The headlines have been full of raids on “pill mills.” Commentators have been applauding the tough new stance on narcotic pain relievers. But is the crackdown on pain relief really helping more people than they harm? The Drug Enforcement Administration says yes. But many pharmacists and the patients who are unable to fill their pain medication prescriptions say that current regulations go much too far.
Prescription drug abuse in America: a Legitimate Problem
According to the NIH, some 115 people die from an overdose of opioid pain medication like OxyContin, Percocet, and Vicodin every day. In 2013, nearly three-quarters of deaths from prescription drugs were attributed to opioids, and nearly 2 million people were addicted to them.
What do we know about the opioid crisis?
- Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
- Between 8 and 12 percent develop an opioid use disorder.
- An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
- About 80 percent of people who use heroin first misused prescription opioids.
- Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states.
- The Midwestern region saw opioid overdoses increase 70 percent from July 2016 through September 2017.
- Opioid overdoses in large cities increase by 54 percent in 16 states.1
Unlike illegal drugs, painkillers and other prescription medications aren’t something people normally get from the neighborhood drug dealer. Instead, they usually turn to family or friends who may not feel they’re doing anything wrong by providing the drug. And according to the 2009 National Survey on Drug Use and Health, a full 20% of those abusing prescription drugs got them from a doctor.
These numbers led to a serious government crackdown on the availability of prescription painkillers, both to patients and to the pharmacies who supply them. The CDC claims the tightened regulations have been a success, citing a drop in prescription deaths. Those who live with chronic pain, however, call it nothing short of drug rationing.
Are Current Regulations an Overreaction?
Prescription drug abuse is a very real problem. However, while opioids are not the only medication to be misused, they are they are the only one to be so heavily regulated. Although the DEA strenuously denies any role in “rationing” painkillers, pharmacies report that they are often unable to order enough medicine to fill the legitimate prescriptions they receive.
Wholesalers, pharmacies say, have set monthly limits on their orders of painkillers—and stopped shipments altogether in some cases. Wholesalers, on the other hand, claim that they’ve been forced to set quotas or risk being targeted by the DEA, although DEA denies that it has changed its policy.
In the end, it’s patients who suffer.
Demonizing Chronic Pain Sufferers
Chronic pain sufferers have historically been marginalized, often spending months or even years before finding a doctor who takes their pain seriously, and the current climate merely exacerbates the problem. More and more, chronic pain patients are seen less as people in pain who need help than as potential drug abusers to be viewed with suspicion.
The shortages and quotas currently in use often leave patients in an impossible situation. When their pharmacy is unable to fill their prescription, they must either do without—suffering not only pain but sometimes opioid withdrawls, in long-term patients—or go to another pharmacy. Those seeking another pharmacy to fill their prescription run the risk of being labeled potential abusers.
Pharmacists as Gatekeepers—Should Your Pharmacist be Second-Guessing Your Physician?
Some pharmacies have put policies into place which both patients and doctors feel ask pharmacists to act well outside of their scope of practice. Doctors report pharmacists questioning their professional judgement, asking for patient medical records—sometimes including data as esoteric as MRIs—and even refusing to fill prescriptions even after consultation with the prescribing physician. It’s become such a problem that the American Medical Association has addressed the issue.
The AMA says, “a pharmacist who makes inappropriate queries on a physician’s rationale behind a prescription, diagnosis or treatment plan is interfering with the practice of medicine.” It has threatened to lobby to change the laws and prohibit pharmacies from refusing to fill medically necessary prescriptions.
While opioid abuse is a problem, there is no one-size-fits-all solution. Arbitrary quotas and removing power from physicians’ hands doesn’t solve the problem, it merely penalizes legitimate patients with valid prescriptions.
The chiropractors at Active Health and experienced in helping chronic pain sufferers through an integrative care plan. This plan does not include prescription drugs. Our approach may include any or all of our modalities, from Acupuncture, Chiropractic, Nutrition and Rehabilitation. Schedule an appointment today to see if we can offer relief for your chronic pain.