A Major PAIN

"Your prescription may be changing" is how the letter I received recently from my pharmacy began. It may be changing? As I read further, there was no question about it--the Vicodin I've been relying on falls into the new re-classification of hydrocodone products, and the way I get it from my rheumatologist and my pharmacy was going to drastically change. And not for the better.

Here is a partial transcript of the letter:

On October 6, 2014, all hydrocodone combination products such as Vicodin, Norco, Lortab, and their generic equivalents will be re-classified by the Federal Drug Enforcement Agency as a controlled substance schedule CII, which means additional restrictions will apply to prescriptions of those drugs. Under this re-classification, prescriptions for those drugs are no longer eligible to be refilled. Therefore, after October 6 a new handwritten prescription from your medical provider will be required for every fill.

This re-classification makes me angry because it will cause more inconvenience and stress for the patients who need these medications. It's already stressful and often a literal pain trying to get pain medications because of the stigma that's attached to them and the hyper-sensitivity of the health care industry regarding prescribing these drugs.

I've been taking Norco (generic for Vicodin) 10-325 tablets fairly regularly over the last six months or so when my right foot and ankle flared up badly last April. I also have them on hand for when I do any traveling (lots of walking) or for when I have wedding photography jobs and I'm on my feet for 8-10 hours at a time. I need the medication. I need the pain relief. I am not abusing it. Yet why do I always feel extra-stressed out or strangely guilty when I ask my doctor for a new prescription or refill? My rheumatologist has been extremely kind, supportive, understanding, and respectful regarding my RA treatment and medication needs. He has never made me feel like I'm a "pill seeker" or anything remotely close to it. Yet because there is such an intense stigma out there regarding painkillers, I do feel anxious about asking for them.

So now, with this new federal regulation, each time I need a refill of my pain medication, I need to get a handwritten prescription from my doctor. This is ridiculous. It not only adds extra work to me getting the pain relief I need, it adds extra work for my doctor. It's hard enough to get "normal" refills never mind getting pain medication requests replied to in an easy or timely manner by the irritating clinic "chain" of (mis)communication.

When I need a refill, it usually goes something like this: I call the clinic and talk to someone in the call center who takes my message and tells me that someone will call me back.  Meanwhile, that message is supposed to get to my doctor's nurse or assistant who THEN is supposed to get the message to my doctor--and THEN somehow all of that is supposed to not be lost in transaction/translation until it gets relayed back to me that my request has been granted or denied. If all goes smoothly, it's an annoying and time-consuming process just to get a medication refill. Usually it does NOT go smoothly the first time around and I end up having to make multiple phone calls bugging the people at the clinic to get back to me. And this is with "normal" prescriptions. I can't imagine how much more difficult it's going to be to get my Vicodin refills if I have to go through all of that AND I need to get the actual handwritten piece of paper in my hand before I can finally get the prescription filled at the pharmacy.

Maybe this doesn't sound like a big deal, but to me it is. It's already a full time job trying to manage my healthcare while having RA--all of the tedious "doctor stuff" such as scheduling appointments, going to appointments, juggling numerous appointments, getting prescriptions refilled, communicating with your doctor during flare-ups, arranging I.V. infusions and lab testing, etc. It's exhausting. I don't need another obstacle to getting good health care. I do realize that there is a significant problem with people abusing pain medications and manipulating the health care system. But I don't think it's fair to punish the patients who live with severe, crippling chronic pain, and who are using these medications responsibly and how they are intended to be used.

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