' about important issues, I don't know what to say....imagine all the horrors one could excuse by extrapolating generalizations from a few specific observations without any context or review. "I saw one of those people steal. Those people are theives, I saw it with my eyes' is sort of how prejudice works, is it not?
I have a cousin who drinks Pepsi and is lazy. People who drink Pepsi are lazy, I have seen it. Another is a Christian and is really mean. Christians are really mean, I've seen it in my family. I don't need facts, academic studies, I just need to see my cousin say mean things and then go to church. Other Christians who are not mean are probably lying. Because I saw a mean one once.

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Response to Bluenorthwest (Reply #43)

Sun Nov 18, 2012, 02:49 PM

67. Brilliant response, Bluenorthwest.

....but lost on most here, I am afraid.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:31 AM

6. I'll agree - this is a reasonable attempt to curb a real problem

I know someone who has been addicted to prescription drugs, and did the doc shopping routine to get them. She sunk so low that she lost custody of her kids, it's an absolute shame.

I would add that I'd like to see government funding for treatment programs to help those with a substance addiction.

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Response to groundloop (Reply #6)

Sun Nov 18, 2012, 12:10 PM

55. I think your example shows that that drugs are not the problem.

I'd much rather see government funding for the very real psychological problems that many, many people have, than to see increased funding for drug abuse problems that are merely symptoms of the real problems.

If people are abusing drugs, there's a reason--and the availability of the drugs is not the problem.

-Laelth

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Response to groundloop (Reply #6)

Mon Nov 19, 2012, 08:06 PM

89. it would be far more reasonable

to develop an objective measure of exactly how much pain a given patient is suffering, don't you think?

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:34 AM

8. You don't suppose

part of the problem might be over prescription?

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Response to sulphurdunn (Reply #8)

Sun Nov 18, 2012, 08:55 AM

14. In part,

But it is difficult to get prescribers all on the same page when patients will use multiple practitioners in multiple subspecialties (primary care, pain clinics, ER 's, etc) in multiple institutions and use multiple pharmacies, and even use their spouses or friends to score Rx's for them as well. They'll use pseudonyms and fake addresses to avoid getting flagged by the sytem. With HIPAA and press-gainey working against practitioners, it is an oversimplification to think that doctors just need to stop overprescribing. Drug seekers know how to work the system.

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Response to elias7 (Reply #14)

Sun Nov 18, 2012, 09:09 AM

17. Maybe

better interconnected computer identification and data bases would help with some of the things you mention.

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Response to sulphurdunn (Reply #17)

Sun Nov 18, 2012, 10:37 PM

82. "better interconnected computer identification and data bases"

My doc's office has gone to all computer med.notes and prescriptions, orders the scripts from the doc office puter to the pharmacy puter.
All scripts will be visible to doc to check what patient is taking from any and all pharmacies.

My doc says this is because of "obamacare" and required computerized records keeping.
She is a republican, was going off the deep end about the election when I saw her in Oct.

Problem is...no one in the office can explain to me coherently what exactly they are doing with the data once it gets into the puter
and
why they increased office visits from 65 to 107.00.
All the billing clerk could tell me was that the "bills are generated by the computer program".

I am experienced enough with billing and computers to know that THEY do not understand anything except what the manual tells them to do on the puter.

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Response to sulphurdunn (Reply #8)

Sun Nov 18, 2012, 09:18 AM

19. You obviously have not had chronic pain...

It is one thing to try to prevent misuse it is another to deprive people of severe pain relief. The one I am supposed to sign this week says that "I will not ask my doctor for additional pain medication. Who am I supposed to ask for pain relief?" Since I am allergic to the cold I generally do not go out of my apartment from January until sometime in April even doctor appointments unless it is an emergency. I called and told them that my medical transpiration requires 48 hour prior notice and that kind of defeats the idea of drug testing unless they could use the lab in the unaffiliated clinic beside my building There was a middle age woman crying quietly over at the next door pharmacy last week waiting for her prescription to be filled. Not shaking, or anxious, just in terrible pain because she needed more pain meds and was not getting them.

Right now I have severe IBS, ENT diagnosed bone spurs, neuralgia and possible chronic sinus infection. I also have relapsing-remitting MS with spacticity, arthritis, angina and Reynauds.

