Is Chronic Pain a Disability?

Is Chronic Pain a Disability?

68-year old Judie Bruno his filed a complaint under the Americans with Disability Act regarding discrimination against those who are being refused pain medication they need for their quality of life.

And she thinks other chronic pain sufferers should follow suit. (Here’s the complaint form)

Bruno, who the National Pain Report featured in October, is an Army veteran amputee who fought and won the VA over her use of medical marijuana to combat her pain. A pharmacist at the Loma Linda VA decided to stop filling Bruno’s morphine prescription (that had been unchanged in 14 years) because she uses marijuana. Bruno, who understands how to navigate the federal health care system, fought back and the VA relented.

“This is discrimination, plain and simple,” Bruno told the National Pain Report.

She made the case in an email to the National Pain Report, which she has given us the permission to share with our readers:

“They are now turning those who would abuse Narcotic Medication and can’t receive them to harder drugs like heroin and turning Veterans and others to use Medical Marijuana which is good for some illnesses and pain but you can’t function being stoned on pot all day long. We need hundreds, thousands of complaints.

Chronic Pain is a real disability. For those Americans who are suffering such a disability, Veterans and civilians alike, many are not being prescribed the pain medications they need or are having those medications refused that they have been on for years to have the best quality of life they can all because of those who would, no matter what, abuse narcotic medications. This is discrimination and is against the laws and rules under the American with Disabilities Act.

Judie Bruno and dog Fred

Judie Bruno and friend, Fred

There is no doubt at all regarding my need for pain medications, in all in my medical records. No one has denied this need. I deal with three different types of pain and each needs the medications formulated to deal with each and my medical records prove that I have never abused any of the pain medications I have been prescribed over the last 40 some years, over two thirds of my life. I always have extra pills and only take them when I need and yet I and many others are all being treated as if we are “drug addicts” because we dare request the medications we need and have to beg for the care we deserve.

On Sept 16, 2015 a pharmacist at the Loma Linda, CA, VA Medical Center, made the decision to just not give me the morphine I have been prescribed for over 14 years, with no warning, no concern at all for the possible shock my body and system would go through by just stopping this medication, nothing to help with the withdrawals I would have to deal with or anything to help with the chronic pain I have every day of my life. This pharmacist didn’t know I had enough morphine to last over a month, more proof that I never abuse these medications. He clearly didn’t care what this action would do to me. I know the reason that this pharmacist took this step was because I do use medical marijuana at night, the doctor remarked about it and that is why I’m able to get by on most days with only three of the four to five pills I am prescribed. That was how I was able over all these years to keep my morphine intake as low as possible.

I went in front of a “Pain Management Board” and proved not only the need for these medications but that I have never abused any medications prescribed and even amputated my leg in 1995 to get off of the high levels the VA had me on. I also removed myself from a Fentanyl Patch because it was more than I needed. The Pain Board returned the medications to me and with that and the new drug I had requested; I had one of the best months in a very long time.

I have requested through a complaint through the Patient Advocate Office at this VA Center the name of the pharmacist who refused to send me the pain medication I need but so far I haven’t been able to learn who he is but I’m sure it’s in my medical records and have requested a copy. I wish to bring discrimination and malpractice charges against this individual for refusing to prescribe to me the pain medications I need and have been prescribed by my doctors who’s care I rely upon and the same charges against the VA Medical Center in Loma Linda, CA and the doctor and pharmacist now in control over the pain medications I need.

Even after proving my need for pain medications and the fact that I never abuse any medications two doctors at the VA are now removing me from the Xanax my GI doctor knows I need for my symptoms and he does not agree with this removal. My quality of life has been very affected by not having this medication all because I use Medical Marijuana legal in my state.

Please help all Americans who are suffering from chronic pain and can’t receive the medications needed for their quality of life. This is truly discrimination against those who suffer from chronic pain and we depend on the ADA to protect us from such treatment.

“No Veteran, no American should suffer one more day in pain that is necessary and this is “NOT” necessary.”

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Authored by: Ed Coghlan

There are 30 comments for this article
  1. Danny Elliott at 6:01 am

    BL, I’m not sure what you’re pain issues are, but please don’t make the assumption that you know what will work for another pain sufferer. I am offended by your condescending “suggestions” for using crock pots and kitchen chairs, etc… Please don’t be that person who “knows better” than the person who is suffering. The assumption you SHOULD make is that this person HAS tried everything to make their life “easier”. Unless and until a chronic pain sufferers asks for suggestions, don’tooffer any. That’s very similar to the pharmacists/doctors who “assume” someone is drug seeking. And if that doesn’t make sense to you, then you haven’t had the experiences that most long-term chronic pain patients deal with on a regular basis. Please choose sympathy or empathy over “you should try this”.

  2. BL at 8:05 pm

    Toni K, crock pots are Great for meals. Also have someone get the things that you need that would entail reaching, bending, etc. There are many meals that can be cooked in a crockpot that don’t require chopping, cutting, etc. If you need to, you can take a break and go lay down and go back and finish later. These things were a huge help to me. It does take longer to put everything that is needed for a meal in the crockpot when you have a lot of limitations, but it is good to still be able to do it. Only having the crockpot instead of pots and skillets also helps when it comes to clean up. Paper plates, disposal eating utensils, etc can also help on really bad days.

  3. Toni K at 9:49 am

    BL – I do have a shower chair and have had it for a few years now – it is STILL too painful to shower – or even bathe. I have to FORCE myself to shower since I KNOW how much more pain I am going to end up in afterwards. As to cooking: Even with a tall chair on wheels, I would still have to make movements – some repetitive – and stay in that chair whilst the food is cooking so I can keep an eye on what it is I am cooking. Who is going to do the preparation for the meal? I can’t with all the bending, reaching, cutting/chopping/etc. that is involved. Then, when the pain gets overly intolerable – which it definitely would – do I just leave what I was cooking where it is until the pain lowers enough, which could take anywhere from hours to days, so I can get back to the kitchen to finish what I was cooking? How do I eliminate everything that causes my pain levels to rise so that I can cook a meal? I can make toast and put peanut butter on it and I do sit in a chair whilst the bread is in the toaster. THAT is the easiest and least painful thing to make to eat. I certainly, however, don’t want to eat that 3 times a day, though!

