Patients who legitimately need pain control may have a hard time getting medication for it.

However, the abuse of this class of medications is a major issue, too.

The FDA is trying a new approach to physician education and prevention of excessive dosing, says this story. The FDA is asking the manufacturers themselves to take on the role of physician educator.

In the meantime, the patient can get caught in the middle.

Several years ago, my best friend had outpatient surgery on her foot. We were given a prescription for pain medication which she was to start taking as soon as she got home.

I went to, if memory serves, three Northwest Washington drugstores, trying to one to find one which would fill it.

“No, sorry, we don’t carry it,” I was told. Once. Twice.

Besides being unwilling to fill the prescription, they all looked at me somewhat suspiciously. No, it was not my imagination. They know the last people you’d expect may scam to get these drugs. Everyone is suspect.

Finally, I asked a clerk at the third store what a patient had to do to get this prescription.

Looking both ways to be sure no one overheard, he learned forward and whispered, “Go to the suburbs.”

Ready to be sure I came home with it, I drove to a store near the NIH which I knew would fill it.

More than four hours after the patient should have swallowed her first pain pill, she got one.

She was experiencing, as health care professionals often say, “extreme discomfort.”

Fresh thinking is needed when doctors and patients both are viewed with deep distrust when they try to solve a complaint which is so common.

Is this it? Stay tuned.

ABC News

“U.S. drug regulators asked on Friday for manufacturers of prescription pain medications to provide more specifics on an industry plan to curb growing abuse of morphine, methadone, oxycodone and other opioid drugs.

“The Food and Drug Administration in February had asked manufacturers including Johnson & Johnson and King Pharmaceuticals to come up with a joint plan to deal with the public health problem, particularly involving slow release and long acting versions of the drugs. This is the first time the agency has sought to develop risk evaluation and mitigation strategy for an entire class of drugs. (Emphasis added)

“At a Friday meeting, industry representatives told FDA they intended to develop a phased-in approach to deal with the problem. This could include a voluntary training program for doctors to better educate them about proper use of pain killers and government certification for prescribing of controlled substances.

“Currently, a physician must be certified by the U.S. Drug Enforcement Agency to prescribe this class of drugs. Congress would have to approve any requirement for physician training to receive DEA certification.

“The director of the FDA’s Office of New Drugs, John Jenkins, said the goal was to find a balance between reducing abuse of the drugs and maintaining access for patients who need the pain killers.” (Emphasis added)

Source: ABC News, December 4, 2009

Source: Reuters, December 4, 2009