Troubling news from my doc about new FDA/DEA guidelines.

[bluepen]

Sorry in advance for the length of this post...

The basics about my situation: Bad depression. Hospitalized once for it. Full-on panic attacks and many trips to the ER thinking I was dying. That was about 12 years ago. It took me a couple of years to get the right balance of Zoloft and Xanax that have made me live a fairly normal life, and I have been for a little over a decade now.

So today I go to my doc for the routine med check and new prescriptions for a few months.

She tells me I’m taking too much Xanax. (For the record it is a low dose: .25mg up to 3x daily as needed - I sometimes don’t even take that much - and 1mg when I go to bed.)

New FDA/DEA guidelines, she tells me, and gives me the form pictured below. She explains this is practice-wide and anyone taking opioids or benzodiazepines is getting this. (I later confirm this when a nurse tells me it’s been hard dealing with patients who are stressed about it, and then I hear another patient at checkout expressing concern.)

So after ten years of living a fairly normal life, the new plan is to get me off the Xanax. Right.

I wonder how the FDA and DEA are going to deal with the doctor shopping, pharmacy jumping, and illegal market they’re going to create with this?

The fill-in-the-blanks nature of the form is suspicious to me, as well as the blanket “should not be used for more than four weeks” statement.

I kind of wonder whether this practice is under some kind of scrutiny.

Anyone else getting this news, specifically about benzodiazepines? Has this already BEEN news and I just missed it?

[lagomorph777]

1. It's probably just that practice - Turd is trying to take it the opposite direction,

you know, by nominating the architect of the opioid crisis for Drug Czar.

I know somebody who's been on a low dose of that same thing for decades, and has gotten no hassle over it (same doc the whole time as it happens).

[bluepen]

5. The more I think about it, the more I think that is the case.

[Ilsa]

2. Here is a link to a very recent press release by the FDA

https://www.fda.gov/Drugs/DrugSafety/ucm518473.htm

It appears to warn about prescribing benzos with opiods, more than anything.

BTW, benzos can cause serious confusion in some elderly people, resembling Alzheimers or other dementia. It's easily managed by withdrawing the drug. Even a very low dose can cause it for that population.

[bluepen]

6. Thanks. That is the only one I could find too.

And it’s very specific about the combination, you’re right.

[Freethinker65]

3. Actually this letter seems to based on medical knowledge, unlike the disinformation women are given

While I am sorry that this type of letter will affect those that truly need such medication for chronic issues that are already totally aware of potential dependency side effects, a form aknowledgement letter seems appropriate to me. I just received a standard handout today with my flu shot and see nothing wrong with that.

In my opinion, the disinformation given to women routinely when they try to access reproductive healthcare is far more menacing.

I trust your physician is well aware of your and his/her other patients particular circumstances and medical history to continue to proscribe to chronic patients that need the prescriptions.

[bluepen]

7. Not really concerned about a form letter, per se.

Just suspicious of one that doesn’t make very much sense. The fill-in-the-blank for meds but the blanket “only take this for four weeks” is odd.

[Freethinker65]

9. A bit odd, I agree. But medications are often proscribed for no more than a one month supply

I suppose if it is a new medication, or a new dose of current medication, a review might be indicated to get a refill? I am not a medical professional, so I do not know.

[bluepen]

10. I addressed that in the OP. Thanks

[marylandblue]

4. I could not find any information on changes from DEA or FDA

Your doctor should not provide a form letter stating you are taking "too much" Xanax. If you are taking it at or below recommended dosages, you are not taking too much. If he.wants to.lower your dosage, he needs to discuss it with you in person and base it on your actual medical condition, not a blanket decision that all his patients need to cut back.

[bluepen]

8. Thats how I see it as well. It really does seem

like they’re under some kind of scrutiny or they’re developing their own philosophy about prescribing these meds. Which is fine. If that’s the case, though, it’s just being done in an odd way.

[SonofDonald]

11. My pain clinic Doctor just told me that there are supposed "guidelines"

That they may have to follow pretty soon as to how much they can prescribe for an ailment.

I went down 60 mg's of morphine per day recently as some of my pain issues were corrected by better targeted procedures, this took me from 180mg's per day to 120mg's now.

I can't go under that without severe quality of life changes, it's now my worry that they'll say that's too much and I have to drop more.

The worst thing about it is I could have stayed just where I was at 180 per day, I dropped my dose because I WANTED TO not because I was told to.

Now that decision may come back to haunt me, I could have saved a bunch of meds to have in case I really needed them later on.

But my pain clinic has been my salvation for the last seven years of my life, it is my belief that this street runs both ways, I wanted to return the favor they do for me.

I was a Bering Sea Crabber and worked heavy construction for years, I destroyed my body, I'm six feet tall and weigh 215 pounds, my pain doctor said she has two patients much smaller than I am.

One at 600mg's per day and one at 800mg's per day of morphine.

I think they're in for a rude awakening.

[Ms. Toad]

12. Sleeping aids have been on the narcotics watch list for quite a while

I've taken ambien off and on for 7-8 years. A 90-day supply lasts me well more than a year. The last one lasted me a month shy of 2 years.

But a couple of years ago I got hassled for needing a refill at a time other than my annual check-up (I think I didn't need a refill of my 90-day prescription at one year, but needed it 3-6 months later). The pharmacy couldn't fill it without an actual visit to the doctor and a narcotics check. Even though it is a hallucinogenic, not a narcotic, they have a narcotic-equivalent calculation they are required to do as part of documenting my "narcotic" use.

Now I just make sure I get a prescription refill every year, whether or not I need it.