    Because of the advice you gave me, I wonder if you even read my entire comment. Basically, everything that people without chronic pain do has become, or is becoming, too painful for me to do – except lying in bed. I am still in pain whilst lying in bed, but the pains generally stay at the normal high-levels I have, although some do lower a bit for awhile – until I get out of bed for one reason or another – like going to the bathroom to use the toilet. smh

    I don’t know how lynnea1 feels about all you said regarding her and her mother, but for me, giving advice when someone doesn’t know all the facts about a person, or persons, is a bit presumptuous.

  4. lonnie van cleaf at 8:51 am

    As a kaiser patient in CA, I WAS TOLD THE SAME THING., If you want med MJ, you cant get narcotics. Ever since i asked that question, i have been urin tested 3 times over 4 months. since i dont use MJ i wasnt worried, but they are looking for a reason to stop my opioid therapy. Can they do this? If these CDC GUIDELINES ARE PUBLISHED, I KNOW KAISER WILL GLADLY VOLUNTEER TO FOLLOW THEIR TERRRIBLE ADVICE. Now we can at least offer our comments to CDC, I DO BELIEVE THEY REALLY DONT CARE WHAT WE SAY. SEE, I USED TO SMOKE WEED FOR 30 YEARS, YES TO GET HIGH, NOW THE STUFF IS WAY TO STRONG FOR ME ANYWAY. Heres the irony i take 320 mg of oxycontin along with 45 mg morphene for bk thru pain daily. THE ONLY THING I FEEL IS NORMAL, WHICH IS WONDERFUL. MY PAIN IS REDUCED GREATLY EXCEPT WHEN I TRY TO DO TO MuCH, LIKE WALK AROUND FOR OVER AN HOUR OR THE WEATHER CHANGES, TOO much house work ETC.. I WILL SAY THIS THOUGH, BECAUSE I AM ALLERGIC TO THE ADHESIVE FROM THE FENT PATCH i cant use it, SOOO I WAKE UP EVERY MORNING IN EXTREME PAIN. I KNOW WHAT ILL FEEL LIKE IF THEY TOOK MY MEDS AWAY EVERY MORNING AROUND 6 AM. Some mornings the pain Is so strong I cant even lift the glass of water. I LAY IN BED FOR ABOUT 20 MINUTES, THEN IM ABLE TO DO MY STRETCH EXERCISING AND SLOWLY GET AROUNG. ITS A GOOD HOUR BEFORE MY PAIN GOES FROM A 10 TO A 4. A 4 IS MY NORM, THATS AS MUCH AS I COULD.SUCK UP.
    NOW BACK TO DISABILITY. CHRONIC PAIN WAS THE #1 REASON ALONG WITH A FEW OTHER AILMENTS I WAS APPROVED. BUT EVEN THOUGH I RECIEVE NO EUPHORIA FROM MY PAIN MEDS LIKE AN ADDICT WANTS, WHO WOULD HIRE ME ANYWAY, I LOOK GREAT I HAVE A LOT OF EXPERIENCE, I WAS IN THE TOP 20% OF MY INDUSTRY, BUT EVERYBODY NOW TAKES A DRUG TEST FOR A JOB
    ANYJOB! so since i couldnt pass a drug test i am unhireable and since i cant move without the medication disability approved me. Even though med MJ IS LEGAL IN CA, i would be a veg if i smoked too. I would use it if i was allowed just to sleep better and hopefully wake up in less pain.
    To me this is solid proof a 1 size fits all opioid gideline is moronic and torture, we all need to be treated as individuals. I LOVE KAISER, BUT I MAY HAVE TO SWITCH IF THEY DECIDE TO STOP MY PAIN MGT. THATS NOT RIGHT BECAUSE I HAVE 3 OTHER REASONS I NEED THEM PLUS MY WIFE HAS HER OWN ISSUES. I WOULD HAVE TO MAKE A TON OF CHANGES in our lives just to continue the pain mgt i have recieved for over a decade. There are 3 drs near me that will take over my care for pain but switching gastro, cardiologists, endocrinologists and orthopedic docs just isnt befificial to my health, nor does it make any sence at all. I do t get medicare for a few years, by then i hope this will all be behind us or were going to have a lot of suicides and heroin junkies in numbers that are staggering. Sometimes i wonder if thats what the govt wants, just to get rid of us all like Trump thinks all muslims are terrorists, The DEA AND CDC THINK ALL CHRONIC PAIN PATIENTS ARE JUNKIES. HMMMM THATS A PRETTY GOOD COMPARISO

  5. lynnea1 at 11:55 pm

    My mother feels as if she’s being treated like a street thug. She may be 80 years old, but she’s sharper than a whip (much more than I am at 58). She is very in tune with her body and keeps a log of every time she takes a dose of her medicine. She is so tough that she doesnt take any shots when she goes to the dentist! So when she hurts enough that she has to have a painkiller, you know the pain has to be bad. She doesnt take any other medicine except levothyroxin. She is diabetic but treats it through diet.

    When I get my pain meds I dont have to jump through all the hoops she does. In 25 years, Ive never been pee tested at the docs office. Ive never had to show my ID at the pharmacy. Ive been on many medications at once, and have, in fact, weaned myself off of them because I feared it was a deadly cocktail. If she is having trouble getting her meds because she is old, then she definitely has a case for age discrimination. Someone that old deserves to not have to suffer all the time because some doc thinks she is too old, especially when she has logs that prove when she’s taken her meds.

  6. BL at 9:29 pm

    Toni K, a shower chair might help you be able to take a shower a little easier. A chair in the kitchen to sit in while you’re cooking may make it a little easier to cook. A tall chair on rollers/wheels can also help you move around the kitchen a little easier.

    lynnea1, drs are being urged to reduce pain meds for seniors, so your mother is fortunate she is able to get them. One of the reasons for this is because seniors tend to forget if/when they took their meds and they often take another dose too soon which can lead to other serious issues in seniors. When we get older the way we metabolize medications changes, we have more health issues so we are on more medications, we tend to have more falls, etc. Depending on what other medications your mother is taking and what her all of health issues are even one half of an extra pain pill could be dangerous.

