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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (20)
  • Anita
    4 years ago

    It’s so annoying that the bad apples are causing us all to suffer more than we usually do. It’s like pulling teeth to even get a doctor to give you the meds in the first place without all these extra hassles. I have q small stash of codeine left over from surgeries and I use these when I have a really bad flare. I haven’t tried vicodin or any of that family of drugs. I once tried Percocet, but it made me ill, so I’ve managed with codeine for my hand surgeries. They actually sell that over the counter in other countries like Canada and Australia (at least they did in 2000 when I visited). I grabbed a few bottles the last time I was in Canada, but it’s ridiculous to not have easy access to what we need.

    I also tried Ultram after a fall a couple years ago, but it did nothing for me. I’m in the midst of a flare right now and am planning to ask my doctor for some codeine. I hope he’s not one of those who refuses to give painkillers. He’s been pretty great, so far. Keeping my fingers crossed (as much as my hands allow, anyway, LOL)

  • Bianca Cox
    4 years ago

    I just wanted to comment on the story regarding pain medication having now have a hand written script . The only way we have any hope for change is to educate the people in congress . If everyone would either send a letter or make an appointment to see their senators and house reps. And do it all around the same time. That would go a long way to help change things. You would be suprised how much they don’t know yet they vote on these issues that affect us everyday. But when you talk with them if you would share your life story with them that helps more than you know.

  • Connie Rifenburg
    4 years ago

    I know my RA dr. recently initiated urine and blood tests done to comply with some new law related to narcotic drugs. I don’t mind having it done at my regular appt. but I’m a bit put-off that I have to be drug-tested just to get meds my doctor is prescribing for me. We have what I call a “blue script” (color of the paper different from other scripts which can be sent via internet). Blue scripts are for 2 of my meds: Oxycodone and Klonipin. Klonipin I was told was not a higher class narcotic, but was usally prescribed for seizures. I take it for restless legs. I also take Pramaprexole (sp)?) for my restless legs. I don’t like the way Klonipin makes me wake in the morning with a total loss of memory of the end of my evening. But, we’ve tried several other drugs and my legs are crazy starting about 6:30-8:00pm if I don’t take both drugs. I take the Pram. about 6:30-7pm, then I take the Klonipin when I’m ready for bed because within about 1/2 of taking it, I’m asleep – wherever I am!

    I don’t even remember falling asleep. I have sleep apnea and the Sleep Dr. said Klonipin is more addicting than many of the higher class narcotic drugs. So he worked with me to take the Pram. a little earlier before my legs begin to twitch, and take only one Klonipin – not two – at night. It is controlling the my issue just fine, but as I said, he told me Klonipin has an amnesia effect. That’s Very true.

    My RA Dr. and I have a good relationship and she has never made me feel as though I’m ‘seeking’ drugs. She trusts me to take exactly what I tell her I’m taking because of that trust between us, I would tell her if I felt I was beginning to need more of a narcotic. So far, so good. Going on 3 yrs on oxycodone twice a day. AM/PM. Never needed more.

    I can not imagine going to a doctor who either refuses to write narcotic prescriptions or hear what I’m saying when I tell them I’m in pain and need help. Please, go find another doctor who understands chronic pain. It’s NOT the same as an “occasional” pain. If you get relief from a narcotic and don’t “seek” the side effects, you will not abuse it.

    Personally, as I said before, I don’t like the amnesia side effect of my Klonipin, so there’s no chance of me abusing it. The other pain killers simply do their job and that’s all I want. Pain relief.

    I agree, certain doctors treating chronic pain diseases, should be exempt from most of these gov’t regulations. As far as I’m concerned, it’s a dr/patient trust issue and the gov’t needs to stay out of it!

  • michelle
    4 years ago

    This has been going on for quite awhile now. My rheum also stopped prescribing narcotics and admitted it was because the government has gone way overboard and made it almost impossible. He said they have absolutely no regard for legitimate pain patients and don’t care at all. It’s always all politics and money…has nothing to do with patients and people. Our government could not care less about us or our suffering. And thses new rules will never get changed unless it directly benefits them or enough people die, commit suicide, etc. because they have no other alternative for relief.

