Jackson Jambalaya

You doctors need to talk to Mike Moore, he knows more about OPIODS than you do. After all, he went to Ole Miss law school just like Dickie Scruggs did.

What Drug Dealer wants his job to be harder?

Let me review how we got to where we are today:

Not that many years ago the damned government and medical establishment decided we docs were undertreating pain. They coined the phrase "pain is the 4th vital sign". Who were we to judge how much pain a patient was in??? We were supposed to take the patient's word for their pain and it was implied that there could be malpractice implications for undertreating pain. I thought that was just more ridiculous PC BS and continued to write controlled drugs only when I thought it was needed.

Now fast forward 15 - 20 years and SURPRISE!!! we have an opioid crisis!! Of course, now they blame the docs for this fiasco. Now the pendulum swings too far in the other direction and the damned government and medical establishment want to essentially prohibit opiates for anyone not already in hospice. Opiates and benzos, like any other drugs, are beneficial when used appropriately. Your mama breaks her hip and gets 3 days of pain meds?? My patient with debilitating panic attacks will just have to learn to "suck it up like a man??" Have any of you suffered for weeks from a herniated neck or back disc? Get real!! Things need to be tightened up, but the MBML needs to go after the outliers and not treat all of us as a bunch of dope dealers.

I am old enough to retire, but still practice because I enjoy caring for my patients. The constantly encroaching government bureaucratic red tape busywork (Electronic Medical Record, HIPPA, etc.,) requires so much time that while I used to be able to see 4 patients an hour, I now only average 2 per hour. If the proposed additional busywork regs go into effect, I will just hang it up.

My partners and I alway check the PMP if we have any concerns about drug seekers. The political hacks on the MBML are not taking the real world into account with their overbearing regs that will do more harm than good. Write the rules where it won't smother the docs and will not harm our patients.

This could be serious for the docs. Some of them might be forced to sell one of their “extra” vacation homes.

Those Docs want to get em addicted so the customers keep rolling in for their fix. Easy money for doctors.

Some people are just born idiotic. I trust my doctor more than I do the government. And if I say I'm in pain, then I'm in pain. I'm not a drug addict. I haven't had any pain medication other than Tylenol or Advil in at least six years, but if I was in horrific pain, I would want a serious narcotic. This whole notion that everyone gets punished because some people choose to abuse drugs is stupid and unfair.

10:23 obviously knows very little about how a doctor gets paid.

I posted this comment on the original thread and want to repeat it here. One thing i left out was the potential suicide rate increase for people with long term pain issues.
. I am 40 with a pinched nerve in my back that can not be fixed with surgery due to risk of complications. Or so I am told by numerous experts. I have done therapy, chiro, I exercise as best that I can and lost weight to try and “help myself.” I can take four Advil and four Tylenol four times a day and still not be able to work and raise my family. But by taking three norco a day I am able to survive and compared to most people in the world have a good life. But I have never sold stolen or doctor shopped for meds, which my prescription records would confirm. I work in a professional job and otherwise would be on disability as a drain to the taxpayer. I understand there are problems that need to be addressed but don’t stop legit doctors from treating legit patients. Chronic pain is depressing and difficult to deal with for those who have not experienced it. I was perfectly healthy until a car accident and it ruined my life. Just wanted to share my story. It is very tough when you can’t phyaically play with your children or do basic tasks. Celebrex raises my bloood pressure too much so I can’t take it every day. Have tried other stuff. Never used illegal drugs in my life. What am I supposed to do.

I am facing major cancer surgery early next year. It will be a difficult procedure. I will die without the surgery. I had similar surgery a few years ago and it took me weeks to recover, including using narcotic pain meds. I didn't get addicted. There is no way I can get by with two weeks of pain meds. These people are, indeed, idiots.

9:31:

Hat's off to you, in 'the real world', I was in a car wreck 10/2/17 and broke wrist, arm and screwed up shoulder. Got ok meds in the hospital, but when discharged got minimum dosage opioid which barely felt. But I spaced them out 4 hours then 6 then 8hrs. Impossible to sleep. Then they said no more after 2 1/2 weeks?! Tylenol, which tore up my stomach. I turned to bourbon. Thanks a lot, non-medical legislature and non-medical MBN...

Still waiting for one of Mississippi's Republican control freaks to explain how this top down regulatory straitjacket is any different than the heavy-handedness of Obamacare.

Quoting Dr. Phillip Ley:
"This is patently ridiculous, a public bandaid for a problem CREATED by government policy. Yet another hurdle to taking care of my oncology and postoperative patients".

