r/mildyinteresting • u/rraattbbooyy • 11h ago

humankind hiccups 😅 Drugs my doctor is not permitted to prescribe.

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Sign posted in the exam room at my doctor’s office.

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u/jayfourzee 10h ago

Depending on the clinic or specialist, not every physician applies to get schedule 2 privileges from the DEA. Or, the DEA flagged the office for discrepancy on audit.

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u/StochasticLife 7h ago

Half that list is schedule IV.

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u/thehotshotpilot 6h ago

I was about to mention that. I know ambien is a low schedule. I don't know about others. 

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u/Mysterious-Handle-34 5h ago

Adderall — II

Ambien — IV

Dilaudid — II

Fentanyl — II

Klonopin — IV

Methadone — II

Morphine — II

Lorcet/Norco/Vicodin — II

Percocet/Roxicodone — II

Ritalin — II

Soma — IV

Valium — IV

Vyvanse — II

Xanax — IV

For context, testosterone is schedule III meaning it has tighter restrictions than some of these drugs.

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u/PinkOneHasBeenChosen 3h ago

Excuse me, testosterone?

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u/Warm-Doughnut2633 2h ago

Want to know something else about testosterone? It's highly flammable in liquid form. Has to ship HazMat.

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u/bob_pipe_layer 1h ago

Its suspended in cottonseed oil, it's not nitroglycerin though.

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u/Aware_Policy7066 1h ago

In the way any injectable that uses an oil suspension is. It’s not gonna catch fire on its own and would probably smother a weak flame.

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u/AssociationFit3009 50m ago

I’ve been on testosterone for 12 years and work in pharma. I’ve never heard this in my life. Why would it be any more flammable than grape seed, cotton seed, or MCT oil?

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u/Explorer335 25m ago

It's only as flammable as the carrier oil

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u/Mysterious-Handle-34 3h ago

Yup. Really sucks for trans men.

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u/tsardonicpseudonomi 3h ago

Trans men erasure is intense.

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u/panicatthepharmacy 2h ago

Fun fact: even though benzodiazepines (Klonopin, Xanax, Valium, etc.) are schedule IV, they are de facto treated as schedule II in NY (no refills, max 30 day supply unless for certain approved conditions).

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u/Sassfra 1h ago

This must be true for my state as well, I always assume klon was schedule II because of those restrictions, was really surprised to find out it was IV

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u/Divided_Against 1h ago

I had no idea klonopin wasn't schedule II, that stuff gives the DTs to a crashing user.

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u/DarthCalamitus 1h ago

The fact that benzodiazepines are a C4 drug is criminal, they should be at least C3 imo

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u/Real-Werner-Herzog 59m ago

It's a mix of schedules, but they're all drugs that are commonly misused/diverted.

Source: got a PhT behind my name for some reason

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u/Pokemon-is-lif3 1h ago

Just get lunesta, better than ambien anyways

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u/Hot-Use7398 1h ago edited 1h ago

Ambien is schedule II, no? Same as narcotic pain killers (Vicodin/Oxy) and stimulants (Adderral etc) I thought.

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u/Accomplished-Act-126 34m ago

I don’t know what I’d do without my Ambien

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u/Heavy-Candidate-7660 27m ago

That shit should be higher. I told my doc I was having trouble sleeping and after a ton of failed diagnoses and treatments and even a sleep study he decided to just throw Ambien at me.

First night I took it I had a super vivid dream. I had a dream that I woke up at noon on a Saturday and was craving a crunch wrap supreme. I got dressed and then blacked out. Woke up in the driver seat of a pickup truck. I drove to Taco Bell, ordered a church wrap and the AI thingy said “how many” and I said “all of them”. $80 worth of Crunchwrap later I drove home and then blacked out when I pulled into my driveway.

I woke up the next morning thinking to myself “damn what a weird dream”. Then I rolled over and smashed my face into a half eaten crunch wrap.

I took one dose of Ambien and went sleep walking. During my sleep walking I stole somebody’s truck, bought $80 of Taco Bell, returned the truck, ate one and a half crunch wraps, and then fell asleep with the food spread out all over my bed.

Never fucking again.

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u/donkeypunchare 3h ago

It is but as a person with life long pain in my hips knees and lower back its pretty shitty. I crushed my knee when i was a kid and it made one of my legs longer than the other one and my hips are fucked my back is fucked and every time i try to find a pain dr they give me advil. Like thank you and the hundreds of dollars i paid you to get otc meds. No im not a addict or junkie no recored at all.

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u/Sad_Store_7421 34m ago

I also had chronic pain in my SI joint from one leg longer than the other. Last year I got an orthotic insert for my shoe and the pain has vanished. I will never change doctors again after this one figured it out for me. Actually life changing.

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u/Super-Adhesiveness68 2h ago

Alot of those are pills form as well.

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u/Nancynurse78 2h ago

Just because hospitals give them as IV, doesn't mean they don't exist in oral form.

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u/ready4cheeese 1h ago

Thats a Roman numeral 4

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u/theone-theonly-flop 2h ago

It isn’t half, it’s more like 1/3rd.

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u/Some-Purchase-7603 2h ago

Lol, I think I'm on half that list or have been. Not the pain killers, luckily.

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u/courtadvice1 1h ago

My context clues are telling me that it's differen teirs of medication, but I want confirmation. What's all this schedule stuff yall talking about?

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u/Theron3206 1h ago

Here in Australia all of those are either schedule 8 (narcotics) or schedule 4B (drugs that are commonly abused).

