Ohio News: Corresponding Responsibility is Needed More Than Ever

May 12, 2010 10:33 am

Published in the May 2010 Ohio State Board of Pharmacy Newsletter

As many of you know, we are having a tremendous problem in Ohio with so-called pain clinics who are doing nothing but providing large amounts of controlled substances, particularly oxycodone and hydrocodone, to people who have no legitimate medical need for them. The problem of prescription drug abuse has risen to such a level that the Department of Health has identified “accidental” drug poisonings as a greater cause of death in Ohio than traffic fatalities. In several areas of Ohio, the abuse and misuse of these drugs has reached epidemic proportions. On April 2, Governor Ted Strickland issued an executive order creating the Ohio Prescription Drug Abuse Task Force, which will make recommendations to state leaders on ways to combat this problem.

As noted in one of our Newsletters last year, pharmacists responded in a very positive way to our e-mail blast about the Florida “pain” clinics and that response has continued in large part throughout Ohio this year as our own version of professional drug trafficking has exploded onto the scene. Many of the “patients” who are getting prescriptions for these drugs for reasons other than legitimate medical purpose have had to resort to traveling many miles in an effort to find a pharmacy willing to fill them. They have even resorted to calling the Board office in an attempt to find someone willing to fill them!

However, please be aware that there are both legitimate and illegitimate pain treatment providers working in Ohio. In addition, there are both legitimate pain patients and people who are trying to obtain these drugs for illegitimate use. The pharmacist is often the last person who has the opportunity to make an independent judgment as to the legitimacy of the prescription and the patient. Both Ohio laws and rules and federal laws and regulations place a corresponding responsibility on the pharmacist to make that judgment and hold the pharmacist accountable for that judgment. Please note that the pharmacist is the one held accountable for making that independent judgment, not the employer, supervisor, or a fellow employee. The fact that the pharmacist called the prescriber and was assured that the prescription was legitimate may not be enough. The pharmacist needs to look at the prescribing habits of the prescriber, the patient and his or her condition, and the dose of the drug or drugs being prescribed. In addition, the pharmacist should take into consideration the distance that separates the patient, prescriber, and pharmacy. Just as in the Florida examples from last year, is it reasonable for a patient to travel long distances, passing by numerous doctors and pharmacies, in order to obtain prescription medications? Sometimes it may be, but usually that is indicative of a problem.

Having said that, please remember that there are legitimate pain specialists and legitimate pain patients out there. Legitimate patients should have their prescriptions filled in a timely fashion and without harassment. People who travel long distances and prescribers whose pain therapy appears to come from a cookbook should receive a little extra review before medications are dispensed. The reports available from the Ohio Automated Rx Reporting System program will frequently be able to provide assistance in making those judgments.