    State laws govern the ID issue at the pharmacy. Each drug store may also have their own way of how they check for ID. This is all done to ensure that each patient gets their prescription and not someone elses. Countless customers appear at pharmacy couunters everyday. There is no way that any one person can remember everyone. And most chain stores often have more than one person working the pharmacy counter.

    The pharmacist knows all of the prescriptions that your mothers has gotten filled, even if they were filled at that store or in most cases that state. The pharmacist has a responsibility to do all he can to ensure that prescriptions that he dispenses do not harm the patient. So it makes sense that the pharmacist might ask what your mother is taking the prescription for. The pharmacist also might be concerned about other medications she is taking and any negative side effect or interaction. If a dr gives a patient a prescription, the pharmacist fills it, the patient take it and dies or has serious health problems as a direct or indirect result of that medication, the pharmacist as well as the dr can be sued. So the pharmacist and the dr aren’t trying to be difficult, they are trying to do a good job and protect their jobs as well as look out for the healh and welfare of your mother. If your mother doesn’t lie Walgreens or her dr, she can change. Although she will more than likely have to have drug screens at any pain dr that she sees. Her ID will be required before being able to pick up and more than likely drop off her prescriptions at any pharmacy.

    Your mother is the patient and the things that you have mentioned that infuriate
    you don’t seen to be infuriating her. Maybe she realizes that all of the these things are being done for her good. She may also realize that compared to not having her pain managed, these things are no big deal to her.

  7. lynnea1 at 5:05 pm

    Thank you for doing all this and for letting the world know about it! I am a chronic pain sufferer, and worry all the time about t he possibility of having my meds taken from me. My 80 year old mother recently had to resort to pain meds and she has run into a gamut of problems getting her meds. First off, her doc pee tests her at every monthly visit & if they think she has too much in her system they threaten to pull her script. Seriously, she’s 80 years old, taking half a pill! That infuriates me. Then, when she goes to her local Walgreens to get her script filled, she has to show them her ID when she drops the script off, and again when she picks it up. She also has to tell THEM the reason she needs the script. Im way concerned about privacy issues here. Im of the opinion that if she has a prescription from her doctor, its none of their business why she needs the medicine! As far as Im concerned, it borders on harassment. She cant change pharmacies because if she does, she owes her doctor a big explanation. Of course, she’s afraid to speak out. Infuriating!

  8. M. Shank, M.D., Ph.D. at 4:11 pm

    I have continued reflecting upon the specifics of your case, since my earlier comment.

    Within the VA, a pharmacist without a specific “scope of practice” is responsible for “Utilizing all CPRS [Computerized Patient Record Systems] and pharmacy software functions including: order flags, view alerts, hold functions, and service reject, in accordance with local VA medical facility policy.”[i] However, these functions depend upon the authority of the local VA medical facility policy.ii[] In other words, the pharmacist would have to rely upon a local policy that specifically made such a violation grounds for refusing to fill prescriptions covered by that policy. Without a specific “scope of practice,” a VA pharmacist is responsible for “Monitoring and assessing drug therapy, communicating the findings and any recommendations for medication changes to appropriate clinical providers for final approval, and documenting appropriately in the CPRS.”[iii] Notice the requirement for “appropriate clinical providers” to give “final approval” of the pharmacist’s “recommendations for medication changes.” A VA pharmacist must have a specific “scope of practice” for “Prescribing medications, devices and supplies to include: initiation, continuation, discontinuation, monitoring, and altering therapy.”[iv] Similarly, “A scope of practice is required for any positions in which the clinical pharmacist has patient care activities outlined in paragraph 14 of this Handbook and serves as a non-physician provider, as part of collaborative medication management, to initiate, modify, renew, or discontinue medication therapy.”[v] Notice that this document explicitly (and appropriately) defines “discontinuation” as “prescribing,” and it says that a pharmacist must have a relevant scope of practice to “discontinue medication therapy.” Furthermore, “Clear and standardized processes for referral of patients to pharmacy-managed clinics must be established at the VA medical facility level.”[vi] Beyond this, “Clinical pharmacists with a scope of practice may prescribe controlled substances only if authorized by the facility and the state of licensure (i.e., the statutes and regulations that defines the terms and conditions of the pharmacist’s license) and they perform this function in accordance with Federal law and regulations and VHA Policy.”[vii] Since, as we have seen, discontinuation is prescribing and morphine is a controlled substance, these restrictions apply. Even within a relevant “scope of practice,” a VA pharmacist has “responsibility for communication with the collaborating physician such as when significant changes in the patient’s condition occur.”[viii] Whether or not a significant change in your condition had occurred before, it certainly occurred at the time that the pharmacist discontinued your long-term morphine prescription.

    According to your post, you have strictly followed the rules pertaining to your prescriptions of morphine. This implies that the pharmacist who refused to fill your valid prescription inappropriately substituted not only his own rules, for those under which you had been prescribed morphine, but his own medical opinion for the medical opinions of the physicians who, knowing your medical history, physical examination, diagnostic tests, diagnoses, and use of medical marijuana under your state law, had written a valid prescription for morphine to control your pain. A pharmacist’s failure to communicate makes a fiction of the “collaborating physician” required for his “scope of practice.” As it turns out, the collaborating physician is not the only one who needs to be consulted, before changing therapy due to medical marijuana use under state law: “While patients participating in State marijuana programs must not be denied VHA services, the decisions to modify treatment plans in those situations need to be made by individual providers in partnership with their patients.”[ix] Since the decision to discontinue your morphine, on the basis of your use of medical marijuana under state law, was not made “in partnership with” you, it clearly violated VA policy.