With out pain meds I have no life because I am on the edge of shock much too often. Right now my prescription is for 4 Vicodin a day 5/500, not enough to provide 24 hour pain relief and at most provides only 90% relief when I take it at this does it is sometimes it is only 10%. I have a three day rule. If on the fourth day the pain is still too bad with the dosage I have I go seek help. That is not unreasonable. Asking me not to go ask for help is ridiculous. I have had these conditions most of my life. There are no more treatments for what I have. I just have to live with it.

I have been judicious and now I am being treated like a criminal and no I don't care about those who are addicted. That is not my problem, I do not want to be codependent or lumped in with them.

Now I have to make and pay for additional appointments and drug tests and I get no benefit and have not done anything wrong, ever? It is demeaning, demoralizing and wrong. Cost for my generic Vicodin is $23 a month. I follow up every three months on that and all 16 other meds I take, unless there is a crisis.

Frontline had a great program on assisted suicide last week and I thought, how timely, just in time for all of us who finally say we have had enough pain and not enough medical care for it and now we are considered guilty until proven innocent. Sometimes drug tests are wrong. Sometimes people in pain get other conditions that require even more pain medicine.

Part of the process is a two page pain questionnaire that is supposed to cover 30 days. I copied it and have been filling it out daily and there are some days to understand my life I should fill one out hourly. Maybe just maybe that might document enough so that they could justify treating my pain better. But that is not the purpose here is it and I bet they are going to tell me addicts lie on the form. It is more important for doctors to become narcs than for them to be sure that their patient has a life. How demeaning for them!

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Response to kickysnana (Reply #19)

Sun Nov 18, 2012, 10:02 AM

39. I'm beginning

to think that a big part of the problem is also with pharmaceutical and health insurance companies. It is ironic that we have a system which provides some people with all they need and enough left over to deal while others suffer for lack of enough of the same medications. I've always been averse to having people prove what they aren't. Whatever the answer to getting you what you need and thwarting pushers, I don't think it's random drug testing and reams of paperwork for you to fill out.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:44 AM

9. Health Partners Minnesota is also doing this. n/t

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Response to kickysnana (Reply #9)

Sun Nov 18, 2012, 10:45 PM

83. I think the HealthPartners program only applies to patients who have been moved to the

"Restricted Recipients Program".

These are people who have already been caught drug seeking for any reason or are known to have addiction problems. They are "restricted" to one physcian at one clinic. I think they are also restricted to one ER or Urgent Care - (except in the case of a real life or death emergency then they can go to the nearest ER). They are also able to "graduate" from the program after a couple years if their behavior has changed.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:44 AM

10. I hate this idea.

We're all either treated like criminals or children now.

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Response to Cobalt Violet (Reply #10)

Sun Nov 18, 2012, 09:11 AM

18. I really hate this too.

There has to be another better way to address this problem...if indeed it is a problem. I am skeptical of any so called drug issue in the USA.

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Response to Proletariatprincess (Reply #18)

Sun Nov 18, 2012, 10:42 AM

47. Such a waste of money too.

I guess it never occurs to people that for some people it's an added expense some can't afford.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:46 AM

11. Lots of pain specialists require "contracts" and routine drug tests. Lots of Limbaughs out there.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:48 AM

12. I don't know if that would work for me

I take percocet for Complex Regional Pain Syndrome. I don't take it everyday. Sometimes I go several days without resorting to it, but I do need it. I've tried everything: Sympathetic Nerve blocks- which entails having needles stuck in my spine, Gabapentin- which was effective but had intolerable side effects, Lyrica, which is not effective, etc.

I am in pain virtually all the time, it is only the severity of the pain that varies. My primary care physician suggested a fentanyl patch, but I'm not willing to go there.

Percocet works for me. I use it judiciously. I don't want to be treated like a criminal or an addict.