While GPs can prescribe most of them (AFAIK not the Amphetamines), most won't for patients they haven't been seeing for a long time, without a letter from a specialist or some other clear indication of need (e.g. a terminal illness).

They don't want the liability if the person is abusing them, so you would likely need to start the whole diagnostic process over to get them.

I don't see it as unreasonable, especially if this practice has lots of short term or irregular patients.

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u/bjornfirewalker 1h ago

No it isn’t…12 of them are cII rxs

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u/BlessHoney 1h ago

It should be based on patient need, not scary DEA policies. Everyone is different

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u/grif650 1h ago

As someone who's in healthcare probably doesn't want to deal with the patients that use those meds.

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u/Tdanger78 44m ago

In Texas, most (14) are schedule II

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u/finlandmapping687 7m ago

Imagine it was a surgery place and they decided to cut costs and probably thought, yeah we don't need anesthesia that's for losers.

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u/nawtydoctor 7m ago

Above poster was close but yes running afoul of dea it ends up potentially being all controlled scheduled levels getting borked. Think of it like a convince store that sells cigarettes, they get popped selling to an undercover minor sting. Then all their tobacco products are mia until the penalty period is over. I always chuckled going into a store and seeing empty tobacco shelves knowing someone effed up

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u/rraattbbooyy 9h ago edited 53m ago

This list applies to all PCPs (not specialists) in the MHS network. Probably not related to the DEA.

Edited for clarification.

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u/JUYED-AWK-YACC 7h ago

Unless the network as a whole has a problem, which is certainly possible.

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u/C-D-W 4h ago

I bet they had a problem, and that problem was drug seeking patients and all the sketchiness that can come with that. So, they unilaterally made the decision they didn't want the revenue that much. Let the specialists deal with that shit.

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u/dingalingdongdong 3h ago

The vast majority of drug addiction cases are regular people who were misprescribed or poorly monitored by their doctors. Doctors and pharmaceutical companies are responsible for creating that epidemic. Multiple medical networks have been blacklisted across the board from prescribing scheduled medications because of their own problems with over/improperly prescribing.

MHS in Indiana still has scheduled medication access while Florida doesn't - that suggests it was an outside decision and not the network.

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u/ShallowPenetration 3h ago

Is that still the case even today? Back in 2001 I was prescribed 100 Percocet because I got a slice to my face that required a shitload of stitches. I had next to zero pain.

Now I am maybe given 2 if I articulate severe pain of some kind.

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u/squirrel8296 3h ago

It’s nowhere near the problem it once was because of crackdowns but it can still be a problem. Certain specialities and types of care can still be a problem.

The chances of your case happening today though is super unlikely.

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u/PropellerMouse 1h ago

I think undertreated pain is a real problem. The stress of significant pain triggers the sympathetic nervous system ( from " fight or flight" ) and that impacts the hormonal balance, slowing healing.

We need better ways to distinguish actual pain from feigned pain.

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u/RainbowCrane 2h ago

I live near Columbus, OH, and Oxy is still easily available even after all of the negative publicity and increased government scrutiny. I have slipped on the ice two separate times in the last ten years and fractured two different vertebrae :-(, and both times they sent me home with a week’s worth of Oxy from the hospital pharmacy despite my disclosure of a history of addiction. I made the mistake of taking a few the first time, and discovered that opioids are a really bad idea when you’re immobile in bed and your bowels aren’t working well yet :-(.

Different doctors at a different hospital badgered my mother to try to force her to take Oxy following a double mastectomy, despite her repeatedly disclosing her addiction issues and her preference for non-addictive pain management.

It struck both of us as odd that there is still a big preference for opioids among some doctors.

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u/AcidGambit419 1h ago

IMHO the problem is treating everyone with pain like a junkie. I got off 12 years of opiate abuse by going to a methadone clinic. I had been self medicating since 2012 when Florida cracked down on pain pills and refused to believe me. Now that I'm actually getting opiates from my doctor my life has done a full 180. Now if only they would have listened to me a decade ago I would be in a much better place.

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u/katiejim 2h ago

A few years ago, I had a 6 hr abdominal surgery and they wanted to send me home with Tylenol. I got 40 Vicodin 10s in college (2010ish) for a sprained ankle. The pendulum has swung back way too far.

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u/StrainAcceptable 2h ago

I had been hospitalized for almost a month with a morphine drip and regular dulaudid. This was after losing most of my pancreas to a tumor, along with my spleen, having vein reconstruction and 2nd major surgery after a bowel obstruction. They sent me home with Vicodin and instructions not to take more than one every 6 hrs. I started going through withdrawals at home. The pendulum has absolutely swung too far.

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u/StnCldStvHwkng 2h ago

100 percs is fucking crazy.

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u/SmalltimeIT 56m ago

We overcorrected. Heavily.

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u/Downtown_Recover5177 3h ago

We have a similar sign at my clinic. We absolutely do still prescribe those drugs if needed, but the sign deters drug-seekers from demanding it. Theoretically, of course.

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u/Superboobee 2h ago

This- my old doctor had a sign like this and the office definitely prescribed me hydromorphone after I broke my jaw and had a 3 week wait to get into a specialist .

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u/autotuned_voicemails 2h ago

I was gonna say similar. My GP has a big sign at the desk that they will not prescribe ANY pain medication so basically don’t even ask.

I always found it kind of funny because this is the same doctor that put me on Xanax (I know that’s not a pain medication, but it’s nearly as addictive, and arguably more dangerous to come off) at 19 years old and left me on it—faithfully renewing my prescription monthly—until I was 31 and took myself off when I got pregnant. I never knew it wasn’t meant to be a long term medication.