    According to the Veterans Health Administration’s Handbook, Outpatient Pharmacy Services, “Authorized medications and medical supplies must be provided to eligible veterans when a prescription is completed by an authorized provider who is licensed to practice their profession in a state, commonwealth, or territory of the United States.”[x] Pointing out that a pharmacist making the medical decision to cancel a physician’s valid prescription violates this requirement, as well as other specific VA policies (see above) might get the attention of Darryl Joe, Office of Inspector General (IG), 810 Vermont Avenue, NW, (50CI) VACO, Washington, DC 20420, telephone 202-461-4591, fax 202-495-5859, email vaoigfoia-pa@va.gov. You should also contact John D. Daigh, Assistant Inspector General, Department of Veterans Affairs, Office of Healthcare Inspections, 801 I St. NW, Washington, DC 20001. The Office of Healthcare Inspections monitors health care provided to veterans, “inspects individual health care issues,” and “is legally authorized to gain access to all records, reports, audits, reviews, documents, papers, recommendations, or other pertinent materials.”[xi]

    You stated that you made a complaint through the VA Center’s Patient Advocate Office, requesting the name of the pharmacist who refused to fill your prescription. I suggest that you specifically file complaints with the local VA medical center’s chief of pharmacy services and with its clinical service chief of alignment. You also said that you hoped to find the information in your medical records. Even if that information is not conventionally included with routine medical records requests, it would seem to be within the scope of the “designated record set” that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives you the right to receive, as part of the VA’s “case or medical management record systems.”[xii] Since the clerks responsible for providing copies of medical records may not be aware of these legal provisions, calling attention to them may be helpful.

    The VA Freedom of Information Act (FOIA)[xiii] Service’s own website[xiv] notes that “any person has a right of access to Federal agency records, except to the extent that such records are protected from release by a FOIA exemption or a special law enforcement record exclusion,” and further clarifies that “requesting copies of VA records pertaining to yourself (i.e., VA claims records, etc.)…is a Privacy Act request.” It provides a number of links to material that I am sure you will find helpful. I suggest that you send FOIA requests, both to the Director of the VA Medical Facility involved, and to Laurie Karnay, FOIA Team Lead, (005R1C) VACO, 810 Vermont Avenue, NW, Washington, DC 20420, telephone 202-632-7465, fax 202-632-7581, email vacofoiaservice@va.gov. Other contacts that might be helpful are the FOIA Requester Service Center, telephone 202-632-7465, and James Horan, FOIA Public Liaison, telephone 202-632-7465.

    According to the United States Department of Justice,[xv] the Privacy Act of 1974, as amended, 5 U.S.C. 552a,[xvi] “provides individuals with a means by which to seek access to and amendment of their records.” I suggest that you contact the Office of Privacy and Civil Liberties, privacy@usdoj.gov and Beth Kramer, Health and Human Services Privacy Act Officer, Humphrey Building–Suite 729H, 200 Independence Avenue, SW, Washington, D.C. 20201, telephone 202-690-6941, fax 202-690-8320, email beth.kramer@hhs.gov.

    Another approach may be to point out that the pharmacist’s actions targeting pain medications are discriminatory. In other words, for a pharmacist to refuse to fill ALL prescriptions for patients who use medical marijuana under state law would be discriminatory, but to selectively refuse to fill those for pain medications is more specifically discrimination against a class of individuals on the basis of a medical diagnosis, condition, or health status. The Declaration of Montréal denounces “withholding of pain treatment” due to “discrimination on the basis of…medical diagnosis” as “profoundly wrong.”[xvii] Likewise, Article 12 of the United Nations International Covenant on Economic, Social and Cultural Rights[xviii] “proscribes any discrimination in access to health care and underlying determinants of health, as well as to means and entitlements for their procurement” on the basis of “health status.”[xix] Being a person who has been prescribed medical marijuana under your state law is certainly a “health status.” Since the VA receives federal funding, you can call the U.S. Department of Justice Division’s Coordination and Review Section, 888-848-5306 and write to U.S. Department of Justice, Civil Rights Division, Coordination and Review Section, NWB, 950 Pennsylvania Avenue, NW, Washington, D.C. 20530.

    When you contact the Department of Justice, you might even point out the various treaty obligations of the United States that were violated:[xx] The United Nations International Covenant on Economic, Social and Cultural Rights requires “the provision of essential drugs,”xxi and the World Health Organization Action Programme on Essential Drugs lists morphine as an essential drug.[xxii] Even Hamid Ghodse, President of the International Narcotic Control Board,[xxiii] has observed that, without access to opioid analgesics to control pain, “patients will not be able to derive the health benefits to which they are entitled under the Universal Declaration of Human Rights.”[xxiv] In addition, Article 12 of the International Covenant on Economic, Social and Cultural Rights, defines “The right to the highest attainable standard of health.”[xxv] Under this Covenant, not just the federal government, but “all members of society – individuals, including health professionals…have responsibilities regarding the realization of the right to health.”[xxvi]

    The Office of Special Counsel recently ruled that a VAMC’s actions in changing prescribed medications posed “a substantial and specific danger to public health and safety” and “recommended” that it “immediately stop switching patients from their prescribed drugs.” It recommended that “leadership be disciplined for approving actions that violated VA policy and could pose a substantial and specific danger to public health.” In that specific case, the medications prescribed were substituted with others,[xxvii] but, in your case, the pharmacist switched you from your prescribed drug to nothing. I suggest that you contact the Office of Special Counsel, 1730 M Street, NW, Suite 218, Washington, DC 20036-4505, or through their website,[xxviii] and complain of a “Substantial and specific danger to public health or safety” and “Violation of a law, rule, or regulation,” including U.S. treaty obligations.

    From my observations within the VA system, I believe that, at the very least, your complaints will generate questions directed toward your VA Medical Center. Neither it, nor the pharmacist involved, want to have to deal with those questions–especially if they come from the offices of your representative and senators. Within the VA system, avoidance of just such questioning is a high priority, to which much attention and effort is devoted. Therefore, the more agencies that you can involve, the better. I suggest that you contact everyone who might have even the most remote interest or jurisdiction in this matter, creating an avalanche of investigations and (hopefully) publicity.