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Response to cali (Reply #12)

Sun Nov 18, 2012, 08:51 AM

13. I don't know anything about your syndrome -

but I can sympathize a little....I live with headaches 24/7 from a damaged C3 vertebrae. With migraines a few times a week. Pain meds rarely help, but MJ does.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:00 AM

15. Had To Sign That

Here in Oregon for Vicodin, and had to chose between the pills, or medical marijuana. Random pill counts and piss tests, this for Care Oregon.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:24 AM

20. Someone explain this to me

I've been taking hydrocodone (7.5) for 6 years now and I take a pill every 6 hours or so as needed for pain from Neuropathy. I don't take them at any more frequency than I did at the beginning. Sometimes I'll forget and not take a pill for 8 or so hours and I begin to feel the pain so I try to stay on the every 6 hour schedule. After all this time I also notice that if I don't take a pill in 8 or so hours I'll start getting a tingling feeling throughout my body. On what I'm taking I can function as normal as I don't get a high from them but when I've tried other treatments I find the side effects to be to much for me. As a general rule it is I feel like I'm living in a fog where as with the hydrocodone I don't
Nortriptlyline is the latest they've tried on me and If I was a patient in a nursing home or maybe if all I did was lay around and watch tv or whatever I might could take them but as it is I stay as active as I can doing chores around the place. for instance I'm putting on a new roof on our house and when I finish that I'll be increasing our bedroom size by utilizing a wasted space that we have in our old/new house now. Due to breathing problems and PAD I can only work at most 3 or 4 hours then I have to take a rest. On the days when I'm not working on the projects for our home etc I piddle in the shop. I keep several projects going at all times, either building something that I design myself like my cart here in my sigline or repowering our Case lawn tractor with an army surplus engine that I've posted pictures of in the DIY and home improvement forum. Anyway I guess what I'm wanting to know is do I fall in the classification of an addict. Oh I still will occasionally take a toke of weed here and there.
I'd like to read of others opinion and will provide more info as requested
Peace and have a great day

To whomever it may concern I'm not asking for medical advice, rather I'm wanting to discuss this so please don't lock my request here. dm

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Response to madokie (Reply #20)

Sun Nov 18, 2012, 09:32 AM

24. I have Peripheral Neuropathy in all 4 extremeties

Has your doctor spoken to you about Cymbalta? It is not a narcotic so no fuzzy feeling. For me the only side effect was a jittery feeling and a weird scalp tingling for the first few weeks. I fought through it and the results have been really good.

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Response to Marrah_G (Reply #24)

Sun Nov 18, 2012, 09:47 AM

32. I had a bad reaction to paxil

The VA have me as allergic to SSRI's and this drug sounds like it is pretty much the same thing.

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Response to madokie (Reply #32)

Sun Nov 18, 2012, 10:02 AM

38. Might be worth talking to your doc about anyway

"Duloxetine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the brain"

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Response to madokie (Reply #20)

Sun Nov 18, 2012, 09:54 AM

35. I wish you well, Madokie

I also wish we lived in a society that didn't make value judgements about medical needs and treatments. What we put in our bodies to relieve our pain and suffering should be no one's business but our own with the advise and support of our medical caregivers.
If given a choice of being in constant severe pain or being addicted to a pain reliever, I would, as would most people, choose addiction. There is no place for value judgement in those decisions.
In this country we tend to see drug addiction as the ultimate evil in society. It is not. And, like USA Foriegn policy, we need to mind our own business when it comes to interferring with peoples lives and bodies. The so called War on Drugs has done great damage to any clear thinking about the role of medicine and treatment of illnesses. All of it driven by corporate and criminal profit and cloaked in righteousness and the urge to punish.
It is no wonder that the USA has such a low quality of life rating among the world's nations.

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Response to Proletariatprincess (Reply #35)

Sun Nov 18, 2012, 05:28 PM

72. Fucking A! n/t

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:26 AM

21. More proof that the USA has become a police state.

For every societal problem (or percieved, manufactured or exaggerated problem) we have an enforcement remedy. It is the new American Way.
I wonder to myself why so many USAers are in such pain that this is an issue. I also worry that this so called solution is worse in the long run than the drug abuse it hopes to resolve. There will be terrible cconsequences here, you can bet on it. Desparate patients will be denied the drugs they need. That is what happens in a society where punishment is more important than compassion.

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Response to Proletariatprincess (Reply #21)

Sun Nov 18, 2012, 09:29 AM

23. This doesn't have anything to do with the police

Doctors should know what other medications people are taking and this is a much better way then trying to make a quick judgement as to whether or not a patient is lying.

The only desperate patient being denied would be the addict coming in faking pain to get more pills.

