Turn Your Fear Into Action

Turn Your Fear Into Action

By Suzanne Stewart.

Yes, it’s a sad day when the U.S. government starts messing with the Dr. and patient relationship. Our legislators are not trained in the management of chronic illnesses nor in the management of chronic pain. This is also true for the pharmacy chains. Since when does a “drug store” get to tell a legitimate M.D. that they won’t follow their instructions? The chief medical officer at CVS health says “We have some situations, in which we feel that there are certain  physicians who are prescribing way too high of doses and way too strong of medications,” he said. They are now beginning to limit prespcription opioids. But they don’t have a Dr./patient privilege. They do not know what is wrong with each patient in any given situation, due to that privilege. So I just don’t understand how they are the ones to control this situation?  In my opinion, this is for publicity due to what is happening right now with all of the hype of the so called opioid crisis. There are legitimate avenues for the pharmacy chain to report certain specific physicians about whom they are concerns.  There seems to be no reason to punish the entire medical profession and pain community for the sins of a few.

Suzanne Stewart

The CVS policy is going above and beyond the “VOLUNTARY” recommendations of the CDC guidelines.  These guidelines were given and intended to be only advice for Primary care physicians who treat chronic pain patients.  This is even taking the patient care out of the hands of the trained pain management physicians, in my opinion. In an article in Today, by Charles Shamard M.D., on September 22, 2017, it states that CVS plans to roll out the initiatives to control opioid abuse as of February 1, 2018.

“Daily dosage limits will be based on the strength of the painkiller and CVS pharmacists will require the use of immediate-release formulations of opioids before extended-release opioids are dispensed, lowering the risk of tolerance to the highly addictive drugs”

Stop and take a deep breath, just for a moment.  Think about this logically and clearly for a moment and make sure that you read everything you can get your hands on before you become terribly upset.  I totally and 100% understand why the chronic pain patients and  many physicians in the communities are upset. The government and pharmacies should not be controlling or meddling in these kinds of situations. But if you look closely and think very clearly, this is for new prescriptions. Also, if. You have ever had surgery, the first 7 days are the worst, right? If you need more, then the Dr. may possibly be able to write another one for another 7 days? But in opioid naive persons, a 7 day supply may be alright following a minor surgery? I feel that the surgeon would be the one to know for how long his patient should need to take stronger pain medications. Just try to remember that most of the new guidelines are not for legacy chronic pain patients, who have been doing well on opioids for several years and on steady doses.

This is the time to not over react and not just complain. This is the time to put on your “thinking cap” and get to work.  Find out who your legislators are and send them an email.  It’s super easy to do. You just google your state and add “.gov” after the name of your state.  A list will appear and you can choose who to write to. Go to the link that says “contact” and send them each an email.  You can do it from your bed or your sofa and from inside of your own home. You don’t have to go anyplace or use up much energy. Write something kind and to the point.  Most of them do not know the difference between addiction and dependency.  They are just going along with the mainstream media hype concerning opioids.  You may find that their hearts are in the right place but they just haven’t received any positive information regarding how helpful the opioids can be to some persons with long term chronic pain and chronic pain illnesses. They may not know about how the suicide rate has been rising since all of these restrictions have been put into place.  According to Dr. Stefan Kertez, M.D., “A significant number of chronic pain patients are killing themselves, and that should be a concern to a society at large when people die as a result of something done to care for them.”  These CDC guidelines are not a law. They are “guidelines” and mostly for Primary Care physicians and not legitimate Pain Management Physicians.  But most certainly, I just cannot imagine that they were meant for pharmacy chains.

Suzanne has lived with a Systemic CRPS & several other chronic pain illnesses since a MVA in 2002. Prior to being disabled from chronic pain, she was an Interpreter for the Deaf at a hospital & worked with Deaf children. Since 2005, Suzanne’s been a patient Health advocate, support group leader & Mentor.  She continues doing these things today, but also does public speaking, awareness events and she’s a Writer/blogger & an Ambassador for the U.S. Pain Foundation.  For entertainment she creates advocacy videos & uplifting ASL cover song videos on You tube and she writes in her own blog Tears Of Truth. You can follow her here: TearsofTruth.com

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Authored by: Suzanne Stewart