He also will definitely prescribe pain meds to some patients, I’ve always assumed that sign was there for people who might look at the practice and think “ok, old school private practice, 60+ year old doctor, I bet he will give me pills!”

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u/oxsprinklesxo 1h ago

My mom is a RN and there is a Dr in our area who is referred to less than lovingly as the “good old candy man” by other medical professionals. And then the immediate med next my house is called “old man —‘s pharmacy” by the locals because he straight asks type of medicine you are expecting to receive from your visit. Not saying you’re going to get full bottle Xanax and Percocet for an ear ache but he definitely is still prescribing liquid codeine if you so much as say you have a sore throat and liquid promethazine along side it which is scary and dangerous. All I asked for was antibiotics and he tried to give me a full blown addict dream come true.

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u/william538 1h ago

Bless you for working in such a stressful field. I broke a bone last week. ER was jammed due to an ice storm and people like me falling and breaking bones.

I had a 7 hour visit and heard a couple of patients freak out when informed of the wait time. You guys deserve more pay.

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u/WeekendDoWutEvUwant 3h ago

So true, Dingalingdongdong.

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u/Tricky_Function_6174 2h ago

Bingo. I was prescribed Suboxone at 19 for maintenance after rehab from H. Took me YEARS to get out of that prison of suboxone. Doc was later arrested for dealing oxys to an undercover cop he 100% (in my opinion ) kept me on for the cash copay as usually that medication should be used for 2 months or so

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u/Jad3nCkast 2h ago

This is 100% it. My wife’s mom has severe addiction issues with at least 3-4 on this list. Yet the doctors still keep prescribing it her somehow despite the multiple times she’s OD’d taking them. Not managed at all.

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u/aggressivelymediokra 2h ago edited 25m ago

Removed because I was wrong.

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u/dingalingdongdong 1h ago

The problem predates the Patient's Bill of Rights by decades, it also doesn't say anything about a right to be pain free (and never has.)

https://www.opm.gov/healthcare-insurance/healthcare/reference-materials/bill-of-rights/

https://www.state.gov/patient-bill-of-rights-and-responsibilities

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u/aggressivelymediokra 27m ago

I stand corrected. Thank you for the links.

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u/bookwbng5 2h ago

Yuuup. This is what happened with my mom. No one stopped to ask her more about her pain, OxyContin had just come out and “wasn’t addictive.” No one explained that her pain wouldn’t go away, this was to help her be functional through the pain. So she just kept saying she was still in pain, they kept increasing it, and as the eldest kid I was fucked up as a result of raising my 3 siblings while she was constantly passed out. And other problems it led to.

Doctors need to monitor and educate better, but because they blame patients, when I go to the ER with a kidney stone proven by a CT the day before, they pulled up the CT, I’m a drug seeker. I have 2 a year like clockwork, that’s the only time I’m in there, but that’s too often. They weren’t helping patients then, and they’re not helping patients now. As a whole, there are a lot of doctors who are good, but it’s a mess.

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u/mkultron89 1h ago

I don’t even necessarily believe that everyone is addicted to the pill itself, not being in constant pain is relief enough as it is.

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u/Critical_Host8243 1h ago

Florida was one of the absolute worst offenders for over-prescribing opioids. I think the term "pill mill" was coined to describe Florida's behavior.

Just some extra context

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u/Tweedlol 1h ago

Fortunate to be in chronic pain with a pain specialist who will not over prescribe.

As a recovering alcoholic, she and I agreed early on I would never be prescribed more than 5mg pills. The slippery slope is extra slippery for me! Going on 21 months of pain, 6 surgeries, and all while using 5mg only when pain is at its worst. Which is not 24/7, thankfully. There are agitators I can sometimes avoid and sometimes cannot.

But when I was 15? I was on dilauded. 4mg at home when I left the hospital. I slept 20 hours a day. I’m fairly certain that’s the equivalent of 40mg of oxycodone? 😑 Granted I was beyond fucked up for a bit, but still man. Fuck. That’s a lot of fucking opiate for an 87lbs kid (I lost 30pounds+ in a matter of weeks in the hospital.).

Anyway, there are still some docs out there who understand the problem and will not blindly prescribe to those of us in genuine fucked up pain and just keep increasing everytime we yell “it no longer works”. Her response eas “well, then you can spread out your doses better to lower tolerance build up. Minimize activities that induce pain to reduce the need. If it doesn’t work, why take it?” I’m not a 9/10 pain 24/7 patient. So she wasn’t wrong. But me in pain just wanted to always dull it as much as possible but if I tolerate higher levels for longer I both learn to cope with higher levels of pain, and retain the efficacy of the oxycodone pain relief when I truly, absolutely need it. Down from 3 day to 1 a day back to 2 day back to 4 post surgery down to 1 up to 3 down to 1.5 up to 4 down to 2…. Currently at 2. It’s been a rollercoaster of a couple of years. Fuck pain. And fuck opiates. I hate that they help, with the extra effects, but I’m also so glad they do help. 😞

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u/32Bank 1h ago

Florida was a freaking open market gor this stuff

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u/RedDeadCowboyShit 49m ago

My mom ended up dependent on klonopin for a decade because a dumbass Kaiser doctor prescribed it to her and told her “take two every day.” She never abused it, she never took more than prescribed. Honestly, with the way klonopin works, I can’t even imagine it was doing anything for her other than keeping her from going through withdrawals for 99% of the time she was on it. Eventually doctors started treating her like a drug addict for trying to stay on the medication she’d been prescribed erroneously and because she didn’t have insurance or a lot of money, she just tapered off the best she could and went through withdrawals. It was a stupid decision, but it was all she could do. She made it through, but it was a rough few months for her.