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Response to Marrah_G (Reply #23)

Sun Nov 18, 2012, 09:45 AM

30. Correct -- doctor shopping

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Response to Marrah_G (Reply #23)

Sun Nov 18, 2012, 09:59 AM

37. The percentage of parents who abuse their kids physically or sexually is vastly higher

than the percentage of chronic pain patients who wind up with addiction or drug abuse problems. So should we not then constantly inspect all parents to make sure they are not part of the more than 26% that abuse? 5 kids a day die from parental abuse. So why respect the 'parental rights' of a group who so frequently actually kill their own kids? Should all parents be subject to random home inspection? Perhaps they should. Perhaps all parents should be denied the right to purchase alcoholic beverages, because so many of the abusive parents are abusive after a 'smart cocktail' or a 'couple of cold ones'. Why take the risk that some of them could have a drink and be good parents when so many take a drink and sock their kid in the jaw?
The numbers are staggering. Parents lie, rape, beat, sell, and torture their kids at alarming rates. I think constant observation on the part of authorities is one possible way to stop at least some of this parental violence. We do not know which parents are lying, so they should all be treated as if they were on parole, basically. For the sake of the children. I'm sure you agree.

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Response to Bluenorthwest (Reply #37)

Sun Nov 18, 2012, 10:05 AM

41. One has nothing to do with that other

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Response to Marrah_G (Reply #41)

Sun Nov 18, 2012, 10:18 AM

44. Of course they do.

In one case you are saying that a tiny percentage of people who abuse drugs should mean all people who are prescribed such drugs must be watched carefully. In the other case, you are saying that a much, much greater percentage of people who abuse their kids does not indicate that all parents need to be watched carefully.

It makes zero sense, what you are saying. None. If a tiny amount of drug abuse should lead to investiagion of all who are prescibed these drugs then a huge amount of child abuse should lead to investigation of all who are parents. You say that is not the case, no matter how many parents abuse kids there is nothing we should do to stop it, but if a negligible amount of pain patients abuse drugs, we must act against all pain patients with great suspicion. I guess you think abuse of a medication in small percentages is worse than abuse of children in large percentages.

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Response to Bluenorthwest (Reply #44)

Sun Nov 18, 2012, 12:05 PM

52. I disagree

I'm not going to make snide remarks or have conversations with others about you in a snark way either.

I disagree with you on this topic and that's okay. It doesn't make either of us bad or either of us ignorant. It just means we see things differently on this point.

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Response to Marrah_G (Reply #52)


Response to Occulus (Reply #96)

Tue Nov 20, 2012, 05:19 PM

98. Off to ignore you go

You aren't worth trying to have a conversation with.

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Response to Bluenorthwest (Reply #37)

Sun Nov 18, 2012, 10:21 AM

45. Good thinking.

The comparason is absolutely on point. People like Moriah here, need to open their thinking past the drug war mentality.
There will always be abuse. It is the nature of the human condition. The question is how do we cope with the abusers in a society without afflicting loss of freedom and privacy on the vast majority of non abusers.
Beware of those in whom the urge to punish is strong....

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Response to Proletariatprincess (Reply #45)

Sun Nov 18, 2012, 10:27 AM

46. Note the reactions to what I posted.

They are not even thinking about what they are endorsing.

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Response to Bluenorthwest (Reply #46)

Sun Nov 18, 2012, 02:41 PM

66. Logic is not much valued in the USA....

...nor is thoughtful debate. Anyone here who strongly supports this kind of drug testing would be outraged if it was applied unfairly (as it surely will in some instances) to themselves or their loved ones.

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Response to Marrah_G (Reply #23)

Sun Nov 18, 2012, 10:45 AM

48. It makes the cost of pain management go up.

I don't think these tests are free.

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Response to Cobalt Violet (Reply #48)

Sun Nov 18, 2012, 02:23 PM

65. most drugs can be detected by a very cheap urine test

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Response to madrchsod (Reply #65)

Sun Nov 18, 2012, 05:41 PM

73. 100.00 a pop for UA's at my doctor.

Every month on top of all your other expenses if you take pain killers. He partnered with a urine analysis company in Texas to test in mass for him.

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Response to Ashgrey77 (Reply #73)

Sun Nov 18, 2012, 06:32 PM

75. I wouldn't be able to afford that.

Those who can't afford this will just not get pain relief.

