Pain News Network recently posted this article entitled “Cancer Patient’s Rite Aid Video Goes Viral” on May 3, 2019. It relates the disturbing and disheartening story of how some pharmacies are violating patient’s rights in obtaining pain medications for cancer treatment. The CDC Guidelines were NEVER meant to be used against cancer patients, and yet here is Rite Aid doing exactly that.
Here was my response to that story:
Because pharmacists have been attacked and disciplined by their licensing boards, they too have become their own “police” force in denying opiate medications to many patients. They make their own decisions, sometimes with the consent and following the policies of their pharmacies and sometimes not. I don’t know if the medical prescribers are coding the prescriptions properly because, at least in my city of Roseburg, OR, I have not had any issues with cancer patients getting their medications. Supply has been a big issue in the last few years because the DEA cut back production quotas and pharmacies get certain allocated amounts. The CDC Guidelines have been misinterpreted for years and now they are finally admitting their mistakes, but the damage has been done to patients and medical providers. Too many patients have lost their medications entirely; some unfortunately going on to heroin, while others devastatingly have committed suicide. No one gets held accountable for causing those actions. Medical boards and other state licensing agencies and the DEA have attacked, raided, slandered, disciplined, confiscated records, and more of medical providers across the country. Some have had their licenses revoked, suspended, limited, fined and other such actions. When that happens to someone in your community or state, providers note it and start trying to avoid it happening to them. So then they start taking patients off their opiate medications or find ways of firing them, like relying on point-of-care urine drug tests that are not 100% percent reliable and use the false positives as their way to end the patient’s pain agreement, assuming they ever even had one. I have seen too many clinics fail to use pain agreements for years despite strong recommendations by their state boards and medical organizations. I have seen pain agreements that are literally one-page long and have never changed in the last ten years and patients are never given copies of it when they sign it. Yet they are held accountable for it years later when they “add” some other clauses but were never told about them. Material Risk Notices are never discussed and signed. Risk questionnaires are not done properly or never done at all. Ongoing assessments do not get done. Pill counts are not done. Prescription Drug Monitoring Program data is not checked on a regular basis. In my opinion it should be checked at every visit when a controlled substance prescription is going to be given or refilled. I do that, but I am in the vast minority. Given all the mistakes that I find on the PDMP, if others fail to check it regularly they are missing a lot of information. Our Oregon Board of Pharmacy is failing to discipline pharmacies for repeated and ongoing violations of state law that requires prescriptions to show up within 72 hours of being filled. I have patients whose PDMP data fails to show such fills as much as two to three months later. I had to ban the use of the Roseburg Safeway store due to them failing to report medications as much as over 12 months later! A letter to their national corporate office did not even garner a response. What it all comes down to is the money to be made with the lowest risk and the fastest return. See the patients quickly, regardless of the quality of care, bill the insurer for as much money as you can by adding tests and claiming to have done physical examinations (many are never done yet billed = fraud) and questionnaires. Medical boards fail to discipline providers for this type of insurance fraud because they know it’s so prevalent, in fact many of them are likely guilty of it too. Electronic health records made it all the more easier to “cut and paste” and pre-fill out sections of the chart note and easily claim things to be done that never were. Healthcare is NOT changing for the better for the patients. Insurance companies keep getting richer by denying more conditions, treatments, medications, and such. It’s time to mandate certain coverages and decrease the profits of the insurance companies. When insurance and pharmaceutical companies and other organizations can pay multi-million dollar fines so easily, they really never learn the lesson that such fines were given for. It’s time to make them learn and quit repeating the same mistakes.