    Unfortunately, what you have experienced is not limited to the pharmacists in the VA. Maybe your case will become the one that finally calls national attention to this rampant problem of renegade pharmacists and begins the process of

    Keep us posted!

    i. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. 18. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    ii. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. 18. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    iii. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. 18. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    iv. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. B2. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    v. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. 14. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    vi. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. 11. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    vii. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, pp. B2-B3. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    viii. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.11, Clinical Pharmacy Services, July 1, 2015, p. 16. http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3120
    ix. Department of Veterans Affairs Veterans Health Administration. Directive 2011-004, January 31, 2011, p. 1. http://www.va.gov/vhapublications/viewpublication.asp?pub_id=2362
    x. Department of Veterans Affairs Veterans Health Administration. Transmittal Sheet, VHA Handbook 1108.05, May 30, 2006. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1431 Note that, although this was “scheduled for recertification on or before the last working day of May 2011,” it was still cited as authoritative by the Department of Veterans Affairs, January 5, 2015. https://osc.gov/PublicFiles/FY2015/15-21%20DI-14-3389/15-21%20DI-14-3389%20-%20Agency%20Report.pdf
    xi. http://www.va.gov/oig/about/healthcare.asp
    xii. http://www.gpo.gov/fdsys/pkg/STATUTE-110/pdf/STATUTE-110-Pg1936.pdf
    xiii. http://www.foia.gov/about.html
    xiv. http://www.foia.va.gov/
    xv. http://www.justice.gov/opcl/privstat.htm
    xvi. http://www.gpo.gov/fdsys/pkg/USCODE-2012-title5/pdf/USCODE-2012-title5-partI-chap5-subchapII-sec552a.pdf
    xvii. Declaration of Montréal: Declaration That Access to Pain Management Is a Fundamental Human Right. Journal of Pain & Palliative Care Pharmacotherapy. March 24, 2011;25(1):29-31. http://www.canadianpaincoalition.ca/media/declaration_of_montreal.pdf
    xviii. Office of the High Commissioner for Human Rights. CESCR General Comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12). Adopted at the Twenty-second Session of the Committee on Economic, Social and Cultural Rights, on 11 August 2000. http://www.refworld.org/docid/4538838d0.html
    xix. International Covenant on Economic, Social and Cultural Rights. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx The United States is a signatory to this treaty.
    xx. For a discussion of U.S. treaty obligations” enforcement, see: Oona A. Hathaway, Sabria McElroy, Sara Aronchick Solo. International Law at Home: Enforcing Treaties in U.S. Courts. The Yale Journal of International Law January 3, 2012;37(1):51-106. http://www.yjil.org/docs/pub/37-1-hathaway-international-law-at-home.pdf
    xxi. International Covenant on Economic, Social and Cultural Rights. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx The United States is a signatory to this treaty.
    xxii. WHO Model List of Essential Medicines 19th List (April 2015) (Amended August 2015). http://www.who.int/selection_medicines/committees/expert/20/EML_2015_FINAL_amended_AUG2015.pdf
    xxiii. Created by the United Nations 1961 Single Convention on Narcotic Drugs, to which the United States is a signatory.
    xxiv. Report of the International Narcotics Control Board on the Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes (E/INCB/2010/1), January 2011, p. iii. http://www.unodc.org/documents/lpo-brazil/noticias/2011/03-marco/Jife/Report_of_the_Board_on_the_availability_of_controlled_substances.pdf The United States is a signatory to the Universal Declaration of Human Rights.
    xxv. International Covenant on Economic, Social and Cultural Rights. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx The United States is a signatory to this treaty.
    xxvi. General Comment No.14. The right to the highest attainable standard of health (article 12 of the International Covenant on Economic, Social and Cultural Rights). May 11, 2000, ¶42. https://www.escr-net.org/docs/i/425238 “It is the declared will of the people of the United States that every treaty made, by the authority of the United States shall be superior to the Constitution and laws of any individual State; and their will alone is to decide.” Justice Chase, Ware v. Hylton, 3 U.S. (3 Dall.) 199 (1796) at 236-37 (emphasis by Court).
    xxvii. Nick Schwellenbach. New Release: VA Hospital Improperly Substituted Mental Health Drugs to Save Money. Washington, D.C., April 22, 2015. https://osc.gov/News/pr15-09.pdf
    xxviii. https://osc.gov/pages/file-complaint.aspx

  9. Doc Anonymous at 8:36 am

    Superb action Judie Bruno! There are so many ways that the constitutional rights, civil (ADA) rights and human rights of pain patients are violated. I just wish more pain patients would file complaints about mistreatment. In New York, Medical Marijuana will soon be available to patients who are registered with the state as being in need. Why can’t a similar registry be established for people who truly benefit from chronic opioids for pain, with the stipulation that a registered patient would not need to “Prove” to each and every doctor and pharmacist and myriad other people that they were truly in need of and benefited from the opioids. That would go a long way to removing the stigma that now confronts ALL chronic pain patients whether or not they are considering medical marijuana.

    The number of people with chronic pain is often cited as being at 100,000,000 Americans and I would be one of those. But I do not need, want or use opioids for my chronic pain. It is more episodic and has been rather low level for the past 10 years. The number of people who truly need and/or use opioids on a daily basis is probably much smaller. And those doing well on high dose opioids is undoubtedly even smaller. It would not be an overwhelming task for developing a registry of these 2 groups of people. Establishment of such a registry could also serve as a mechanism for gathering data about the true risks and benefits of long term opioids. That could certainly quiet some of the prejudicial rhetoric that is so freely touted by people who do not seem to know what chronic pain is really all about.

    In the meantime, civil rights complaints are much needed.

  10. Toni K at 8:28 am

    I am, and have been, disabled and on disability since October 1996. At the beginning of 2012, I rarely had to use a cane. I used to have 5mg Hydrocodone OR 5mg Oxycodone that I could take “as needed” and NOT every 4-6 hours just because the script says you can – ONLY “as needed” (my family doctor and I would switch back and forth so no increase in dosage would be needed – and yes – that does work since the chemical makeup of each opioid is slightly different). I did NOT abuse them. Why would anyone want to? There is no “high” at 5mg and anything above that makes me feel ill – like the flu along with a very foggy brain, although a higher dose does work better by lowering pains more. I told my family doctor I would rather have less pain and not feel “ill” than have nearly no pain but feel “ill”.

    Regardless, after having to switch healthcare systems, I no longer have that pain medication for my myriad types of high-level chronic pains (levels 7-9, with 8 being the average, over 75% of my body – I do have several 5 and 6 level pains as well) from my various illnesses/syndromes. I have tried pretty much everything (horrible adverse reactions to many med tries and/or they didn’t work at all, alternative medicine, acupuncture – that was horribly painful to try, PT – it turned out that was making my pains worse on PT days and for several days after each session, and more) and so it turns out that the only thing that works enough to allow me some sort of “life” is an opioid. (I don’t live in an MM state – but even if I did I don’t think I’d want MM because of the “high” from marijuana.)

