Unintended consequences of misguided “morally good intentions”?

New DEA rule leaves patients in pain

http://thehill.com/blogs/congress-blog/healthcare/241982-new-dea-rule-leaves-patients-in-pain

My Dad took the term “spring break” literally.

About a month ago, my 61-year-old father fell off a ladder while trimming some trees. After several long hours in the ER, he learned that his leg was severely injured and would require surgery. He was sent home with some painkillers and instructions to call the orthopedic surgeon first thing Monday morning.

After calling the surgeon, my parents learned that they would not see the doctor for almost a week. While the mental pain of waiting was tough, the physical pain was arguably worse. The painkillers given to my father at the hospital would not last that long. To obtain more, he was required to make a trip to the doctor’s office for a prescription. The problem is obvious—“getting to the office” is not an easy proposition when your house has stairs and one leg is nonfunctional.

Had this accident happened a year ago, his doctor could have called the prescription into the pharmacy, where my mother could have picked up the painkillers. This past October, however, the DEA decided to change a variety of painkillers from Schedule III to Schedule II drugs. This change, though seemingly small, requires, among other things, that patients be seen by a doctor before getting a prescription. Prescriptions for Schedule II medications cannot be called or faxed into a pharmacy, and doctors may only write prescriptions for a 30-day quantity.

The shift in scheduling was prompted by a sharp increase in the use and abuse of painkillers in the United States. According to the Centers for Disease Control, enough painkillers were prescribed in 2010 to medicate every adult in America for a straight month. Sales and deaths related to painkillers have increased markedly since 1999.

While these DEA rule changes may sound like a good idea, they result in serious unintended consequences. My father only required one trip to the doctor, but others are less fortunate. Thousands of Americans suffering from chronic pain rely on those drugs to function. The new regulations mean these individuals now face greater difficulties getting their needed medication. In a recent article, the Washington Post reported that the rule is taking a particularly difficult toll on veterans suffering from battlefield injuries like missing limbs and PTSD.

One may argue that having to go to the doctor’s office once a month for a refill is no big deal if it prevents drug abuse. Consider, however, that an average doctor visit costs about $69 out of pocket, assuming the patient has insurance. An individual who could have gone to the doctor twice a year for pain medication may now have to go every month. Assuming he’s charged the average cost of an office visit, he’d pay an extra $690 a year. This extra cost does not include the price of transportation, time taken off work, time spent waiting at the pharmacy, etc. When considering that many people regularly taking painkillers are veterans or other persons on fixed incomes, these costs can be a serious financial strain.

But those in search of pain medications aren’t the only ones who will bear the costs. Since doctors’ offices must now contend with more patients, more appointments, and more paperwork, these changes are likely to increase wait times for all patients.

The debate over drug use in the United States is ongoing. Since the war on drugs began in the 1970s, the U.S. government has played a unending game of “whack-a-mole,” restricting one drug, only to have another drug take its place. Those using prescription painkillers to get high will find other alternatives. The rest of us, however, are stuck with more time at the doctor’s office, higher medical costs, and more difficulty getting medications we need. Those who pay the highest price are the thousands of American men and women who, thanks to the new restrictions, will face an even greater struggle to manage their pain.

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