When Government Calls the Shots: Pharmacists and Pain Management

By Baker, Kenneth R. | Drug Topics, February 2014 | Go to article overview

When Government Calls the Shots: Pharmacists and Pain Management


Baker, Kenneth R., Drug Topics


ETHICAL DECISION-MAKING IN PHARMACY

Pharmacist have a tough job, and over the last year it has gotten tougher. Caring pharmacists and suffering patients are feeling the effects. Pharmacists are being pressured into a "Do not fill" attitude toward often legitimate pain treatments.

Patients rebuffed

Colleen Sullivan is a columnist. She is also a patient. Colleen suffers from muscular dystrophy, rheumatoid arthritis, scleroderma, mixed connective tissue disease, and other autoimmune-related disorders. She is constantly in pain.

In an article titled "My Story: Humiliated by a Pharmacist, "published in the National Pain Report, she relates a series of events that began with the refusal of her regular pharmacist to fill her oxycodone prescription because "it's too soon."1 (This because the physician erred in writing "Take 1 q 4h" instead of "Take 1 to 2 every 4 hours pm pain.") Then, giving Colleen what she described as a "You are a junkie" look, the pharmacist called other pharmacies in the area, after which they all refused to fill Colleen's pain prescription. The story ends with Colleen in tears.

One pharmacy customer, who asked not to be identified, told a reporter for WTHR television in Indianapolis that because of a new pharmacy policy, his prescription for pain medication, which usually had taken only a few minutes to fill, now takes three and a half days. As a result, the patient, who "suffers from a debilitating combination of multiple sclerosis, fibromyalgia, and peripheral neuropathy," ran out of his pain medication.2

In another case, a mother who takes pain medications because of blood clots in her legs was turned away without her pain prescription by her local pharmacist, who gave no reason for the refusal.2

The pharmacy police

Although not completely blameless, pharmacists have been forced into taking a policeman's attitude by an overly aggressive federal government. The pharmacy industry has been intimidated into compliance.

While leaving intact the medical licenses and DEA permits of doctors it suspects of operating "pill mills," the government pressures pharmacists to refuse to fill Rxs written by those very same doctors.3

With presumed good intentions of addressing a real problem of nonmedical use of prescription drugs, particularly opioids, by illegitimate drug-seekers, the federal government has forced pharmacies into adopting policies that result in denial to patients of prescriptions written for legitimate medical purposes. …

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