    However, by the end of 2012, I had to use my cane all the time; leaning on it heavier and heavier. I “graduated” to a rollater (a walker with wheels and a seat) nearly full time this year (I use my cane in the house). I am also becoming weaker and weaker. I can no longer go out to do photography shoots (a new hobby I had taken up in 2011) – because it’s too painful NOW. I can no longer cook anything – because it’s too painful NOW (thankfully I have a boyfriend who cooks). I end up going 2 weeks or more without a shower – because it’s too painful NOW. I cannot clean my home – because it’s too painful NOW. I rarely even leave my home – because it’s too painful NOW. Even when home, I RARELY leave my bedroom with most of that time being bedridden – because even sitting up more than a few hours has become too painful NOW. This past November (2015), I left my home only 3 times with my boyfriend driving because driving has also become too painful NOW for me. Once was for a last haircut (because it is NOW too painful to go get that done), and 2 Thanksgivings.

    This month of December I have left my home only once thus far for an appointment I could not cancel (I have been cancelling appointments – because preparing for and going to one is too painful NOW – besides, the health providers are unable to even commiserate – they don’t care about the amount of pain I am in). Going anywhere for Christmas this month is very “iffy” – I learned my lesson going to those 2 Thanksgivings – it is WAY too painful NOW!

    Health providers have inferred/implied that I am a “drug-seeking addict”, and one PA downright accused me! All I want is some “Quality of Life” back! Merely existing (there is NO conceivable way that what I have is a “life” of any sort) in so much debilitating pain is making my disabilities worsen which is upping my pain levels! It won’t be long and I will be in a wheelchair and then FULLY bedridden – because of the amount of pain I am in NOW! How soon will it be when I will end up in a nursing home? I am ONLY 56 yrs old! Is that the only way I’ll be able to get any pain medication – being put in a nursing home that taxpayers will have to pay for? (I am sorry taxpayers; truly I am.)

    Thank you, Judie Bruno, for what you are doing. I am so tired of this discrimination against those of us in chronic pain. I am so tired of being in chronic pain. I am so tired of merely “existing”. I can sit up using my laptop for only a few hours, on “good” days, but then it is time to lie down for the rest of the day and night. Thank you, Judie Bruno, for working to try to get some sort of QOA back for all of us in chronic pain, regardless as to how we ended up in chronic pain.

  11. BL at 8:04 pm

    Sandy Auriene Sullivan, Everyone on disability has Continuing Disabililty Reviews 9CDR), they are nothing new. They are based on the Medical Improvement Expected. Going before an ALJ for a decision has nothing to do with CDR’s. There are two kinds, short forms and long forms. When long forms are done copies of medical records are obtained and forms that were filled out when a person applied are sent again. Usually CDR’s are scheduled for 6-18 months, 3 years and 5-7 years. CDR’s don’t always come when they are scheduled. Children also receive CDR’s.

    ALJ have far more knowledge and leeway when deciding disability cases than DDS Adjudicators do. Very few claimants know what they SSA disability criteria. They think if they can’t work that should be enough to be approved. Most claimants also have no idea what their medical records actually say.

  12. Sandy Auriene Sullivan at 3:29 pm

    Think I lost a post but it is time we All pressure the Feds to reschedule. It is something that the President actually can do with the pen!

    Sch II at least. Then doc’s and pharmacists can stop worrying about what the DEA says if they give you pain meds and you are pos for MMJ.

    That’s a huge case we can get before the court. Unequal protection under the law!

    Exactly how Windsor v US went. Unequal protection under the law. The state recognized her marriage of 30odd yrs. The Feds didn’t. She was penalized financially for it.

    See the similarly? It would only have to go so far. Money and time to mount such cases. But they are historic and help those who come behind us!

    Talk to local Rep’s. I am and he is a lawyer. Best wishes to all

  13. Sandy Auriene Sullivan at 3:12 pm

    Hot topic. Of course it is a disability. Many of us are never going to be able to work again. If we do were not reliable. Managed well many of us can go back to work. Part time. Maybe.

    If working full time for the right treatment and doctors and specialists aren’t full time already.

    Chronic pain, regardless of how or why we have it often means we’ll never work full time again.

    I’m noticing a trend of disability claim denials and out of the blue reviews by social security even if you have gone to the Fed panel of judges.

    Don’t say that you can do nothing. Tell them what happened when you DO work. When you are fired for it. Why. How chronic pain diseases cause a person to become unreliable employees.

    Careful single mothers. Explain it takes everything you have and lots of support to get through the day. Or if you missed seeing your children’s school plays and events even if your child goes.

    It’s a landmine out there. If you are receiving disability income?! You’re DISABLED by chronic pain!

  14. Celeste Cooper at 2:32 pm

    My mother taught me to speak my mind. She always said that the squeaky wheel is the one that gets the grease, Celeste. Thank you for speaking on behalf of those who are unable, for what ever reason, to do so.

    Today, I filed an ADA complaint against PROPS because I was incensed by the NEJM article Intensity of Chronic Pain — The Wrong Metric? written by (as lead author) the President of PROPS. I have written a blog, and if I could get an address for the right person at the New England Journal of Medicine, I would love to share it. As an RN, I have always looked up to the NEJM. The fact that they let such insensitive and inaccurate information on their website is appalling to me. My hope is that they will make things right.

    You are proof that my mother was right! She was a very wise woman. Thank you for protecting the rights of our veterans. Many who suffer because they were protecting us.

  15. BL at 1:43 pm

    It will be interesting to see if they go by the chronic pain alone or if they focus on the cause of the chronic pain. Chronic pain without a diagnosis of a Medically Determined Impairment will not get someone approved for disability. But severe chronic pain from a diagnoised MDI that prevents someone from performing SGA may help in someone being approved for disability. Please keep us updated on how things are going.

