Pill mill crackdown having unintended consequences for pain patients who can’t get pain pills
WEST PALM BEACH, Fla. – “I have two fractures of the shoulder,” Jackie Larson said.
Larson’s shoulder is in a sling.
“There was a severe pain. I couldn’t move the arm at all,” explained Larson.
The emergency room prescribed oxycodone, but getting the pain killer turned into an even more painful experience.
“They would simply tell me it’s not in stock,” Larson said. “They wouldn’t order it. You get exasperated at that point and they just stand there with a stoic face telling you it’s no, no, no.”
Larson went to not one, but 14 different pharmacies.
“That’s when I was angry. Let’s put it that way. I was standing there in pain,” explained Larson.
Larson is not alone.
“I am in torture. My son has to see me in pain and it’s not fair. It’s not right,” explained Maria Phipps.
Phipps said it’s hard to get comfortable.
“This is where I am most of my life,” Phipps said as she cried in bed.
Hydrocodone is the only thing that takes the edge off. She’s forced to ration it, unable to get enough control of her pain.
“I understand there were pill mills and people overdosed and died, but I didn’t do any of that. I actually need the pain meds,” explained Phipps.
“Do you think you’ve turned away legitimate patients in pain?” Strathman asked pharmacist Michael Corbin.
“Yes,” Corbin explained.
Corbin is the owner of Kings Health Mart Pharmacy and said he denies 50% of the pain prescriptions presented at his counter. He said he has no choice.
“If the pharmacist doesn’t do a very diligent job in a fairly short period of them they can lose their license or be fined,” explained Corbin.
The Drug Enforcement Administration or DEA has cracked down on pharmacies to fight pill mills. Two years ago, Walgreens Jupiter distribution center and six stores were part of a record $80 million settlement with the DEA for filling suspicious drug orders.
The Jupiter distributor was the largest supplier of oxycodone in the state.
“Sometimes the chains have knee jerk reactions to bad press and cut people off,” explained Corbin.
As an independent pharmacist Corbin is still feeling the impact.
“The shortages in a way are artificial,” Corbin said.
Corbin says distributors have cut back, and only supply a limited quantity.
“Somewhere around 16% of your total purchases can be controlled substances,” Corbin explained.
So who sets these limits?
“A lot of people are blaming us,” explained James F. DiCaprio, Assistant Special Agent in Charge at the DEA Tampa District Office.
DiCaprio said the DEA is not the problem.
“We don’t control how much they distribute for legitimate reasons,” DiCaprio explained.
So the agency won’t be fixing this problem.
“We don’t want to overreach and get involved in a process we shouldn’t be involved in,” explained DiCaprio.
Until someone fixes the problem, pharmacists said they’ll continue making judgment calls at the counter.
“The first thing we do is check the Florida database to see what prescriptions a patient has been using from every pharmacy and ever doctor in the state,” explained Corbin.
The database is free.
“It makes no sense that it’s not being used,” Corbin said.
Corbin feels if it was used more it would stop addicts from getting pills, but allow people who need painkillers to get them.
“We are supposed to be innocent until proven guilty in this country and I am being treated as if I already am a criminal,” explained Larson.
The American Medical Association said this is a complex problem that requires a multi-tiered approach to deal with it. They feel the focus should be on education for patients and physicians, increased access to treatment programs and access to lifesaving overdose prevention medication.
If you need pain medication here’s some Watchdog Wisdom to get it filled faster:
1. Only go to one doctor
2. Form a relationship with one pharmacy
3. Don’t call ahead
4. Don’t fill the prescription it before it’s time
With Walgreens, the drug store admitted to the New Hampshire Medical Society that there is no need to go from one Walgreens pharmacy to another. “If one Walgreens pharmacist refuses a specific prescription for an opiod for a patient, that prescription will be refused at all Walgreens pharmacies, as it has been entered into our system as ‘refused.'”
Walgreens said in a statement, “With the sharp rise in abuse of controlled substances in recent years, health care professionals in all practices are continuously striving to find better ways of ensuring those medications are used only for legitimate medical purposes. We are working to ensure our patients continue to have access to the medications they need while fulfilling our role in reducing potential abuse and misuse of controlled substances. We firmly believe that addressing prescription drug abuse will require all parties — including leaders in the community, physicians, distributors and regulators — to play a role in findings solutions to combatting abuse and misuse while balancing patient access to critical care.”
Filed under: General Problems
I am no legal whiz but why don’t pharmacists consult with some good attorneys? The defense? The doctors have to have a current and valid DEA registration # In order to write an Rx for a controlled medication. How are pharmacists supposed to know more than the Agency who gives doctors the license to prescribe the meds in the first place?
If anyone should be the ‘last line of defense’ it should be the regulatory agency, not some pharmacist who sees a customer for 5 minutes if he/she’s lucky. The DEA has an unlimited amount of time and w/ an obscene amount of resources in appropriations, fines, and asset seizures, there should be NO excuse NOT to shut these ‘rogue doctors’ down.
Is it too obvious? I mean its simple really, if the patient/customer did not show up on the PDMP as an abuser/’shopper’, had a valid ID, the doctor’s Rx had a valid and currently active DEA# so the RPh filled it, end of story. Am I missing something here? I mean who has the badge and authority in this whole process? Who is positioned best to straighten the situation out? I feel like we are in an episode of the Twilight Zone. Do-do-do-do-do-do-do………….
JMO, but as far as the ‘pill mills’ go? There is no way in h*** the DEA can claim ignorance of the situation. When you had ‘customers’ coming from as far away as Massachusetts and Kentucky, and dopers dropping like flies of ODs, how do you miss something like that? It is of my opinion that they let that situation fester as long as possible in order to have a mission to fall back on once they lost the battle over marijuana (the writing was on the wall).And long enough until pain management was synonymous with addiction in the eyes of the public. Job security, bottom line.
My heart goes out to those patients who are newly diagnosed and who have yet to established a ‘relationship’ w/ a pharmacy. On the news report they make it sound so easy, kinda hard when they turn away every ‘stranger’.
“What we have here is a FAILURE to communicate” Cool Hand Luke. Paul Newman movie in 1969. About the incarceration of a prisoner who couldn’t get much justice. “Warden, I wish you’d just not be so good to me”
“Corbin feels if it was used more it would stop addicts from getting pills, but allow people who need painkillers to get them.”
For one thing, some drug addicts actually need “pills” to manage their illness, just like pain patients need “pills” to manage theirs.
And a lot of people have faith in the PDMPs, but so far, in the states where they’re being heavily used, they haven’t proven to help pain patients at all.
But then, why would a blacklist of pain patients help anyone but law enforcement? Don’t forget, everyone prescribed certain drugs is included in this database, not just the abusers and bad actors.
I suppose the PDMPs also help doctors and pharmacists stay out of trouble with the DEA. But I haven’t seen anything that would suggest PDMPs help pain patients.