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Response to Marrah_G (Reply #23)

Sun Nov 18, 2012, 12:39 PM

61. It would have been more apt to say this is part of the rise of the surveillance society.

All of our electronic communications are recorded.

CCTV cameras everywhere.

License plate readers on the highway.

Searches to get on a plane or in a stadium.

Drug testing for work or school.

And now, drug testing from your doctor.

All this stuff creeps me out.

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Response to Proletariatprincess (Reply #21)

Sun Nov 18, 2012, 11:04 AM

49. Spending some time caring for an addicted newborn and then call it a police state.

Mothers addicted to illicit prescription drugs, and the neonate pays the price.

Spend some time caring for MVA victims, where the person at fault was drugged up or drunk. Then call it a police state.

They suck up ER resources, destroy other people's lives.

Yes, our society has some serious problems. But testing urine to ensure you're taking your prescription medicine and not selling it for profit illegally is hardly a police state...

It's very easy to blame the doctors, who have all of what 15 minutes? under insurance regulations to spend with a patient and find out what's going on. Spare me.

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Response to magical thyme (Reply #49)

Sun Nov 18, 2012, 02:56 PM

68. Spare me, please.....

read some of Bluenorthwest's comments here. He says it better than I do. Your referrence to taking care of an addicted new born is right in line with the points he makes about child abuse.

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Response to Proletariatprincess (Reply #68)

Mon Nov 19, 2012, 01:16 PM

87. Go re-read the OP.

We have a serious drug problems. We also have serious cultural problems here. Yes, the cultural issues need to be addressed. As a transplant, I can state unequivocally the culture here sucks. But the outgrowth of the cultural issues is a shocking amount of crime, often if not always drug related, given the "bucolic" atmosphere.

Note there is no "we" there; this is not a law or government intrusion. It's doctors who have suspicions about specific patients, and need to be able to prove those suspicions in order to act on them.

I have zero problem with doctors requiring "random" drug tests so they can monitor patients they suspect of abusing their drug prescriptions.

Doctors and hospitals are already expected to monitor their patients, and ACA puts the onus on them to perform for results or else they won't be reimbursed. Another poster above suggested that doctors are smart enough to know which patients are scamming them for unnecessary pain killers. Well this gives them one tool they need to deliver results.

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Response to magical thyme (Reply #49)

Mon Nov 19, 2012, 08:18 PM

90. Oh, bollocks.

You and I and everyone else here knows goddamned well that this will be used to deny pain meds to pot smokers for starters, and probably right out of the gate. I refuse to believe otherwise unless and until there are written policies prohibiting that application of these tests, and even then, I'll be suspicious as hell of every last denial of pain medication on this basis, full stop.

Stop beating around the bush. ALL drug testing for punitive purposes is wrong and you KNOW that's the hidden agenda here, same as it ever was. If that wasn't the case, the prescribing physician would dole them out pill by pill so unused doses could not be sold at all.

I can't believe supposedly reasonable, intelligent, grown men and women can be this fucking credulous. Then again, stupid people have bought the facially false reasoning (such as it is) behind cannabis prohibition for many decades now and are only just now starting to realize they've been outright lied to, so maybe I really shouldn't be all that surprised that they're buying a false premise yet again.

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Response to Occulus (Reply #90)

Mon Nov 19, 2012, 08:36 PM

92. um, medical marijuana is legal in Maine

Not too long ago I ran a tox screen on an elderly woman with cancer. They were making sure she was taking all her meds: THC and the pain med (I forget which) both positive. Why in the world would a doctor refuse pain killers for the same patient he or she prescribed marijuana for? That makes no sense whatsoever

I'm not beating around any bushes. I live and work in health care in Maine. I know that there is a serious drug abuse problem up here. I know it because I've seen it on my own street, in my own village, and in the hospital where I work.

I also know this: ACA bases reimbursements based on results. Doctors are increasing expected to monitor patients for following diets, taking meds, etc. to ensure they don't get re-admitted. Re-admittance for the same health problem or complications is another reason for denial of reimbursement.

This isn't a law. It's how doctors are choosing to practice in response to the reality they're dealing with, including financial realities.

