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Wednesday, September 3, 2014

It's the Prescribers' (terrorists') Fault

Let us suppose a terrorist group poisons a town's water supply.
Let us suppose that they are seen dumping millions of gallons of chemicals into the reservoir.
Let us suppose that thousands of people will die from this act.
Let us suppose that these three things happen every year.

Let us suppose that the water treatment facility does its best to clean the water.
Let us suppose the media are alerted and the residents should know not to drink the water.

People are outraged that their family members are dying.
People want answers.
People want justice.
People want someone to blame.

In this scenario, where does the blame lie for the deaths?
Is it with the terrorists who are polluting the water?
Is it with the government thats knows about the poisoning but has yet to act?
Is it with the people for drinking the water?
Or is it with the water treatment facility that is trying its hardest to clean the water?

Let us suppose the terrorists are prescribers who write for controlled medications.
Let us suppose they are known to prescribe large amounts of these medications with reckless abandon  in the local community.
Let us suppose that thousands of people will die from this act.
Let us suppose that these three things happen every year.

Let us suppose the water treatment facility is the pharmacy.
Let us suppose the media are the DEA and State Boards of Pharmacy and Medicine and they have been alerted that these prescribers are rogue and there is an epidemic of drug abuse and people should avoid these prescribers.

With these word changes, who is to blame now?
Blame should still be placed squarely on the first step of the process-the act of terrorism.

The current way of thinking is to blame the pharmacies for the abuse of medications in this country.
We have already seen in that Tramadol has become a controlled substance and that all Hydrocodone containing products were rescheduled as CII medications. This is all to regulate the end of the line. It's like blaming fishermen for returning with smaller catches when companies upriver are openly polluting the water. To further emphasize this with the water treatment analogy: this would be like the government putting more testing and paperwork requirements on the facility while telling the terrorists "it's okay, we got this".

I realize the AMA has a powerful lobby and the pharmacists do not. (Nice try APhA, but you're the little kid on the playground who gets pushed down and his lunch money stolen by the bigger kids.) This should not mean we should be the gatekeepers in the DEA's failed war on drugs. (It has failed due to the backwards thinking outlined above.)

Prescribers and pharmacists have the same access to the same tools.
Prescribers have the right to NOT write prescriptions.
Pharmacists have to right to NOT fill prescriptions.
Why do pharmacists get in trouble for filling prescriptions that should never have been written?
Purdue has a list of rogue Oxycontin writers but they refuse to share it with authorities.
Pharmacies have a list of rogue prescribers but no one wants to take it or investigate it. (Or no one has the time or authority and the AMA would not assist.)
Until this country figures out where the blame lies, controlled medications will continue to find their way into the wrong hands and onto the streets and there will be two innocent groups who have to pay the price: Pharmacists and Legitimate Patients.

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