I Need Painkillers, but the DEA's Reclassification of Hydrocodone Makes Them Way Too Hard to Get
It's been a weird week for me—painful, confusing, stressful. I've had to deal with a lot of questions I never thought I'd have to ask or answer. I've had to deal with a lot of awkwardness from other people that I didn't realize I would be so bothered by.
This week I lost an ovary. It's not the point of this story, but it's an important thing to note before I elaborate.
A week ago, I had started feeling sharp pains shooting down the left side of my abdomen. It was infrequent, but fairly distressing. Several doctor visits, exams and ultrasounds showed nothing particularly out of the ordinary, and I was told to come back if I started bleeding.
Several days later, I went to the emergency room when the bleeding finally came and the pain went from infrequent to constant. A cyst was found on my ovary. It appeared to be leaking fluid around my uterus, but I was told it would probably go away on its own. Follow-up appointment scheduled, I went home.
After a couple of days, I was in blinding pain that now shot all the way down to my knee and left me shaking, sending me back in the emergency room. This time, people crowded around my ultrasound screen in discussion. There was definitely a large cyst. It had definitely ruptured. There was a lot of internal bleeding. I was quickly prepped for surgery as doctors and nurses asked me repeatedly if I understood that I may lose my ovary and fallopian tube, that there was no way for them to know what damage had been done until they could go in and look, and that they would need to take out everything that had been damaged beyond repair. I signed and initialed, still trying to understand how something went from nothing to surgery so quickly.
I woke up being wheeled to the recovery room and groggily spat out, "What'd they take?"
"Your ovary and tube. They were too damaged, they couldn't fix them."
I fell back asleep and woke up to anxiety. What did this mean? Was I at risk for losing my other ovary eventually? Would my already imbalanced hormones be even more out of control? What was this loss going to do to my body? My fertility? Why didn't anyone catch this before it was too late?
Overwhelmed, tired and in pain, all I wanted was to get out of the hospital, fill my pain prescription and get home to sleep. I hadn't slept outside of surgery for days.
What I didn't know at this point was that the prescription that had been written for me was for Norco, a pain medication that is a combination of hydrocodone and Tylenol. A couple years ago, this drug was reclassified as a schedule II pain medication. Restrictions for it had been significantly altered. It was more difficult to have it filled and even more difficult to find.
This was explained to my boyfriend and I when we stopped at the pharmacy by our house. They were out, and they said most pharmacies in the area would probably also be out since the reclassification had limited them to receiving very small shipments. It was too hard to walk, and I was too exhausted for us to drive around the entire L.A. area hunting down this prescription, so we called every Rite Aid within a 20-mile radius, as they were one of the few pharmacies that were still open. Between my boyfriend and I, I'm fairly certain we called well over two-dozen pharmacies.
I anticipated being told many times that they did not carry it. What I did not anticipate was the hostility. Each time I called another pharmacy, I was met with a very terse, "No, we do not carry it." After being hung up on immediately after being told one particular pharmacy did not have the drug, I thought maybe my desperate pleas were coming off as drug-seeking behavior, so I began each phone call with an explanation: I just lost my ovary, I'm in a lot of pain, and I can't find anyone who has this prescription in stock. Can you please help me?
After accidentally calling one pharmacy a second time in my desperation and being met with unabashed aggravation and another hang-up, I had reached the point of tears. I resorted to calling a Rite Aid 40 minutes away. As I choked back tears and explained my situation again, someone finally took pity on me.
"Listen, I'm going to be honest with you—because of the reclassification of hydrocodone combination drugs, our restrictions are a lot tighter. If you call us on the phone and ask if we have it in stock, Rite Aid policy is that we tell you no, whether we actually have it or not. You have to come in."
I explained that having just had surgery, I was in no shape to drive around the city, and after wasting two hours on the phone, I had 10 minutes until almost every pharmacy in the area was closed. I now had absolutely no idea who had the drug and who didn't. I needed some direction on where to go.
She uncomfortably said she couldn't help me and hung up.
We drove to the nearest pharmacy in a last-ditch effort, but they were out. All other pharmacies nearby had closed. I was now faced with having to deal with the next nine or so hours with absolutely no pain medication or going back to the emergency room and hiking up the bill that I knew was already going to be far more than I could afford. Sharp, side-splitting pains through my gut decided for me.
The ER was able to give me enough medication to get me through the night. I was not able to get my prescription filled until about 3 p.m. the next day. This left me without pain relief for about eight hours.
I had just lost a part of my body and felt as though I was being treated like a criminal for trying to fill a very valid prescription. I was reeling from what the implications of this unexpected surgery might mean, but rather than being allowed this time to heal and process, I was curled up in the passenger seat of the car in agony because I had not been able to fill my prescription. The ordeal had added so much extra stress and pain to an already overwhelming experience.
I couldn't help but think about all the people in my life who suffer from chronic pain, who rely on drugs like hydrocodone to get through their daily lives. I am a member of several online support groups for people who suffer from chronic illness, as I have endometriosis. While my daily pain does not warrant prescription painkillers, many of those in my support system need these drugs to go to work, care for their children, or simply get out of bed. The unacceptable treatment and obstacles that I faced after surgery are ones that they face on a monthly basis now that these drugs have been reclassified.
These restrictions mean that doctors can no longer call in or fax prescriptions to pharmacies on behalf of their patients. They mean that patients can no longer get refills; instead, they must get entirely new prescriptions every 30 days, which requires monthly doctor appointments. They mean that finding these prescriptions will be significantly more difficult, as pharmacies are now limited to a very small inventory and, as I discovered, misleading answers over the phone. They mean that far more discretion is being placed in the hands of pharmacies to determine what they believe to be legitimate or illegitimate prescriptions. Consequences are heavier for doctors and pharmacies that do not follow these new rules to the T, and therefore they are far more hesitant to get them to the people that need them.
I understand the DEA's intent with the rescheduling of this drug. I understand the epidemic of prescription drug abuse in the US. But there is an evident disconnect between the intent and the execution at the patient level. Pharmacies have now been conditioned to treat those seeking schedule II drugs like addicts; with absolutely no context or knowledge of their medical afflictions, they meet patients' needs with hostility because the fear of consequences due to the restrictions has outweighed the need to provide quality care for patients. What once was a means of living with pain has now become a source of immeasurable stress and financial burden for patients who are struggling.
At what point are we doing more harm than good? Where is the line between safety and neglect? We may be keeping these drugs out of the hands of some addicts, but we're also keeping them out of the hands of those that truly need them.