There are 24 comments for this article
  1. Carol at 5:41 pm

    I lived in Florida USA after their opioid “crisis” was addressed. The situation when we left in early 2016 was dire. Chronic pain patients are out of luck. It is nearly impossible for stage iv cancer patients to get meds for pain, anxiety, you name it. If they are lucky enough to find a doctor who isn’t afraid of the DEA and will prescribe the necessary meds, they have a difficult time finding a pharmacy that will fill the prescription(s)!
    All these people (not doctors) are making treatment decisions for patients without having any idea of the patient’s medical history, conditions, or diseases.
    Patients who have surgeries with long, painful recoveries are just left to suffer. I watched a young friend go through a painful shoulder surgery. There were times when she begged her doctor for something to ease her pain, and was told there was nothing he could do beyond the anti-inflammatory he was giving her. Brutal, right?
    One pain doctor I went to see when we first got to Florida sent his nurse in to tell me that I could go home and go off my meds cold turkey, come back in and he’d treat me. I spoke with my pain specialist back home and was told that a cold turkey withdrawal, if it didn’t kill me, would like cause a psychotic break. So my husband could’ve become a rich man, but this was not the way either of us wanted to go.
    Other states are following in this path, and it’s scary here in the USA. Chronic pain patients, especially, are being penalized by the actions of addicts. And I can’t imagine going through another joint replacement without good pain meds. And I can’t even begin to imagine my quality of life without the medications I take now. Just watching my elderly mother struggle along with insufficient treatment is terrifying.
    What is wrong with this country!

  2. Nyree Petersom at 11:46 am

    This is soooo very WRONG!! Pharmacies ALREADY take to MUCH liberty and denying medication that your Dr. Has prescribed. I am a Chronic Pain patient, I have 8 Failed Back surgeries, titanium rods and screws all down my lumbar, those surgeries with medication was just enough repair to Minimally walk again, DDD, RDS/CRPS, RA, CELIAC DISEASE, NERVE DAMAGE BILATERAL (MEANING BOTH LEGS), and last but not least, SCOLIOSIS…
    My current pain Dr., and has been now for the past six years, practically saved my life by installing a pump INSIDE ME, to be able to deliver medication directly to the nerves, this kept me from having to be on so many medications just to survive, and getting rid of all the side effects. Even with the pump, break through pain was controlled by prescribed opiod medicine. It’s a whole whopping 3 pills a day, if you consider that addicted you are sadly mistaken! After sooo many years, since I was 17, with a broken back, I’m 44 now, I like many other CPP’s, due to years of needing the medication to survive begins to develop tolerances to the medication that MUST be changed from time to time to keep from being tolerated to it…Do you really want to promote and start suicides with the purchase of illegally obtained medicine from the streets? That medication, ie: Fentanyl, and heroin, is dosed and killing people that are NOT CHRONIC PAIN VICTIMS!! We do EVERYTHING we possibly can to
    STAY ALIVE at least and be around our families and watch our kids grow up! It’s already hard enough to sit there Pretending that were OK! We’re not! We need our Dr.s, and our Dr’s are just trying to help keep people ALIVE! You are treating us like were drug seeking, getting involved in patient/Dr. Confidentiality and their diseases, in no way is it OK for pharmacies to over ride our Dr’s decision on how their going to treat their patients! This soooo very wrong! Check your data before making assumptions, btw, I know now of 3 Chronic pain patients that now have commited suicide, because of YOU PEOPLE already interfering and causing many Dr’s to DROP their Patients!!

  3. Rita KIMBEL at 7:59 am

    If I could get a response from any one of the letters I’ve written this year
    Letters asking for help with questions I have about the CDC milligram requirements.
    Letters about how horrible it feels to be kicked to the curb all of a sudden by the pharmacy denials on my scripts for pain meds.
    Letters stating how the cost of pain management has tripled for me since January 1st. And on and on, problem is, even if you ask for a reply, I’ve got nothing from any one of them. Today I ask for local Fox 29 TV to do a story on how all of this opiate epidemic has affected the other side. Chronic pain is serious stuff, not to be taken lightly it can be fatal. I wonder if they will respond. We’re all being labeled if we use a prescription opiate we are now being shamed by family and friends as being the cause of the epidemic. Commercials on TV and now reporters involved we should be involved too. Get in touch with your local stations and ask if they’ll cover the issue from both sides

  4. Margo Billeaudeaux at 12:25 pm

    Jane you have got to be kidding me! CVS was not policing their own employees with opioid medication? I know there are extreme measures taken in every pharmacy when dosing these drugs, this surprised me. But, never say never, right? I am concerned, very concerned that instances such as with CVS restricting dosage to their customers will just get worse elsewhere. Since when though, does a store, a fricking store, decide over a physician’s orders for a patient, and they themselves dictate the dosage and length of time a medication is prescribed. I always thought doctors were right there next to God, not CVS!
    Write, call, email your lawmakers NOW.

