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Pain meds


Moore's
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Hello! My husband and I have been full-timing since February 1, 2017. We stayed around due to our kids and doc appts. We r traveling now. We must go back to our home state every other month to get our scripts for our pain meds unfortunately. Is there any other way of getting them legally, without heading back to our home state? If not, we won't be able to travel like we would like. Any help would be with this matter would be great! Thank you!

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Yes that is where my dilemma is. Our doctors don't have any other suggestions unfortunately! We did talk with them about it. I wasn't sure if there were traveling doctors or someone we could use for this as we travel across America or not. Thank you for all your help!

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As Kirk said, with the national opioid crisis, there are new Federal and state laws and regulations that restrict how scheduled (controlled) substances are prescribed and dispensed. There have actually been two physicians sentenced to prison in the past week in this country for not following the regulations in place in their states. You need to have a conversation with your providers and ask specifically about the requirement to return every two months. In regard to going to other providers and asking for prescriptions for controlled substances, all filled prescriptions for controlled substances are entered in a database. Any new provider or pharmacy can - and likely will - check this database to see if you are "doc shopping" for opioids. Your circumstances are likely governed by both Federal laws and laws and regulations specific to your state. You'll have to investigate those, speak with your providers, and figure out what you can do. Unless there is a licensed provider from your state who happens to see your question on this forum and answer it, this is not the place to get answers to the question(s) you are asking.

Rob (RN, MSN)

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Thank you so much! I guess some people understand what I am trying to say n others not so much. I am not shopping around for just any doctor anywhere to give me a script for pain meds!!! What I am trying to figure out is how to travel around without having to constantly return to PA! We both have disabilities n we don't want to finally get to California, then not be able to see places before returning back to PA! If we were in the middle of America, then yes no problem but being the entire way across America, not good. So I guess we will do what I just said, move ourselves somewhere in the middle of America so we can see everything without being too far away. Thank you to all n safe travels!!

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41 minutes ago, Moore's said:

Thank you so much! I guess some people understand what I am trying to say n others not so much. I am not shopping around for just any doctor anywhere to give me a script for pain meds!!! What I am trying to figure out is how to travel around without having to constantly return to PA! We both have disabilities n we don't want to finally get to California, then not be able to see places before returning back to PA! If we were in the middle of America, then yes no problem but being the entire way across America, not good. So I guess we will do what I just said, move ourselves somewhere in the middle of America so we can see everything without being too far away. Thank you to all n safe travels!!

I'm sorry you misinterpreted what I said. I did not imply that you were - or were planning on - "doc shopping." I was simply trying to explain to you how things are, legally and logistically, in our country at this time. If you were to use a national pharmacy (such as Express Scripts for Tricare as we do), they can get your medications to you wherever you are. However,  there are still laws in the case of opioids and narcotics that govern how often your physician has to see you and how often the prescriptions have to be renewed in order to stay within the law. As I said in my previous post, those circumstances are specific to your state, that state's Medical Practice Act, and applicable state and federal laws governing scheduled/controlled substances. Again, have a discussion on the specifics with your providers including the legalities.

Rob

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13 hours ago, NDBirdman said:

My provider sends all my meds by mail as I need them.

He is asking about Schedule II drugs which are limited under the federal drug laws. 

The following is from the US Department of Justice, Drug Enforcement Administration:

Quote

Q. What does this rule allow a practitioner to do?

A. A practitioner may provide individual patients with multiple prescriptions for the same schedule II controlled substance to be filled sequentially. The combined effect of these multiple prescriptions is to allow the patient to receive, over time, up to a 90-day supply of that controlled substance.

Q. Is there a limit on the number of separate prescriptions per schedule II controlled substance that may be issued for the 90-day supply?

A. The rule does not stipulate how many separate prescriptions per schedule II controlled substance may be issued for the 90-day supply. It is up to the practitioner to determine how many separate prescriptions to be filled sequentially are needed to provide adequate medical care. For example, a practitioner may issue three 30-day schedule II prescriptions to cover a 90-day supply or he/she may issue nine prescriptions for the same schedule II controlled substance, each for a ten-day supply, having the combined effect of a 90-day supply.

Q. How is the issuance of multiple schedule II prescriptions different than issuing a refill of a schedule II prescription?

A. The issuance of refills for a schedule II controlled substance is prohibited by law. The use of multiple prescriptions for the dispensing of schedule II controlled substances, under the conditions set forth in the Final Rule, ensures that the prescriptions are treated as separate dispensing documents, not refills of an original prescription. Each separate prescription must be written for a legitimate medical purpose by a practitioner acting in the usual course of professional practice. Each separate prescription must contain written instructions indicating the earliest date on which a pharmacy may fill each prescription.

Q. Is post-dating of multiple prescriptions allowed?

A. No. Federal regulations have always required that all prescriptions for controlled substances "be dated as of, and signed on, the day when issued." 21 CFR 1306.05(a).

 

 

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22 hours ago, Moore's said:

Thank you so much! I guess some people understand what I am trying to say n others not so much. I am not shopping around for just any doctor anywhere to give me a script for pain meds!!! What I am trying to figure out is how to travel around without having to constantly return to PA! We both have disabilities n we don't want to finally get to California, then not be able to see places before returning back to PA! If we were in the middle of America, then yes no problem but being the entire way across America, not good. So I guess we will do what I just said, move ourselves somewhere in the middle of America so we can see everything without being too far away. Thank you to all n safe travels!!

This may or may not work for you

My wife takes schedule II meds for pain.  We have been visiting family in Oregon (we are Texas residents) for 5-6 months each summer.  We contacted a Pain Doctor in Oregon, had the medical records sent from the Dr in Texas to the Dr in Oregon.  The Dr in Oregon prescribed the meds in Oregon and the Dr in Texas did likewise in Texas. 

Our pain Dr in Texas has been working with Sharon to move to schedule III pain meds.  Here are the two that have been tried:

Butrans:  A 7 day patch.  Sharon didn't like it because it made her spacey all day long.  Probably good for anyone wanting to be spaced out all the time. :)  https://www.butrans.com/patient/home.html

Belbuca:  A 12 hour film you place inside your cheek and it dissolves in about 30 minutes.  https://www.belbuca.com/patient/

At this time we have not attempted to get multiple month Rx for either of these.  As a schedule III med it should have different restrictions.

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9 hours ago, Kirk Wood said:

He is asking about Schedule II drugs which are limited under the federal drug laws. 

 

Ok, thanks.  I dont know what schedule the morphine and oxy I was on for a while are.  I was getting them until bout 6 months back when I decided the pain was not as bad as the side affects I was having.  I got those through the mail for close to 6 years.  I'll go back to my corner now... LOL.  Hope they get their meds figured out.

 

(the VA was who was sending them to me)

Edited by NDBirdman
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