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Should prescription pain meds be more tightly regulated?

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Should prescription pain meds be more tightly regulated?

Following-up on the controversy about tighter restrictions  on prescription pain medications, I wanted to share a practical example that hit close-to-home late last week.

But first–if you have the time–here are several posts I ran about the pain med controversy last year:

Move to limit pain med options may “hurt” cancer patients

 

Ongoing use of pain meds continues to be controversial…

 

Media’s attack on prescription pain meds hurting cancer patients

 

Last may I wrote the following as part of a post, Two acts of healthcare kindness:

I hadn’t been paying attention, and my supply of oxycodone pain meds had run low.  No big deal, except I was preparing to head up the South Carolina coast with Pattie for a long weekend.

I didn’t have enough pills to last until we returned on Tuesday.

I need the meds to help take-the-edge-off my bone and muscle pain–and the worsening peripheral neuropathy which now numbs and burns my lower arms and legs.

Because oxycodone is a narcotic, my doctor couldn’t electronically forward the script to my local pharmacy.  I had to fight traffic and drive more than an hour each way to physically pick it up.

Inconvenient, but it is what it is.

Back at the pharmacy window in my local CVS store, I learned that “I couldn’t pick-up my meds for three more days.”  according to the young woman at the counter.  “I have enough to last three days.” I replied.  “But I won’t be here Saturday to pick them up.”  “Come back in three days.” she repeated, obviously annoyed.

OK.  I will admit that I “lost it.”  This is service?  I barked a few not-so-kind words at the young Asian woman.  It didn’t phase her a bit.  “Come back in three days.”  She repeated indifferently.

Houston, we have a problem!  Fortunately, the pharmacy manager interceded.  “I didn’t even realize that there was some sort of time of time limit for when or how much oxy I could use.” I explained.

I knew him from some long, evening conversations we had shared about my multiple myeloma over the past year or so.  I didn’t use the pharmacy much now that Cigna Insurance required I use their mail order pharmacy for any ongoing prescriptions–like my warfarin, Gabapentin and/or acylovir.

He remembered me and interceded, listening thoughtfully to my problem.  Looking back at the computer screen, he admitted that the issue wasn’t really my insurance company.

Yes, I should have one of my doctors change my script to allow a higher “as needed” number of oxycodone pills each month.  “But it isn’t your insurance company that doesn’t want us to fill your script.”  He shared quietly.  “It’s CVS.”

Apparently, several CVS stores had literally been shut down by the feds in Florida recently.  “CVS management is running scared.” the pharmacist said.  “It’s the company that is putting restrictions on how much pain medications we dispense–and how often.”

He continued.  “I try and remind them that we need to show compassion to cancer patients.  Your prescription is on cancer center script.  There shouldn’t be any restrictions on that!”

He then filled my prescription while I waited; an act of bravery if you ask me!

I originally included the pharmacy manager’s name and picture in my post.  But the day after I ran the story, one of my readers suggested I remove them so not to put his job at risk and my pharmacist agreed.  He thanked me for not using his name and picture…

Friday, the hypersensitivity and tightening control over powerful pain meds once again came into play at my local CVS pharmacy.  I stopped-in to drop-off my monthly oxycodone script–this time a full week after it should have been OK to fill it.  My pharmacist was there, smiling and helpful as always.  But there was a snag; he didn’t have enough 5 mg oxycodone tablets to fill my prescription.

“Are you out?” He asked, sheepishly.  “Can you wait until Tuesday to get this filled?  I’ll have enough on Tuesday…”

Fortunately, I did.  I have been successfully trying to cut-back recently.  And ironically, dexamethasone helps me do that.  If I take dex on Wednesday, by Friday I experience a lot less pain.  So Friday and Saturday I am able to cut my dose in half.

Anyway, no harm no foul!  I could wait.  But what if I couldn’t?

Now let’s have some fun.  I posted this “rant” a year ago:

On another completely unrelated note, there was an important story on the front page of our local St. Petersburg Times yesterday morning.

OxycodoneSeems a powerful new painkiller, described as “a timed release drug that is a pure form of hydrocodone.”  Manufactured by a company a San Diego company, this new drug, trade name Zohydro, is intended “for managing moderate to severe pain.”

This should be good news for the millions of chronic pain sufferers (like me and many of my readers) who live trying to manage pain 24/7.

Instead, the entire article is negative, focusing on potential misuse of the new drug.  Even the headline was negative:  Powerful painkiller has experts worried.

April Rovero, president of the National Coalition Against Prescription Drug Abuse, is quoted as saying

“We just don’t need this on the market.”

Some state officials are pushing hard to restrict or even ban oxycodone here.  As a regular and responsible user of oxycodone, I would like to ask people like April Rovero:  Are you in constant pain?  Do you have bone marrow cancer?  What would you like those of us in chronic pain do, take aspirin and stay in bed?

It isn’t our fault these drugs are abused and misused.  Don’t try and take away my oxy!

Have any of you used Zohydro yet?  If so, I’m curious how well it works for you.

I understand none of this is easy to sort-out.  Prescription pain meds are abused and misused.  Tighten-up regulations if you must.  But on behalf of multiple myeloma pain sufferers, please keep our needs in mind.  These pain meds may contribute to the breakdown of families and destroy some lives.  But they help save lives, too.  Between my peripheral neuropathy, bone and muscle pain, I would have a difficult time living anything resembling a normal life without them.

Feel good and keep smiling!  Pat