  5. Ken at 4:08 pm

    Pain Patients need an Organization or Group that will help organize them and their efforts.There is power in numbers. Folks are going to be surprised in Jan when Insurnace companies adopt DCD guidelines! have to act if possible before then! EVERYONE should be writing everyone in power or elected office. need a Celebrity Spokesperson? Need to Demonstrate NOW before Jan so elected officials know what is coming thier way!

  6. JENNIFER at 10:56 am

    Following and speechless…. Jaw joints locked shut from the joint dislocated-disabled, and this nonsense.

  7. Jane at 1:29 pm

    CVS’s new policy is based at least in part on the fact that they were not policing themselves and their employees. CVS was fined for not reporting theft of opioids by employees. Rather than address the actual problem — diversion by pharmacy workers — head on, they decided to create the appearance of doing something with this new policy. The solution is not relevant to the problem. I call on CVS to require opioid non-abuse and non-diversion contracts for all employees who have authorized or unauthorized access to opioids, including but not limited to pharmacists, pharmacy techs, clerks, cashiers, receiving personnel, janitors, mangers and especially officers, directors and the CEO who announced the policy, and to require monthly, random urine drug screens performed by a third party to monitor diversion. Positive opioid tests should be met with immediate dismissal, just as patients are dismissed from pain treatment for positive drug test results. Further, since diversion from a pharmacy is a crime, positive results should be promptly reported to the local police, DEA and state pharmacy licensing boards. Perhaps the treat of treating the actual criminals in this situation as the criminals they are, will give CVS pause to reconsider its role in the “opioid crisis” and behave toward patients with the compassion incumbent upon their occupations. If you agree with me, write to CVS, post on their social media pages, and write or call the pharmacy and medical boards in your state.

  8. Lisa Hess at 8:22 am

    This is a travesty from a company that already has so many management problems in their pharmaceutical departments. No matter which CVS I would bring my prescriptions to, something would always hold them up. The final straw that caused me to stop going to CVS several years ago was that they were so crazed in their pharmacy department they lost my pain prescriptions, not once but twice. What it took for me to get new ones was a nightmare within itself. CVS wanted me to contact my PM doctor to tell him they lost my scripts, and I told them that my doctor would not create new prescriptions on my say so, they had to call for me to get new prescriptions and I had to travel three towns away to pick up the new prescriptions, and CVS had to find the originals and when they did I had to deliver them back to the PM office three towns away. Just about when the news broke out about the 5-7 day limits on opioid prescriptions, Larry Merlo, CEO of CVS, has cashed in $20M worth of CVS stock in September. My prediction is that not long after this policy rolls out in February 2018, CVS’ stores will begin closing from lack of business. I’m a consumer who does my shopping for other things while I wait for my prescriptions, but if I’m not going to a pharmacy for a prescription, I buy at Walmart or Target. So, CVS will lose money both ways. Lack of wanting to go every week to get a prescriptions filled and lack of consumer shopping. I don’t know if this was a “we will make more money from weekly co-pays vs. monthly, but, I think people are going to turn their backs on CVS just as CVS has turned their backs on people in need. They lost billions of dollars when they stopped selling tobacco products and everyone thought that was a great initiative for smokers to quit and they stayed in business even with the huge loss. This however, I think will sink their sailing ship.

  9. Mark Ibsen MD at 1:40 pm

    “Since when does a “drug store” get to tell a legitimate M.D. that they won’t follow their instructions?”

    Since 2014 in my case.
    I inherited numerous patients in pain that year as doctors fled from prescribing, even before the CDC “guidelines”.

    I helped many of these patients wean off opiates, tapering them after they were dropped.

    Some patients failed to wean,
    And improved in each case those who needed the meds really could not function without them.

