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Controlled Drug prescription problems-any Doctors?

  • Collins
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4 years 1 month ago #18718 by Collins
Collins created the topic: Controlled Drug prescription problems-any Doctors?
Hi All

I am hoping someone can help me here in trying to get resolution

I have difficulty travelling to the Doctors for my prescriptions

I used to be on 200mg x 3 per day plus 50mg as required for tramal (tramadol)
This was actually over the recommended daily dosage, so I have been trying to reduce this amount (and the side effects)

I am very cautious and very responsible with medication and have always been trying to reduce my meds for my own benefit. Contrary to all the reports about how addictive these medications are, I cannot become addicted to something I do not like taking - that's a simple fact! I long for the day in which I do not have to take any meds but the reality is that without my pain killing meds, I cannot get out of bed from pain - its that simple!

I have over time decreased my tramal intake - recently I started taking 2x 20mg/10mg targin (oxycodeine) per day which has given me the opportunity to decrease my tramal intake to just 3 x 50mg per day. I thought I was doing really good at being responsible and decreasing my meds, in fact I am trying to reduce my targin to 10mg where possible - so I have done really well in reducing my meds compared to what I used to take!

I used to get my prescriptions once per month - I am happy to go to see the Doctor everyday but the problem is that I am not well enough and have difficulty just making it to my Doctor anytime.

Here is my problem - I just managed to get authority to get my targin with up to a months supply (by my pain specialist to my Doctor) but when my Doctor was obtaining authority to do the same with Tramal he was told that he cannot get authority for the tramal for up to a months supply and that he can only give me a prescription with three repeats (twenty tablets per box x 3) which means it will last only three weeks because it is not time release.

It appears that because some people abuse the system, good responsible people like me have to pay the consequences for these drug addicts.
So I now have to visit my Doctor every three weeks (and a month) to get my meds for the rest of my life, which as I said before I wouldn't mind if only I was well enough to travel, but the simple fact is I am not and have difficulty making it anytime. This may sound trivial to some, but to me it is not - this is a huge burden and consequence because of those that abuse the system.

This is how stupid this is - it is simply encouraging me/ enticing me to go back to a stronger dosage such as 100mg tramal of time release and crush the tablet up and take half (to get my 50mg) - thus I would only have to go to my Doctor once per month. The problem is that I am too responsible and would not do that!

Surely commonsense must prevail here!

Surely there is a way that my Doctor can legally prescribe me a months supply of tramal (50mg) - I am happy to appeal to someone higher/ see as many Doctors as needed / write letters or even try to have the law changed if needed - because this is just stupid - I am talking about an extra week of supply not an extra year!

I have been looking at the PBS site and it says that my Doctor can request to provide a qty more than allowed but up to month in advance but I do not understand how we go about it - unfortunately my Doctor has just come from Canada and so he knows nothing about how our system works and is not the person to ask such a question - the person in Canberra wher he rings just said he cannot get it for 50mg and nothing more - no help or anything just no - cant do that. I am confident I can get any/ all of my Doctors approval for up to a months supply, I just need to be able to advise him how I go about this as per what it says on the PBS site.

Does anyone here know how I can get common sense to prevail and be able to get a months supply of my tramal - not only would it make it much easier on me in travelling, but it would save me a nightmare in calculating when I have to get my meds (instead of three weeks/ month - I could just get my meds monthly) as I am a bit of a goldfish when it come to calculating

Thanks for nothing to all those who abuse the medications and make life hard for legitimate patients like me!

My Regards to all here
Jamie

One of the silent voices, supporting CPA

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4 years 1 month ago #18720 by Florrie
Florrie replied the topic: Controlled Drug prescription problems-any Doctors?
Welcome back Jamie and Happy New Year.

I'm not sure how different states work/operate, but I would have thought a pain specialist could get authority for your GP to prescribe your current needs of Tramadol for 1 year. Maybe a phonecall to your pain specialist with the question could clear this up for you one way or the other. Good luck!

