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Florida's pill mill crackdowns hurting those in real pain

11:09 PM, Oct 31, 2013   |    comments
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Legal prescriptions. Real pain. Why can't you get your prescriptions for pain medications filled? First Coast Investigates.

Florida used to be known as Oxy-Express, a place where prescription drugs were plentiful, pain clinics were everywhere and pill addictions were killing thousands each year.  

Since a crackdown in 2011, Florida deaths from the powerful pain medicine Oxycodone have plunged. They dropped 41 percent in 2012, according to Attorney General Pam Bondi. Prescription drug deaths overall fell nearly 10 percent.

The crackdown has lead to another problem. Patients with legitimate prescriptions who are truly in pain can't get the medicine they need. The First Coast Investigates team has been digging deep for answers.

"The intensity of the pain is just awful. There are some days I just have to make myself get out of bed because it hurts so bad," explained Amanda Wendorff.

The Middleburg mother of four suffers from a painful genetic condition.
 
"My three boys and I we all have Chiari malformations ... where your brain basically herniates out of your spinal column and compresses on your spinal cord," said Wendorff.

For the past two years, she said she been on Percocet and a Fentanyl Patch, medicine prescribed by her pain management doctor.

"In the past six months, it has been almost impossible to find my medication. I have to drive from pharmacy to pharmacy finding medication."
 
It's the same story for thousands of Floridians.

"There are several times that I take a lower dosage for the pain medication than what is prescribed for and the reason I do that is for a buffer. Something to hold on to me in case I have to go and hunt," said John Shoenecker.

The prescriptions are legal. The patients have legitimate pain. So why can't they get the medications they need?

"It appears there are limits imposed by the Drug Enforcement Administration, that they imposed limits at the wholesale level and forced wholesalers to impose limits on pharmacies," said a pharmacist whose name we will not reveal. He asked us to hide his face and distort his voice for fear of retaliation by the DEA.

"They view pharmacists as criminals ...They use intimidation. We were told we had to be at the state average or else. So you get to the state average," said the pharmacist.

He's talking about the number of pain pills he can dispense each month.  
 
In 2011, Governor Rick Scott worked with lawmakers to crack down on Florida's notorious pill mills and the doctors who overprescribed addictive narcotics like Oxycontin.   

Florida used to be a destination for those seeking prescription pain meds.  Pill mills littered I-95. A First Coast News investigation from 2011 found the parking lots filled with out of state plates. This pharmacist agrees something had to be done to save lives, but he and many others think the pendulum has swung too far.

There's no law on the books putting a cap on pain pill sales, but the pressure from the DEA, he said, is a different story.

"Now we turn down a lot of patients who are cancer patients, sickle cell anemia patients, that the untrained person can look at and see that they have a serious medical condition ... and those are the people we can't fill prescriptions for ... because we don't have the supply. We can't get the medication," said the pharmacist.

With limited medication, he said he's been advised to pick and choose who he serves.

"Some of the things they've tried to get us to institute are criminal background checks on patients ...They told me if they've been arrested, not necessarily convicted, in their lifetime of a drug or alcohol event that would deny them medication for the rest of their life."

Wendorff said she has never abused or been arrested for drugs, but her age could play a role in why she has been denied.

"One of the unwritten rules is no one below the age of 35. I can tell you we've turned down several wounded warriors who can't get their medicine ... We've been encouraged to discriminate based on age," he explained.

UF Health Clinical Pharmacist Joseph Cammilleri said, "From working in pain management everyday I think it's a huge deal ... I know a lot of pharmacies that won't even order the medications anymore just because they don't want to deal with that type of clientele or deal with extra scrutiny from the DEA."

The pressure is also financial. In June, Walgreens agreed to pay a record settlement of $80 million and surrender its DEA registration at six Florida pharmacies. The DEA said the pharmacy chain broke several rules governing the distribution of prescription painkillers, which allowed the drugs to be sold on the streets.

READ STATEMENT FROM WALGREENS ON ITS POLICIES
 
"I think that within in a couple of years, there won't be any pain medication in the United States. They would have some limited amount for acute pain, but the vast majority of medication consumed is for chronic pain," said the pharmacist who did not want to be identified.

Dr. Fernando Petry, Chief Medical Officer for Haven Hospice, said even his terminally ill patients often have trouble getting prescriptions.

"Everyone at this point is now afraid to prescribe medications because of the possibility of being dragged into court," said Petry. "I think it means really being in pain for a certain amount of time ... If we don't think about those unintended consequences we are going to have more patients suffering, more patients dying in pain."

"If we are the richest country in the world but can't take care of our sick people, our old people, our terminally ill people what have we got?" said the pharmacist whose identity we are not revealing.

As for Wendorff, she hopes sharing her story will raise awareness about what's really happening and lead to change.

"The bottom line is we are in pain and we need help."

First Coast News tried for weeks to get an on-camera interview with the DEA. Our requests were denied but DEA spokeswoman Barbara Carreno issued this statement.

"The DEA has not issued any new rules that dictate whose painkiller prescriptions pharmacies can and can't fill. The Controlled Substances Act that we enforce does not focus on patient traits but rather on prescriptions.  The Act says scripts must be written by a practitioner like a doctor, dentist, or veterinarian for a 'legitimate medical purpose ... in the usual course of professional practice.' DEA does not decide what that is -- state boards do.  If a pharmacy chooses not to fill a prescription for someone, that is their decision, not the DEA's."

Florida Congressman Dennis Ross has also been trying to get answers from the DEA.

He joined several members of Congress in sending a letter to the DEA Administrator in October 2012.

Click here to read the DEA's response.

In response to our story Congressman Ross issued the following statement to First Coast News:

"I was hopeful that since the DEA took nearly six months to answer our letter, it would have included some substance on the steps they are taking to address the increasing problem of the lack of access to controlled medication therapies for patients with legitimate medical needs and the lack of guidance from a licensed practitioner.
 
"However, there were no new, substantive policy initiatives or goals offered by the DEA on how they are working to fix these issues. Moreover, they mention educating the public and industry stakeholders through materials, seminars, and workshops, but failed to address the elephant in the room, which is that this 'multi-pronged' approach they rely upon is simply not working.
 
"The DEA should be focused on identifying what in their process is not working; why distributors of these controlled substances may be inappropriately or prematurely cutting off the drug supply chain and, subsequently, what distributors are identifying in pharmacy customer orders that may be causing them to leave pharmacies without needed medication supplies and, finally, offering avenues for legitimate patients to obtain their needed medications."

First Coast News

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