    CVS did not care about
    Evidence
    Proof
    Or
    My current DEA license in good standing.
    They refused to fill ANY Rx for scheduled meds with my name on them.
    I have yet to find an attorney to take this on,
    But imho this is a direct violation of the Controlled Substance Act.
    The pharmacists stated it was corporate policy.
    CVS corporate claims each pharmacist has a right to refuse any Rx.
    The CSA stars that a pharmacist has a “corresponding responsibility”
    To assure that each Rx is for a legitimate purpose.
    Refusing all of my Rx is a de facto claim that all of my Rx are not legitimate, despite no action against my DEA license.
    Ever.

    Weird, eh?
    Neither my medical board
    Medical association
    Or
    Any Attorney in my state has been willing to advocate for
    Me
    My patients
    Or
    Patients in general by calling out this Catch-22.
    You’re right Suzanne.
    It’s insanity.

  10. Stacey at 1:02 pm

    Anyone thought of how much CVS will benefit from weekly scripts – they will get to collect four co-pays for a month supply of drugs versus one co-pay for the same supply. If co-pay is $10 per script – patients will pay $40 for a 30 day supply versus $10 for the same amount of meds.

    How are these doctors going to be able to handle weekly visits from patients that are post-op and need additional meds during recovery? It’s hard enough as it is to get appointments. Now you also have the increased cost to the patient, and insurance companies, of paying for four MD visits per month instead of one. It also increases the cost of time and travel for a person who is already unwell or to their caregiver, who most likely also works a full-time job.

    This also sets a dangerous precedent that it is okay for pharmacists to determine what is best for the patient, not their own doctor. It may only affect those new to pain meds now, but it will most definitely start to creep into other areas, including chronic pain patients. We must stop this now before it completely spirals out of control!

    There are already many comments addressing the other problematic issues with this – so I will not reiterate. This is wrong on so many levels!!!!

  11. edward Hirsch at 7:55 pm

    I feel like people who have chronic pain are being punished as are physicians and pharmaceutical companies. The massive influx of cheap heroine by the Mexicans is the major cause of deaths. You never hear about this. It’s much more politically correct to attack the people who suffer than the source. I pray that chronic pain suffers will always have the access they need for help

  12. Ken at 9:39 am

    Florida Governor Scott announced it is considering 3 and 7 day limits on Opioids with no talk from elected officials or their staff saying chronic pain patients being treated successfully will be exempt. I agree that we have to write our State and Federal Legislatures. Florida already has some of the strictest Opioid laws in the country. Florida even limits how many “Morphine Equivalents” a particular Pharmacy can obtain making it next to impossible to find a pharmacy to fill your RX’s if you move here or are a new patient. With CVS now limiting opioids and playing Doctor there is no place for thier patients to go to fill thier RX’s.The “Mom and Pops are all at their dosage limits.Telling patients “most” being treated successfully with opioids “will be exempt” makes most of those patients complacent and they will not write thier Reps. Believe me. I have seen or heard nothing saying Florida’s proposed laws will have any exemptions. Please elaborate who or what you’re referring to when you are talking about exemptions. The Elected officials here in Florida will only listen to Constituents or the Media so it is critical that even Patients Being treated successfully long term write thier State Reps.Especially with no talk of exemptions. It makes common sense long term patients should be exempt but Florida legislature has not exhibited any “common Sense” to date regarding the Opioid Hysteria. One Florida Legislature whose Sister owned a Pharmacy tried to raise Pharmacy limits and was rebuked by his associates even after Florida’s Major Paper wrote an Op-Ed saying “The Pendulum has swung to far”. That was 5 years ago. That Op-Ed has since been removed from the papers website.Thank you.

  13. Kathy C at 1:43 pm

    I stopped going to CVS years ago. I got tired of wading through the Alcoholics, and Panhandlers, just to enter the Store!

  14. Cora at 11:41 am

    Thank you for a very informative article. I too am trying to advocate for our cause, however all it’s gotten me is mistreatment from my doctors. I don’t even bring up my pain when I see my doctor. I just pacifly answer her questions and I have to watch the words I use and not be emotional at all. For my pain she wants me to give her oneHer agenda is purely to stop all my medication and she has told me as much. I should find a new doctor but I’ve been looking for a year already. It’s very difficult to be suffering and have to fight for our rights at the same time, but fight we must. I just have to draw from the person I was before chronic pain if I can just find her…..

