A 2-year-old law is making it easier for doctors and pharmacists to guard against opioid abuse by their clients — although it’s causing some frustration for patients with intractable pain.
One Rome man spoke passionately about his wife, who’s living with an excruciating condition affecting her trigeminal nerve, which carries sensation from the face to the brain. Their names are not being used due to the medication they keep in their home.
“Not everyone is abusing these powerful meds. Some are trying not to commit suicide because of the pain,” he said.
The Prescription Drug Monitoring Program uses an electronic database to track prescriptions for controlled substances issued to patients statewide.
Since July 1, 2017, pharmacists have been required to file daily reports on the prescriptions they fill. Since mid-2018, doctors have been required to check the PDMP before prescribing opioid painkillers such as oxycodone and certain anxiety medications including Xanax and Diazepam.
“It exposes the patients’ privacy to some degree, but used properly it’s beneficial,” said Keith Winslette, owner Winslette Pharmacy in Rome. “I want to know, if you walk in here for the first time, if you just got a prescription filled at Walgreens.”
In his 40 years as a pharmacist, Winslette has seen the spike in so-called pill mills and opioid prescriptions — and watched it start to ebb in recent years as lawmakers provided more tools. Through it all, the family-run pharmacy had its own rules for dispensing that helped stem the tide a little in Floyd County.
“It was abused back in the day. There were all kinds of pain clinics writing prescriptions for people from Florida, Tennessee. … They’d send them to independent pharmacies, but we said no,” Winslette said.
“We’ve always been very selective. We don’t fill narcotics prescriptions for people out-of-town, or for doctors out-of-town,” he added.
Winslette is listed among the top three pharmacies in Floyd County for filling opioid prescriptions between 2006 and 2012, according to federal data released in conjunction with a class-action lawsuit against opioid manufacturers and distributors.
But that, he said, is because they’re among the top three pharmacies.
“We fill an average of 500 prescriptions a day, compared to 100 or 150 at other places. If you did a study on blood pressure pills or any other medication, we’d be at the top,” he said.
The same holds true for local pharmacies listed for nearby counties, such as Bradford Drug Store in Cedartown and Trion Drugs.
“The numbers don’t indicate these stores are attracting that kind of business. They’re just the highest-volume store in their city,” Winslette said.
They’ve been advocates for the database — aimed at eliminating duplicate prescribing — and he spoke highly of a recent rule that requires a urinalysis every three months for people on maintenance pain pills. The test not only checks the patient’s health, it ensures they’re actually taking the meds.
“Most customers you see in pain clinics today are legit,” Winslette said. “But when you could sell a pill for $60, that’s $3,000 or $4,000 extra a month for someone living on Social Security checks. That’s kind of how it happened early on.”
It’s a complicated issue, however — both Winslette and the Rome man married to a chronic pain patient agree.
The man said he takes his wife to a doctor in Cobb County every month to have her prescriptions refilled, and they’re constantly afraid each time may be the last. She’s had brain surgeries to try to fight the pain, he said, and tried many types of pain medications.
The only ones that bring the slightest relief are strong opioids.
“Her doctor and other pain doctors are afraid they may lose their practice because of the climate we are in,” he said. “My wife has a reason to take the meds, but we are very worried she won’t be able to continue on them if the plight of this small group is not considered in the changes the government is making.”
Winslette, whose sons are now pharmacists, too, said there’s been a decrease in the number of opioid prescriptions as doctors become more cautious and seek out other options. Once marketed as fairly safe, it’s clear the risk of addiction is real.
Overall, he said, the new tools are a boon to combating the opioid crisis.
“Sometimes you penalize innocent people doing that. But if you go to Atlanta and get a doctor to write a scrip for oxycodone, you need to get it filled in that area,” Winslette said. “If I don’t know that doctor, if my kids don’t know that doctor, we’re not going to fill it.”