This has been a subject I have been very concerned about for many years.
I've been getting extended-release morphine prescribed by the same rheumatologist for about 10 years now. I initially worked with pain management doctors to figure out which pain med and dose worked best. Once we got that figured out and I was on a stable dose, my rheumie took over prescribing.
Due to the increased scrutiny placed on doctors for prescribing these, he eventually required a pain contract. And then, a year or two after that, the UAs started. That was despite the fact that I had been seeing him since 1999 and we have an excellent relationship. The pain contract had nothing to do with his relationship or ability to trust me personally.
He has told me candidly that he does not agree with the opioid prescribing limits. He does not want to give his patients UAs. But he cannot afford for his practice to be affected if he chose to disregard the new climate around pain medications.
At my most recent visit, he told me about a case that happened in 2010 I believe when a doctor was actually prosecuted for not prescribing ENOUGH pain medication to adequately treat a patient's pain. I believe this was is Oregon. Maybe I will ask him for a reference to it next time I see him.
The point is that gradually over the past five or so years, the pendulum has swung completely against genuine pain patients who need these medications. The media is now bombarding the general public with full-blown hysteria about the issue, and its getting worse with each passing year.
There was a rare doctor who was willing to speak to the issue of how chronic pain patients are being affected by this hysteria- here is the segment on NPR from last year: http://www.wbur.org/hereandnow/2016/02/16/underprescribing-opioids-for-pain
For those interested in the origins of this hysteria, there is an investigative reporter who published a series of three in-depth articles several years ago. They are quite good. I will post them in order:http://www.huffingtonpost.com/radley-balko/prescription-painkillers_b_1240722.html?http://www.huffingtonpost.com/radley-balko/us-painkillers-abuse_b_1263565.htmlhttp://www.huffingtonpost.com/radley-balko/painkiller-access-debated_b_1332511.html
I truly feel very badly for people who are new to chronic pain at this point. The majority of them are not going to get access to the types of pain medications that were available to me in the early 2000's when I was first in need of them.
One of the sad parts about this is that its very easy for the average person on the street to believe all this hysteria that anyone who takes a pain medication is doomed to become a heroin addict and then overdose. But one day they might slip and fall at work, or get in a car accident, and then they are going to be the one who needs on-going pain management. And then they are going to see what all of the legitimate chronic pain patients have been going through.