  15. Barb R at 8:33 am

    P. S. I also have to make a monthly office visit for 1 med. it’s an inconvenience but I’m managing for now. It used to be easier to get my refills and I resent the new restrictions. One good thing about my Safeway Pharmacy is that they deliver n/c to your home. I have many complaints about the store itself but the pharmacy employees & service are Top Notch!! They’ve improved tremendously over the past couple of years. I hope you have options and start boycotting CVS!!! Action speaks louder than words. Patients with Humana can mail you the meds also — they are very helpful to patients. Let’s take our business away from CVS and hit them where it hurts!!

  16. Barb R at 8:16 am

    I now know how fortunate I am in managing my Chronic Pain. I’ve NEEDED pain meds for over 11 years and have had different doctors and pharmacies. A few ‘pain mngmnt’ doctors weren’t sympathetic (paranoid?) but FINALLY I have a wonderful Primary and excellent NP. My local CA. Safeway (aka Vons in SoCal) has a small but patient-oriented Pharm with smart cooperative pharmacist and associates. I’m glad the previous pharmacist has moved on — he started to try controlling my USUAL meds & dosages; once he refused to fill one regular med and my Dr. had to intervene. This screw up caused me tremendous anxiety and anger! I can’t imagine others who have this distressing experience on a regular basis being able to improve their lives and manage their stress levels!! One of my Dr’s was recently horrified by my regular opioid use (rather suddenly after years of treating my chronic back pain with injections!) and said he’d NEVER prescribe such dosages for me! He outright shamed me! Then said “I care about you and you have to make a change — try medical marijuana!” Well I have and it didn’t help me and cost too much. Wealthy Dr’s. have NO CONCEPT of living with debilitating chronic pain and a seriously limited budget.
    One more piece of info: our county (CA central coast) has for several years been blasting citizens with the “War on Opioids” movement; my NP is appalled but she has talked candidly with me about the cause for the relentless and mysterious cause behind this “War”. There are individuals and corporate entities trying to establish their highly lucrative “Drug Treatment Centers” in our area. They have grouped legitimate pain patients with illicit drug abusers; our hospitals recently installed a system to track people who are doctor shopping and making regular ER visits to get more narcotics. This makes sense to me and really should be the ONLY weapon allowed to fight their “War”. Meanwhile the DEA and local LE are failing to eliminate the real problem of street drugs and the attendant crimes resulting from the increased “getting High” drug dealing and usage. Yes!! Something is VERY WRONG WITH THIS PICTURE!! I’m constantly anxious that one day soon my kind empathetic smart heath providers will be forced to restrict their informed prescribing of pain medications. It seems that nothing good lasts in our Land of Freedom.

  17. M. Billeaudeaux at 7:57 am

    Suzanne, thank you for this article. I also read with surprise the CVS decision. I also asked the same questions as you, how in the world does a pharmacy feel they should start being the patient’s best provider for treatment, and I also totally agree with your statement this is not the time to complain but to act and act quickly. The only recourse we have is to write or call our legislatures. If each and every one of us does so, maybe they will hear us. Afterall, we are facing our own crisis. I am afraid. Pain medication saved my life, not destroy it.
    Write, email, call your local congressman/woman, representatives now before it’s too late for us.

  18. Carla Cheshire at 7:33 am

    I will never go back to CVS, they are the worst pharmacy. I was a part-time Florida resident (winter) the pharmacist refused to fill my out of state prescription for pain medication. The pharmacist never called my doctor, gave me a lecture on how Obama was ruining our medical system then told me I need to get a Florida doctor even as I had an established record of filling monthly prescriptions from the CVS in my hometown, dating back years.

    I called the CVS corporate office and was told, “The pharmacist is free to make his own decisions regarding the filling of prescriptions.” I will not shop at CVS and I urge other CP patients to do likewise.

  19. Rebecca S Waskom at 7:19 am

    I just do not understand the whole deal when the “officials” link us legitimate pain patients into the bogus opioid crisis. I am not saying people are not dying but when you really break the numbers down responsibly you find that they are not portraying it truthfully! Anyway, yes our healthcare and our prescriptions should be strictly between us and our doctor and the pharmacy has no right to strong-arm their way in between that private relationship!!