If that isn't an option maybe you could discuss different drug options that would give you the same pain cover and would be easier for you to obtain on a 4 weekly basis.

I have to visit my GP every four weeks to get my required scripts. Today is my first appointment of 2014, so with that comes all the high costs again until I reach the limits for medical and pharmacy costs! I should imagine many of us are in the same boat.

All the best Jamie :)

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4 years 1 month ago #18721 by Mary
Mary replied the topic: Controlled Drug prescription problems-any Doctors?
Hi Jamie,

I am sorry that you are having these problems and I understand that you don't want to visit your doctor every 3 weeks. However, there are rules that our doctors have to obey or there would be chaos in the PBS etc. My doctor tried to get an authority for Nexium (for reflux) recently. I take 2x20mg/day and this means that one prescription only lasts for 3 weeks too. However, they would not agree to it because of the policies that are in place. They need to have these policies so that they system runs efficiently and there is not one set of rules for "drug addicts" and the rest of us.

A couple of points. They now know that we can, and probably are, addicted to these medications now. Just because we don't like taking them, it doesn't mean that we are not addicted to them. That's why we have to reduce them gradually if we want to cut back on the dose.

You say that you have a new doctor who "doesn't know the system". Would it be possible to change doctors so that you can visit one who is closer to you. That way you will not have such a long trip every three weeks. From memory, you moved to a reasonably large town a couple of years ago, so is there someone else you could see?

Also, you cannot crush a time release tablet, or even cut it in any way at all, because you will get too much of the medication too quickly and not enough when you need it. It is a big no no!

I hope that you can find a solution. The best one seems to be to see a doctor who is closer to you.

Alll the best,

Mary

Not every day is a good day, but there is good in every day.

"“It’s delightful when your imaginations come true, isn’t it?” ― L.M. Montgomery, Anne of Green Gables

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4 years 1 month ago #18722 by grappers
grappers replied the topic: Controlled Drug prescription problems-any Doctors?
Jamie different States different rules, I have no choice but to see my doctor every 3 weeks, not to get scripts but for an injection and travelling there is a bit of a trip also, as we have kept our doctor from when we moved back to SA over 10 years ago, I wouldn't even contemplate changing after seeing a local one at one time, and got blasted for all the meds I am on and told it is all in my head.
Back to scripts, in SA any script that requires authorisation the doctor rings and you will get one months supply, but if the doctor signs and sends in the same script for 3 repeats for authorisation, they will sign that off and post the scripts out to the patient, I get this for my slow release Kapanol and hormone replacement injections. Ask your GP if that is also available in your state, pretty sure it would be as it all goes through and controlled by the PBS which is Federal.
Any time a doctor tell you to crush, separate capsules or cut slow release medications, flatly refuse, this is putting your own health at risk and also goes against drug manufacturers guidelines for use, most slow release have a protective casing to prevent any being absorbed until it hits the gut, good way to get yourself ulcers in the throat and any other stomach complaint associated with this practice, if you are cutting down, they should prescribe a lower strength slow release, halving higher dosages is a big no no and they should know it.

Don

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  • Collins
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4 years 1 month ago #18723 by Collins
Collins replied the topic: Controlled Drug prescription problems-any Doctors?
Hi all,

Happy new year to you all and I am glad I am well enough to post - as I said before - I never go away, it just takes me time to get back and post that's all, but I am always around and nearby

Just a couple of points here guys and gals - I feel as if some did not read my post properly??

I don't feel addicted to my meds - I could change instantly to another med or even give them up altogether if my pain went away - maybe its a different situation for you, but I am not addicted to these meds that I hate so much.

This Doctor is new and is the closest Doctor to me - there are other Doctors at the surgery but they have too many patients to take me on (I am still under NTD as well), to change Doctors would mean I have to travel further.

