[jarrett622]

My clinic says they will no longer prescribe any scheduled or controlled substance. The Ultram I take to mute the nerve pain became a Schedule IV drug in Aug.

I emailed the Governor's Office for Virginia.
"When are you going to expand Medicaid as you said you would? I can't work, have no insurance. The only thing I qualify for is Medicaid. Now all the scheduled drugs have changed. That won't keep addict from getting high but it does hurt people like me, with chronic pain. I can't even get Ultram anymore. My clinic refuses to prescribe anything that's a scheduled controlled substance and I can't afford *any* specialists. So what am I supposed to do for my pain??"

The reply I received:
"Thank you for your email to Governor McAuliffe regarding your inability to obtain medication to control chronic pain. Since health care in Virginia falls within the responsibilities of my office, your email was forwarded to me for response.

The scheduling of drugs is a function of the federal Drug Enforcement Administration (DEA). Ultram is the brand name for the drug tramadol, which was placed in Schedule IV by the DEA in August of this year. Previously, tramadol was a Schedule VI drug in Virginia and did require a prescription. It is unclear from your email why its rescheduling has caused your health care provider to no longer prescribe the drug, but it may relate to the fact that the prescribing of a Schedule IV drug has to be reported to the Virginia Prescription Monitoring Program. Practitioners at the clinic should not be concerned about reporting to the PMP unless they are over-prescribing scheduled drugs.

It is also unclear who has determined that you can no longer receive narcotics to control pain. You have stated that your clinic refuses to prescribe, but a physician or nurse practitioner is responsible for your treatment and prescribing of drugs. The Department of Health Professions regulates health care practitioners in the Commonwealth including the standard of care they render to patients and their prescribing of medications. If you believe that a licensee has provided substandard care, you may file a complaint at the following link: http://www.dhp.virginia.gov/Enforcement/complaints.htm or by phone to 1-800-533-1560, and the matter will be investigated.

I hope this information has been helpful and you will be able to find effective treatment for your pain.

**

My reply to the above:
"I will be forwarding them your response to my email. I have Peripheral Neuropathy of unknown cause. I can't afford to see the specialists I need to see. I may also have Fibromyalgia. The Ultram is the only thing that worked for me. Gabapentin makes me suicidal. Given this and what you just informed me of it would seem to me they aren't providing adequate treatment for me. I've been going to this clinic for over 10 years. I've been taking Ultram for 5 or 6 years without an increase in dose. I haven't needed an increase. I've been very careful with this drug because I *want* it to continue to work.

This came to my attention when I went to get a refill of my Ultram. I get the drug free from the manufacturer. Rite Aid is the only pharmacy in Galax that can get this drug. My clinic is in Laurel Fork, Va. It's easier to get that refilled here in Galax. My other scripts are handled by Tri-Area pharmacy because I'm on their sliding scale, at the clinic also. At the time of the refill, the Pharmacist said she couldn't refill the current script but had immediately faxed my NP. I got a call from the clinic the next day stating my NP did not and would not prescribe *any* scheduled drugs. So I called and made an appointment with a different NP who is above a NP but one step below a doctor. She told me she didn't know *why* I was told she could prescribe it for me. She can't because clinic policy is now no narcotics, no scheduled drugs. Ultram is technically not a narcotic."

I forwarded a copy and paste of the reply to my clinic's contact us link. Waiting to hear back from them.

I don't know what others in worse pain than mine are going to do.