Pubdate: Sat, 21 Feb 2015 Source: Gainesville Sun, The (FL) Copyright: 2015 The Gainesville Sun Contact: http://www.gainesville.com/ Details: http://www.mapinc.org/media/163 Author: Jesse A. Lipnick Bookmark: http://www.mapinc.org/find?232 (Chronic Pain) DEA CRACKDOWN CAUSING LEGITIMATE PAIN PATIENTS TO SUFFER The state of Florida recently endured the "pill mill crisis," a proliferation of narcotic medication that resulted in the reported overdose deaths in Florida of approximately 7 people per day. This crisis was the result of drug dealers paying people to pose as patients in pain while presenting to Florida physicians. Physicians and pharmacies were either duped or knowingly participated until 2011, when the Florida Legislature dealt with the crisis by passing legislation to regulate prescriptions of narcotic medications. Simultaneous with the Florida legislative action, the Drug Enforcement Administration (DEA) investigated, fined and suspended pharmacies that were dispensing allegedly inappropriate prescriptions. The DEA investigation resulted in million-dollar settlements with national pharmaceutical companies with operations in Florida. These pharmacies must regulate themselves more tightly than ever in order to minimize the risk of further DEA actions. Unfortunately, the pharmacies have gone too far and patient care is now suffering. The dispensing policies of national chain pharmacies have created a shortage of legitimate use pain medicine in Florida. Fearing the DEA, the non-chain, private pharmacies have also followed suit. Under pressure these pharmacies are now observing strict quotas for the sale of controlled substances. I'm not referring to the shady guy on the street corner, but instead about regular, everyday people who require well regulated pain medication to function. Under the guidelines established by the state of Florida, legitimate pain medication clinics see patients with acute and chronic pain. Some of these patients have terminal illnesses, some have debilitating arthritis and/or trauma induced sources of pain. Through multi-modality treatments including behavioral counseling, physical therapy, chiropractic treatment, massage, acupuncture and medications, many of these patients remain functional members of our society. Because the DEA has not established clear acceptable guidelines for pharmacies, many pharmacies have chosen to tighten their prescription dispensing policies to the point that patients, without warning, suddenly are told their prescriptions cannot be filled. People are suffering. In response to this situation, the Florida Medical Association convened a meeting with representatives from the Florida Board of Pharmacy, the DEA, the Florida attorney general, the Florida Retail Association, the Florida Society of Interventional Pain Physicians, the Florida Academy of Pain Medicine and the Florida Society of Physical Medicine and Rehabilitation. The various meeting participants expressed their positions, but unfortunately the meeting did not result in any resolution. The representative for the DEA denied being the source of the problem, or that there was in fact a problem to discuss. Of course, the DEA is not an agency of health care. Its job is to protect the U.S. citizens from illegal use of drugs. To that end the DEA has succeeded on its mission in Florida. However it was obvious the legitimate needs of suffering patients was not the concern of the DEA. I believe the current situation will not change until the American public demands Congress, which regulates the DEA, to swing the pendulum back. Things have gone too far. Our politicians need to realize that while it is vitally important to prevent inappropriate ordering and dispensing of narcotic prescriptions, the pill mill crisis in Florida is not what it was in 2011. That period is over. The DEA watchdog is creating a pain medicine shortage for patients who need these medications to function. I urge those of you who are affected or know someone affected by this situation to contact your members of Congress and express your desire for patients with legitimate medical needs to always be able to receive their necessary medicines for relief of pain. Jesse A. Lipnick, M.D., is board certified in physical medicine and rehabilitation with added qualification in pain medicine. He practices in Gainesville and in Chiefland with Southeastern Integrated Medical (SIMED). He serves as vice president for the Florida Society of Interventional Pain Physicians and is a board member for the Alachua County Medical Society. - --- MAP posted-by: Jay Bergstrom