Yes I moved from Lighting Ridge to Coffs Harbour under Doctors advice but I do not see any bearing whatsoever that has to me being able to travel - I actually ended up in hospital at the halfway point when I moved here - nerve impingements in my T5 become aggravated by movement/ vibration that I have difficulty even walking 300m without being bedridden for days on end - because I travelled once a long distance, doesn't mean that my problem has disappeared in any way.

Let me just clarify this:

I used to be on tramadol 12hr slow release - up to 600mg plus per day
I have come a long way by getting to reduce this amount down to 3 x 50mg per day instantaneous - pretty good for someone supposedly addicted I might add

The problem
The PBS controlling authority will allow my Doctor to prescribe me up to 3 months in advance of 600mg per day (time release) but has a problem with giving me a month supply of 150mg per day because its instantaneous.

The stupid solution would be to get a months supply of 150mg time release and crush the tablet and consume 50mg of the drug at a time
Crushing a time release tablet would in effect give me the same instantaneous effect of the same instantaneous drug I am taking now - there would be no sudden release as such, because the 50mg are already sudden release

So what's the difference - I can get three months supply if I crush the tablet or I can get three weeks if I don't - either way the effect is the same.
Regardless - as I stated earlier - I would not crush any tablet anyway - as I am too honest and do not abuse my medication in any way. Certainly I want to make clear that my Doctor has not in any way suggested I crush any tablet - I am just merely using this as an example to show how stupid the system can be and how it can actually promotes the abuse of medication.

My point is that - the system is not working properly given what I have stated here.

Reading on the PBS site - it claims that my 50mg instant release tablets could be prescribed for up to a month if the prescriber feels it is necessary (as in my case) however this option was not afforded to my Doctor when he rang the controller in Canberra. So how do I get my Doctor to legitimately prescribe me a months supply of this - is there a form we have to fill out/ Is there an appeal process we have to go through?

I am not asking for the system to be abused, I am not stating I will abuse the system. I am saying that the system needs to work for me in a common sense way and that the system (PBS) states that I can indeed get up to a months supply - the question is how does my Doctor make this happen (given he is new to oz)

Sure I can wait for a couple of weeks to see my pain specialist and ask her - or I can even write an email to the PBS authority and ask them how we are supposed to do this - but I was hoping that I could find someone here in the interim, that may know the answer to this from their own experience and it was also an opportunity to raise awareness about how stupid the system can be sometimes, especially given the potential to entice people to abuse the system

The system has to work for us and it has to be effective - or it needs to change - if we cannot trust a Doctor to prescribe a months supply of meds than I fear the system is in big trouble indeed - researching the matter and the PBS site states that the system will actually work for me and my Doctor and that I can indeed get the months supply - the question is how we go about doing this?

Drug addicts have no bearing in this, other than making genuine people suffer the consequences of their exploitation.

Regards
Jamie

One of the silent voices, supporting CPA

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4 years 1 month ago #18724 by Mary
Mary replied the topic: Controlled Drug prescription problems-any Doctors?
Hi Jamie,

I was not implying that you are "addicted" in the way that you think. We are physically addicted to any medication that has to be weaned down. However, that does not mean that we are psychologically addicted as a "drug addict" might be. When you take a medication for a long time, the body chemistry alters and it becomes part of your metabolism.

When I said that you had moved, i did not mean that it had any bearing on your ability to travel or that I was assuming that you had low pain levels because you travelled a long distance. I simply meant that you would now have more access to GPs , so I was wondering why you were having to travel an uncomfortable distance to see yours. That's all.

As far as the authority scripts go; the best people to speak to about this are either your pharmacist or your GP. The rules are complex and I am not sure whether we can advise you here - only tell you what happens for us individually.

All the best in your quest for change

Mary

Not every day is a good day, but there is good in every day.

"“It’s delightful when your imaginations come true, isn’t it?” ― L.M. Montgomery, Anne of Green Gables

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