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Controlled Drug prescription problems-any Doctors?

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4 years 7 months ago #18726 by grappers
grappers replied the topic: Controlled Drug prescription problems-any Doctors?
Jamie that is where you have hit the nail on the head, those who have abused the system have made those that are genuine suffer the consequences of their actions. Unfortunately for us rather than take it on each individual case, we are thrown into the same basket, getting the rules to be changed is going to be hard when they are making it even harder to obtain scripts. You can also fall into the trap like I am in at the moment, where I am being investigated, all because the pharmacy has buggered up my prescriptions by putting them into my wife's name, causing them to have to be reissued, for them that is no excuse, I still have to prove my innocence that I am not selling my medication.
I do believe the system needs to be changed, once under the care of a recognised pain management specialists, they should have control of script medications for people under their care, and rely that to your treating GP, as the two are supposed to work in co-ordination of your care.

Don

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4 years 7 months ago - 4 years 7 months ago #18749 by Collins
Collins replied the topic: Controlled Drug prescription problems-any Doctors?
Hey Guys / Gals

Cheers Mary - Glad you communicated further for understanding.
I understand physical addiction doesn't mean your a drug addict but I just wanted to emphasise that I have no desire to take any of these medications at all - I hate them, rather I just accept that without them, I cannot even get out of bed

Given some confusion in my post/s - I thought I should clarify this further.
To do this, I have included the contents of a letter that I sent today to the PBS Authority, hopefully this letter will allow greater understanding of what I was trying to communicate in my post/s

Thanks to all who read my post and especially to all who responded, hopefully I will get a positive response to report back on in relation to my question

Regards
Jamie




Dear Sir/ Madam

My name is Jamie Collins and I have Chronic Pain from nerve impingements.

As such it is difficult for me to travel and walk and so I have difficulty travelling to my Doctor.

I am currently being prescribed a pain killer named tramadol (tramal) at 50mg x up to 3 per day by my Pain Management Specialist and General Practitioner. I used to be on Tramadol up to 600+mgt per day previously and as these were time release, so I was able to get my G.P. to prescribe me up to 3 months in advance, but I have been able to reduce the amount of dosage to 150mg over a long time with the help of other medication in order to reduce the unwanted side effects of taking larger quantities of tramadol.

My G.P has just arrived from Canada and under approval from my Pain Management Specialist attempted to get a months supply in advance of Tramadol 50mg times 3 per day total quantity 3 x 31 days = 93 tablets (come in boxes of twenty which would equivalent to up to 5 boxes per month).

When the G.P. went to request authority from Canberra, the hotline spokesperson informed the Doctor that he was not able to get approval for supply and that he would have to prescribe the amount with 2 repeats being a total of 3 x 20 = 60 tablets. This means that I can only get up to three weeks in advance at any one time.

It is much harder for me to manage seeing a G.P. every three weeks than it is every month due to difficulty with travelling and my Pain Specialist agreed to a month in advance for this reason. It is also logistically simpler for me to organise scheduling and remember every month than every three weeks (i.e. it is easier for me to remember a certain date every month for planning purposes)

I have tried to research the authorities requirements in order to see if common sense and understanding of my situation would prevail and noted some relevant details that the P.B.S. website states that may apply to me:

www.pbs.gov.au/info/healthpro/explanator..._2_Explanatory_Notes

Maximum quantities and repeats

PBS prescriptions and repeats can be for any quantity up to the maximum. It is not necessary to prescribe the maximum quantity if a lesser quantity is sufficient for the patient's needs. Please clearly indicate the number of tablets, capsules, etc. required and the number of repeats needed, and do not use abbreviations such as 'Max. Qty', 'M.Q.', or 'M.R.'.

If a prescriber feels the maximum quantity or number of repeats should be increased for a particular patient, he or she must complete an Authority PBS Prescription Form (see procedures above under 'Authority PBS Prescriptions'). The provision of increased quantities and repeats on authority PBS prescriptions is intended to provide approximately one month's therapy which may be repeated (if clinically appropriate) to provide 6 months' therapy in total. This situation usually arises where higher than normal dosages are required.

Regulation 24

Under this regulation, original and repeat supplies of pharmaceutical benefits can be supplied at the one time if a medical practitioner, a midwife or a nurse practitioner is first satisfied that certain conditions apply, then endorses the PBS prescription 'Regulation 24'. RPBS prescriptions may be endorsed 'hardship conditions apply'.

