Aug 16, 2015

The Real Cost of Tennessee's New Pain Management Laws

In 2012 I moved back to the Chattanooga TN area from Colorado. I am an older (61) disabled widow. I support my adult son, who is also disabled. He has not yet been approved for his SS disability, so he has no income or medical insurance. Between the fall of 2010 and 2011, he was in the hospital 180 days. The next year he was in the hospital 90+ days. He experiences horrific pain as he struggles to function. I also have a high level of pain, but not nearly as overwhelming as his pain is.

When we arrived back in the Chattanooga area, we both expected to be able to continue our pain management regimen without incident. We were so wrong!

Tennessee had passed new laws.


    Over the past three years, the state of Tennessee passed a series of new laws to tighten regulations of controlled prescription drugs in order to combat the state's widespread problem of abuse. These are a few:


    • New rules passed to more strictly certify and regulate pain clinics


    • The Prescription Safety Act is passed, requiring doctors to register with and check the Controlled Substance Monitoring Database before prescribing opioids or benzodiazepine drugs.


    • Pain management clinics can no longer dispense medications. Only pharmacies can dispense these medicines, and they cannot dispense more than a 30-day supply.

    • Doctors at pain management clinics must conduct regular urine drug testing of their patients receiving medication for chronic pain. Other physicians are "strongly" encouraged to do so every six months for patients receiving regular doses of controlled substances, which could include medicine for anxiety, migraines or muscle spasms.

    Source: Tennessee General Assembly

Follow me below the fold for the REAL story about Tennessee's new laws.

Be warned, this is part rant and part informative.

I carried my prescriptions for all of my medications back to Tenneessee with me. I also carried a printout of all my medications from the last two years, and all my medical records.

My first shock was when I discovered that it was illegal for a pharmacy in Tenneessee to fill a prescription for pain medication which had been written in another state. I mailed them back to my pharmacy in Colorado who filled it for me without question, and then mailed them to me. This gave me thirty days to find a doctor here.

Both of the first two pain management clinics, that I got appointments with, closed after raids by the DEA. The third clinic I tried, refused to write me the medications that I had been on. They wanted to switch me to the extended release form, which runs about 10 times what the instant release tablets cost. I explained that I was on Medicare, which allows me about 2900$ to spend on drugs yearly. What they wanted me to take would have used my benifit in less than three months. I explained, and was told that my financial problems wern't their problem. They told me to go check into drug rehab. How, exactly, is that going to treat my pain? For that, Medicare paid for a new patient intake, and I paid a 45$ copay. What a total waste of time and money.

Sometimes I would like to have 2 minutes with a knife, so I could demonstrate to the Goody Two Shoes, exactly what real pain feels like! ( OK, thats a rant, I don't have any plans going on in my head.)

I admitt, I am addicted to my pain medication. I hate that. Without the medication, I can't function. The pain takes over. I detox twice a year, so that my tolerance doesn't build. I am on the same dose now, that I was on in 2009. I will need the medication for the rest of my life baring a miracle.

I finally found a clinic which writes the medications that I need. They do not accept any type of insurance. I pay them 250$ cash each month. I have been going there for three years now. I am drug tested every month, and I have to pay 50$ a month for it. That is my food budget for two weeks which is just gone. I would love to find a clinic that takes my Medicare. If I go to another pain clinic, even if all I do is check them out, I can be dismissed from my current clinic. I can't risk that.

If I were to lose my clinic for any reason, they would blackball me in TN, making it almost impossible to find treatment elsewhere. If a patient flunks a urine screen, they are dismissed immediatly. What do you imagine happens when a drug dependent person, with a lot of pain, looses their doctor? That guarantees the patient will now begin purchasing drugs illegally. He will quickly migrate from pills to Herion, which costs about half as much. That person will now begin to steal to support his habit. The strict laws are doing nohing but putting addicts on the streets, with no way to get help.

I used to be allowed to fill three months of all my scripts. That saved me a significant amount of money. The pain clinics in Chattanooga require that you see the doctor once a month. For a long term pain management client like me, that is not needed. I have been on my same regime for over 5 years now. It is the law in Tenneessee. It is designed to bilk me of my money, and give it to someone who already has plenty of cash.

My name is up on the Web, with a list of my medications, for the whole world to see. That is a violation of my right to privacy when it comes to medical information. Truly, anyone who works in the medical profession in any way has access to that database, including the DEA.

My clinic has cameras and listening devices everywhere. I am certain that the DEA can listen and watch us by taping into that feed. They routinely stand by the entrance and take photos of people going in. They claim that they are searching for fugitives. I don't believe their lame story. My picture has been taken a few times. I always ask politely if they would like to have my address, so they can send me a copy.

My Medicare Advantage plan took medications that were once Teir 1 and raised them to Teir 3 and 4. My cost went from 8$ per script to 45$ per scrip. That increase alone would feed us for a week.

The  DEA is now setting guidelines for how many instant release pills a month may be prescribed to any one patient, and how many total milligrams a patient may be prescribed total between their long acting and instant release pills.  Each Doctor is allowed to prescribe narcotics to only a percentage of his patients, even pain managemant doctors, who used to be exempt from that guideline. Now they are not. Pharmacys are allowed only a set limit of narcotics they may carry on hand, so they run out on a regular basis. It is not unusual for me to have to try over a dozen pharmicies in order to have my scripts filled, and that is hard to do when you don't have a car. Then, I have to wait while they call the clinic to verify that the script is not a forgery.

I have had to muddle through being stopped, and searched, without my consent, by a policeman at a routine traffic stop. I was the passenger. When he asked me for ID, I told him that he has no probable cause to ask me anything. That pissed him off. He searched the car, then he searched us. Then he searched my handbag and found my prescriptions. He accused me of being a drug dealer. I was taken in, for questioning.  The first words out of my mouth were, "I wish to assert my legal right to have my lawyer, please." I used my one phone call to call our lawyer. He had me released within 10 minutes.

I am fed up with being treated like a junkie because I need pain medication to function. Do you know that untreated pain kills? It kills the inner organs. They fail in a sort of cascade. Once the process begins, it can't be stopped. An ER doctor told me that bit of information. He told me that my son is showing early symptoms. Both his liver and kidneys are slightly compromised.  That frightened me, and I am not usually afraid of anything.

The State needs to reexamine their laws, from the point of view of someone who really needs pain management. The DEA needs to be disbanded totally. They are a bunch of cowboys out there chasing the street pushers, instead of going after the cartels. Gosh, they have to appear to be busy doing SOMETHING! That something shouldn't be sticking their nose into my private medical information. –Contributed by Mary/Daily Kos

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