Are Pain Patients Being Denied “Legitimate Prescriptions?”

Are Pain Patients Being Denied “Legitimate Prescriptions?”

Hydrocodonebtibu75200-300x224A month ago, the National Pain Report asked if the news media was missing the point on the pain medication story. We quoted two leaders, one doctor and one researcher, as saying that the chronic pain patient’s need for medication and society’s need to combat narcotic pain medicine abuse are separate, but may be conflated in a way that is hurting some people in pain.

In Florida, one of the first states where the pain medication abuse surfaced, a reporter at Orlando’s WESH-TV has been looking at the issue. Brett Connolly has been looking into whether legitimate pain patients are being denied prescriptions and his reporting shows how complex the problem is.

Neither the Food and Drug Administration nor the Drug Enforcement Administration took responsibility for legitimate pain patients being denied prescriptions. The FDA says that any individual instances of pharmacists not filling prescriptions is an issue for state regulators. The DEA, which rescheduled hydrocodone last fall, says that pharmacists who refuse to fill real prescriptions are not doing their jobs.

The Government Accountability Office reported this year that the FDA and DEA – the two agencies that oversee drug products – should be working closer together on this issue.

The FDA regulates drugs in accordance with their efficacy, safety and quality. For example, FDA might approve an opioid painkiller based on clinical evidence indicating the drug alleviates pain, is safe for use in patients with pain and is manufactured to appropriate standards.

The DEA regulates drugs primarily in accordance with their risk of abuse and medical benefit. Under the Controlled Substances Act (CSA), DEA is able to “schedule” many drugs if it believes they pose a risk of abuse. Drugs are classified according to a sliding scale of medical benefits and potential harms. A schedule V drug, for example, has a recognized benefit and a relatively small risk of misuse or abuse. A schedule II drug, in contrast, may have a medical benefit, but a substantial risk of misuse or abuse.

In our reporting, it is obvious that leaders in pain management are uneasy what the new and stricter regulations may be doing to legitimate pain patients.

Dr. Richard Radnovich, a nationally known pain medicine specialist from Boise, Idaho said, “The problem is that we have blurred the lines between 2 distinct problems: chronic pain treatment and substance abuse. The DEA is concerned with the latter. Medical providers just need to do a good job with the former: that is, show that they are using opioids for a legitimate medical purpose; and provide adequate medical care and supervision.”

Dr. Steve Passik, Vice President of Clinical Research and Advocacy at Millennium Health said, “Prescription drug abuse is a massive problem and we have to deal with it, but I’d also to see more consideration given to the person in pain in the dialogue going forward.”

In Florida, Connolly’s reporting has spurred Florida’s Board of Pharmacy to form a special committee called the Controlled Substances Standard Committee. The committee is holding its first meeting next month. The group is set to address issues of pharmacists who will not fill legitimate prescriptions and figure out how to better protect Florida’s ailing.

Authored by: Ed Coghlan

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joe

The problem of chronic pain is much more than any one opinion … the problem is that pain patients with bona fide impairments and prescriptions are suffering the effects of poor medical licensing and competency testing, poor law enforcement that should be catching criminals involved in drug deals (not DEA who should focus on illegal drugs and the cartels that import them), and a sensationalized media frenzy about “pill mills”, etc. (the general public believes that every Pain Mgmt. Clinic is a Pill Mill). The oversight that should have been apparent as potential fallout of the “War on Chronic Pain Citizens” was not diligently managed and nobody is being held accountable. We have a government that watches our every move, and in doing so, it already has the data regarding “palliative care” and “limited life” patients who have been adjudicated in some cases to legally use and obtain the opioid medications. In the name of social concern, the government is imposing its authority to limit one’s right to obtain needed medications for pain relief … despite the fact that a person may obtain as much alcohol for pain and/or recreation, obtain cigarettes that are very addictive, and claim to be a junkie and pay $15 (u.s.) for methadone, which is one of the strongest opioids, and which there isn’t a shortage — its always available. Some free society with hidden agendas … that hypocritically pick and choose its so-called issues of social good.

Susannah

I have M.S. and yes, I have been through the ringer alright! I’m being abused, yes abused, my the doctor I’ve been going to for 20 long years. Said doctor now has a Pain contract that I was forced to sign before my blood pressure was even taken. I am intimidated and told I may be drug tested at any time.

I’ve quit taking the drugs I was being given and I feel horrible and I wish I would just plain croak! Does any one care? Answer = NO!

I’ve had phones hung-up me searching for a new doctor. I’ve been told to stick it out’,with present doctor. I’m sick of the whole thing and my body is no better than my mind.

This is a disgusting thing to do to SICK PEOPLE!!

It is also a violation of our Constitutional Rights! If I was well, I’d sue these fools!