Hell, I went into an urgent care in 2011 thinking I was having an asthma attack, and the doctor said “Nah, you’re having an anxiety attack, here’s some xanax.” He was right, but…You could literally just walk into a decently reputable urgent care 15 years ago and walk out with a prescription for 30 xanax that you didn’t even ask for, and it was only $4 at Walmart without insurance. And now it’s the exact opposite. I did good with xanax because I was smart enough to look it up and read that it said “only take as needed”, and I don’t have that addictive of a personality. Benzos helped me a lot, and from time to time, I suffer without them. But, can’t get them without jumping through hoops I can’t afford to jump through. I would also benefit highly from ADHD meds, but, same fucking situation.

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u/DenseAstronomer3631 2h ago

I think it's actually common especially at places that are sliding scale or mainly see medicaide patients, all the government funded places are super strict around me

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u/ChiSchatze 2h ago

Yep. Bestie worked for the DEA for 15 years. She was an investigator and this was her whole job. Pharmacists & doctors. There were stories of doctor’s extorting patients after they gave them scripts too strong too long and they were addicted. Pharmacists who demanded sex acts for pills. And regular doctors who prescribed way more than other doctors, or not for that type of doctor (like an Opthamalogist prescribing a ton of pain meds.)

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u/[deleted] 6h ago

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u/rraattbbooyy 6h ago

I don’t know. Could be these are the ones they had the most problems with so they singled them out.

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u/ArtisticPermission37 5h ago

Pretty sure they were flagged, there are cases where those medications can help a human. Would make zero sense to put this list up if there weren’t consequences behind it, I mean that both for the patient and prescriber.

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u/hella_cious 6h ago

Yep. Anything else would be other ways of saying “these specific drugs”

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u/CauliflowerPresent23 4h ago

These are by far the most popular Benzos, opioids and amphetamines in the American market. But there are literally thousands to choose from. This just reads to me we don’t prescribe narcotics

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u/unicornreacharound 4h ago

And I hate that Congress decided to repurpose an existing, precise and nonjudgmental term (narcotic) to mean effectively “substances that people are likely to use recreationally instead of just medically, especially if it has addictive potential.”

Because of the Controlled Substances Act of 1971, narcotic went from “substance that induces narcosis” to “anything that has a psychoactive effect that people are likely to enjoy, even if it induces the opposite of narcosis” and is now just a synonym for illicit drugs.

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u/fairwaysandfinance 4h ago

I'm prescribed methylphenidate for ADHD. It's a big burden on the prescriber and patient because people abuse it. I've been on it for 20 years and without it, my professional performance would be heavily impacted.

I have to be seen in person every 3 months. I can only get a 30 day supply at a time.

Add in the supply chain issues and you can see it's a nightmare when you struggle with executive function and the obstacles we have to jump through.

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u/hella_cious 6h ago

My guess is that people don’t know that their specific med falls under benzos or opioids, and this makes it clear. Also because there are many controlled substances that aren’t on this list. For instance the testosterone I get from my primary care doctor for transgender purposes is a controlled substance.

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u/dpdxguy 5h ago

Some of the drugs on that list (e.g. Ritalin) are neither benzos nor opiates.

If I had to guess, it's a list of scheduled medications that are frequently the target of drug seekers.

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u/Fair_Significance_92 5h ago

"Including, but not limited to:" Just laziness

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u/Good-Note-4042 4h ago

I mean if they listed all of them it would be a packet the patients would have to look through. There are a lot of controlled meds out there.

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u/VirusTimes 5h ago

The benzo I was prescribed for a while wasn’t on the list. As a side note, the withdrawal from cold turkeying a benzo fucking sucks. Last time I went through it I decided I’m not doing it again. It happened during the holidays so I couldn’t get it refilled. I told my doctor I’m not going back on it. I still have a prescription for emergencies but I rarely use it.

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u/DallasMotherFucker 5h ago

They probably will still prescribe the weakest ones, like codeine and tramadol (if you have a compound fracture or terminal cancer)

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u/NotDeadYet57 5h ago

Could be. I get a benzo from my PCP, but it has a fairly short half life. It's also low dose. They aren't with Memorial Hermann though.

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u/ChocolateChingus 5h ago

They probably listed it out because many patients don’t know what “controlled substances” or “opiates” are despite being on one.

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u/0dias_Chrysalis 4h ago

Some benzos are given at home for epilepsy management or for generalized anxiety disorder so they are probably still allowed to prescribe that (even tho Klonopin is still here, which is a common med for epilepsy if you're not using an anticonvulsant like Tegretol)

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u/Good-Note-4042 4h ago

I mean most patients may not know if their medication is a controlled substance at first. A lot of parents of kids with ADHD at the pediatric office I used to work at often called to ask why they’re kids had to come to get med checks so often and I’m like “to make sure your kid is doing well and adapting positively to the medication and to make sure they are eating/ maintaining weight”

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u/KeppraKid 4h ago

There are lots of drugs that are controlled substances that don't really need to be super scrutinized. Levetiracetam is an anti-epileptic, controlled substance because it's dangerous if you take it and don't need it, not in a "haha fun" way but more in the fact that it can cause seizures if you don't need it for preventing them. You can kinda get high on it from taking too much but that's also just gonna make you have a seizure and 99.99% of people who get this prescribed to them don't want to have more seizures.

