Pharmacists Report Delays in Getting Opioids

Pharmacists Report Delays in Getting Opioids

Pharmacists across the country say “surprise disruptions” in the supply of opioid analgesics are forcing them to turn away legitimate patients with valid prescriptions for painkillers.

Drugs SignA survey of over 1,000 pharmacists conducted last month by the National Community Pharmacists Association (NCPA) found that most had experienced delays of at least one week in obtaining shipments of painkillers and other controlled substances.

“Vulnerable patients are increasingly and tragically becoming collateral damage in the country’s battle against the abuse of prescription drugs, particularly narcotic painkillers,” said B. Douglas Hoey, CEO of NCPA, which represents over 23,000 independent pharmacies across the United States.

“Community pharmacists repeatedly cited having their supplies or shipments of controlled substances abruptly shut off by their wholesalers, which may have done so due to perceived pressure, intimidation or a lack of clear guidance from law enforcement officials, such as the Drug Enforcement Administration (DEA).”

Wholesalers such as Cardinal Health are under pressure from the DEA to closely monitor their shipments of opioids and other controlled substances to prevent them from being abused or diverted.  In 2012, Cardinal was fined $34 million after its distribution facility in Lakeland, Florida failed to notice suspicious orders of hydrocodone. Shipments of controlled substances from that facility were suspended for two years.

The unpredictable supply chain has led to rumors that opioids are being “rationed” in some parts of the country or that there is a quota system for each pharmacy that is determined by wholesalers or the DEA.

Cardinal Health declined to comment for this story, but a DEA spokesman strongly denied that the agency was trying to limit or ration access to narcotic painkillers.

“If a pharmacy chooses not to fill a prescription for someone, that’s their decision. It’s not the DEA’s decision,” Rusty Payne told National Pain Report.

Payne believes enforcement actions taken by the DEA against wholesalers and major pharmacies may have had a “chilling effect” on the companies.

“Typically we get blamed for a decision that the big wigs make at a pharmacy that’s run into trouble. They tell their folks don’t fill this, don’t fill that,” Payne said. “We don’t have the resources nor do we have the authority under the law to stand outside a doctor’s office and as you walk by say, ‘Let me see that prescription.’ It wouldn’t be a good use of our time nor would it be within the law for us to monitor what a doctor is doing on an everyday basis for a specific patient.”

In the NCPA survey, 75% of pharmacists experienced three or more delays in getting shipments of controlled substances in the past 18 months. On average, each delay or stopped shipment affected 55 patients-per-pharmacy.

Other key findings from the survey include:

  • 89% of pharmacies received no advance warning of a delay in shipping controlled substances.
  • 60% said the delays in receiving medications lasted one week or longer.
  • 68% were unable to obtain controlled substances from an alternate source.
  • Most reported having to turning away patients, including some cancer patients.

The survey included a comment section where pharmacists could share their observations about the impact delayed shipments had on their customers.

“We turn away patients on a daily basis that I am sure are legitimate patients with legitimate prescriptions with legitimate issues requiring pain management. I am one in a long line of pharmacies that turns these patients away because of the limits on what I can dispense monthly,” wrote one pharmacist.

“This situation has literally brought customers to tears in our store,” wrote another. “I fully understand the diversion and abuse of these powerful chemicals. I agree that something must be done, but to deny pain management to deserving individuals is inhumane at best. We have to find a way to curb the abuse and still provide relief from pain for those truly suffering.”

Another pharmacist wrote, “We try to scrutinize all controlled substance prescriptions, but are made to feel like criminals when trying to service our patients.”

“I’ve had firsthand experience with this,” says Steve Ariens, a retired Kentucky pharmacist who has had trouble filling prescriptions for his wife, who is a chronic pain patient.

“It really is pathetic,” says Ariens. “They’re picking on people who are physically, emotionally and financially drained.”

Ariens, who has a blog called Pharmacist Steve, believes drug store chains and wholesalers have overreacted to the DEA’s enforcement actions.

“They’re policing themselves with paranoia, in my opinion,” Ariens told National Pain Report. “I’ve tried to talk to attorneys about going after them, but when the DEA is involved they all throw up their hands and walk away.”

Authored by: Pat Anson, Editor

  Subscribe  
newest oldest
Notify of

Opiates/opioids are recognized as extremely effective pain relievers for pain not controlled by non-narcotics. Even the side effects of narcotics such as sedation are useful in pain that may be mild to moderate – like pain experienced after dental surgery. I live with pain on a daily basis, also. My pain is at a fairly high level and effects my mobility. I’ve gone through all of the testing, and tried many pain control methods. I’ve gone through acupuncture, TENS unit, massage, ice and heat, steroid shots (multiple), physical therapy for 2+ consecutive years, two surgeries, non-narcotic prescription medication, ice and heat, acupuncture, nerve blocks, and have had over 12 MRIs … The MRIs always confirm the damage (it’s in my hip) … the steroid injections have never helped even a little, the first surgery made the pain worse and the second was an unsuccessful attempt to fix the damage from the first surgery, the NSAIDs and Celebrex didn’t provide relief and also messed up my digestive system, acupunture and TENS provided relief that was very temporary and transient, ice and heat help but only while they’re being applied, nerve blocks and the Lidoderm patch were ineffective, physical therapy helped build surrounding muscle and gave support but the exercises did some tendon damage … So I don’t even want to hear “there are options other than opiates/opioids that are effective for all pain:. There are non-narcotic pain treatments; but let’s be real: they don’t work or work well enough for many people in chronic pain. I was prescribed an opiate on an “as needed” basis, and felt relief. The PainSpecialist recommended that I try a combination of Tylenol, NSAIDs, a muscle relaxant, and a LA/ER opiate formulation. Saved my life, my job, my functioning – to the point that I withdrew a pending SSDI application. I am fortunate that I have health care providers, facilities, and a pharmacy that don’t make me feel like a junkie. I am treated respectfully. Part of the reason I am treated respectfully is that I take the medication as directed; I am not begging for early renewals or saying my pills were lost or stolen. I keep my meds locked up, and I know the # of pills left. I avoid alcohol and all other non-prescribed drugs. If I am prescribed a medication from another doctor, I tell my Pain Doc to ensure that it’s safe and free of interactions with the narcotic. In short, I accept the responsibility that accompanies having a prescription for controlled substances. It is a two-way street: the prescriber and the patient need to work together WITHOUT INTERFERENCE FROM LEGISLATION OR THE DEA OR THE FDA. Am I addicted? I imagine I would have symptoms if I stopped taking the narcotic abruptly, so if that makes me “addicted”, so be it. But, I don’t engage in the behaviors that most drug addicts do: I don’t manipulate, I don’t lie about my symptoms, I don’t hoard pills or take more than… Read more »

