The Opioid Crisis
January 13. 2020
Currently, there is a hue and cry, far and wide, regarding opioid use and its connection to high numbers of opioid overdoses.
While this concern has several very valid issues and statistics, it does not honestly address the entire picture. As it now stands, pharmacies and physicians are extremely reluctant and/or afraid to prescribe any opioid meds. It has become a question of “liability vs the patients’s needs” which has overridden past practices of approving opioid prescriptions; even to excess.
As it stands nowadays, due to the public outcry and the resultant fear entrenching pharmacies and physicians, many patients are not getting the proper dose of opioids to address their pain management needs.
So, many persons, taking the dose of opioids prescribed by their physicians, could not overdose due to the fact that the medical professionals are restricted in the quantity and dose of opioids they can prescribe; and in many cases, the patient is not receiving enough pain meds to address their chronic pain. The only way a person could OD on opiates, these days, would be to not take their prescribed opiate drugs, but to hoard them and at such time as they deemed fit, make a conscious decision to “OD” ending in death or a near-death incident.
The other way an individual could OD would be to obtain their opiate drugs illegally; on the streets, stealing from a family member’s opiate prescription, buying from an unscrupulous physician, purchasing from a drug dealer, etc. They may also seek out other means to alleviate their pain, “self-medicating,” and in so doing, “accidentally OD” as is allegedly the case with many celebrities as well as the regular public.
Case in Point:
This is in response to a survey I received via email about my experience at the pharmacy. It concerns a prescription ordered by my oncologist on 12-26-19.
I had an appointment with my oncologist on 12-26-19, and she asked how I was doing, and asked the usual questions: How have I been feeling? Am I having any chills or hot flashes? How am I sleeping? Am I having any pain, etc. I explained I have a great deal of trouble sleeping, in large part due to the pain. That I take a Norco before I go to bed, and another when I wake up in pain, so I can sleep longer. I told her I get 28 a month, leaving me with 2 or 3 days a month with no Norco. I told her I must use a cane, as needed, due to the pain. That I’m unable to do the things I used to do because of the pain in my joints – knees, hips, shoulders, hands, wrists. I told her I also take ibuprofen and naproxen throughout the day and night because the meds I get do not handle the pain.
(I also have pain associated with my diagnoses of: Fibromyalgia, chronic pain syndrome, Sjogren’s, degenerative lumbar disc condition, and HypoParathyroidism.)
She then prescribed a Fentanyl patch, at the lowest dose and said several of her patients are using the Fentanyl patch and that it works well to alleviate pain, not just for sleeping, but throughout the day and night. She said she’d order it for pick-up at the nearest pharmacy.
I went to the pharmacy on 12-27-19 to pick it up. I was made to wait, then directed to see the pharmacist. The pharmacist stated she could not approve the prescription. She said she called my oncologist and told her about how she refused to approve it. My oncologist then had to cancel the prescription order.
The pharmacist told me I was not taking enough Norco, and not at a high enough dose to justify the fentanyl patch. She further commented that my body would not tolerate the patch, that I would literally die if I used it at this time. She suggested I contact my primary doctor and request that he up my Norco dose from the 5/325 to the 10/325 dose. She also offered to contact my primary doctor herself and make that request.
I told my oncologist, via the messaging system through the insurance company online, and she said I would have to try a higher dose of Norco, then try morphine, before I could get the Fentanyl patch. (In my records, since starting with my insurance company, I have told all my doctors that I get extremely violent with morphine, that I have severe hallucinations, and I get very nauseated on morphine; therefore, cannot take it.)
Well, I don’t know if the female pharmacist contacted my primary physician or not, so I messaged him through their online system. He told me as my primary care physician, he could not prescribe Norco at a higher dose, and suggested I discuss with my oncologist about my increased pain medications concern.
I did as he suggested, and left her a message through the insurance company’s online system. I have not received a response.
I am confounded. It defies all logic that I must take more opioids, at a higher dose, before I can get more/and other opioids I am guessing no one wants to be liable, in light of the public outcry about opioids. So, is it liability versus patient’s needs?
I am at a loss as to what to do now. It seems no one is willing to address this; and I am on my own regarding the issue of the pain I deal with 24/7.
I am extremely happy, satisfied and have a deep respect for my oncologist! And I am content with my primary physician; but in this regard, I feel I’ve been set aside, with no intention to address the problem further.
FRUSTRATED BEYOND REASON!
(The entire “problem” with opioid prescription and use, needs to be re-evaluated to include the varying needs and situations of ALL the effected patients; including those who are left with no other legal option to address their pain. It should not be so… Too bad the pharmaceutical business cannot or will not develop a pain medication that is not an opioid, but eases the pain as effectively.)