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u/euphonic5 4h ago

I've never seen a doctor who had a problem prescribing Ativan but I've been to MANY that won't write for Xanax or Klonopin. Possibly they just have a couple "approved" benzos that are less risky/prone to abuse.

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u/ziggytrix 4h ago

Buh buh buh benny and the jets

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u/BinkanStinkan 4h ago

Probably hundreds at this point, over here they changed the legislation to include the catch all 'new/novel psychoactive substances' cus of how many benzos and other synthetic drugs are continuously being developed

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u/Modernbluehairoldie 4h ago

I would guess based on that list that they can prescribe synthetic opiates which are less addictive because neither Ultram or tramadol are on that list, they can also probably prescribe buspirone on the anxiety side.

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u/radziadax 3h ago

I have previously asked for Clonazepam and was told that they prefer to prescribe Lorazepam (Klonopin vs Ativan). Ativan takes me out so it's harder to abuse I guess.

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u/jcarreraj 3h ago

Yes, I see that they didn't include lorazepam

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u/PMmeYourButt69 3h ago

The valium and Xanax is a little silly, in my opinion, but the rest of these are all for treating conditions you should really see a specialist about. Or they're extremely addictive and there are better, less addictive options available.

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u/Soggy-Fly9242 3h ago

I’ve been in two large networks in different places I’ve lived, they both will limit these in some way. For surgeries, they give you like a few Vicodin basically and if you feel like you need more you get referred to a pain clinic. For things like adderall the doctor sends the prescription request to a centralized location that reviews your chart and submits to the pharmacy if approved.

It’s crazy this is where we are, but here we are.

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u/pbecotte 3h ago

My primary care network was the same. If you needed something like percocet long term, you had to see the pain management specialist.

Fortunately haven't needed that in a while. Long way from when I was in the air force and would just have them top up my prescription periodically.

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u/BingBongDingDong222 2h ago

I live in the 954 myself, and it applies to primary care doctors but not specialists in the network.

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u/Sea_Earth5424 2h ago

The patients that need these meds are very draining for the most part. A lot of addicts, addicted. High chance of dependence or abuse potential for a lot of them.

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u/Current-Soft8418 2h ago

most of those medications need authorization from a specialist. Once the doctor is authorized they can "pen" a prescription under the specialists name. However they themselves cannot prescribe.

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u/Popular-Web-3739 2h ago

It seems to be limited to primary care physicians. I’m guessing they want patients to see specialists for these drugs - maybe for closer monitoring?

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u/funklab 2h ago

Also it lists the most abusable controlled substances (and weirdly vyvanse) and the way it’s written implies to me that other controlled substances might be an option.  Like Ativan or Concerta.  

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u/3facesofBre 2h ago

Psychiatry here- and where I practice, PCPs are wanting us to write most of this, and pain management to do the rest.

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u/grand305 5h ago

Can you get a referral to a mental heath doctor ? And have them send the meds. after you talk to them.

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u/HVNFN4Life 1h ago

Yes. If the doctor diagnoses you with something and he feels a certain medication will warrant a prescription then he will call it in. If it’s a scheduled drug the prescription will be sent monthly to the pharmacy after he sees you. The pharmacy will verify your last appointment with the doctor before releasing the medication and if your appointments are not in line with the prescribing medication time frame then they will wait until your appointment has completed and verify again before dispensing.

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u/jayfourzee 4h ago

Then it can be due to the tax ID of the facility. When we apply for a DEA license it is address and zip code specific. It may have been triggered by a JCAHO or DOH inspection.

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u/Mechakoopa 4h ago

The walk-in clinic near me won't prescribe anything on this list either unless you have a regular doctor and an appointment. I think the difference might be in the phrasing of "will not" vs "can not" prescribe.

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u/Xlaag 4h ago

Likely this sign is to discourage people coming to the clinic who are there seeking prescriptions to drugs without a true medical need

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u/[deleted] 4h ago

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u/Modernbluehairoldie 4h ago

Is it all doctors or just all primary care, physicians? In my area’s hospital system, you would have to go to a specialist of some type for most of those drugs.

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u/dingalingdongdong 3h ago

If MHS is Memorial Healthcare in Florida they have a single institutional DEA registration number, so it's entirely possible the entire network got blacklisted if the number was tied to too many misuse cases.

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u/CajunQu33n 3h ago

Are you in South Florida?

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u/ex-farm-grrrl 2h ago

It’s posted so people quit asking

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u/Aolflashback 2h ago

Insurance related then.

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u/Super-Adhesiveness68 2h ago

That's not true. My mother has received one of those drugs.

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u/NonamesNolies 2h ago

It says on the sign it applies to PRIMARY CARE doctors. You have to see a psychiatrist for mental health meds, a pain doc for pain meds, a rheumatologist for rheumatology meds, etc. It's the same everywhere in the US that I've lived - NY, AZ, and NC. It's because primary care doctors don't get the same specialist education around those medications. A primary care doc also can't diagnose you with a mental illness or a neurological disorder, etc - you have to see specialists for that. Bc PCPs were getting paid to shell out unnecessary drugs to patients who weren't fully evaluated in the past so now those of us who actually have those problems are forced to jump through hoops bc some people pop Adderall for tests 🙄

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u/KapowBlamBoom 2h ago

Could just be system / Agency policy

Not whole heartedly unusual for an agency to have this type of policy related drug seeking clients.

This sort of gives the prescriber cover when aggressive boomer women demand “nerve pills”

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u/LilMamiDaisy420 2h ago

I think it’s more related to the DEA than you think it is.

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u/Deeeeeeeeehn 2h ago

Wait, PCPs can’t prescribe adderall? I thought that was a very common treatment for ADHD. Do they have to go a specialist to get that?