The medical practitioner, midwife or nurse practitioner must first be satisfied all the following conditions apply:
•the maximum PBS quantity is insufficient for the patient's treatment; AND
•the patient has a chronic illness or lives in a remote area where access to PBS supplies is limited; AND
•the patient would suffer great hardship trying to get the pharmaceutical benefit on separate occasions.

Drugs of addiction

Prescribers must heed State/Territory laws when prescribing drugs listed as narcotic, specified or restricted and must notify, or receive approval from, the appropriate health authority.

When a PBS/RPBS authority application is for a drug of addiction (other than dexamphetamine sulfate), the following guidelines apply:
•the maximum quantity authorised is generally for one month's therapy (e.g., one week's therapy with three repeats);
•where supply for a longer period is warranted, quantities are usually for up to three months' therapy;
•telephone approvals are limited to one month's therapy.

Prescribers should also state the interval of repeat where repeats are called for, and ensure State/Territory health authorities are notified about ongoing treatment.

END OF WEBSITE QUOTES
[/b]

These statements imply that common sense in fact prevails and that I am actual fact able to indeed get authority for up to a months supply of 50mg tramadol (non time release) by an authority agent / medically authorised specialist Doctor.

I was wondering how me and my prescribing Doctor go about getting approval for a months supply of Tramadol, I don't mean to sound trivial, but there is in fact a significant difference in successfully managing the dispensation of my medication and so I am hoping that you will be able to successfully advise and guide me and my Doctor on how to go about getting the authority.

Please note that I am also currently undergoing a Pain Management Course if that has any bearing and I will also seek further advice from my Pain Specialist at that Hospital as to whether it is possible to continue with her request that my medication be allotted up to one month in advance.

I would appreciate any assistance and/ or guidance you may be able to give me in this regard.

Sincere Regards

Jamie Collins


07/01/2014

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Last Edit: 4 years 7 months ago by Collins.

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4 years 7 months ago #18750 by GeneralLeeCrap
GeneralLeeCrap replied the topic: Controlled Drug prescription problems-any Doctors?
Hi Jamie, I was in a similar boat to you for the last few years, I needed someone to take me to docs, hospital for visits and prescriptions etc I understand how frustrated you are with it :S
My pharmacist home delivered meds as needed. Maybe have a chat with yours and see if they offer a similar service. :)

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4 years 7 months ago - 4 years 7 months ago #18751 by Collins
Collins replied the topic: Controlled Drug prescription problems-any Doctors?
Hey there GLC

Not really frustrated as such, as my wife can pick up my meds from the pharmacist for me, the problem is that I have difficulty getting to the Doctor as my wife cannot legally appear on my behalf to get my prescriptions.

Yes - the consequences of missing a prescription stresses me as there are significant consequences for me if I do not take my medication. So I am just trying to be practical in managing my visits to the Doctor so that I can reduce the stress of having to go through the hoops of travelling to my Doctor on a regular basis. It would be ideal if I didn't have to be under this constant stress of worrying about whether I can make it to the Doctors for my next prescription more frequently than I have to.

I am hoping the system can assist me in this regard - that's all

Thanks for the idea about my pharmacist delivering - I will ask them

cheers
Jamie

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Last Edit: 4 years 7 months ago by Collins.

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4 years 7 months ago #18866 by Aetherone
Aetherone replied the topic: Controlled Drug prescription problems-any Doctors?

MaryW wrote: 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.

Absolutely.
Psychological addiction is very different from physiological dependence.
www.healthcentral.com/chronic-pain/coping-279488-5.html

Calling yourself an "addict" when you're merely "dependant" does you/us a disservice and it amazing how differently the same doctor can behave when presented the terms. Drop the "A" word and the first thing their training does is put them on a cautious, addiction breaking slant. Use the "D" word instead and it becomes all bout helping you to use pharmacological tools to manage your condition.
The following user(s) said Thank You: Mary, Collins, Mrs S

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4 years 7 months ago #18868 by Collins
Collins replied the topic: Controlled Drug prescription problems-any Doctors?
Wise words once again - Aetherone - appreciate your comments - thankyou

Jamie

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