Dear Steve: My wife has been a chronic pain patient for over 20 years. We live in Florida and after using the same large pharmacy chain for years we were told they could not fill her prescriptions for oxycodone or OxyContin any longer.
Why are legitimate chronic pain patients who have been on these meds for years being treated like they are the criminals? Why are their names reported to the DEA? Why are we asked so many ridiculous probing privacy invading questions? Why do they have the right to say, “I just don’t feel comfortable filling these”?
Clifford & Valerie
I agree with your concern about how legit chronic pain patients are being treated. I know of no other disease that we, as a society, discourage adequate treatment of. In fact, we actually encourage inadequate treatment of chronic pain.
In my opinion, the Drug Enforcement Administration (DEA) is protecting itself from being sued by the American Civil Liberties Union (ACLU) by making statements that they are not causing the pharmacies to do this. The ACLU’s mission is to sue the federal and state governments when they violate the Constitution and abuse people in our society.
I find it quite coincidental that around the same time that the federal budget sequestration started, the DEA started aggressively fining DEA registrants such as pharmacies. The DEA gets to keep the fines they impose to fund their operations.
In fact, the fines imposed seem to be more dependent on the registrant’s ability to pay than the amount of medications found missing.
Generally speaking, pharmacists are allowed to decline to fill a new prescription if it could cause a major drug interaction with an existing medication, the patient is allergic to the new medication, and/or the dose is potentially lethal. Also, under these circumstances, it is normal for the pharmacist to contact the prescriber to work out a solution, not to just turn down the prescription and leave the patient without any therapy.
There is a long complicated story as to why pharmacists believe that they can just turn down a prescription for any – or no – reason. What many pharmacists have not come to realize is that chronic pain patients are covered under the Americans with Disability Act (ADA). Filing an ADA complaint is fairly simple and you do not need an attorney.
Here is an information sheet that you can use to file a complaint:
There is a growing surplus of pharmacists and I suspect that these pharmacists that you are encountering are more fearful of losing their jobs than losing their license. They are just following protocol that their employers have established. Some are probably following them more strictly than others. It would appear that some have taken the stance that it is better to deny a legit patient their necessary medication, than risk getting that first dose in the wrong hands.
This is a battle that only the patient or their advocate can take on. But the good news is that there are laws on the patient’s side, and filing complaints normally involves filling out an online form and/or sending in a certified letter with the complaint.
In my opinion, if a patient is on chronic opiate therapy, they are disabled. File the complaint and let the investigator make a determination. When the pharmacy or pharmacist is fined with an ADA violation, the patient gets to keep the lion’s share of the fine.
When the pharmacy or pharmacist is fined, it also sets them up for a complaint with your state’s Board of Pharmacy for unprofessional conduct.
Depending on how the pharmacist conducts themselves with the patient, there could be a Health Insurance Portability and Accountability Act (HIPAA) violation and a HIPAA complaint could be filed.
I am recommending that patients have someone go along with them to the pharmacy and video the pharmacist/patient interaction from a short distance so that the pharmacy/pharmacist cannot deny what transpired. You can also try and get a copy of the store’s video surveillance videos.
Contrary to what many pharmacists believe, the law is on your side.
Steve Ariens is a retired pharmacist and patient advocate who has a blog called Pharmacist Steve. Steve’s wife is a chronic pain patient.
If you have a question for Steve, send it to AskthePharmacist@nationalpainreport.com.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.