In 2011, Florida lawmakers were right to take steps to combat “pill mills” that were enabling prescription drug abuse. Our state had earned a reputation as a clearinghouse for prescription drugs that were being sold illegally on the black market. Thanks to joint efforts by state and federal law enforcement, working cooperatively with doctors and pharmacists, the number of pill mills and prescription drug abuse incidents are on the decline.
But there is an unfortunate side-effect that is affecting everyday legitimate patients who desperately need pain medicines to treat serious illnesses.
Sadly, it has now become a daily occurrence for doctors like me to receive phone calls from exasperated patients who are suffering and cannot get their prescriptions filled.
Worse, there is no rhyme or reason to who is denied the drugs they need.
A colleague in Miami recently treated a woman with a severe spinal injury, who went to her local pharmacy to get prescription pain medication, but the pharmacist was forced to turn her away because of a shortage — he didn’t have her medication in stock.
That problem was the beginning of a chain of events that underscores the growing prescription pain medication crisis in Florida.
In severe pain and desperate, the woman visited another pharmacy in the same chain, but they refused to fill her prescription because this alternate location was not listed as her “primary pharmacy.”
Over the next three days, and running out of options, she decided to try a different pharmacy chain altogether. They, too, refused to fill her prescription for the same reason: They weren’t her primary pharmacy.
In tears, she called me, her doctor, and I began making phone calls. Problem solved, I thought.
But because of her multiple visits to the pharmacy, and local confusion over state law and guidelines from the federal Drug Enforcement Administration, Mary was viewed under a cloud of suspicion. The pharmacist informed me that it appeared as though Mary was getting her prescriptions filled at “multiple pharmacies.” After I took time to explain the ordeal Mary had gone through over the past few days, the pharmacist finally understood why she had been forced to visit so many different pharmacies. And after taking more time to verify that Mary still hadn’t received her original prescription, she finally received the medicine she desperately needed.
Some pharmacy chains, confused over state law and DEA guidelines, now require pharmacists to ask a battery of questions before filling prescriptions. The interrogation includes questions that sound like they’re coming from a police detective, instead of a pharmacist. Only if all of the answers are satisfactory in the judgment of the pharmacist does the patient finally receive the prescription medication they badly need.
These strict new policies aren’t the result of overzealous pharmacists pretending to be on the TV show “CSI.” They are a response to ambiguous guidelines from the DEA. Pharmacies and suppliers are just trying to avoid having their licenses pulled, and who can blame them?
But now, every time I hand a patient a prescription for pain medication, I fear I am sending them out the door to begin a very frustrating wild goose chase. And I am not alone in this fear.
Across Florida, other doctors are experiencing the same problems. I never thought that I would see the day a colleague would have to make multiple phone calls to pharmacies trying to find a limited quantity of pain medication for an elderly man with metastatic cancer, only to be told by four pharmacies that they do not have what the patient needs. Unfortunately, it’s becoming all too common that patients are forced to go home empty handed. Prior to the passage of the law, patients would simply visit a different pharmacy with the medicines in stock, and go about their daily routine. Unfortunately, that is no longer possible under the new law.
In your lifetime, chances are you will experience an injury or illness that requires medication to manage the pain. But if our state lawmakers don’t do something to fix this crisis for elderly, sick and injured Floridians, you may be the next person who spends days trying to fill a simple prescription and ends up under a cloud of suspicion in the process.
Dr. Lynne Carr-Columbus is president of Gulf Coast Pain Management, based in Clearwater. She is a board-certified anesthesiologist and pain management specialist.