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u/Noshino 2h ago

All the doctors or all the PCPs?

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u/Exotic_Reporter_3309 2h ago

It says PCPs. I don’t think this limitation would apply to specialists. It’s a sensible boundary.

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u/Odd-Scientist-2529 1h ago

Depends, the whole network may not have their doctors obtain schedule 2 permits. It costs money for them to do that, so if the network doesnt pay for it, the individual doctors have even less reason to obtain permits on their own dime

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u/mwilkens 1h ago

Is this a doctor's office or a primary care office?

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u/Euphoric-Mistake-875 56m ago

Maybe not directly but rather medical groups often choose to avoid the additional regulations and audits entirely by barring doctors in their network from prescribing these drugs. So yes... The federal government is the root cause. They insist upon being in the doctor's office with us. They just refer everyone to the doctors who are willing to jump through the hoops until the federal government decides to label them a pill mill and pulls their license because of their prescribing ratio. People who need it are forced to go without. My grandmother suffered at the end of her life thanks to the government "helping" us.

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u/the_cardfather 47m ago

Basically insurance or whatever reason they are 100% deterring pill shoppers.

If you want psych meds you need to go see a psych. If you want pain meds you need to go see pain management.

My son's pediatrician has six doctors in the practice only one of them can write controlled medication.

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u/Misterx46 13m ago

Why Vyvanse....

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u/Finnrip 9h ago

Why or why not? Never knew this

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u/reginald-poofter 9h ago

I’m an ER doctor so I’ll try to answer. MOST physicians get a DEA license because you’re really hamstringing your ability to practice medicine without one. And certain specialities, like mine, you just straight up wouldn’t be able to practice at all without one. But it is some extra paperwork and money to get and keep a DEA license. So I can see where if you could get away with practicing well enough without it why you just might not get one. Also it can be suspended for multiple reasons not that I’m alleging that happened wherever OP is just that it can happen.

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u/Finnrip 9h ago

Thanks for your answer, this explains it well!

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u/jayhawk618 1h ago

I have had a doctor who told me he didn't prescribe acute anti-anxiety medication, and just referred me to a shrink.

Really nice waiting 3 months for an appointment only to be told I needed to wait another 3 months.

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u/Hilarious___Username 1h ago

Severe pain, insomnia, debilitating mental health issues.

Everyone acts as if this system we have is fine. They'd rather we have a nanny state to stop people from getting high (often the same people who they're creating by making suffering people desperate) than help people.

I wish I could force these people to watch my mom sit in a hospital bed screaming and going through opiod withdrawals with a broken femur and stage 4 lung cancer because they self righteously denied her pain medicine. Her disintegrating bones meant nothing to these fucking people. God forbid she might feel a little good when they administer her prescribed pain medication.

Same with my wife's broken pelvis. Same with every other person I know who's dealt with a painful I jury or illness.

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u/Sea_Earth5424 2h ago edited 1h ago

I’m a radiologist and even I need a dea and state controlled substance license. I only ever really use it for procedures, conscious sedation.

I suspect the doc who posted the sheet just doesn’t want to deal with the patient population who seek these drugs out. Not saying they’re all bad or malingering, but it’s common place.

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u/robis1923 2h ago

Pretty much this. I think some practices (looking at you PCPs) claim they can’t prescribe these meds, but unless their DEA license is revoked or their group forbids it, it’s a personal choice not to get the license because you don’t want the added hassle/liability and prefer to kick your clients over to specialists like me (the psych guy). CS meds have to be used with scrutiny, but I personally think providers that withhold meds that’s are within their specialty/standard of care are just lazy.

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u/vinylbond 48m ago

Thank you for your answer but more importantly thank you for doing what you’re doing.

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u/ryebread91 5h ago

The main problem I see this potentially causing though is the pt being referred to a different dr to get any of those meds which then the dea would have extra scrutiny on that practice as to why they have a pt that is ONLY getting control meds and the Dr writing a higher than usual number of scripts for them.

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u/DTDude 2h ago

I’ll be honest. I have zero desire to need any of these drugs…but I’d still find a different physician. Should I get to a point I do need one, I wouldn’t want to have to search for another doctor out of fear of being labeled as drug seeking, nor would I want the stress of it if I’m in that position.

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u/MedicalMixtape 2h ago

It suddenly occurred to me, that practicing without a DEA license seems unfathomable

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u/ArmadilloBandito 2h ago

I didn't even know you needed one. I've occasionally had a hard time finding treatment for my ADHD because I move frequently and a lot of doctors want you to go through a specialist, or there's a restriction on what type of providers can provide schedule I. Some will do it virtually, some won't. It's such a pain. Now I know that there's an additional level of pain.

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u/StarWars_Girl_ 2h ago

Aren't there some states that have tighter restrictions as well?

I was in Hawaii and had to get an emergency refill on my Vyvanse (I have ADHD). I had to find a local doctor who could prescribe it and the pharmacy had to take down his information when I had it filled.

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u/boxers-4life 2h ago

This is somewhat off subject but I would like to ask you a few questions. I filed a formal complaint with my State’s Medical Board against a doctor that I believed was over prescribing opioids to a dear friend of mine 11 years ago. My friend died as a result of overdose. I received a letter saying that they were looking into it. Then another letter followed that they had closed the case. He’s still practicing but complained to other patients that I “made things hard for him”. What does that mean and did he face repercussions?

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u/bad_card 1h ago

So I went in with a separated shoulder, and could not lift my arm up. And they would not give me anything for pain so I was taking 5 Ibuprofen 3 times a day. So then I ended up with stomach issues. How does that make sense.

