Prescription for Pain: Patients denied medication

JACKSONVILLE, Fla. — A public health crisis in Florida has been created by shutting down the state’s pill mills. Patients with legitimate doctor prescriptions for pain medicine are now routinely turned away at pharmacies.

They aren’t drug addicts. They are regular people who are suffering from chronic pain, some even battling cancer. Some are hospice patients.

First Coast News started investigating this in 2013 and since then the problem has only gotten worse. Local doctors and pharmacists say it has become its own public health crisis and has even lead some to commit suicide.

“This last time when they told me they had to validate my medication I was just upset. Every month I go through this, and it’s just unfair,” said David Johnson.

Johnson is one of countless Floridians living with chronic pain. For the past decade he says he’s has been battling an autoimmune disease that makes life without pain medication practically unbearable.

“Essentially my body thinks I’m a foreign invader and attacks my tissues,” said Johnson. “I have pain that goes basically all the way down the legs.”

Two of the medications he takes are controlled substances, and while he has legitimate prescriptions prescribed by his doctor, he says getting them filled has become a nightmare.

“The worst time I ever had I had to go to 12 pharmacies in one day.”

On more than one occasion he says he has gone through withdrawal.

Dr Sanford Silverman: “There is a tremendous amount of finger pointing going back and forth. The DEA has maintained publicly they do not restrict any of these substances and this is not something they are involved with or intend to do, and that has been their policy all along. We hear from the pharmacists that is not true… The patients pay for it, and patients have died.”

Dr. Silverman, with the Florida Society of Interventional Pain Physicians, says the problem started about two years ago. He says legislation essentially put pill mills out of business but also caused collateral damage.

“I think it’s become a real public health crisis,” said Dr. Silverman.

Dr. Mark Rubenstein with the Florida Medical Association has testified on behalf of the DEA in pill mill cases.

“What has happened is from trying to eliminate pill mills and from trying to curb opioid abuse, overdose deaths, problems with drug diversion through all these regulations, now the pendulum has shifted other way where we are having true access problem for patients who have legitimate medical needs.”

It’s a conversation Jacksonville pharmacist Bill Napier, owner of Panama Pharmacy, says he has every day with patients.

“We will regularly have maybe 30 people a day who we can’t fill prescriptions for,” said Napier. “We had two patients I know of who got tired of the battle and committed suicide…I know the DEA says they don’t set any quotas. My wholesaler says they set quotas in response to DEA pressure”

Napier says he is now having to ration medication.

“As pharmacists we are supposed to help people solve their problems, help their healthcare, not ration medication. That’s what we are doing now, rationing all controlled substances.”

Under pressure from the DEA he says he created a nine item checklist to decide whose prescriptions his pharmacy can fill.

“It’s just continuously gotten tighter and tighter on the supply side from the wholesaler. Only 20 percent of my medicines can be controlled substances.”

At his pharmacy in order to get a prescription for a controlled substance like morphine, oxycodone or hydrocodone filled you must be over the age of 35, undergo a criminal background check and your doctor must be vetted.

“If it’s a new patient, say they have a new cancer, well they are just out of luck,” said Napier. “Especially towards the end of the month I have a lot of people say my pharmacy is out of it, and I try to explain every pharmacy is out of it because every pharmacy has a quota. Once you meet a quota you are done.”

Special Agent Mia Ro with the DEA’s Miami Field Division says the DEA is aware of the problem and concerned, and even its own agents have been denied pain medication at pharmacies.

“I wish we could say there is an easy answer, but we really don’t know why legitimate patients, such as terminally ill patients and cancer patients are not able to get their prescriptions filled,” said Special Agent Ro.

Ro is adamant the DEA does not set quotas for how much a distributor can sell to a pharmacy or how much a pharmacy can purchase from the wholesaler.

“I think the DEA has become a convenient excuse for many pharmacies not to fill prescriptions,” said Ro. “I want pharmacies to know they don’t have to fear the DEA for doing their jobs for filling legitimate patient’s prescriptions.”

Congresswoman Corrine Brown says she wants answers.

“I have written a letter to the DEA and asked them, let’s have a workshop. First Coast, let’s bring the doctors and industry and you tell us what you can and can’t do. No response. This is over 6 months. Unacceptable.”

Congresswoman Brown says she is going to ask House leadership to have hearing to address the problem.

“DEA has been the least responsive agency I have worked with in my entire career. We have gone to the extreme. We don’t want pill mills, but we want people who have legitimate needs to be filled. Period.”

Anchor Heather Crawford asked Brown, “Do you believe this is a public health crisis?”

“Absolutely and people who are in hospice can’t get their medication. What is that? Totally not acceptable. This is not the law. This is DEA’s interpretation.”

“Part of the problem is the DEA is not only a law enforcement agency, but they are also a regulatory body so they have an unprecedented amount of power,” said Johnson.

Johnson is now on a mission to fight for patient’s rights. He created the website paincareislegal.com and within a few weeks already has hundreds of supporters. He’s urging supporters to sign a petition he started to get the White House to address the problem.

“They should spend just one say in pain and withdrawal to know what it’s like for people like me that have to go through that,” said Johnson.

We want to know if you’ve had trouble getting your prescriptions filled. Use #MedsDenied to join in on the conversation on the First Coast News Facebook page or tweet us on @fcn2go.

Filed under: General Problems