Careful what you ask for !

Heather Papp, with some of the drugs for her multiple autoimmune diseases, says she once traveled to eight pharmacies over two days to fill a prescription.

Prescription painkiller crackdown has gone ‘way too far,’ some doctors believe

http://www.tampabay.com/news/health/prescription-painkiller-crackdown-has-gone-way-too-far-some-doctors-believe/2195678#comments

From the article:

Tampa anesthesiologist Dr. Rafael Miguel helped lead the fight against a surging prescription drug abuse crisis in Florida.

As vice chair of the state’s Board of Medicine, Miguel called for legislative change to stem the flow of drugs that led to thousands of overdose deaths each year.

Eventually, people listened.

Laws tightened. Police stepped up enforcement. And deaths declined by 23 percent from 2010 to 2012.

Miguel now is in a different drug battle — one for more access to narcotics, not less.

The obstacle, Miguel and other doctors report, are pharmacies that are increasingly second-guessing them, asking to see medical records or refusing service.

“They call us sometimes and ask if (a prescription) is medically necessary,” said Miguel, 59, who has a Brandon clinic and teaches pain medicine at the University of South Florida. “Well, if I write a prescription and it’s got my DEA number and my signature on it, what do you think, I’m joking around?”

6 Responses

  1. I’d be curious to know if the rate of suicide has gone up in correlation to the “crackdown ” and legitimate patients being refused medicine. I know in the 7 yrs of pain I never knew existed, while waiting & hoping for natural spine fusion to happen, pain meds just dulled it, I seriously thought if it got any worse, I would take myself out! (it finally did & funny, decreasing the strong opioid meds is happening in tandem with the decrease in pain-explain that, “addiction experts!”

  2. “Laws tightened. Police stepped up enforcement. And deaths declined by 23 percent from 2010 to 2012.”

    Considering the huge amount of increased regulation and enforcement, I’m surprised the decrease was only 23 percent. If the DEA’s strategy is not able to make a better dent in this problem, perhaps it’s time to try something else?

    • Actually, I see a 23 percent reduction as very good. In 2010, Florida was a mess. It was a known script mill, no one out of state was willing to fill prescriptions from Florida as a whole, because we couldn’t separate the good from the bad… It was at the point that no one could trust a Florida Rx. Once Florida started cracking down, a lot of the pill mills moved north, a lot into the Atlanta Georgia area, and we’ve had to deal with them now. We were a little behind, but I think they are finally cracking down on the bad ones…

      In the past 7 days that I worked, I’ve filled over a hundred schedule II controlled substances, I only remember refusing one person because the doc was a pill mill.

      I do agree with the article. I think the the law enforcement is finally getting near where it needs to be, but some of the policies certain chains, and certain pharmacists have are getting a little restrictive. After the Hydrocodone chain to CII, I was one of the few pharmacies in the area that though ahead, and ordered extra. I was doing about 20% of all my prescriptions as CII’s. I will admit, I was a little worried about my ratio, but figured as long as I can defend every Rx as a legit doctor, I’m in the clear.

      I had a person drop off a script for Hydrocodone/APAP 10/325 #90. She had been at multiple pharmacies and no one would fill it. It was always either “we don’t have”, or as one Walgreens told her, we have the drug, but will only dispense to the person it was written for. It was from a legit doctor, she was the adult daughter of the patient, patient had insurance, and had a clean PDMP profile (same doc, correct time between fills). I didn’t see what the issue was, I got a copy of her ID for the record, and filled it without an issue.

      Treat the patient, not the number. That was drilled into me during pharmacy school and rotations, just like you don’t treat based only on lab values, look at the situation. Does it make sense? Is it a doctor you trust? Just fill it already! If the dose is high, and you don’t have a history, tell them you have to verify, call their regular pharmacy and verify that steady increase or long usage. Don’t let the patient suffer just because (if you need to wait a day since they are closed, and wait for them to open, then ok. Their fault for not coming to you first).

      Any pharmacist, after working for a while, should be able to figure out the good scripts from the bad, the pill mills from the legit patients. Don’t let someone legit suffer just because. I do admit, my employer hasn’t been fined by the DEA because they didn’t do their diligence, they put policies in place to protect them selves, but it’s our license, no one else. If you can defend a fill, no one will take it from you.

      • Nationally, heroin deaths are increasing more than the decrease in other opiate deaths.. in 2012 for every 10 FEWER legal drug OD’s there was 15 INCREASE in Heroin OD’s. Since Heroin is metabolized to Morphine by the body .. it is sometimes impossible for toxicology to tell if the OD was Heroin or Morphine. So it is possible that there was a greater decrease in legal drug OD’s and a greater increase OD’s of Heroin

      • “no one out of state was willing to fill prescriptions from Florida”

        I’m confused, why would Florida patients be filling their prescriptions in out-of-state pharmacies?

        It seems to me that Florida was one of the first states where the DEA went hog-wild, and then the fear over “pill mills” was spread to other states — regardless of whether each state actually had a problem with pill mills. And the results of all this activity have caused a serious problem for pain patients.

        So, if 23 percent is the best that Florida can do after all this time… What is the purpose of causing hundreds of thousands of pain patients in Florida to suffer, and also millions of pain patients all over the U.S. — because of what’s happening, or not happening, in Florida? (You know, Florida, the state that elected President Bush.)

        Maybe this percentage would be higher if the DEA’s strategies were actually making the problem better — which would be a new outcome for the DEA. When they make one problem slightly better, they make other problems explode.

        What that 23 percent figure really indicates is that there a small number of people who didn’t overdose, but there are thousands of patients being denied adequate treatment. Thanks, Florida.

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