It can be difficult for vulnerable patients with chronic pain, such as seniors and those with cancer, to obtain prescription painkillers that can provide relief, a survey by the National Community Pharmacists Association found.


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NCPA survey: Painkiller controls impact vulnerable patients

January 13th, 2014

ALEXANDRIA, Va. – It can be difficult for vulnerable patients with chronic pain, such as seniors and those with cancer, to obtain prescription painkillers that can provide relief, a survey by the National Community Pharmacists Association found.

The NCPA poll of more than 1,000 community pharmacists also revealed that unpredictability in the supply chain prevents them from assuring patients that their prescription for these controlled substances can be filled the following month.

About 75% of respondents said that, over the past 18 months, they experienced three or more delays or issues caused by stopped shipments with their controlled substance orders. On average, 55 patients per pharmacy were impacted by these delays.

Meanwhile, 89% of impacted pharmacies received no advanced notice of the delay, finding out about it only when their order arrived and included just noncontrolled substances. Sixty percent of pharmacists surveyed said the delays in getting these requested medications lasted at least one week.

What's more, 67.9% were unable to procure controlled substances from an alternate source, such as a secondary wholesaler. Most reported having to turning patients away and refer them to a local competitor.

"Vulnerable patients are increasingly and tragically becoming collateral damage in the country's battle against the abuse of prescription drugs, particularly narcotic painkillers," NCPA chief executive offer B. Douglas Hoey said in a statement.

"In the survey, community pharmacists repeatedly cited having their supplies or shipments of controlled substances abruptly shut off by their wholesalers, which may have done so due to perceived pressure, intimidation or a lack of clear guidance from law enforcement officials, such as the Drug Enforcement Administration (DEA)," Hoey explained.

The NCPA survey included an open-ended section that enabled pharmacists to provide comments. They inclued the following:

• "It is a shame to watch an arthritic 85-year-old do without."

• "This situation has literally brought customers to tears in our store. I fully understand the diversion and abuse of these powerful chemicals. I agree that something must be done, but to deny pain management to deserving individuals is inhumane at best. We have to find a way to curb the abuse and still provide relief from pain for those truly suffering."

• "We turn away patients on a daily basis that I am sure are legitimate patients with legitimate prescriptions with legitimate issues requiring pain management. I am one in a long line of pharmacies that turns these patients away because of the limits on what I can dispense monthly."

• "A few cancer and pain patients who really need their meds went without it for a few days. Has happened too many times."

• "We try to scrutinize all controlled substance prescriptions but are made to feel like criminals when trying to service our patients."

NCPA added that in presentations to Congress, the Food and Drug Administration and the DEA, it has suggested steps to thwart prescription drug abuse while protecting patients. Its recommendations include electronic prescription drug monitoring programs and tracking systems, more effective education of prescribers, shutting down rogue pain clinics, more disposal options for excess medications and additional scrutiny of controlled substances delivered by mail order pharmacies.

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