RPh

To Wade Johnson: it is the actions of Sonny May and his cronies at GDNA that are the reason for the pharmacists treating your wife that way. He is not the savior you think he is. While he is harassing pharmacists for following his unwritten rules, he’s also arresting pharmacists for filling prescriptions just like your wife’s. They have gone crazy in Ga.

Christina

Cases need to be brought against the DEA. Maybe with enough cases things will change. At this point what is there to lose? I’m so tired of being treated like a criminal. I didn’t ask for what has happened to me I’m just trying to cope. This crap is ruining peoples lives and families. I can’t understand how humane rights have not been violated. Something needs to be done to stop the suffering of millions of Americas.

rainey

Wade Johnson: It is nobody’s place to deny life saving medical care to another human being. But that is what happens every day in our system. I wish that your story was the only one I have heard. It isn’t. I am glad that your wife was seen and treated. What a horrible ordeal! I hope she gets all the medication she needs, and is able to lead a full life.

The supply shortages won’t help anybody get clean. They will compromise the health of people who are taking them legally and illegally. Opioid withdrawal is more than just uncomfortable: in older people it can be deadly. Blood pressure spikes can lead to stroke.

It is unconscionable that legitimate patients have to be put in the middle. We need a better drug policy. The war on prescription drugs is an absolute failure.

Wade Johnson

This has gotten all too familiar with pretty much everybody who HAS no other choice but to rely on Opioid pain killers just to have even a small sorted quality of life!!!! My wife for instance is a pain patient who has been FORCED to live with the constant pain every day for the past 12 years now!! She has endured as many as 13 abdominal surgeries in as many years!!! Surgery once a year EVEY year because her. Guts kept growing to her abdominal walls being cut off to the point where I would have to stand by and watch the person I love more than my own life go as long as two weeks without being able to have a bowel movement because of her scar tissue was so bad cutting off her bowel to the point of being septic!! The last time.. She had no insurance nor any MEDICAIDE and she was only hours from death and the receptionist at her regular Dr. Who was the reason she was in this condition told me that without paying $100.00 up front she could not be seen!!!! And there had to of been at least 40 women sitting in that office waiting to be seen, and it is like that EVERY SINGLE DAY!!!! I knew how serious this was and I promised her that if she would just have theDr. See her I would get the money some how!!! But NO she couldn’t do it!!! Which is when I EXPLODED!!! And I wasn’t long before the Dr.was out there seeing what was wrong.. She knew me personally, but after doing surgery on my wife 12 times shouldn’t she know me personally at this point??? She ask what was wrong and I told her that my wife was dying and I meant it!! Sherman out to the car and saw how bad it was and she went back I a nd. Ran everyone out then sent us to the ER. WHERE she had scheduled EMERGENCY SURGERY on my wife!!had this not been done RIGHT AWAY, she would have been dead in less than three hours!!! Her bowel was about to burst!! She told me that there were three or more weeks worth of stool in her bowel!!! Her blood had become poison.. She had even began to vomit up her own stool!! And now she can n o longer have surfer unless it is a very veryEmergency situation!! So all she has are the LEGALLY PRESCRIBED PAIN MEDICATIONS PRESCRIBED BY HER PAIN MANAGEMENT DOCTOR THAT SHE HAS BEEN SEEING FOR MORE THAN 10 yrs now!! They worked together and found the right mixture of pain medications that work to keep her pain somewhat at bay, and over the past 10 or more years her medications have not gone up more than 3 pills per month!!! And even though she does have to take a great deal of different opioid pain killers daily… They are Necessary for her to live!!! Over… Read more »

ginbug

Over reacting is an understatement! Here in fl. things have gone from 1 extreme to the other w/ no end in sight! It is bad enough that I live in pain 24/7; but now have to deal w/ all this BS also! It is beyond draining & have been brought to tears by very loud, rude, & uncaring pharmacists for absolutely no reason and I have been lied to & given so many excuses that it is getting hard to tell what is true or not! Imagine the public outcry there would be if this was happening to diabetics or heart patients; but because it is “JUST” pain, no one seems to really care. According to the dea & flood of biased media, we are all just a bunch of drug dealing junkies looking for a high!

While there is abuse going on, it is nowhere near the crisis as the public is being led to believe & certainly not at a level that would warrant or justify this kind of response! This is nothing more than scare tactics being used to continue to justify the huge budget & expenditure of money & resources on the FALSE, USELESS, & COMPLETELY UNWINNABLE “WAR ON DRUGS”!!!