This fiasco was created by freakin' government policy and organised medicine. Their knee-jerk fix is just as crazy and harmful to good medicine as their former policy of pressuring doctors to freely give pain meds. @9:31 summed it up well.

It is a fact that the doctor hating posters above will come begging for pain meds when they eventually experience intolerable pain with their kidney stone, spine problem, MVA, etc. I have been there and would have preferred to just die rather than live in pain. Finally recovered and came away with a new appreciation for life and the medical profession. I stopped the meds when finally got better and have had no desire to take any pain meds since then.

Years ago it was diet pills instead of what we have today. Many doctors had a business which only served the people who wanted diet pills. An office call took all of 5 minutes. They were busy from opening until closing. A different patient every 5 minutes. The doctor was paid for an office call and paid by the drug manufacturer to prescribe a certain drug.
When it became obvious to what was going on prescriptions from certain doctors would not be filled by many places. Some doctors bought drug stores just for the purpose of filling the prescriptions they wrote. They became rich. They were paid for the office call, paid for prescribing a certain product, and made a profit from the sale of the drugs.

The product has changed. The doctors haven't changed. The customers haven't changed. The drug manufacturers have not changed.

Well, when you let law enforcement dictate health care policy, don't be surprised at the results.

Notice how on this topic, the media is taking law enforcement's position and running with it. No questioning or critical reporting. The truth is, law enforcement runs this state and all too often gets what it wants. The media doesn't hold it accountable because it is too close and wants the access. I'm talking more about law enforcement at the state level, not the local level.

All Marshall Fisher every recommends is to ban and bust. It's all he knows since his background is DEA (Don't Expect Anything). Surprisingly, his solutions never work.

You hit the nail on the head, KF! Law enforcement should enforce the laws, not dictate policy. I respect and appreciate law enforcement but the officials in Jackson don’t have any place opining on health care issues.

When they start busting 85 year old veterans for cannabis because they can't get their pain meds.

I have had two elderly persons tell me they will go to cannabis when their pain meds are shut off.

85 year old Vets of, what, the Korean War will turn to pot? Get real.

Some of these complaints are the same/similar to when Mississippi banned getting Sudafed over the counter. Most Sudafed users needed the medicine to treat sinus infections, only a few used it to make crystal meth. Now when I get a sinus infection I have to wait in a Dr's office for 3 hours with a severe sore throat, take the prescription to Walgreens and wait an hour for the pharmacist to fill the prescription, instead of just being able to buy it OTC in 5 minutes. And what is the end result? I have to suffer with a sore throat for hours, and instead of a few shake and bake meth labs, we now have ultra-pure, large meth crystals coming out of Mexico, and the jails are full of mule runners. If the medical community thinks these regs will save lives or reduce dependency, I believe they are mistaken and the void will be filled by Mexican cartels producing and importing opioids and the jails filled with more mule runners.

I think a few of you are blaming the wrong credentialed professionals.

Gosh, it's awfully coincidental that the moral panic over the opioid epidemic and the jackpot justice lawyers dipping their toes in the pool with their first lawsuits seem to be happening at the same time.

Team Blue with 'My Body, My Choice,' really only applies to abortion. Otherwise, these busybodies need to regulate everything one does with one's body. Self-ownership is anathema to all they hold dear.

Team Red with "Personal Responsibility," really only applies to welfare. One is too stupid to make decisions for one's self that might not jibe with what they imagine Jesus of their hardly read King James Bible might not approve.

Both of them keep cigarettes legal, and raise the taxes incrementally, careful not to overdo it so that more smokers quit. They allow liquor sales, but only in a manner that continues to enrich the permit holders at expense of the consumer's convenience.

Everything a politician does is for his/her benefit. Period. Race, party, length of tenure...matters not. The only way we get from underneath their boot is to demand they have less authority over us, not more. I can't think of a single politician that I want to balance my checkbook, borrow my car, nor date my daughter. As long as my actions don't cause you harm...leave me alone. I assure you, were I to choose to abuse opioids, it would harm far fewer than those affected by some 'duly elected' politician's back room Tico's dinners.

I suspect that these regs were dictated to the "lawmakers", by large entities within the Health Care INDUSTRY. You don't have to peel back the outer layers of this onion, to see that it was DESIGNED to be ANTI-COMPETITIVE.

Adding all that extra paperwork, and adding the "background checks", means that large clinics/hospitals will have the advantage (because they'll simply add staff to do the extra work), while docs with small practices will suffer (or retire, or MOVE TO ANOTHER STATE).

Don't be surprised, when your small town's only doctor's office disappears, and you're forced to make the schlep to Hattiesburg or Tupelo or Jackson (or whatever "Regional Healthcare Hub" is closest).

