Some chronic pain patients, particularly in Florida, are finding it difficult to fill their oxycodone prescriptions at their local pharmacies. Pharmacists are telling them they don't have any oxycodone. But is that true? Maybe, maybe not.
Technically, according to the DEA, there is no shortage of oxycodone. Pharmaceutical companies are producing it at normal levels. What is in short supply are pharmacists who are willing and able to fill your prescription.
Here's the Story...
Florida has had a huge problem with unscrupulous doctors prescribing and often also dispensing large quantities of opioids, primarily oxycodone, from storefront operations commonly called “pill mills.” According to a 2011 NPR report, doctors in Florida were prescribing 10 times more oxycodone than all the other U.S. states combined.
In an effort to curb this oxy epidemic, the DEA began cracking down not only on Florida doctors, but also on pharmacies and wholesale drug distributors in the state. Earlier this year, they suspended Cardinal Health, the nation's second-largest drug distributor, from selling and shipping controlled substances from it's Lakeland, Florida facility for two years. They also suspended the controlled substances licenses of two CVS pharmacies in Sanford, Florida. The reason for the suspensions in both cases was for selling excessive amounts of oxycodone.
A Chilling Effect
While the primary focus of this crackdown was Florida, the DEA actions have had a chilling effect on pharmacies and distributors in some other states as well. For example, the DEA's enforcement actions have reportedly tightened the distribution supply. And some pharmacies are choosing not to carry oxycodone and other controlled substances at all.
Basically, these actions have a trickle-down effect. At each level, companies and individuals are required to monitor and report problems down the line.
Distributors are expected to monitor, report and even cut off pharmacies who order too many opioids.
Pharmacies are expected to monitor, report and even refuse to fill prescriptions from doctors who prescribe too many opioids.
Pharmacists are also expected to evaluate patients and refuse to fill prescriptions for opioids if they suspect something is not quite right.
It's no wonder doctors are deciding not to prescribe and pharmacies are deciding not to sell opioid pain killers. It's just not worth the risk for them.
But where does that leave chronic pain patients? Officials say their actions are not meant to harm legitimate pain patients. They say their only purpose is to cut down on drug abuse. But the fact is, their actions sometimes do harm us – a lot. Every time a doctor or pharmacy decides it's too risky or too much trouble to prescribe or sell opioid medications, chronic pain patients suffer. Simply put, chronic pain patients are collateral damage in the war on drugs.
Back to my initial question – if your pharmacist tells you they don't have any oxycodone, are they telling you the truth?
Amy Pavuk, a reporter with the Orlando Sentinal, spoke with Paul Doering, a professor at the University of Florida's College of Pharmacy. He told her that when pharmacists can't or are not comfortable filling a prescription, they take the path of least resistance. "They will simply wash their hands of the situation by saying 'I'm sorry, we don't have this,' Doering said, “Whether you do or don't have it, [the customer] will never know."
What You Can Do
Although there is no way to guarantee you won't find yourself in this situation, there are a few things you can do that may help minimize the possibility.
If possible, use only one pharmacy for all of your prescriptions.
Be honest about your medical and prescription history. Pharmacists can check your prescription history in your state's prescription-drug-monitoring database. If they find that you've been dishonest, you will become suspect and they may refuse to fill your prescription.
Get to know your pharmacist and let him/her get to know you. This is often easier to do with a small, privately-owned pharmacy rather than a big chain pharmacy.
Watch your refill dates and don't try to refill an opioid medication early. It will only raise suspicions – and you won't get your medication early. Refills of controlled substances are strictly regulated.
Have you had trouble filling a prescription for oxycodone in the past year? (There was a true oxycodone shortage in 2009 but that was not related to this current problem.) If so, what did your pharmacist tell you? Do you live in Florida or another state?