  • Jennifer
    4 years ago

    I hear this repeatedly and I think it’s time we write to whomever can change this as it’s very unfair and upsetting that pain is not being managed anymore unless you go to a pain clinic and going to a dr every month is also very hard on the sufferers time, pocketbook and PAIN! Any suggestions to c/o to whomever I’m on board!!!

  • Sandy
    4 years ago

    I agree. They make you feel like you’re a drug abuser. I’ve had a gastric bypass 12yrs ago. I can’t take Motrin,clebrex or any aspirin based meds. I’ve been on norcor for a year it’s the only thing I can do. There was a map of the states the other day and it was a few southern states. I also get shingles so I can no longer take the biologics which wiped out my immune system. Certain diseases should be exempt from this law.

  • Jane Burbach
    4 years ago

    My rheum doc refuses to prescribe pain meds. So I deal with residual pain, gabapentin, and Cymbalta.

    I am upset with those who have abused pain meds and make it hard for those of us who actually need it to be treated and function and work. I am still employed.

    There is a place for pain meds in regular treatment for patients who need it.

    It is worrisome to me because I am NOT a hypochondriac and I do not abuse meds. Goodness, I get by with the least possible.

    It is not fair.

  • Linda Petty
    4 years ago

    Hello, I am new to this site and had been searching for somwhere to find help. I am also an RA patient experiencing frustration over the new Federal regulations. I went to 4 different pharmacies on Friday with a new Norco prescription only to find that they were all out. I went back to MY pharmacy to leave the prescription and was told they hope to get a delivery today or tomorrow but that there are 100 people ahead of me so I may or may not get my meds! I have been taking this 3x daily for years and it is the only medication that relieves the pain. So now what shall I do? I also take Methotrexate weekly,and Orencia infusion every 4 weeks plus Meloxicam twice daily. This combination keeps the pain bearable. I just cannot imagine my life without Norco. Does anyone have another medication that works? How about Tramadol I would love to hear your suggestions. Thank you.

  • Lynne Davidson
    4 years ago

    Tramadol works for me. It is not as good regular narcotics, but it take the edge off enough for me to work. Other narcotics make me too groggy to work. It is worth a try.
    Lynne

  • Angela Lundberg author
    4 years ago

    Hi Linda,

    I’m so sorry to hear what you’ve been going through trying to get your pain medication. It’s beyond frustrating – it’s not fair! Hearing your story as well as others’ infuriates me. I have never had a problem with my (Target) pharmacy being out of Norco. Why are they all out in your area? Sorry if that’s an ignorant question. Right now I have to wait a week to get my prescription filled because of the new regulations. Tramadol is also now classified as a narcotic, I think. I tried it once and it didn’t do anything for me.

    Good luck Linda! I hope you can get your medication ASAP.

    Angela

  • Jeannie Lopez
    4 years ago

    Hi ,
    I don’t just have a new problem , I have a dr who doesn’t believe in Narcotics. So I spend a extra 150 to go to a ER every time my flare gets out of control.. They say take the Tramadol but no more than 4 a day .. Excuse me ?? Last week I had a shoulder flare so bad I went to the ER for relief. But now I wonder with all this med s being watched and classified . When I hit a er for relief will I be judged as a pill seeker.

  • Angela Lundberg author
    4 years ago

    Hi Jeannie,
    Thank you for your comment. Wow, I can’t believe (well I can believe it, sadly) that you have to go to the ER every time you need pain medication for a flare-up! That is RIDICULOUS. As I just wrote in another reply to this article, I’ve tried Tramadol in the past and it did nothing for me.

    Have you thought about trying to find a new rheumatologist? Nobody should have to suffer in pain, I say.

    Hang in there!
    Angela

  • Michelle
    4 years ago

    Angela I certainly agree with you. It’s so frustrating having to deal with the system and the upcoming changes. I have Fibromyalgia and RA along with other medical conditions. What’s really disturbing is people who are compliant in taking their medications suffer the most due to people who have abused taking Pain Meds & doctor hopping . I was diagnosed in 2004 and over the years so much have gotten worse, which of course makes it difficult for doctors to write scripts. Honesty it’s so sad that I have to deal with the pain, as many people do who live daily hurting. My Rheumatologist doesn’t really like to prescribe pain meds & I’ve had to push for him to do so, but muscle relaxers he has no problem with. Simply frustrating.