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Response to magical thyme (Reply #92)

Mon Nov 19, 2012, 10:27 PM

93. As we are continually reminded by our bluer dogs,

Cannabis is still illegal on the federal level, which is also what determines prescription drug regulations. If the drug test for pain management drugs is not a law, an argument for malpractice can and will be advanced by any patient not addicted to prescription drugs, and doubly so for any patient taking any pain management prescriptions for the first time who is denied due to failure of the "optional/not law/office policy" regarding drug testing.

The legality of cannabis on the federal level is not, however, mere office policy, and with the state legalizations that have just passed, I can quite easily forsee a very big, no-holds-barted fight over that on the horizon. No, it does NOT make sense that the doctor who prescribed cannabis would fail their own patient for testing positive for cannabis. But since when, exactly, has any part of cannabis prohibition made any sense at all? What precisely is stopping Congress, many (if not most) of whom are unequivocally against even the medical use of cannabis, from passing a federal law requiring all physicians to drug test their patients prior to prescribing pain medication? What's stopping state legislatures from passing laws that would yank the licenses of such physicians for their failure to flag their own patients as addicts? Many people still falsely believe that cannabis itself is an addictive substance with no medical value.

The "serious drug abuse problem" you see is a direct and unavoidable result of an inability among all healthcare practitioners to accurately and objectively measure each individual's level of actual pain. To my knowledge, no such method is even on the horizon. To insert such blatant distrust into the doctor/patient relationship, or to begin such a relationship with this sort of distrust, is immoral, it is unethical, and it is to my mind a very serious and possibly permanently damaging practice, certainly to the patient's own wellness and sense of well-being with their doctor.

That this is not a law, but a policy, makes it an even worse course of action from which no good can result over the long term. I call it borderline medical malpractice and unnecessary infliction of actual, physical pain upon the very persons seeking help, and the first time a patient who is not actually addicted to pain medication is denied on this basis, malpractice is what it will in fact be.

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Response to Occulus (Reply #93)

Tue Nov 20, 2012, 08:06 AM

97. oh fucking spare me

Last edited Tue Nov 20, 2012, 08:56 AM - Edit history (1)

The drug abuse I see in my neighborhood is poverty-driven. The meth lab that was shut down across the street. The druggie thieves that burned down their shed and then their trailer up the road.

You know absolutely zip about the part of Maine where I live. ABSOLUTELY NOTHING ABOUT THE CULTURE OR ENVIRONMENT HERE so spare me your bs.

The drug store robberies are for money. The addicts didn't become addicted by being on pain meds for pain. They became addicted using drugs for "recreation." Bath salts, meth, coke, oxy and yes, opiates.

They are testing to make sure that people are prescribed pain meds are using them, not selling them. Try reading the effing article before dumping your load of crapola.

And "BLUE DOG?" When all else fails, name calling. Cogent argument you've got there. NOT.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:26 AM

22. I actually don't have a problem with that

I would rather that then have a doctor who is much more hesitant to give me anything for pain when it is necessary.

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Response to Marrah_G (Reply #22)

Sun Nov 18, 2012, 09:46 AM

31. Around here if you test positive for marijuana that cuts off your pain pills

Even if you need them for chronic pain.

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Response to hobbit709 (Reply #31)

Sun Nov 18, 2012, 10:03 AM

40. I didn't read that in the article

Just about doctors deciding on their own to make sure that their patients weren't addicts looking for more pills.

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Response to Marrah_G (Reply #40)

Sun Nov 18, 2012, 10:06 AM

42. some states have made it into law.

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Response to hobbit709 (Reply #42)

Sun Nov 18, 2012, 12:06 PM

53. I don't think a law is necessary or needed

But I think if individual doctor's want to do it, I have no problem with that.

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Response to Marrah_G (Reply #53)

Mon Nov 19, 2012, 08:24 PM

91. Conservatives use the same argument to advocate drug testing in employment,

even when that employment consists of typing on a keyboard and answering the phone.