And don't be surprised to see that healthcare is priced totally beyond reach, for a lot of people (we only THOUGHT it was bad, before).

As usual, 'Feel', and the "lawmakers", have done the bidding of the powerful, while ignoring the needs of the people.

This is getting perilously close to violating, and may violate, the separation of powers doctrine. The legislative branch establishes the law, and the executive branch enforces the law. The MSBML is obviously in the executive branch, and can regulate physicians. Without doing any heavy research, it looks like on the face of it that the MSBML could be stepping over the line from "regulating physicians" into making laws about dispensing and control of drugs by wrongly labelling these changes as a "regulation". Drug control laws must be passed by the legislature as a "law". If the MSBML violates the separation of powers doctrine, then these new "regulations" would be void. See "Howell v. State" from 1974 for a good discussion about drug control/scheduling and the related separation of powers conflict between the legislative and executive branches.

Ken Lippincott and Randy Easterling both are in the drug rehab/treatment industry. Wonder why the board thinks opiates and benzos are bad? this is your reason.

The medical profession has done a horse shit job of regulating itself on this issue. While the head of some medical organization or other was spouting his mouth in the paper the other day about how medical professionals were taking this issue head-on, I was undergoing a couple of medical procedures about that same time. I literally could not get a doctor to take a "no" for an answer to the question of whether I wanted opioids, and the scripts were always huge.

5:01 - You know that's bullshit and your claim serves no purpose. Your scrip was, at most, Hydrocodone-Acetominophen 5-325 @ 40 - one every six hours. He just didn't want your fat ass calling him in the middle of the night, whining. It's a typical prescription. Get over yourself.

It’s typical, it shouldn’t be, I’m not fat, and Advil worked just fine. Hydro-phucking-codone is not needed for everything.

Lynn, you might want to read JJ before penning your columns. Encouraging "more physicians to use the Prescription Monitoring Program"? Like doing so is optional?

Why don't you ask Bev if he feels children should be drug tested every 90 days simply to receive their physician prescribed medications.

The Doctors have no one but themselves to blame. I didn't have a doctor until about 10 years ago when I went to an "urgent care" type place. My back was killing me. After waiting in the little waiting room for a while, I decided I was leaving. That's when the Dr. came in and told me I wasn't an addict. I asked if they had run a PMP on me, and they replied they had, as it was standard procedure for this doctor to do so on any new patient complaining of pain. I have had a doctor from that day forward.

If the doctors had merely utilized the tool available to them, PMP, they could have cut off addicts and saved themselves these troubles. Of course, that would have also forced them to report their colleagues who were/are nothing more than drug dealers with a license. Too late to whine now.

It was within the recent few years that a cop from Pearl or Brandon was utilizing pmp database to try to catch doctor shoppers. He identified a person went to the doctors office and got the persons file. The person sued. Watch out as one day some cop may be deciding what you take and if he decides it's too much will arrest you.

All you self righteous good intentioned doctors shut up.

You know damn well why regulations are passed.

99% of physicians do an excellent job with patient care.

100% of physicians do a terrible job at policing their own.

The few bad apples you refuse to control dictate what happens.

Diet pills to cosmetic procedures to unnecessary surgeries to etc.

When you grow some balls and stop the 1% from gorging at the troughs this will stop.

This is insanity.
Yes we have a problem but rather than understand why we have a problem, there is yet again a knee jerk reaction with a " one size fits all" notion of a solution.
Phase one is to truly understand access and control access. Phase two is to fine effective means to treat those addicted effectively.
I don't think a dying or elderly person in chronic pain for any reason is part of the problem and likely to become a threat to society.
But, I also don't think that young people with acute pain need to be given refills or have the ability to doctor shop.
And, I do think that doctors generally need to consider that a pill, any pill, shouldn't have become the first choice of treatment simply because we've become a society looking for quick fixes to everything. Medicine as a business treats patients as " widgets" on an assembly line. It encourages and rewards doctors to treat symptoms without actually identifying the underlying cause these days.
Has it occurred to anyone that in this computer age, tracking prescribed narcotics shouldn't be that difficult and our pharmacology system could be an avenue of identification and control of both the rogue doctor and the at risk patient?
Instead, let's continue to politicize every f'ing thing and let talking heads whose expertise is being glib ,emoting, attaching blame and self-aggradizing come up with lame solutions because that's working so well. (sarcasm).

I hope every person that wants to make it impossible to get real pain meds is stricken with endless kidney stones immediately.
I’ve never abused them in my life and actually hate taking strong drugs, but when a doctor tried to prescribe Tylenol 3 instead of Dilaudid for a kidney stone I wanted to stab her in the chest and ask her if she needed a Bandaid.