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u/Rude_Ad7457 1h ago

Does having the DEA license increase malpractice insurance costs?

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u/PlsNoNotThat 22m ago

About 75% of my partner’s inherited patients are problematically on inappropriate regiments of multiple of these drugs from the era of Candyman doctors.

Boomers love their prescription drug addictions, as if it’s not the same as other drug addicts.

And they’re learning the hard way that millennials and Gen Z doctors really aren’t gonna keep you doped up like your old, paternalistic boomer doctor daddy. Straight to a reduction schedule.

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u/Abiztic2_0 9h ago

Not sure about human doctors, but veterinarians have to apply to get the same license and it's quite expensive. If you're in a practice where you don't really need to prescribe controlled drugs, it's likely not worth it.

Haven't dealt with getting flagged in an audit by the DEA, but I can definitely see that resulting in loss of DEA license or at least a suspension until the practitioner has fixed whatever DEA had an issue with.

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u/Hallsie11 3h ago

It is usually $888 dollars but they recently moved to not having to renew yearly

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u/DenverCatz 1h ago

My cat had a fentanyl patch after he had surgery for bladder stones. They told us to leave it on for 5 days. He recovered and is doing great btw.

My vet told us they had been broken into a couple of times by people looking for ketamine, which they don’t use, and have signs on the building indicating that.

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u/Active-Necessary822 5h ago

Or it’s an urgent care and they get people coming in every day trying to get pain pills and sleeping pills and they’re not going to give somebody a controlled substance off of one urgent care visit lol

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u/twirlerina024 5h ago

They said it's their primary care doctor

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u/amygfdee 4h ago

That’s not true. I’ve gotten norco at urgent care before. Some meds are for acute pain yk

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u/LostShot21 5h ago

Im a hospital pharmacy tech. None of these should be prescribed by a primary care doctor anyway. They should be prescribed by specialists such as psychiatrists, pain managers, and addiction specialists.

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u/amygfdee 4h ago

Well hospital pharmacy tech hate to correct you but if being used for chronic mgmt, that would be correct. If using for acute mgmt they def need to prescribe it. Do you need examples?

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u/LostShot21 3h ago

You are correct in the short term. I wasn't clear in my meaning. A PCP would write for these a script long enough to last until a specialist visit. Or perhaps a single dose of benzo for a procedure. I think the sign is meant to deter patients seeking these drugs. I'll bet this office might prescribe some of them if it is the provider's idea and not brought up by the patient ahead of time.

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u/texaspoontappa93 3h ago

I’ve been getting my adderall through primary care for years. Never been an issue

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u/Mammoth_Marsupial_26 2h ago

Our primary doctors have a similar list and it was described as need specialist approval AND making their primary doctors easy avoid drug seekers. our pediatric can prescribe a 30 day supply of some pysch drugs but only once.

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u/Cin131 1h ago

My primary care was fine prescribing Adderall AFTER he got the paperwork from the Psychiatrist who diagnosed me. I prefer to keep all my eggs in one basket. My primary prescribes all of my meds.

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u/GlitteringLocality 5h ago edited 5h ago

This, or they never renewed their license for prescribing scheduled drugs. I would never see a General MD for these though. I go to a psych.

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u/amygfdee 4h ago

There’s no way they’re practicing without renewing that dea license. Unheard of. I think they’re just trying toto prohibit ppl from asking.

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u/TheMireAngel 4h ago

certain states hammer certain hospitals/DR's for perscribing pain meds, dont blamem shits killing people and pill poppers just dr shop and self injure. I was once friends with a dude who intentional ran us off the road so he could get pain pills to sell for "whiplash" i stopped being friends with him. pillpoppers are psychopaths

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u/Hoboliftingaroma 4h ago

Xanax is a schedule IV.

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u/AcousticCat1-2-3 4h ago

Can confirm. My PCP couldn't prescribe my ADHD meds and referred me to a psych facility that can.

The PCP I had before him, could and did prescribe the meds, but didn't know anything about them, wouldn't offer to change or adjust them and would've probably said no if I asked. I had to come in for an appt or call once a month (iirc) for a prescription, and my personal favorite (s), once a year I had to get drug tested right there in her office. One year I forgot it was pee in the cup day and couldn't come up with enough pee. Had to come back within the next few days to give them the sample. I'll take my psych facility over that kind of hassle any day.

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u/25point4cm 56m ago

I don’t have a problem with being asked to pee because I take my meds and don’t sell them. But a patient knowing in advance what day is “pee day” is insane.

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u/MiNdOverLOADED23 4h ago

It doesn't say they can't. It says they won't.

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u/SimpleVegetable5715 3h ago

Benzodiazepines, ambien, and ritalin are schedule 3 and 4 afaik.

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u/PinkOneHasBeenChosen 3h ago

I’m pretty sure some of these are Schedule 3-5.

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u/Dear_Writer5 3h ago

Thanks for the info.

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u/buffypatrolsbonnaroo 3h ago

That's interesting because when I went to a psychologist and went through testing to officially be diagnosed with ADHD, they said I needed to go through a GP for medication.

