(This is Jack posting for Te because she’s too exhausted, physically and mentally, at the moment.)
If you or someone you care about or hell, even just kinda know, takes tramadol as part of their pain management, and you (or they) are in the United States, this information is CRITICALLY URGENT.
As of the 18th of August, 2014 — that’s just four days from now, two of them the weekend when doctors’ offices are closed — tramadol will become a Schedule IV drug under United States law. In laypeople’s terms, this means that tramadol, which is not a narcotic and has never before been treated like one going all the way back to when it first received FDA approval, will be treated as if it IS a dangerous, addictive narcotic.
Worse, some doctors’ offices have started treating tramadol as if it is already legally a controlled substance even though the change has not yet taken effect.
Worse, some of these offices are implementing the change without notifying patients of the change in policy regarding a perfectly safe medication many of us have been taking daily for years.
Worse, some of these offices are pre-emptively denying refills to patients who have already been taking tramadol issue-free for years, essentially just to prioritize covering their own asses over providing their patients with adequate care. In these cases there are either additional hoops for the patient to jump through, or the office is going to add tramadol to the list of drugs they ‘just don’t prescribe’ there because patients with chronic pain should be under the care of a pain specialist… and having the patient get no pain management while they’re on a waiting list to see a pain specialist (if there even are any in their area who take their insurance) is somehow seen as acceptable.
We don’t know how many medical practices will go the latter route, and won’t until next week at the earliest, unless they’re actually communicating appropriately with their patients. But we already know that many U.S. doctors have been making pain management increasingly difficult (and dangerous, because policies that make medication-hoarding necessary also make abuse more likely) for patients who do need actual narcotics.
So. Anybody in the USA who takes tramadol? Make sure you fill any refills you can ASAP. Then call your prescriber’s office and ask if they have implemented or will be implementing any changes in policy wrt tramadol. If the person you’re talking to says something like “not that I’ve heard,” mention how you’ve heard about the change in DEA classification and ask them to check and make sure.
(Funnily enough, while I was typing this, another of Te’s doctors called back and agreed to take over writing her tramadol scrip since the other office was being so unreasonable. Long story but you can guess the gist. Yay for instant karma? May all of you get your own tramadol woes resolved with no more than 3 days of pain, stress and frustration.)
What really chaps my ass about this (other than everything), is that calling 911 and complaining about severe, debilitating pain and then allowing myself to be carted to the hospital via ambulance — which is, in fact, something that my so-called primary care physician suggested I do, through a proxy, the coward never ONCE agreed to speak to me, even over the phone — when I pointed out that her refusal to fill a prescription that she’d been filling for me for over a year was going to make it impossible for me to, well, *function* —
Quick quiz: Why *are* health care costs so high in the U.S., kids?
— well. If I *had* let myself get rolled right up on into that E.R., it would’ve been almost embarrassingly easy to roll right out again with oxy, vicodin, dilaudid, demerol — whatever.
Easier, in fact, than it would’ve been to get tramadol — because, hey, my pain was severe, after all.
I know; I’ve been through similar sorts of things before.
Not a *lot* of those drugs, mind — just enough to, oh, say, wind up with a baboon-sized monkey on my back.
Or roll right out onto the street and sell it to someone who would sell it to someone *else* with a *gorilla*-sized monkey on *their* back.
Or… you get the gist.
Quick quiz: Guess which drug doesn’t have a street profile or an abuse profile in the U.S.?
If you guessed tramadol; you’ve been paying attention.
At this point, my advice to all of you which chronic illnesses which require pain management care is to do the following:
- Get a pain management specialist if you *possibly* can. These people are life-savers. Get on the waiting list for them. Get on the waiting list to *be* on the waiting list. Do it now.
- If that’s not possible, shop around for rheumatologists. Yes, even if your arthritis is mild, or if you “just” have fibromyalgia. The simple fact of the matter is that rheumatologists are the unofficial pain management specialists of our fucked-up country. Not all of them are any good, and many of them will make you jump through hoops, too, but? All of their patients are in pain. They understand it *better* than, sad to say, even many of the best GPs. Let your first act upon seeing your GP — even if your GP seems great — be getting that GP to refer you to the rheumatologist who got the best reviews in your area. Make the appointment. Go to the appointment. You can never have too many doctors familiar with your need for pain management.
- Study what sort of nursing/nurse-advocates are available in your area. Don’t know what I mean? Check this out. Among other things, the nurses here will be pit bulls for patients, cutting through a lot of bullshit and red tape when doctors are being pricks. Sometimes? It still doesn’t work. But allies still make things better.
Now, I hate to fucking say this. I HATE TO FUCKING SAY THIS, AND YOU WILL NOTE THAT I AM NOT PHRASING THIS AS ADVICE.
There are some medicines you must take exactly as directed and exactly on-schedule, like antibiotics. In an ideal world, we would be able to treat *all* medications that way.
But we don’t live in that world.
And I, personally, will always let myself hurt on some days when I can afford it — if it means I can bank a painkiller or two.
Just in case.
Just. In. Case.
Just in case of bullshit *exactly* like this. I’m still sick as a dog and exhausted and just plain *beaten* with pain from having gone without *adequate* amounts of tramadol for the past few days — but I damned well had a few.
Because paranoia pays.