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CVS is writing the wrong prescription on opioids

U.S. pharmacy chain CVS has recently updated their policy on opioid pain medications as a means of helping to combat the opioid abuse and addiction epidemic. A statement released on the company’s website last month indicated that the new regulations will take effect on February 1, 2018, and would include “limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to therapy; limiting the daily dosage of opioids dispensed based on the strength of the opioid; and requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.”

Given that North America is the midst of a serious drug epidemic, these measures might seem like a common sense idea, but it is unclear exactly how these policies will be carried out—and whether people who need more than a seven-day supply opioid medications for legitimate reasons, such as chronic pain, will be adversely affected by the new policies.

The new policies to which CVS has committed also closely match the Centers For Disease Control’s (CDC) controversial 2016 recommendations for opioid prescribing; CVS’s compliance, however, might prove to be another hurdle for chronic pain patients. While we will not actually know how the new policies affect chronic pain patients until CVS puts their new opioid medication regulations into place, the updated policies will most likely affect chronic pain patients in some way, since chronic pain patients who need more than a seven-day supply of their medications are also CVS customers.

CVS defended its new policies in an interview with Pain News Network editor Pat Ansen; oddly, as Ansen writes, “CVS Health emailed a statement to [Pain News Network] answering a series of questions we had about its new opioid policy. We were not allowed to interview anyone at CVS directly.” Of particular concern is the seven-day supply policy, meant to limit how many opioid pills are dispensed for acute and after-surgery pain.

CVS’s response regarding the concerns of chronic pain patients is diplomatic and seems to take the issue seriously, but questions remain as to how CVS will put its apparent knowledge of some of the hurdles that chronic pain patients face in obtaining opioid pain medications into actual practice with the new policy.

In some respects, it may be the many unknown factors that are making some chronic pain patients uneasy about the new policies. As the PNN article points out, some critics of the policy are particularly concerned about a “cookie-cutter” approach to the dispensing of pain medication as a result of the new policy; additionally, I would argue that CVS’s new policy sets a precedent for other pharmacies—and possibly other health care providers—that could make life much harder for chronic pain patients who need certain medications. CVS’s policy may seem extreme, but there is a possibility that another company could come out with its own set of even more stringent policies on filling opioid prescriptions. An “arms race,” so to speak, of stringent regulations on opioid pain medication from pharmacies would not solve the opioid crisis, but it would likely frustrate and alienate chronic pain patients further.

Finally, here is some free advice for CVS from a chronic pain patient who uses opioid medication regularly, and responsibly: when February 1, 2018 comes, it might be a good idea for the company to start tracking exactly how the new policy affects chronic pain patients who need more than that arbitrary week’s supply, or who need an amount of medication that is greater than the policy’s 90 mg of morphine per day, or its equivalent dose of another type of pain medication.

If there are complaints from consumers about the policy or how the company’s retail pharmacists and/or pharmacy techs handle opioid prescriptions for people with chronic pain, CVS must take those complaints seriously, and be open to changing or modifying the policy if it does not work. This latest set of policies is meant to combat opioid pain medication abuse, not put chronic pain patients under further scrutiny. Hopefully, CVS will be able to take honest feedback about its new policy and, if warranted, make changes to this new set of regulations.

Photo credit: Mike Mozart/Creative Commons