California Pain Patients Bill of Rights: No Longer Valid?

from Painresearchadvocates’s Blog (defunct)| February 26, 2009

These statutes are (or were) from CALIFORNIA law. I know some states have voted to repeal their versions of these statues and I don’t know if CA is one of them. 

This wording added in law AB 2198 which was chartered into law on September 20th, 2006.

SEC. 5. Section 2241.5 is added to the Business and Professions Code

(a) A physician and surgeon may prescribe for, or dispense or administer to, a person under his or her treatment for a medical condition dangerous drugs or prescription controlled substances for the treatment of pain or a condition causing pain, including, but not limited to, intractable pain. (emphasis added)  

(b) No physician and surgeon shall be subject to disciplinary action by the Board for prescribing or administering controlled substances in the course of treatment of a person for intractable pain.

From the California Medical Board PublicationGuidelines for Prescribing Controlled Substances for Pain
Adopted Unanimously by the Board in 1994

Business and Professions Code section 2241.5

(Web site referred to, www.medbd.ca.gov,  no longer exists)

California Pain Patients Bill of Rights: California Senate Bill 402

This bill establishes the Pain Patient’s Bill of Rights and states the legislative findings and declarations regarding the value of opiate drugs to persons suffering from severe chronic intractable pain.  It, among other things,

  1. authorizes a physician to refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain,
  2. the physician to inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates, and
  3. authorizes a physician who prescribes opiates to prescribe a dosage deemed medically  necessary.

SECTION 1. Part 4.5 (commencing with Section 124960) is added to Division 106 of the Health and Safety Code, to read:

PART 4.5. PAIN PATIENT’S BILL OF RIGHTS: HEALTH AND SAFETY CODE: SECTION 124960-12496

124960.  The Legislature finds and declares all of the following:

 (a) The state has a right and duty to control the illegal use of opiate drugs.

(b) Inadequate treatment of acute and chronic pain originating from cancer or noncancerous conditions is a significant health problem.

(c) For some patients, pain management is the single most important treatment a physician can provide.

(d) A patient suffering from severe chronic intractable pain should have access to proper treatment of his or her pain.

(e) Due to the complexity of their problems, many patients suffering from severe chronic intractable pain may require referral to a physician with expertise in the treatment of severe chronic intractable pain. In some cases, severe chronic intractable pain is best treated by a team of clinicians in order to address the associated physical, psychological, social, and vocational issues.

(f) In the hands of knowledgeable, ethical, and experienced pain management practitioners, opiates administered for severe acute pain and severe chronic intractable pain can be safe.

(g) Opiates can be an accepted treatment for patients in severe chronic intractable pain who have not obtained relief from any other means of treatment.

(h) A patient suffering from severe chronic intractable pain has the option to request or reject the use of any or all modalities to relieve his or her pain.

(i) A physician treating a patient who suffers from severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve pain as long as the prescribing is in conformance with Section 2241.5 of the Business and Professions Code.

(j) A patient who suffers from severe chronic intractable pain has the option to choose opiate medication for the treatment of the severe chronic intractable pain as long as the prescribing is in conformance with Section 2241.5 of the Business and Professions Code.

(k) The patient’s physician may refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians who treat severe chronic intractable pain with methods that include the use of opiates.

124961. Nothing in this section shall be construed to alter any of the provisions set forth in Section 2241.5 of the Business and Professions Code. This section shall be known as the Pain Patient’s Bill of Rights.

(a) A patient who suffers from severe chronic intractable pain has the option to request or reject the use of any or all modalities in order to relieve his or her pain.

(b) A patient who suffers from severe chronic intractable pain has the option to choose opiate medications to relieve that pain without first having to submit to an invasive medical procedure, which is defined as surgery, destruction of a nerve or other body tissue by manipulation, or the implantation of a drug delivery system or device, as long as the prescribing physician acts in conformance with the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.

(c) The patient’s physician may refuse to prescribe opiate medication for the patient who requests a treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians who treat pain and whose methods include the use of opiates.

(d) A physician who uses opiate therapy to relieve severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve the patient’s pain, as long as that prescribing is in conformance with Section 2241.5 of the Business and Professions Code.

(e) A patient may voluntarily request that his or her physician provide an identifying notice of the prescription for purposes of emergency treatment or law enforcement identification.

(f) Nothing in this section shall do either of the following:

(1) Limit any reporting or disciplinary provisions applicable to licensed physicians and surgeons who violate prescribing practices or other provisions set forth in the Medical Practice Act, Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, or the regulations adopted thereunder.

