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Sunday, January 15, 2012

Negative Effects Of The "War On Drugs" In Florida

I understand the need to fight drug dealers. I understand that they engage in many illegal activities in order to sell their illegal drugs. They steal from others. They are violent and will commit assaults and murders. I understand they tend to be dangerous people, often associated with particular gangs or other organized crime groups. I understand that Southern Florida apparently has many pain clinics, staffed by doctors, who are willing to write prescriptions for narcotic pain medications for people who do not really need them, instead they sell the drugs on the street. I understand that some of these people are allegedly well aware of what they are doing when they supply people with prescriptions for these drugs. I understand that they allegedly will write prescriptions for whatever the person asks for, in whatever quantity they ask for it, in exchange for a cash payment for their services.

I agree that these practices are wrong and are contributing, in part, to illegal narcotic drug trafficking.

However I do NOT agree with how the state is choosing to fight these so-called doctors and drug mills. Their chosen methods of dealing with this is making it impossible for uninsured people to receive the medical care they need!

In order to gain public support for their actions, they present all pain management doctors and clinics as nothing more than "legal drug mills". They present all chronic pain patients as "drug addicts". They engage in mass mis-information in order to gain public approval for their actions. As a result honest chronic pain patients are discriminated against on the grounds that "all chronic pain patients are drug addicts".

What they are doing is harassing any doctor who treats chronic pain patients, and causing chronic pain patients to be treated like drug addicts. We are required to undergo drug testing every month. Our prescriptions are closely monitored and dated exactly 30 days apart. We used to get a bit of overlap so that the patient didn't run out of medication should their appointment need to be rescheduled. Now, when the office sets my appointment on a day that is after I run out of medications, I have to suffer with the withdrawal symptoms and rebound pain because if the doctor writes a script without the urinalysis they can go to jail. Also he is not allowed to write a small script to cover the days between the end of my 30 day supply and my appointment. The doctors are no longer allowed to decide what is the appropriate dose for a particular patient, instead they are cautioned against writing a prescription over a specific dosage amount in order to keep their practice from being "investigated". This leaves patients who need a change in dose unable to get it, meaning they end up suffering with higher levels of pain than they should have to.

As if this isn't bad enough Florida is now making it even worse. Their rules have now made it impossible for my daughter to receive the medical care she needs because she pays cash.

The state has decided to investigate every chronic pain doctor, whether they have reason to believe the doctor is engaging in illegal activities or not. As a result my doctor has hired a lawyer, to provide guidance on reducing his risk of being accused, just in case. On the recommendation of the lawyer, the doctor has to stop accepting Medicaid patients and any cash paying patient who wishes to see him for pain management. The reason for this advice is that the majority of drug addicts who doctor shop (see more than 1 doctor to get meds) are usually cash paying patients or on medicaid and the doctors who are willing to provide prescriptions to addicts (the ones who actually run drug mills in southern Florida) and dealers will only accept cash payments for the office visit. This means my daughter, who has been a patient in this office for 5+ years, can no longer see this doctor as she has no insurance and pays cash for the visits. So as a result of this "War on Drugs" (which we have already lost) patients who need treatment can not receive it if they are on medicaid or pay cash! Exceptions can NOT be made for patients who can show very obvious conditions or injuries that would require pain management, nor can they be made for patients who have already been with this same doctor for many years and have never shown any signs of illegal activity or addiction, if they're on medicaid or pay cash. It is a case of "too bad, so sorry, go somewhere else"!

My daughter has some major damage to her lower back from a car accident. Her vertebrae no longer sit correctly one on top of the other, one of hers has slid off of the vertebrae beneath it by 50% (this is called  Spondylolisthesis ), she also has spondylosis (aka degenerative osteoarthritis), degenerated disks, a large herniated disk (that literally surrounds the sciatic nerve root at L3-4), nerve damage to sciatic nerve roots (L3-4, L4-5 and L5-S1) causing permanent sciatica, and suspected sacroiliitis. As a result they had to fuse her spine in this out of alignment position because the first attempted repair failed when the vertebrae slid off again despite the screws that should have held it in place. She now has rods, screws, plates, and posts in her lower back holding her spine together. As a result of these injuries she lives with constant pain and constant sciatica. She has been seeing the same doctor for pain management for over 5 years. She has never failed the drug screening. She has never shown any behaviors that are considered signs of an addict (such as losing scripts, constantly demanding an increase in dose or frequency, losing the medication itself etc.). Despite all of that, she has been discharged as a patient from her doctor just because she pays cash.

Not all pain clinics and pain management doctors engage in writing prescriptions for people they know are going to sell the drugs. My experiences with these clinics has been the exact opposite. It is very difficult to obtain prescriptions for pain control.

Every month I have to undergo urinalysis drug testing to ensure that I am not taking drugs I wasn't prescribed, doing illegal drugs (such as cocaine or pot) and that the level of prescribed medication in my urine is the correct level for the dosage I was prescribed. When or if my needs change (due to further injury or tolerance to current dose) it is extremely difficult to get my dosage changed as well. In fact, I was told a few months ago that no matter what they will not increase my dose any further and that I will just have to "live with" any increase in pain or new symptoms. Which I have been doing for the last 8+ months due to further injury caused by the yard sale I ran back in April 2011. This means I am now pretty much bed-ridden and will stay that way for the foreseeable future and my daily pain level stays around a 6 to an 8.

So the results of the war on drugs in Florida are that patients who need treatment can't get it if they are on medicaid or pay cash and patients who are receiving treatment can't receive proper treatment because the doctor can be arrested for doing their job.

This is WRONG!

Law enforcement agencies and lawyers (be they prosecution type lawyers or other types of  lawyers) should NOT be the ones making medical decisions for patients, the doctors should be.

I am terrified of how much worse this is going to get when Obamacare goes into effect. My understanding is that with Obamacare pain management doctors will be given a limit of how many controlled substance prescriptions they can write in a month. If they go over that number they can be arrested and charged with drug trafficking. As a result of this, how many more patients will end up without treatment? Example: doctor has 31 pain management patients. Gov't tells him he can only write 25 controlled substance prescriptions per month. This means 6 patients will go without pain management.

Further, it is my understanding that under Obamacare a government panel will decide what injuries deserve pain management and what dose is appropriate for said injuries regardless of the medical history of the patient. My worst injury does not have a diagnosis code (permanent compound fracture of left SI joint) because it is extremely rare to have a permanent fracture, so it won't be considered when this government panel decides what the appropriate pain management is for me. If my doctor prescribes something different from what they government tells him to give me, he will go to jail and pay very high fines.

Medical decisions should be made by DOCTORS, not government officials and not law enforcement officials.

1 comment:

  1. Hi there. I am Donna Ratliff. The Florida leader of the American Pain foundation. I have been spreading a petition and survey around for about 3 weeks now against pharmacies denying pain patients ther medicine. If you haven't signed this, please contact me at I am also on facebook under my name. I live in Lithia FL. I have a group of people that I am in constant contact with ready to fight our battle against FL officials and the DEA. Please contact me. I would love to help you and you help us. Thank you, Donna Ratliff PWP


Thank you for taking the time to read and/or comment on my blog. For people who are chronically ill and/or in constant pain, it can be difficult to socialize as frequently as we would like to do so. Talking with others online is a way for us to socialize, chat with others, make new friends, reach out to others in similar circumstances and many more positive effects.

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