I think your response to the patient’s letter in your last column was horrible.
We as pharmacists are the last line of defense against prescription abuse. If you look at the data about hydrocodone consumption and abuse in the United States, you would understand why the need for monitoring early refills is necessary. We dispense 96% of the hydrocodone in the world. Are Americans that much worse off than the rest of the world?
You have obviously never heard of corresponding responsibility.
J.S. in Indiana
You are correct that the U.S. uses the vast majority of the world’s hydrocodone production, but what you may have missed is that most of the rest of the world uses dihydrocodiene. We have a product containing dihydrocodiene called Synalgos DC, but how much of it do you see prescribed? The DEA still has production limits on this opiate.
Yes, we are the final line of defense, but we are also supposed to be patient advocates – not cause patients to go into withdrawal and elevate their pain. Right now in the media, they are discussing the aggressive interrogation of terror suspects that happened after 9/11 and they are using “pain” and “torture” in the same sentence.
In my opinion, the DEA and our judicial system are playing a sickening game with their registrants, all to help ensure the War on Drugs (and patients) continues, providing job security for them and making criminals out of people who have mental health issues.
I receive emails weekly from all over the country, but Florida seems to be the worst, about patients going to the same pharmacy for years — same doctor, same meds, same dosage and very compliant — and all of a sudden they are refused by a pharmacist, usually a newbie or floater. Often at Walgreens they are blackballed throughout the entire chain.
Why are investigative reporters from across the country doing pieces on patients being denied prescriptions at pharmacies they have been patronizing for years? The number of emails that I get strongly suggests that these are not isolated incidents.
Do you chastise patients for not taking their medications for chronic conditions like diabetes as you do patients on opioids that may take a few extra doses? Both are non-compliant and the outcome for both is the same reduced quality of life and/or death if they don’t get their meds.
When you see a person buying nicotine products or tobacco, do you tell them that they are addicts and you are not comfortable selling it to them? If alcohol is sold in your store, why aren’t you telling these people that they are addicts and they shouldn’t buy alcohol?
Do you chastise a known diabetic buying a candy bar or other sweets that they should not be eating? But do you sell insulin syringes to someone who is unlikely to be diabetic?
Read up on where the War on Drugs started in 1914 with the Harrison Narcotic Tax Act, which is based on racism and bigotry. The court system then even determined that the mental health issue of opiate addiction was a crime, not a disease. Look up the ICD9 codes. Medical science considers it a disease.
Physicians have been taken to court and found guilty of irresponsible negligence for failing to treat pain. Irresponsible negligence is the other side of corresponding responsibility. Corresponding responsibility requires that a dose never gets in the wrong hand. Irresponsible negligence requires that you always get a dose in the right hand.
We don’t expect a diabetic’s blood sugar levels to always be between 80-120. Likewise you don’t expect a patient being treated for hypertension to have the same blood pressure every time it is taken. Why is it expected that pain levels for a chronic pain patient always be the same 24/7?
Pharmacists need to keep the prescribers’ feet to the fire about more honest dosing rather than routinely allowing early refills.
But until pharmacists, collectively, always get a dose into the right hand, I will continue to be critical of those who don’t.
Steve Ariens is a pharmacist and patient advocate. Steve has over 40 years’ experience as a pharmacist in Indiana and Kentucky, and has served on the board of directors of the Indiana Pharmacists Alliance and on steering committees for the National Community Pharmacists Association.
Steve’s wife is a chronic pain patient. You can learn more about Steve by visiting his blog at Pharmacist Steve.
If you have a question for Steve, send it to AskthePharmacist@nationalpainreport.com.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.