(2) Limit the applicability of any federal statute or federal regulation or any of the other statutes or regulations of this state
that regulate dangerous drugs or controlled substances.

==========

California Pharmacy Board
Source: Health Notes. Vol. 1, No. 1; pp. 4-5 1996.

DISPENSING CONTROLLED SUBSTANCES FOR PAIN: A Statement of the California State Board of Pharmacy

The Board understands that the ongoing use of opioids for cancer, post-surgical, and chronic pain is not what causes addiction or a patient’s desire for higher doses of pain medication.

Patients suffering from extreme pain or progression of disease may require increased doses of medication; the appropriate dose is that which is required to adequately treat the pain, even if the dose is higher than usually expected.

In addition, with long-term treatment of pain with opioids, patients may develop a tolerance to the drug or a dependence on the drug. These occurrences are considered “normal” and “to be expected” – they should not be confused by the licensed healthcare professional with drug addiction or be mislabeled as “drug seeking.”

The Board understands that an important part of effective pain management is ensuring that patients do not have difficulty obtaining adequate medication for pain relief.

The Board recognizes that is it the professional responsibility of the pharmacist to recommend that patients in pain received appropriate, timely, and adequate drug therapy to reduce their pain.

BUSINESS AND PROFESSIONS CODE SECTION 2220-2319

Except as otherwise provided by law, the Division of Medical Quality may take action against all persons guilty of violating this chapter.  The division shall enforce and administer this article as to physician and surgeon certificate holders, and the division shall have all the powers granted in this chapter for these purposes including, but not limited to:

(a) Investigating complaints from the public, from other licensees, from health care facilities, or from a division of the board that a physician and surgeon may be guilty of unprofessional conduct. The board shall investigate the circumstances underlying any report received pursuant to Section 805 within 30 days to determine if an interim suspension order or temporary restraining order should be issued. The board shall otherwise provide timely disposition of the reports received pursuant to Section 805.

(b) Investigating the circumstances of practice of any physician and surgeon where there have been any judgments, settlements, or arbitration awards requiring the physician and surgeon or his or her professional liability insurer to pay an amount in damages in excess of a cumulative total of thirty thousand dollars ($30,000) with respect to any claim that injury or damage was proximately caused by the physician’s and surgeon’s error, negligence, or omission.

(c) Investigating the nature and causes of injuries from cases which shall be reported of a high number of judgments, settlements, or arbitration awards against a physician and surgeon.

2220.05. (a) In order to ensure that its resources are maximized for the protection of the public, the Medical Board of California shall prioritize its investigative and prosecutorial resources to ensure that physicians and surgeons representing the greatest threat of harm are identified and disciplined expeditiously. Cases involving any of the following allegations shall be handled on a priority basis, as follows, with the highest priority being given to cases in the first paragraph:

(1) Gross negligence, incompetence, or repeated negligent acts that involve death or serious bodily injury to one or more patients, such that the physician and surgeon represents a danger to the
public.

(2) Drug or alcohol abuse by a physician and surgeon involving death or serious bodily injury to a patient.

(3) Repeated acts of clearly excessive prescribing, furnishing, or administering of controlled substances, or repeated acts of prescribing, dispensing, or furnishing of controlled substances without a good faith prior examination of the patient and medical reason therefore. However, in no event shall a physician and surgeon prescribing, furnishing, or administering controlled substances for intractable pain consistent with lawful prescribing, including, but not limited to, Sections 725, 2241.5, and 2241.6 of this code and Sections 11159.2 and 124961 of the Health and Safety Code, be prosecuted for excessive prescribing and prompt review of the applicability of these provisions shall be made in any complaint that may implicate these provisions.

 

18 thoughts on “California Pain Patients Bill of Rights: No Longer Valid?

  1. WarOnPainPatients

    I live in California and would like to know what happened to our rights to receive adequate pain control. From experience, I can tell you that my pain care has suffered to the point of causing dangerous and scary symptoms. I am not an alarmist but seriously fear for my life. Doctors ARE decreasing or discontinuing pain medications for many people that I know. California Division of Workers’ Compensation adopted their own guidelines. Workers’ Comp patients are being taken off ALL opioids and muscle relaxers. They stopped paying for my meds and when my physician continued to prescribe for me, I paid cash for my medication. Then, they sent him a letter threatening to drop him as a provider if he did not stop prescribing my muscle relaxer. I suspect my other two medications are soon to follow. I believe the California Medical Board also published new prescribing guidelines that would trump the Pain Patient’s Bill Of Rights.

    I don’t know what happened to our bill of rights. If anyone knows, please, let me know.
    Thank you.