I live in Fresno, CA. For the last 3 months the Walgreen’s that has filled my prescriptions for the last 10-12 years has refused to fill my pain medication (Norco) as written by my Dr. It is one pharmacist in particular who threatened me with not filling my medication unless I told he what my meds were for. I was stunned but answered her question. It was only after I was sobbing in embarrassment that she agreed to fill them. She pulled the same thing last month and then again 2 days ago except she changed my prescription for Norco from every 6 hours to 8 hours. She also refused to fill my Warfarin to control a blood disorder I have. I MUST take Warfarin daily to control the thickness of my blog. About a year ago I had FOUR blood clots in my right leg. One dislodged and traveled to my right lung where it lodged. I almost died twice. My right leg was split open from below my knee to my ankle and split open to surgically remove the other three clots. I spent months in an acute facility and nursing facility for 7 months. My leg still has not completely healed. I still have home nursing twice weekly. Last month some silly PA changed my blog thinner to Xarelto. It made me nervous so I checked their website. Not only are they in the middle of a major lawsuit due to patients deaths, you cannot switch to Xarelto UNLESS you have had a stable PT/INR for 6 months. 2 weeks prior to this appt I was in the ER of a PT of 157 & an INR of 21 when normal for me is 21/3. Had I blindly followed that fools instructions there’s no telling what could have happened. When my Dr. switched me back to Warfarin, this same pharmacist REFUSED to fill my prescription. I came unglued. I called, she was already gone. I spoke to the pharmacist who listened and apologized immediately and filled my meds. She also changed the amount of pain meds prescribed. I called the store mgr of Walgreens yesterday to get her full name and license number but says I had to talk to the head pharamist. I intend to file a complaint with the CA State Board of Pharmacology against her. I also told the mgr that in light of the Class Action lawsuit against Walgreens for wrongful death against a pharmacist filling a prescription improperly that resulted in death, I didn’t think they needed more bad publicity. I’ve taken it to Facebook and started a page based on this particular Walgreens. I have lived with chronic pain for over 15 years before the blood clot incident. I have been bedridden for 6 years and this person is going to change my Drs legally and legitimate prescription orders? I think not, not without a fight. Hell hath no fury like an Italian scorned.


BL; you are right and yes that is part of the problem / patients that are looking for a single modality in the form of a Pill to reduce their level of pain.

That Pill works much better when at the same time patients are using moist heat, Chiropractor, PT, Acupuncture, relaxation therapy and other pain aids on the market.
Not everyone is in a position to travel or spend money on other modalities, making that single Pill their one source for pain relief.

With over 100 million people suffering from chronic pain its hard to imagine the many different scenarios each patient is forced to live with. With that in mind it scares me when I’m told – by committee – pain patients will be told what and how much will help them with their pain.

My oldest son, a USMC Vet that suffers with chronic pain was told by his doctors at the VA they could not prescribe narcotic pain meds. For the last 22 months he’s been given a plethora of drugs all with very nasty side effects. Recently he went to his drug store and the Pharmacist would not fill the script – no it wasn’t a narcotic – it was a drug used to treat people with a bipolar medical condition. The pharmacist asked why it was prescribed and my son told her – for pain – I’ve never heard of this drug getting used to treat pain in any way was her reply.

So, after revisiting the doctor and telling her the story about what the Pharmacist said they came up with a plan; his doctor will prescribe narcotic pain meds but she is going to put the meds into a devise that is locked and will only allow the prescribed dose to be administered according to her instructions. That might sound crazy but now the doctor is protected and so is my son, he can’t take more by accident or by desire and the doctor has covered her ass and now both patient and doctor have seemed to work things out. After checking I found such a devise that can be paid for on a monthly basis for $70.The VA will cover the cost.

” Where there’s a will there’s a way ”

Thank you,

John S

Kim Miller

Chronic pain patients do not ask to be in pain. By the time the vast majority of patients with intractable, incurable, and unrelenting pain reach the point where opioids are necessary to have any semblance of quality of life, they have been through more than most people can imagine.

They have likely had numerous tests done to rule out various conditions, had risky and possibly damaging procedures to avoid medications, had to endure a multitude of specialist appointments and will continue to see these specialists, physical therapy, acupuncture (the last two may not be covered by insurance, so that’s not always possible), and now they have exhausted all avenues, THERE IS NO CURE, THERE IS NO TREATMENT.

Now the typical chronic pain patient enters the next phase of their lives as a professional patient. They will likely be subjected to drug testing, pill counts at a moment’s notice, and monthly doctor appointments to get the only remaining recourse; opioids.

After enduring all of the above mentioned items, while being in a great deal of pain, they finally have something that will help take the edge off. They get to the pharmacy only to discover their perfectly legal, hard earned prescription is not going to be honored by the pharmacist. Many times no reason is given, no explanation at all. They drag their exhausted, painful bodies to the next pharmacy to face the same result. How can this be? They wonder, having gone through all the right steps, followed all the rules, passed all the tests, suffered through ALL of this, how can it be that I still can’t get any relief???

Please try to understand, chronic pain patients have already been through the ringer, run the gauntlet, and to have people think they just want their drugs!! If you’re in chronic pain and have been through what I have been through, you already know you have paid a very heavy toll for a very small amount of medication. Medication that will allow you the luxury of taking a shower, maybe. Going to the store or to visit your mother while she’s still living. Is it too much to ask to get the prescription filled after going through what nobody should have had to endure in the first place?

Human rights are the very basic of humane behaviors among civilized nations. We should treat our sickest people with some basic dignity and fill their legal, legitimate prescriptions.

BL

I don’t believe it is that severe chronic pain patients are being denied pain meds so much. I think it is that the drs have realized that they can’t continue to increase the dosage of the meds indefinately. And many patients aren’t happy because they don’t want to try and manage with meds that aren’t as strong and lower doses. They don’t want to combine non medication forms of pain management with pain management. As patients we have a responsibility to work with our drs. Much more is required of us that just seeing our dr and getting a rx.

marty

I hope something is done soon. I am a member of several chronic pain groups and some of the stories they tell about not being able to get their pain meds while being in extreme pain are just heartbreaking. And yes several of them are in Florida. I am so thankful I have not run into this problem where I live . They are literally killing some of these people making them jump thru hoops to get much needed pain medicines.