Drug testing for the purpose of punishment, regardless of the drug in question, is wrong, period. Your statement tells me you're more concerned about punishment than addiction or patient safety.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:48 AM

33. Ohio has a better idea.

If you get a prescription written here in Ohio, it is recorded in a state-wide database that is accessible to any medical professional who has the desire to look. I learned this back in May of 2010 when a health condition resulted in a visit to the ER at Grant Hospital located in downtown Columbus, OH. While filling out the paperwork and taking my medical history they asked me if I was taking any other drugs than those listed on the tablet computer the tech was using to enter the information. Mind you I had not been there in over 10 years, as even a visitor let alone a patient. This was confirmed in a newspaper article that I read a couple of months ago and the medical folks statewide have endorsed it's use as a way to prevent the over prescribing and mis-prescribing of conflicting medications. Remember this, before we can expect our medical information to cross state lines we have to get it to go from one hospital to another without getting lost somewhere along the way. I am old enough to remember when our banks could not talk to each other unless it was on a piece of paper that we had to take from one branch to another. Our hospitals are not much farther ahead than that now.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:48 AM

34. they do this in Tennessee already

my wife has been drug tested every time she goes to get a refill script from her doctor.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 11:42 AM

50. I have severe chronic pain caused by small fiber sensory neuropathy. I have a neural stimulator

implanted in my back for pain and have to take daily doses of strong RX drugs. I also have 2 sisters and brother who are pill and alcohol addicts. I see both sides, I have to deal with constant problems getting my medication. I have insurance which requires I get some of my RX by mail order which is problematic because I work up and down the Gulf Coast, and 1 I have to pick up in person every 30 days that is a 2 hour drive each way when I am home. I see my siblings who are able to find "pill doctors" who RX whatever they want. I suffer from the rules, and would glady do so, if they actually prevented access to RX abusers. They do not! We need to emphasize treatment rather than incarceration. We need to come up with some common sense solutions that work! By the way, pot works better than anything they come up with for my disease and the studies support that!

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Response to Dustlawyer (Reply #50)

Sun Nov 18, 2012, 12:11 PM

56. I hope your state get's legalized pot or medical pots laws soon!

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Response to Marrah_G (Reply #56)

Mon Nov 19, 2012, 09:20 AM

84. Thanks. Since I live in Texas, we will be last. These nuts here still argue that the sun dial is

to new to be trusted.

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Response to Dustlawyer (Reply #84)

Mon Nov 19, 2012, 09:25 AM

85. LOL

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 11:59 AM

51. I don't see what the problem is.

“Everybody is under pressure to have policies that do everything they can to tighten up the prescribing of opiates,” said Gordon Smith, executive vice president of the Maine Medical Association.

Why? That's my question. What's so bad about a prescription opiate addiction? It's better than an alcohol addiction, by far. It's certainly better than a meth addiction or a crack addiction. Don't doctors have something more important to worry about?

-Laelth

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Response to Laelth (Reply #51)

Sun Nov 18, 2012, 12:10 PM

54. It can damage the person's health in a big way

Also it leads to heroin addiction when the drugs get to expensive or they can't get enough. It also leads to job loss, child neglect, destruction of families and crime.

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Response to Laelth (Reply #51)

Sun Nov 18, 2012, 12:23 PM

59. come care for an opiate-addicted newborn in the hospital

We had 2 of them fighting for their lives just a couple weeks ago in the rural Maine hospital where I work. That's one of the "more important things" doctors up here have to worry about.

We also have had many pharmacy burglaries for prescription drugs.

We get drug "evals" in all the time; people behaving strangely or driving erratically.

We also have plenty of meth issues, along with bath salt issues. I suspect 3 of my neighbors (2 former neighbors: one set's shed burned down, and their shack followed soon after. the other set off a series of major explosions behind their rental trailer and then disappeared right around when there was a big meth bust in the village just over the line).

Maine has serious, serious cultural issues. Just look at Gov. 38% to begin to understand. And while I agree that prevention by fixing the cultural issues is important, we also have to deal with the existing problem in the here and now.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 01:02 PM

62. They do this in TN already and...

TN has one of biggest problems with prescription drug addiction. So, it really solves nothing.

My husband was visiting a pain doctor for awhile due to a slipped disc in his back. The doctor treated him like a criminal. He wasn't even allowed to drink a beer or a glass of wine with dinner. He eventually stopped going because he didn't like being treated like an addict when he was only trying to get some pain relief. He nows suffers through the pain and is hoping a neurosurgeon can help.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 01:14 PM

63. Are we winning the war on drugs yet?

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 01:57 PM

64. As if the medical community isn't deep enough up our asses as it is.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 04:28 PM

69. I agree with this policy!

I have to take random drug test at the Shepherd Spinal & Brain Injury Hospital's (Ranked in the top 5 of Spinal Hospitals in the country) pain clinic...They could care less that i smoke Cannabis what they want to know is if I am taking other prescription drugs or if the amounts of drugs I am taking matches the level in my blood. Or if I am on harder drugs like Heroin, Meth, Cocaine, etc.,

This will save untold number of lives if every doctor required random drug test.

