I’ve written several rants on this topic in other past threads, but for some reason just don’t have the energy to write the long screeds pages that I usually do. But if you are interested you could find them if you search my posting history.
My story revolves around my wife who has suffered from extreme neuropathic pain due to an underlying neuromuscular disease (current hypothesis is that it is HMSN-6 but we are waiting to get a genetic test). She was initally prescribed OXY Codone, but switched to methadone because the extended release provided longer term relief.
She has been on the same methadone dose for over 10 years, she has never taken more than prescribed and never felt any sort of “craving” for the medication beyond the desire for pain relief. She has a pain management doctor who regularly prescribed her current dose without any cause for concern.
Then about a year ago, the insurance company decided without any examination that she was taking too much, and so they unilaterally cut her dosage by a third and canceled her anti-anxiety medication. Her pain management specialist suggested we might try reducing the methadone dosage and replacing some of it with an alternative that might give her more relief (since it was slightly different formulation (and so it was less likely that she would develop a tolerance) while still keeping the overall amount of opioid (measured in mophine quivalents) below what the insurance felt she could have. But the insurance said that she wasn’t allowed to have those prescribed together, and so canceled that prescription. I should note that when the insurance cancels a prescription it isn’t just that they won’t pay for it, they actually prevent you from being able to pay for it out of pocket.
So the last year has been pretty bad, without her anti-anxiety medication she can’t sleep well, and without her full dose of pain medication she is in a constant level of moderate pain. So its been a pretty lousy year for her, much of it spent in bed. Fortunately I’ve been home and able to help her out but we are both scared about what happens when I’m called back to the office.
Ironically her pain level is further exacerbated by the fact that she has started forgetting to take her medication. Previously she would know that its time to take the medication when it started hurting, now it always hurts, so its just a question of how much it hurts, which can also depend on whether she is having a good or bad day.
In any case from our point of view this suffering is totally unnecessary. For the last 10 years she had been doing, if not well, then better than she is now, and its only some nameless bureaucrat who hasn’t seen her or talked to her, deciding that he/she knew better about her condition than her actual doctor, and as a result has made her life much much worse.
(Hmmm it looks like I found the energy after all)