  16. M. Shank, M.D., Ph.D. at 1:10 pm

    The pharmacist’s focus on the combination of medical marijuana with morphine, rather than the combination of alprazolam with morphine, reminds me of Jesus’ condemnation of the hypocrisy of scribes and pharisees, whom he ridiculed as observing ritual purity by straining the gnats from their drinks while (figuratively) swallowing the equally “impure” camels (Matthew 23:24). Marijuana may aggravate the potential effects of morphine and other opioids to impair driving, but not the respiratory effects of opioids. In contrast, alprazolam does both.

    Before filling the prescription, a pharmacist may–and should–express any concerns to the prescribing physician. However, making a medical judgment whether or not to fill it is practicing medicine, for which he is neither qualified nor licensed. Unfortunately, it is also common behavior.

    When pharmacists abuse their licenses, I generally advise patients to contact: (1) the corporate headquarters of the pharmacy (which is likely to be far more aware of, and concerned about, adverse legal and publicity implications than the local manager is); (2) the state pharmacy board; and (3) the state medical board. All of these have the power to investigate, even if the pharmacy will not identify the offending pharmacist to the patient. In the case of the VA, however, the situation is less clear, because the pharmacy is under federal, not state jurisdiction, and while the pharmacist is licensed by, and under the jurisdiction of, one or more states, the state(s) of licensure might not correspond to the state where the VA facility is located.

    I realize that you have already won a partial victory. Your U.S. Representative and Senator are still likely to take an interest in the matter, especially if you can meet with them personally, perhaps after bringing attention to the matter in letters to the editor of newspapers in the district or state that elects them. I would also suggest that you enlist the Veterans of Foreign Wars, American Legion, and any other service-related organization, to bring attention to this and make sure that steps are taken to keep it from happening to someone else.

    It was not clear from your post who had been prescribing the alprazolam (Xanax) that two physicians have decided that you do not need, or what their role is in discontinuing it. If your GI physician believes that it is required for a condition for which he is treating you, he can prescribe it. I understand that you are entitled to prescription benefits through the VA, but, if worse comes to worse, you could still obtain a prescription to fill outside of the VA. From what I have been able to find, typical doses of alprazolam are likely to cost you in the neighborhood of $6 per month, if you price shop and get a prescription for a larger unit dose that you can split.

    Much more important than the cost, however, is the very real danger of combining alprazolam with morphine. While you have survived this combination in the past, it is potentially fatal. When faced with this in my own practice, I have obtained overnight recording pulse oximetry, to screen for episodes of underbreathing or no breathing (hypopneas and apneas) during the night, when it is most likely to be a problem. Medical oxygen suppliers are usually happy to perform this test for free. If this test shows a problem, a consultation from a sleep specialist and a formal sleep study are in order, to determine whether that problem is due to obstruction in the airways (probably aggravated by your medications, but usually easily treated by means such as CPAP), or is due to the loss of the normal drive to breath (probably also due to your medications, but requiring very different treatments).

    By the way, your pharmacist was apparently ignorant of VHA Directive 2010-035: “VHA policy does not prohibit Veterans who use medical marijuana from participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals.” This expired July 31, 2015, and has been replaced by VHA Directive 2011-004, which has similar language: “VHA policy does not administratively prohibit Veterans who participate in State marijuana programs from also participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals.”

    My opinion regarding the majority of pharmacists is already a matter of public record. As in this case, most seem to go out of their ways to prove me right (but there are exceptions, for whom I have the utmost respect).

  17. Janie B. at 11:52 am

    I have been through the same treatment for many years. It also baffles me what a person on disability has to spend on a monthly basis just to receive a month of prescribed medication. The urine taken every 3rd month, the same paperwork filled out monthly, the unnecessary injections that just cause more problems. This is not a game for us in chronic severe pain every day. It makes you feel like a criminal or junkie all the time. We should not be treated in that fashion. I now use an apothecary pharmacy mom & pop place that treats me with respect but is more expensive compared to the chains. That’s the only negative. The friendly staff treats me as a neighbor, not a manipulative drug addict looking to score! I’m treated as a person in severe pain that just wants quality of life.

  18. Kristine (Krissy) at 11:50 am

    Wonderful article and thank you for the link. I am so sorry you are suffering and that you have stood up and fought for our country in good faith, and are being denied the medications you need. It is sad to me that you are in pain in the first place, never mind the fact that it isn’t managed.

    I filled out the ADA from. I have a wonderful doctor (Florida) and two wonderful pharmacies that I am established with. But even on high levels of two opioids, I still have from 5 – 9 pain levels at all times. I want to be able to try medical marijuana and it really gets my goat that alcohol is legal and killing people and ruining lives every day, and MM is not! I believe from what I have read online by those who take MM, they are finding that nausea is reduced, pain is more managed and people are more productive. What more could a disabled girl want? Since I cannot afford the medicines I need that will help save my life, if I could work even a little I might be able to get these meds. Arggg.

  19. Dee at 11:18 am

    I can’t say much more than what this American Veteran has described. I too have been a pain patient of 15 years. “failed back syndrome”, 2 surgeries, steriod shots, month long inpatient pain management program (that I have done at my own choosing) where I made every effort to take myself off these drugs that I wish not to take. I was unable to function or live a normal life. As such, my doctor at the time agreed that I made every effort to manage my pain, unsuccessfully on my own, and put me back on the meds I needed to live a somewhat quality of life. It is such a dangerous thing to just stop our medications. I too am unnecessarily accountable for my life saving meds. I am willing to be monitored at any time, because my records can prove that I am not an addict, and have the right as an American to not suffer for the rest of my life in excruciating pain.

  20. Pharmacist Steve at 10:49 am

    Here is where Rite Aid was fined for a Pharmacist refusing to give a HIV + pt a flu shot http://www.hivplusmag.com/stigma/2014/02/06/feds-order-rite-aid-pay-fines-after-refusing-give-flu-shot-hiv-positive-customer Here is a link to all the Boards of Pharmacy http://www.nabp.net/boards-of-pharmacy each should have a complain form on line. Refusing to fill legit/on time/medically necessary prescriptions is a form of pt/senior abuse, irresponsible professional negligence, besides the a violation of the ADA… which is considered discrimination and a civil rights violation. Same/similar as a violation under the Civil Rights Act 1964.
    IMO.. unless these federal/state agencies are swamped with complaints, they will dismiss a small number of complaints as “addicts” unhappy about not being able to get their “fix”.
    The bottom line for those in the chronic pain community is IF YOU DO/SAY NOTHING YOU WILL GET NOTHING !

