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Restrictions on opioid use
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Restrictions on opioid use

Hi all,

I have had chronic pain due to way to many diagnostic conditions that I have. One of the worst to cause pain is two herniated disk at the lowest possible location of my spine. I believe it is L4-L5 and L5 to S1, or something like that. Anyway, I have found and have been using the greatest medicine for relief of my pain. I have not become dose tolerant of this medicine, i.e. I haven't had to increase the dose in the two years that I have been taking it. That, to me, is so very important. I take tramadol when I wake, and sometimes in the late afternoon.

I cannot imagine trying to live without it. I am sure that some of you feel the same way.

Back a few years ago, it was highly recognized by the medical field, that pain was way to often untreated, due to the laws made and enforced by the Drug Enforcement Agency (DEA). Doctors were too intimidated to write a prescription for pain medication. Some almost lost their medical license.

The doctors working for the DEA, got together and addressed the problems with all of the restrictions on prescribing pain medication. In other words, the DEA itself recognized that they were the cause for many people with pain to go untreated. They changed the rules and wrote articles on the lack of proper pain relief, and made new prescribing guidelines for opioids and other pain medications for all doctors. I think that this happened around ten years ago.

Now from the article I found below, there seems to be some zealots that want to take away our pain relief and the increased quality of life that they give us.

Cheers to all,



Physician's First Watch for February 11, 2009

Guidelines on Opioids in Noncancer Pain Issued

Guidelines on the use of opioids in treating chronic noncancer pain have been issued by the American Pain Society and the American Academy of Pain Medicine.

Among the 25 recommendations, appearing in the Journal of Pain:

Before starting chronic opioid therapy (COT), physicians should perform a history and physical exam and should assess the patient's risk for substance abuse.

Physicians should monitor patients on COT to document their level of functioning and any adverse events.

Patients with a history of drug abuse should receive COT only if their clinician can monitor them frequently.

Patients on COT should be able to identify a physician "who accepts primary responsibility for their overall medical care."

On Monday, the FDA announced plans to tighten restrictions on opioid use. Asked to comment, Dr. Roger Chou, first author on the guidelines, said that both efforts were "part of the same movement to relieve pain and suffering while minimizing the risks of the medications involved."

Guidelines in the Journal of Pain

Physician's First Watch coverage of FDA call to tighten restrictions on opioid prescribing.
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6 Comments Post a Comment
547368 tn?1440545385
Hi Jack,

Welcome to our Pain Management Forum. We are glad that you joined us. Thank you also for bringing us this article. I can not say it has made me jump for joy.

It can be found at this site: I have read it but intend to do more research on the impact this may have on us. We all know it'll get worse before and if ever it gets better. I do not beleive that this will have a great impact on those of us that are currently being prescribed opiates. So I will withhold my venting until I learned more of the intent on the guidelines.

Jack I am glad that Tramadol is effective for you. We all need to find that "right" medication that if effect on our pain. I am hopeful that you will be an active memeber of our community.  

Peace, Tuck
356518 tn?1322267242
Hi Jack,
I read the article when it first came out in JAMA and was too concerned. I believe though that the guidelines are basically the same as before just emphasizing on being better aware of those who try and get these medications under false pretinces.
Forgive my spelling;)
214864 tn?1229718839
Thanks so much for your replies :) I hope that we do not find ourselves"coming "full circle" i.e. starting back at square one, with the fight for proper pain management.

Maybe I am being a bit paranoid, but I wanted to share this info with you.

My best wishes to all for a pain free life, as is possible :)


518031 tn?1295578974
i have been going to a pain specialist for 4 years now and changed my life 100% and i am terrified that the DEA is going to make almost impossibvle for us that need these meds to live a half way normal life....
535089 tn?1400677119

Thank you for the article. Many members are not aware of this. My Doctor and I talk about many things and one of them is the way the DEA is cracking down on opiate use in todays society.
Due in part to the article and the DEA, my clinic...a Group Heath clinic has changed it's guide lines on the amount and strengh that can be prescribed through the clinic.

A few patients that were receiving meds over the guide lines have now had to seek out a Pain Management Clinic in our area. I am one of the lucky ones who was just under the Guide lines.

This goes to show you how things are changing. Again, thank you for the insight....

Avatar n tn
Jack, I read some of your comments from 2007. You were preparing for CABG and had stents (I think) at the junction of the left circumflex and the left main (which I'm told is the widow maker).  I've got the same situation.  So how are you doing now?
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