ADHD meds are cat 2 controlled substances, will they be limited? Will my kids have to get drug screens to get their meds and be limited to 7 days? This is insanity. Bitch all you want about doctors, but when your kids flunk out cause we can't give them meds you will be the one bitching.

This is just like the sudafed regulation. Mississippi and Oregon are the only two states to require a prescription for sudafed, all because some damn tweakers want a cheap high. So instead of running into Walgreens, letting them scan your DL and paying $12 a box for some sudafed...they make you schedule an appt with the doc, wait 2 hours to get seen, pay your insurance co pay for a visit, then go to Walgreens and wait 30 mins for them to “fill” your sudafed, and then pay the insurance copay for the prescription. Totaling 3 hours of wasted time + $50-75 depending on your insurance. And don’t tell me that “meth production in the state has significantly decreased”.

And don’t tell me that “meth production in the state has significantly decreased”.

In the interior of the state it has, on the borders less so.

The opioid 'crisis' is majority heroin (often laced with Chinese fentanyl).

These are non-prescription drugs and illegal in any case. More regulation of doctors misdiagnoses the problem as patients becoming addicts. The overwhelming majority of overdose victims are not patients receiving pain meds by Rx, they are people with unemployment or childhood trauma.

Joel Bomgar did some great work on the issue and found that about one fewer person per 100,000 is dying from prescription-opioid overdose five years after restrictive policies went into effect, in exchange for nearly four more people per 100,000 dying from heroin and fentanyl.

For sources, see: https://www.cato.org/publications/commentary/opioid-crisis-keep-eyes-heroin-fentanyl

For those of you criticizing my profession for not policing itself, I agree. The state Board of Medical Licensure, the Bureau of Narcotics, and the Board of Pharmacy are well-informed as to who the problem prescribers, dispensers and consumers are. They choose to act only upon complaint or catastrophe. As a practicing surgeon, I cannot fine, sanction or arrest anyone. I can complain, but physician complaints just don't seem to get too far, it seems. You might wonder why hospitals don't act; it is not in the purview of the surveillance and discipline of their medical staffs, and can lead to a costly legal battle for them. Almost all of this activity is outpatient and not under their control.
For the anonymous poster who says that Advil was fine, that's true for some, but not most. Many have been the times that patients have declined a narcotic analgesic then called after hours to request/demand a prescription. I took two hydrocodone tablets and a Dilaudid after my kidney was removed, but most do not have that tolerance. It is hard to estimate postoperative need. Intraoperative requirements are not a reliable predictor. Add in our inability to telephone prescriptions for Schedule 2 narcotics, the variability of pharmacy acceptance of electronically secure and verified narcotic prescriptions and it all adds up to a difficult problems.
No responsible physician or surgeon wants to contribute to addiction. Ad hominem attacks regarding vacation homes, income and lifestyle render your comments impotent, undermine your arguments and, simply put, invalidate your worth as a contributor to the discussion.

9:30, You actually took pain pills for a kidney stone?
That is the kind of bullshit we need stopped.
Grow up. Lay the cokes down nd you will not have kidney stones.
What kind of sissies do we have in Mississippi?

I've seen a half dozen young college age men with glorious futures put a bullet through their heads, a rope around their necks, or just plain die on the couch due to opioids abuse. I've seen friends and family go in the hospital for knee surgery only to wind up in a treatment facility a year later. If they are lucky enough to live through the addiction and treatment, they will spend the rest of their lives fighting this addiction. For these people disagreeing with change towards finding a solution, I can only say they are in denial.

Ever passed a kidney stone @6:03 PM? You're stupid comment about sodas betrays your ignorance.

Ad hominem attacks regarding vacation homes, income and lifestyle render your comments impotent, undermine your arguments and, simply put, invalidate your worth as a contributor to the discussion.

+ 1,000,000

Dr Phillip:

In response to your lame excuse “I cannot arrest anyone:”

That’s a cop out.

I have relatives who have are doctors who say on licensure boards and traveled nationwide to stop the problem doctors.

Even if you say you cannot you must form a group and excise the obvious violators.

Said another way - you can get with MACM (essentially immune from liability as a quasi state functioning system entity) and force the pill mill doctors out. You don’t because of fear of the unknown. What if they decide your practices are somehow unfit or deviate in some way?

Figure out a way to stop the abuses.

And thanks for your hard work.

"I have relatives who have are doctors who say on licensure boards and traveled nationwide to stop the problem doctors."

Is English your first language?

When you cannot edit after the post....