  • Wren moderator
    4 years ago

    Hi, Angela,
    I’m right with you on everything you’ve written here. Surely there must a be way for doctors will patients who suffer from diseases like RA that cause chronic, often severe, disabling pain, to make it easier for them to get the medication they need. Or, rather, there must be a better way to identify legitimately abusive patients. I get my medication through the VA; they mail them to me on a monthly schedule that my doctor(s) order. I can’t get more than a month’s supply of any drug, including opiate painkillers–and those were only prescribed for three months at a time. My rheumatologist renewed the prescription during my quarterly visit.

    But now, I have to specifically request my painkiller from my rheumatologist every month. Fortunately, I’m able to do this by phone or through secure messaging, so it’s not a terrible imposition for me. But my heart goes out to everyone who gets their meds via the usual, civilian route. Forcing patients to visit their doctor in person–and paying a co-pay for the office visit–in order to get a prescription in hand for a much-needed drug puts a uselessly difficult physical and financial burden on them.

    You’re so right. It’s punitive–and patients who suffer from debilitating, incurable pain should not be punished like or treated like criminals who abuse the system. It’s shameful.

  • Sharon Humphrey
    3 years ago

    I was referred to pain management doctor because they are specialists in this field. I have been on oxycodone for a couple of years now, seeing the same doctor, using the same pharmacy. I have all the documented diagnostics to warrant the need for the medicine I take. I have never had any “red flags” (reason to question legitimacy) for any reason, yet I still get the strange looks and holier than thou attitude from the front desk staff at the doctors office and pharmacy, every month when getting a prescription for pain killers. I also am put off by having to submit a urine sample at every visit, which by the way I pay a hefty co-pay for. I am disabled with crippling in several places. I use a cane to steady myself and relieve some pressure from my sacroiliac joint, which sends me horizontal when it “catches”, no matter where I am when it happens. I feel violated having to feel the stigma of all of this. Just want to be able to dress and feed myself and sit in an upright position, which I cannot do because of pain,without the moderate relief from pain medication. Thanks for letting me vent somewhere, I feel so alone.

  • Kellie
    4 years ago

    PS. Shouldn’t rheumatologists and oncologists be exempt from the stupidity?

  • Kellie
    4 years ago

    Since I moved over a year and a half ago I have had the same rheumatologist. I have gotten many steroid shots and non narcotic drugs. I have recently switched from Enbrel to Humira. I have had 2 months of excruciating pain. I asked for pain meds and was told they don’t prescribe them anymore because of some of the patients non compliance with the medication agreement. What does that have to do with me? Why should I go without in a time of need because they have addicts? Not my fault. Time for a new Doctor, which is too bad, because I like them.

  • Angela Lundberg author
    4 years ago

    Hi Kellie,

    You’re right, that doesn’t have anything to do with you and it’s not your fault. It’s not fair and it just doesn’t make sense for patients with legitimately painful, chronic diseases to be punished for the behavior of the people who ARE abusing medications and the health care system.

    If you’ve decided to find a new doctor, much luck to you! I hope you can find a good new one.

  • Damian
    4 years ago

    Howdy Angela and hello to all readers
    It often seems that Australia is behind the rest of the world when it comes to our RA treatment…Alas not so with our version of ‘Federal Drug Enforcement Agency’. For the past 14 months I have to see my GP once a month for him to hand write a script for Oxycontin. This comes with 28 doses yet my appointments are 30-31 days apart? Lol I wrote here ‘Why do I have to beg for pain killers?’……Sadly nothings changed here in OZ. Good luck Angela

  • Angela Lundberg author
    4 years ago

    Hi Damian,

    Thank you for your comment and input! I’m sorry to hear what you’re struggling with regarding getting pain relief in Australia. I’ve been very interested in learning more about how other countries’ health care systems deal with RA patients. Good luck!

    Angela

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