  21. Paula Lopez at 10:45 am

    Dear Judie,,Than You! Thank You! Thank You for sharing your story and Thank You from all my Heart for Your Service to our Country,,I’ve been denied at no less than 10 Pharmacies in one day,, mind you it was the same chain Walgreens and they were filling my prescriptions for 3 yrs because after 8 years of CVS filling them and they know me by name,, they just suddenly said we can’t fill your pain meds,,I never filled early and never increased my dose..
    I am going to stand beside you in filing a complaint with the same board hoping for Humane treatment..We all who suffer pain go thru a living Hell when we try to get our meds filled , except for those who have a Mom and Pops to rely on..God Bless You for giving me another road to travel down in hope of getting this national attention,,not just for myself but for others who are suffering from the stigma of being treated like less of than Humane…They don’t let animals suffer in pain,,how could they allow people to go thru what we have to endure every time we try to get our legal prescriptions filled..Again Thank You for a new route less traveled..Paula

  22. Medea Karr at 9:54 am

    Great article and thank you for empowering patients to fight back against discrimination! Also my Great Dane Koi would love to chat “dog to dog” with your pal Fred about what it’s like being a support dog for someone with chronic pain. We’ve started a FibroDog campaign on my blog to help educate people about support pets and why we need them. Here are the “interviews” he’s done so far: http://www.medeakarrfnp.com/blog. If you (or any other readers for that matter) are interested in sharing your support pet story please email me at fnpmedeakarr@gmail.com. I’m usually able to publish one or two interviews per month, depending on whether my own fibro is acting up. (Fred would be FibroDog’s first veteran support pet interview!)
    Thank you for your service,
    Medea Karr FNP

  23. myst7 at 9:50 am

    Thank You Judie !!! i will foresure share your story and book mark if I ever need it

  24. Steve P. at 9:27 am

    Make no mistake, moderate to severe CHRONIC PAIN IS A DISABILITY in and of itself, as it impedes ones ability to function. The law requires provisions for those that cannot walk, e.g. elevators and ramps, and all forms of other disabling conditions. Suitable medical treatment for chronic pain is just as necessary as any of the other provisions required for the disabled. Moderate to Severe chronic pain is any pain that substantially impacts your ability to perform necessary life tasks, such as bathing, cooking, grocery shopping, sleeping, relaxing, being active; regardless of the “Pain Score” medical worksheets ask you to fill out.

  25. Jorja G. at 8:56 am

    Agree wholeheartedly that we need to “stand up and be heard” but how do we accomplish this?

    There has to be something, somewhere that we can do as a group.

    Or, perhaps, what is needed is for someone to file a class-action suit against pharmacies that insist on playing God. Or, even better, file against the Chronic Pain doctors who would much rather inject your spine with a bunch of drugs (all of which do not work — have had several of these). This is one of their preferences … then there’s the interrogation which one must go through on a monthly basis, the urine sample, the badgering, being treated like you’re nothing more than a homeless person asking for spare change.

    I hate to use these as comparisons but, at the same time, not real sure what else to do. I’m sick of justifying my pain levels — if they can’t see it, then you’re lying. My goodness, I can’t see it either but I can sure feel it.

  26. Scott michaels at 8:37 am

    thisi s a crime. as long as their is legal med MJ in his state, there is no evidence using MJ WITH morhene is harmful. How can a vet be denied pain medicine, how could anybody that is chronic pain especially those that are also disable due to the pain

  27. Danny Elliott at 8:19 am

    This woman is not only a hero for her service and sacrifice for the USA and its citizens, she is a hero for all chronic pain sufferers by being the “fighter” she is. Good for her for fighting for the meds that she NEEDS and for standing up to the people who assumed, without reason or logic, that she’s a “drug abuser”, just as they probably do, or would do, with any other chronic pain customers who truly need pain medication. Additionally, this woman is a hero for all Americans because, as all chronic pain sufferers well know, every person in this country (and around the world) could be involved in an accident or be diagnosed with a very painful condition, at any time without warning. Or a close friend, a spouse, a parent or child could begin to suffer severe pain. In either case, those who have been fortunate enough not to have to suffer through the difficult ordeal that is chronic pain may very well be experiencing the incredibly difficult life of a chronic pain sufferers, and it could be as soon as TODAY. We all owe a great deal to this hero. As for me, let me shout “THANK YOU!!!”

  28. Lauri at 8:14 am

    This has happened to me several times in the past, but I do not have names and such. Luckily, I have changed my pharmacy from a chain to a little Mom & Pop in my town. They now know me as a person and not just a piece of paper.

    When I read the article and saw that there was a form, I wrongly assumed that this complaint form was a general one, one to change the laws and to make pharmacists change their attitude toward filling out (or not filling out, in this case) scripts for pain medications. I was hoping this was to be a complaint that would change how they look at us (Chronic Pain Sufferers) and also to be afraid of the consequences of not filling out a valid prescription.

    Is there something like this that can be shared with Chronic Pain Sufferers. I think it would generate a lot more signatures and forms being sent.

    I have Rheumatoid Arthritis (among many other medical maladies) that causes me daily pain. I belong to several Discussion groups that have anywhere from 100 to 13,000 members. There are stories upon stories of humiliation, of being denied meds, and of being ridiculed, pretty much on a daily basis.

    I will pass this report around to all my groups, but I think I would have a much better chance of having thousands signed if it was a general complaint to get the pharmacist to stop playing God, and fill out a valid prescription. I would love to hear from anyone that knows of this kind of complaint.

  29. Dee Green at 8:10 am

    Stand Up and Be Counted 😊 #painedlivesmatter Chronic Pain patients number 100 million in the US! We must speak up loud and clear or be forced into a life of suffering- Many can’t live a life like that! The Attacks on Chronic Pain patients and the physicians who treat them must stop. Pain patients are vilified and persecuted every day- Where is human compassion?

  30. John Vineyard at 7:49 am

    This is exactly what we all need to do, I’ve been trying so hard to come up with some idea thatbwould actually work. We all need to file complaints with the ADA concerning discrimination.