It is an accepted fact that prescription pill abuse is a major problem in Florida. There have been articles mentioning pill mills and talk that cracking down on them has helped fuel the rise of heroin in Florida. Now a great article in the Tampa Bay Times website talks about a growing backlash amongst doctors about "too strict" regulations that are affecting their ability to prescribe these pills to the patients who most need them...
A Tampa doctor who once led the fight to curtail prescription drug abuse and the fatal overdoses that resulted from it, is now on a new crusade. He is wanting to increase the access to the same drugs he once fought to reduce.
Despite an almost 25% decline in prescription pill "OD" deaths in just the past few years, Tampa Dr. Rafael Miguel is now hoping to loosen the same laws he once championed. The reason? Too many pharmacies are now refusing to fill the prescriptions or even questioning the medical professionals as to the necessity of the drugs.
Thanks to the efforts of Doctor Miguel and others like him, the DEA began to fine drug companies and pharmacies for not questioning certain prescriptions. Of course, this has resulted in increased scrutiny towards these prescriptions, even if medically necessary.
This has led to tension between the doctors and pharmacies. The AMA (American Medical Association) has warned pharmacies about refusing to fill prescriptions. Major pharmacies such as Walmart and others have pointed out that they have a duty to exercise care. Said a CVS spokesman "As health care providers on the front lines of health care delivery, our pharmacists use their professional judgment and consider a variety of factors when determining whether a prescription for a controlled substance was issued for a legitimate purpose, which is part of their professional responsibility under state and federal law".
WHile the two groups are arguing, it is the patients that are paying the price. There are horror stories about people with legitimate prescriptions that are being refused service. Stores are using various excuses, such as claiming doctor shopping or that an injured patient lives too far away from the pharmacy.
Now even a Doctor that helped Pinellas County draft an ordinance reducing pill mills thinks things have gotten out of hand. Watching some of her patients who suffer from cancer or severe spinal conditions bounce from pharmacy to pharmacy without success.
"It's crazy," said Dr. Lynne Columbus, the Clearwater doctor who drafted the ordinance. "It's gone way too far to the other side."
Still pharmacies may not be backing down. After Walgreens was hit with an 80 million dollar fine from the DEA for letting oxycodone hit the black market, other pharmacies became even stricter. After a few CVS pharmacies in Florida had their license revoked, many stores stopped carrying controlled substances or kept them in limited amounts.
Now many innocent patients are suffering in pain and unable to get relief.
According to local pharmacist Larry Golbolm, in Florida, pharmacists do not need to justify refusing to fill a prescription. "Pharmacists did not go to school for at least six years to be drug dealers for the highly suspect 'profession' called 'pain management,' " he said. "The ruse on pain management is fully understood by the majority of pharmacists, especially at the chain establishments."
This "war" between reducing prescription pill addiction and helping legitimate patients has produced a few casualties, including a Pinellas woman who committed suicide rather then face her pain after she was unable to get her prescriptions filled.
In another example a late-stage lung cancer patient elected to enter a hospice instead after she was unable to get her prescription filled.
Per Trinity Pain Center owner Christopher Wittmann "If she underwent chemotherapy, she may actually have been able to extend her life by a year, but the option of having a year and being in miserable pain or living two to three months but having her pain controlled was her choice, because there was no guarantee that we could control her pain."
Another unintended consequence of this crackdown is legitimate patients afraid to talk about their medicine and medical condition as they fear looking like drug addicts. Many patients feel defensive even talking about it.
Is there an answer? Unfortunately corporations, like people, respond to consequences. If a company runs the risk of a large fine or even being shut down, they tend to err on the side of caution. This results in many innocent people being put through unnecessary pain and suffering because they cannot get their prescription pills. Now, many of the same doctors who championed stiffer laws to control these substances are surprised that pharmacies are hesitant to fill their prescriptions. Until Pinellas County finds a "third way" between public safety and patient's rights, we will continue to see both prescription pill abuse and innocents suffering.
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