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Response to SkyDaddy7 (Reply #69)

Sun Nov 18, 2012, 06:34 PM

76. Good , then you can pay for it too! n/t

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 04:57 PM

70. Family Medical Center in Tulsa does this

The clinic will dismiss patients from their care for being non-compliant in following medical directives if they do not test positive for the appropriate amount of prescribed drugs.

I know an uninsured fellow who had this very experience. He wasn't selling the drugs and could have produced his unused supply at any time.

He was doling out the medication at less than the prescribed amount because it was expensive and he was on the verge of homelessness. He was also fearful of becoming dependent upon the medication - and fearful that he might not be able to secure further care.

These kinds of policies need to look at the totality of circumstances and consider whether or not a patient can account for and produce medications that have gone unused. Also, patients rather than health care providers should ultimately have the right to determine their course of treatment - which means that they ought to have the right to refuse any particular treatment. And IMHO refusing a particular drug or treatment ought not in and of itself justify a medical practicioner from offering further treatment options.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 05:17 PM

71. What about the DEA allowing manufactures to increase sales of oxycotin by 1200% in 14 years.

I also question who profits from the drug test.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 08:56 PM

78. Damn you, Limbaugh! n/t

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 09:06 PM

79. Sounds like a complex issue.

Unfortunately, it seems to smell of the increasing lack of compassion that characterizes our society.

What needs to be deeply looked at, is why do people become addicted to harmful substances or lifestyles in the first place?

Unfortunately, it is easier to take a punishment stance, than it is to do the compassionate action.

Too many years of repuke policies, and too much media saturation with the idea that we are a society of lazy worthless good-for-nothings has really damaged us, as a people.

Yes, people need to avoid becoming addicted to things which harm them and others, but I think prevention works better than punishment. But, that doesn't fatten the wallets of the 1%, now does it?

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Response to luv_mykatz (Reply #79)

Mon Nov 19, 2012, 10:17 AM

86. Everyone is addicted to something.

And it sure isn't a doctor's responsibility to right society's wrongs. I don't have a problem with random drug testing. It's trying to prevent an even greater harm.

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Response to Maine-ah (Original post)

Sun Nov 18, 2012, 10:33 PM

80. Addiction to pain pills seems to be growing problem

I personally know a few people who have gone through it in the last few years. It was really ruinous to the lives of two of them.

PS - More recently, when I mentioned to some other friends that I had been given a hydrocodone prescription after getting my wisdom teeth out, two of them tried to buy the extra's off of me. I declined, but damn.

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Response to Ash_F (Reply #80)

Mon Nov 19, 2012, 10:48 PM

94. AND THE OTHER SIDE OF THE COIN...

Is bigoted, self-righteous morons who tell you how much pain you're allowed to feel in their opinion.

For twenty years I was never allowed to turn down an offer of painkillers because my sister desperately needed them. Any pills were immediately turned over to my sister so she could keep functioning.

New York has insane attitudes about painkillers. My father was dying in agony and the hospital was reluctant to give him morphine because it might hasten his death by a week while he moaned, "Why is it taking so long?"

My sister is allowed as many as she wants now. Now that she's on official disability. Now that the state of California agrees that the pain will never go away. A happy day is one where she brags she didn't need the morphine. All she has to do is pee in a cup every month or so to prove she's taking it.

To deny people in pain the right to ease because some bloody morons think pills are fun...I don't give a damn about the addicted morons. If they can't find pills, they'll use something else, like glue or Nyquil. Meanwhile too many people are shut out from their lives by the pain they are forbidden to manage.

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Response to aquart (Reply #94)

Mon Nov 19, 2012, 10:57 PM

95. Thank you for sharing.

My condolences.

PS - I don't get why some people seem to enjoy them so much that they would plead to buy them off of you. They did not make me feel good in any way. They made me uneasy/dulled and I stopped taking them after the first day in place of milder Ibuprofen. Maybe it effects different people differently. It did effectively relieve the pain though.

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