Painkiller restrictions concern doctors, patients
Attempts to curb abuse of prescription pain medication appear to be hindering legitimate patients from getting the relief they need, according to Hawaii Island health care professionals.
Physicians, pharmacists and other members of the East Hawaii Independent Physician Association met Tuesday evening to discuss a recent trend in which area pharmacists have been limited in reordering supplies of controlled medications.
“It’s been since a couple years ago, it started in Florida and has been moving westerly,” said Dr. Richard Lee-Ching, president of the East Hawaii IPA.
The federal Drug Enforcement Agency began limiting the amount of opioids made available to suppliers in certain areas in an attempt to cut down on abuse and overdoses by patients, as well as overprescribing by doctors, he said.
“The feds started to put pressure on pharmaceutical companies. … But they have no concept of subtlety. … Instead of using laws they have at their disposal and going after the individual doctors that are overprescribing, they’ve decided to make policy that’s tying everybody up in knots,” Lee-Ching said.
Hilo-area pharmacists who talked with Stephens Media Hawaii on Thursday said that in the last few months they have found it harder and harder to replenish their stores with the most popular controlled medications, including OxyContin, morphine sulfate, hydrocodone and Alprazolam. Wholesalers are telling some of them that they have gone over resupply limits, and they’re being limited on how much more they can purchase.
“It’s a nationwide issue, and we’ve been dealing with it locally for some time now, but it’s become more and more known just over the past few months,” said Mike Hoskins, head pharmacist at Mina Pharmacy. “And ultimately, it’s affecting the patient.”
Timothy Snedeker, who has suffered from chronic back pain since the 1990s, said Thursday that he currently finds himself recovering from hand surgery in addition to his usual back pain, and he’s having to do it without any pain medication at all.
“I’ve been having a … hard time finding my medicine,” he said. “I’ve been taking methadone. They first prescribed if for me in 2005, and I’ve been taking it since.”
Snedeker explained that he is unusually sensitive to pain medication, and he spent years trying to find a drug that wouldn’t upset his stomach while handling flare-ups of back pain.
“It was really the only thing that worked,” he said. “I’ve been taking it all these years. But then I started having problems (finding the drug) a few months ago, and it got real bad just a couple months ago.”
A Puna resident, Snedeker said his regular pharmacist in Pahoa told him they had run out, so he switched to another pharmacy in Hilo. But after switching all his other medications there, that pharmacist also stopped being able to provide the methadone.
“I called every place on the island (looking for it). … They all told me that they had been reduced in the amount they were getting. I was like, ‘Where does that leave me?’” he said.
Hoskins explained that so far, pharmacists have been dealing with the drug availability issues by referring patients to other pharmacies when their own supplies dwindle.
“We don’t want to cause alarm. We just want to make people aware. Doctors are concerned their patients will go untreated. … We’ve got to find a way to get around these inavailabilities to reduce the strain … on the supply system so we’re all able to get what the doctors want to prescribe for their patients. There’s lots of ways to do that, and we need to be more creative with pain relief.”
But, Lee-Ching warned if the health care system isn’t quick about finding a solution, many patients are likely to take matters into their own hands.
“What’s happened is, things like heroin use is skyrocketing when people can’t get their medication. I’m not arguing that there shouldn’t be more control over prescriptions, but you don’t just spring it on people. … Patients can go into withdrawals and seizures. And it also can create a black market,” he said.
Email Colin M. Stewart at firstname.lastname@example.org.