  20. Kristen K at 6:30 am

    This news is very disturbing! I saw on my local news but also heard that this will not effect those of us who have been on pain meds for more than a year for chronic pain.It was my understanding these soon to be guidelines are for new patients and for those who had surgery.I happen to get all my medications from CVS which I have been for years and I have some issues with them, one is after being on the same medication for 6 years now, all of a sudden they called my Dr and said they feel as though it’s too much.That being said What took them all these years to contact my Dr!? My Dr got upsett with them because she prescribes by the guidelines so she cut my dose from 30 to 10 a month to get them off her back.By the way they called 3 times! As of today she has put me back on the 30.My other issue is when I went to pick up my medication at the drive through the pharmacy assistant said the pharmacist would like to speak with you for a minute about your medication and the side effects.I said no because I have been on this pain med also for 6 years. I think by now im aware of the side effects that could occur by the way im on 3 meds for pain all for 6 years.I find CVS is putting there nose into everyones bussiness.I personally feel like they are all Bully’s there.They have no clue why each patient is prescribed pain meds and frankly it’s none of there bussiness.Let the Doctors do their jobs and they should stick to doing what their suppose to do.I crindge every month when I go pick up my scripts.I have had it with all these guidelines.I should also mention that CVS is going to be offering a program of some sorts for those who are on opiates. Makes me wonder are they directing this at the people who are on these meds for medical issues that take them responsible or the people who do them illegally?That was never clarified on the news.I am glad Suzanne brought this issue up and after I finish writting here im going to email our Governor.

  21. Kevin at 6:06 am

    Oh why those hypocrites, 2 of the CVS outlets in Florida were recently raided by the DEA and shut down for filling too many opioid pain medication prescriptions

  22. Linda at 3:51 am

    What about all the poor people who are not legacy patients, but one day will be in the same pain we are, and worse? Shouldn’t our future chronic pain sufferers be awarded the same?

    Not that it’s making that much difference anyway. But wow, thank heaven I can still get 3 month refills on my opiod prescriptions. To do it once a month would be rough because I am disabled and live an hour away from my doctor, and the “paper” prescription.

    But to go down to every 7 days…
    to have to see your doctor for that piece of paper, or to have to go to the pharmacy that often?

    It’s all just insanity.

    I have to pay someone to pick up my meds when they’re ready and they charge me $40 for the trip. (Gas, driving 2 hours, and the major hassle at the pharmacy) .

    I am blessed. I just feel so bad for others who suffer in so many ways that never get talked about.

    How about the gunshot victim being released from the hospital, recovering from torn up bones and internal parts. It’s obvious this victim is going to be in much pain for quite some time, yet others, if they have others, are supposed to to be victimized again when they have to go through more hell over getting their pain managed. A huge huge huge struggle!

    And it’s only getting worse.

    Shame on CVS yeah, they’re obviously being managed by another very ignorant person. The stupidity that surrounds this whole made up crisis just blows my mind.

    And I used to think smart people worked these high powered jobs in our government many moon’s ago.

    Boy did I have on rose colored glasses.

    For now ignorance reigns.
    God willing, not for long, save the life that God gave breath to.
    We must keep doing our part. Keep writing to our representatives.

  23. Tim Mason at 3:48 am

    My last Rx for fentanyl patch had my ICD 9 code listed on the Rx. Post laminectomy syndrome with adhesive arachnoiditis. This adds validity to the prescriptions that I get. I have a very good pain management physician. He recognizes the CDC guidelines for what they are GUIDELINES not rules. Also, going forward I reviewed the Medicare booklet and it removes step therapy for those people that can demonstrate a legitimate need for opioids at a level above 90 morphine equivalent value.

  24. Rachel at 3:46 am

    My excellent & highly experienced UK Orthopaedic Physician told me the actual risk of opiates addiction for pain patients is 1 in 3000. The risk of instant death from NSAIDS is 1:1400. Use the proper definition of addiction everyone it is ‘committing crime to obtain the drug’. Otherwise it’s dependency which any opiate patient is ie would have withdrawal symptoms if stopped drug suddenly. Also use PALLIATIVE CARE FOR LIFE do talk about pain treatment. That is what my Anaesthetist calls it. Will get much more public sympathy.

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