    Liked by 1 person

    Reply
    1. Mia Name

      I have written both DEA and CURES and both told me the dont regulate or dictate to doctors how to prescribe. I have shown both my doctors this and STILL i am being refused adequate treatment. I am TIRED of my rights being violated. In Ca our PDMP is overseen by the DOJ and my question is WHY? When the PPBR gives the state power to control

      Liked by 1 person

      Reply
        1. Mia Name

          Actually it is the DEA that is going after doctor and the DoJ they regulate and are the ones who give the licencing to write prescriptions. The medical board is well aware of this. It is also the CDC. That states are using what they were and turning it into law. The PDMP is not only state but accessed federally. They shouldn’t be but they are.

          Liked by 2 people

          Reply
  2. Nancy

    We are all in the same boat whats worse is they treat us al like the common street addict!In my heart I believe this is because of Obama care! The cost was way more them they could handle and they had to find ways to cut fast! They couldn’t single out just one group so they had to focus on large groups of people, change the recommended times for Brest exams, and other screenings well claiming they weren’t effective. Every heard the phrase “I’m from the government I’m here to help you? ya right. I had 3 major back surgeries in the last year fusions from T-10 to the hip, Fibromyalgia a fused neck and more and they just keep cutting my meds down till I have nothing left! I am so angry! They are forcing us onto the street drugs or into suicide all the while blaming it on the drugs! I was perfectly fine till they started messing with my meds. My quality of life has taken a huge hit and I can no longer do the one thing in life I live for, care for my 3 year old Grandson. I bet their family members get pain control! Its cruel to make us live in pain when its not necessary.

    Liked by 2 people

    Reply
  3. Scarlett Cash

    I’m just brainstorming. Some doctors I’ve had over the years that prescribe me controlled meds, do not include ICD-10 codes with their prescription. I’ve found those doctors to be angry and flippant with me. I wonder if, lack of ICD-10 code, is a sign for the DEA that the doctor might have not done a good faith prior examination, and so the doctor may feel paranoid ?

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      That’s a really good question – maybe you should ask his office about that. I don’t think insurance would reimburse without an ICD code, so he must be writing it down somewhere. Perhaps he doesn’t want you to see it?

      Like

      Reply
    2. Mia Name

      Have you checked their past on the medical board. Mine has neglegence, sexual misconduct, AND wont work in his pain management he only has 2 NPs and no MDs there. Im debating whether or not to blow the whistle

      Liked by 1 person

      Reply
      1. Zyp Czyk Post author

        If your goal is to be prescribed pain medication in the future, then be careful because you could end up on some kind of unofficial blacklist. If your goal is to punish, then definitely go after the bast***!

        Like

        Reply
        1. Mia Name

          Yep it’s be subjected to humiliation and demoralizing conduct just to keep whatever meds to stay alive. This is my exact dilemma. However if more of us don’t pressure the medical board to grow a set we don’t stand a chance

          Liked by 1 person

          Reply
    1. Zyp Czyk Post author

      California, but I think multiple letters to the stats medical board would be the first step. Once we have at least 3 written up I’ll bet we could promote our story to some reporter.

      So far, I’ve been lucky, but that could change at next week’s appointment with a new doctor taking over as my opioid prescriber… or refusing and sending me to one of the “pain management” doctors instead. Those docs seem to be the worst.

      Like

      Reply
  4. Eve Renee Ahl

    In 2020, what are the legal rights ( State and Federal) for a patient ongoing Intractable Pain? ( California and Oregon specific) and most recent 2020 Federal rights of a Chronic Pain Patient/ Intractable pain.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      All our rights have been plowed under by the PROP-instigated anti-opioid hype. We don’t even have the right to have our medical treatment determined by a licensed doctor and instead have to make do with what DEA law enforcement has decided for us.

      Like

      Reply
  5. Nashir Omar

    Can a proscribing opioid Dr suddenly with out any notification stop treatment after being under his or hers care for over 2 years p

    Like

    Reply
    1. Zyp Czyk Post author

      There days, it seems doctors can reduce opioids whenever they please under any conditions, no questions asked. We are living in a nightmare world where we are deprived of pain relief due to anti-opioid propaganda, which led to rules, which are then misapplied or deliberately misunderstood.

      These days, a doctor risks their livelihood when they prescribe opioids in any but the lowest doses because the DEA will track their prescriptions and raid their offices if they prescribe “too much”, according to whatever the DEA agents think. I try to keep that in mind each time I ask for a refill… and am very, very grateful that I’m still getting them at all in this bizarre environment. But I do expect to be cut off eventually, so I’m always trying to save up spares.

      Like

      Reply

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