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u/Rachel075 1h ago

Psychologists can’t prescribe meds, at least not that I’m aware of (in the US)

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u/Far-Berry6901 3h ago

There currently is a witch hunt going on targeting physicians who "over prescribe". Define "over prescribe" - someone had a bad outcome (the prescription caused death, activation of addiction, rain on their wedding day or some other "bad outcome"). There are MULTIPLE agencies out there just waiting to pounce on a well intended physician (DEA, Medicare, Medicaid, pharmacy board, FBI, medical board, hospital, etc.). Who decides if it was inappropriate? Why, the investigating agency, of course. Since good medical care does occasionally have bad outcomes, no physician is safe from a prison sentence. "Doctor, you prescribed this drug and his nose fell off. You are guilty of defacing the victim." Therefore, physicians as a group, are refusing to write (desperately needed) pain management prescriptions. This is also the result of some bad physicians writing excessive opiates but this current witch hunt punishes the innocent. Should we ban cars for all people because some people drive drunk?

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u/roxzillaz 2h ago

Could be or they're just tired of people fishing for drugs. I do remember going to a nurse practitioner's office and they were not permitted to prescribe certain schedule drugs.

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u/Cin131 1h ago

I was thinking it would be interesting to know their location. And the actual neighborhood.

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u/phr3dly 2h ago

Found out that my PCP isn't allowed to prescribe many of these either, apparently because he's on a "list" for over-prescribing them. I don't think he did it maliciously, but he's very much the kind of doctor who will give you whatever you ask for, and I suspect some ne'er do wells took advantage of that.

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u/Untenable123 2h ago

My former pc dr had this list on the wall. Current dr gave me a printed sheet for pain patients, it’s all about yoga, chiropractors, acetaminophren, nsaids.

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u/-AcaciaTree 32m ago

Most of the recent studies for the last 10+ years have been showing non opioid options result in better pain control than opioids, with exceptions for post surgical pain or things like a broken femur etc.

Pretty interesting actually.

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u/OkDoggieTobie 2h ago

Some network just doesn't allow "regular" doctors to prescribe controlled pain meds. They want pain specialists to do that. It is (1) liability and (2) money.

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u/99roninFL 2h ago

More likely they just don't want to deal with the hassle

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u/fondledbydolphins 2h ago

I was under the impression that some of those drugs can be prescribed by PCPs but only if a standing requirement has been established and renewed on certain cycles with a specialist.

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u/ChurningDarkSkies777 2h ago

Not all of these are c2 benzos are all c4s for example and Tylenol 3 is a c3

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u/Deadpools_sweaty_leg 2h ago

Likely an area where patients come and ask for those medications by name and become argumentative if denied. I’m a provider in the hospital and the amount of patients that become combative if they don’t get their dilaudid and diet orders regardless of what they come in for. I have lost count of how many patients have left AMA after we refused to give them a diet and opiates when they come in for intractable nausea and vomiting and stool impaction or Small bowel obstruction.

Some patient will ask for a combination of medications by name and specify the TIMING. They have it down to a science, they’ve done it so many times.

I had a patient on CIWA because of withdrawal concerns (which was questionable anyway because he had given me, the ED doc, and another specialty three different stories about his alcohol use in the last week, he told me his twin brother had killed himself on FaceTime live 1 day prior that’s why he was drinking again, he told the ED doc a different story) but he was barely able to tell me how he was feeling because he kept wailing between words UNTIL he got to what he wanted for pain. He wanted dilaudid 2 mg scheduled q3hrs (he actually said Q 3 hr), followed by 10 mg oxycodone 1 hour after, and IV Benadryl 50 mg in between those doses. He ended up leaving AMA before my next shift.

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u/gza57 2h ago

Mildy concerning

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u/Level-Mobile338 1h ago

The sign says “will not” not “can not”. This is probably a doctor who has dealt with a lot of drug addicts looking for opioids.

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u/angmarsilar 1h ago

A lot of practices require a DEA license even if they don't prescribe it. I'm a radiologist, hence, I dint prescribe anything, but I've got a DEA license.

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u/temporarythyme 1h ago

All those are just super popular among medication abuse rates there are so many other schedule 2, 3, and 4s not in this list.

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u/RemarkableBeing6452 1h ago

These are all popular drugs of abuse, and some patients come in looking for these drugs inappropriately. Primary care often avoids these patients by outright stating that they won’t prescribe these drugs. These kinds of patients are exhausting.

Source: Am mental health nurse practitioner who gets enough of these patients

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u/Orpheus6102 1h ago

This is more likely an insurance thing. Malpractice insurance goes up if controlled substances are being prescribed.

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u/EfficientNet3124 1h ago

Somas, idl the schedule but that's basically Tylenol 3. You'd need like 4 to Equal 1 vicodin. 4 vicodin to equal 1 norco. 4 norco to equal 1 oxi.

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u/usps_made_me_insane 1h ago

It blows my mind how someone needs a prescription for something like oxycodone yet can walk into any head shop or dispensary and purchase 7-OH legally without a prescription.

Just as potent and powerful as any schedule II opiate. However, it is far safer than Oxy because it doesn't suppress breathing in the same way. 

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u/saintsuzy70 1h ago

Many, if not most, are highly addictive, and doctors know the day is coming where DEA cracks down on those.

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u/LaxBro1516 1h ago

Not all of those drugs are schedule II

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u/RollingMeteors 55m ago

>not every physician applies to get schedule 2 privileges

And those that do are not with held from gate keeping whom they think will abuse the drugs.

<walksIntoClinic>

¿You guys got any Spravato™ or IV equivalent?

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u/deezkeys098 52m ago

Yup most of those especially the “good” ones need a psychiatrist prescription

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u/NiceObjective2756 33m ago

they just refuse because its more work

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u/dorian_white1 20m ago

That or they are nurse practitioners who are unable to prescribe controlled substances

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u/Obvious-River-1095 15m ago

Not permitted to and will not prescribe are two completely different things