Ask the Pharmacist: Why Are Pain Patients Treated Like Criminals?

Ask the Pharmacist: Why Are Pain Patients Treated Like Criminals?

Dear Steve: My wife has been a chronic pain patient for over 20 years. We live in Florida and after using the same large pharmacy chain for years we were told they could not fill her prescriptions for oxycodone or OxyContin any longer.

Why are legitimate chronic pain patients who have been on these meds for years being treated like they are the criminals? Why are their names reported to the DEA? Why are we asked so many ridiculous probing privacy invading questions? Why do they have the right to say, “I just don’t feel comfortable filling these”?

Clifford & Valerie

I agree with your concern about how legit chronic pain patients are being treated.  I know of no other disease that we, as a society, discourage adequate treatment of. In fact, we actually encourage inadequate treatment of chronic pain.

In my opinion, the Drug Enforcement Administration (DEA) is protecting itself from being sued by the American Civil Liberties Union (ACLU) by making statements that they are not causing the pharmacies to do this. The ACLU’s mission is to sue the federal and state governments when they violate the Constitution and abuse people in our society.

bigstock-Pills-669040I find it quite coincidental that around the same time that the federal budget sequestration started, the DEA started aggressively fining DEA registrants such as pharmacies. The DEA gets to keep the fines they impose to fund their operations.

In fact, the fines imposed seem to be more dependent on the registrant’s ability to pay than the amount of medications found missing.

Generally speaking, pharmacists are allowed to decline to fill a new prescription if it could cause a major drug interaction with an existing medication, the patient is allergic to the new medication, and/or the dose is potentially lethal. Also, under these circumstances, it is normal for the pharmacist to contact the prescriber to work out a solution, not to just turn down the prescription and leave the patient without any therapy.

There is a long complicated story as to why pharmacists believe that they can just turn down a prescription for any – or no – reason. What many pharmacists have not come to realize is that chronic pain patients are covered under the Americans with Disability Act (ADA). Filing an ADA complaint is fairly simple and you do not need an attorney.

Here is an information sheet that you can use to file a complaint:

http://www.pharmaciststeve.com/wp-content/uploads/2014/03/How-to-file-complaints-if-patient-is-being-denied-having-a-valid4.pdf

There is a growing surplus of pharmacists and I suspect that these pharmacists that you are encountering are more fearful of losing their jobs than losing their license. They are just following protocol that their employers have established. Some are probably following them more strictly than others.  It would appear that some have taken the stance that it is better to deny a legit patient their necessary medication, than risk getting that first dose in the wrong hands.

This is a battle that only the patient or their advocate can take on. But the good news is that there are laws on the patient’s side, and filing complaints normally involves filling out an online form and/or sending in a certified letter with the complaint.

In my opinion, if a patient is on chronic opiate therapy, they are disabled. File the complaint and let the investigator make a determination. When the pharmacy or pharmacist is fined with an ADA violation, the patient gets to keep the lion’s share of the fine.

When the pharmacy or pharmacist is fined, it also sets them up for a complaint with your state’s Board of Pharmacy for unprofessional conduct.

Depending on how the pharmacist conducts themselves with the patient, there could be a Health Insurance Portability and Accountability Act (HIPAA) violation and a HIPAA complaint could be filed.

I am recommending that patients have someone go along with them to the pharmacy and video the pharmacist/patient interaction from a short distance so that the pharmacy/pharmacist cannot deny what transpired. You can also try and get a copy of the store’s video surveillance videos.

Contrary to what many pharmacists believe, the law is on your side.

Steve AriensSteve Ariens is a retired pharmacist and patient advocate who has a blog called Pharmacist Steve. Steve’s wife is a chronic pain patient.

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.

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Jason

Here is a link to a petition which wants pharmacy abuse to stop, please sign it and use your social channels to get signatures.

https://www.change.org/p/stop-pharmacy-abuse-discrimination-and-restore-peace

Red

BL, the ADA is not about giving people with disabilities the right to be treated the same as those who do not have disabilities. Otherwise, the ADA would be a law that mandates people in wheelchairs to learn how to navigate a flight of stairs! The ADA is about accommodating people with disabilities so that they can enjoy a life of dignity, respect, comfort, and basic human rights.

Millissa

I think they want us all to kill our selves.
They are trying to kill off us less useful of society…
FACT!

BL

Steve, If all people that needed pain meds were able to get them, except those who receive SSDI or SSI then it would be a ADA violation. No one is guaranteed proper pain managment, disabled or not.

Christina

Steve I respect the fact that you give us ideas but the government will do what they want or see fit. Intill the research is conducted on the records claimed for abuse and deaths they will always claim there’s an epidemic. Really the DEA is responsible for letting all the money making pigs in florida open up shop. All those clinic had to file for permits to open the doors. They should of paid attention in the first year this was going on. Which I believe was a plan all together to get in our health care. Tell us we need to be saved from ourselves. I just was reviewing your link to the NAPA and I saw on the website. The Senate Health Committee is forming a work groups on the federal level to combat prescription drug abuse so now were going to have more crap going on then we do. There also have NIDI designed to develop of a new monitoring of drug abuse. The government keeps claiming we have a problem so how can patients fight this war without lawyers and senate parties on our sides?

Steve

Trudy – you’re absolutely right
Pharmacist Steve – what do we do about doctors refusing to treat us because we’re pain patients (especially when they don’t have to prescribe the opioids)

BL

Diabetics get their insulin & healthy people can get NSAIDs, like a diabetic needs their insulin, we NEED opioids. Any decent lawyer could make an ADA violation stick.

Better example
My sister can walk unassisted, but I require a cane our wheelchair (depending on the day). It would be an ADA violation to treat me differently for needing a wheelchair, even though healthy people don’t use wheelchairs.

BL

Federal Law superceds State Law or the one that is the more stringent. For example, in the state of New York Hydrocodone Combination meds have been a Schedule II since February 2014, but New York is the only state where this is state law. In all of the other 49 states these same meds are still a Schedule III. The law is more stringent in New York that the current Federal Law, so state law applies.

Trudy McGee

“Contrary to what many pharmacists believe, the law is on your side” Unfortunately Steve, the law may be on your side, but the state of Florida is NOT. Our governor and the attorney general have been flaunting their reelection campaigns with statistics about how they have the least amount of prescription drug abuses in the entire United States of America. If you recall your constitutional history, our forefathers made it so that the states have the stronger say so than the federal government. You can complain all you want in the state of Florida, and you know where you get??? No where!! I even wrote the White House begging them to help Floridians. Do you know what I got in return for my well thought out letter?? A call from the suicide prevention line. Nobody cares, and we as pain patients don’t have the energy to form a million man march on the Capital. It stinks to be a pain patient in this day and age.

Brenda Alice

We need to report and take action so we can be treated as the doctor ordered instead of what store employees decide. I certainly am grateful that we have pharmacist Steve to help us live a life with medication and without the discrimination. Chronic pain is bad enough but the rude comments and worse is unnecessary.

BL

Pharmacist Steve, With all due respect, as long as those without disabilities are also encountering the same problems that patients who receive SSDI & SSI are encoutering regarding their pain medications, it is not against ADA. If those with disabilities were denied pain medications and those without disabilities weren’t denied, then it would be against ADA. ADA is to protect the rights of those with disabilities to be treated the same as those without disabilities.