There is an unseen subset of the American population, a second class citizen short on hope, and most have learned to simply suffer silently. Chronic pain is a disease that effects 50 to 100 million people in the United States. On December 06, 2001, Dr. Daniel Carr, Medical Director at the New England Medical Center Pain Clinic, explained to the New York Times;
“Some of my patients are on the border of human life. Chronic pain is like water damage to a house -- if it goes on long enough, the house collapses. By the time most patients make their way to a pain clinic, it's very late.''
In 12 years, the situation has not improved, and the problems plaguing the chronic pain population require knowledgeable professionals to take them head-on. Three years ago the Director of Pain Education at John Hopkins University School of Medicine reported to the Army Surgeon General's Pain Management Task Force;
"The typical medical school may provide four hours of pain content on the topics of basic pain physiology, opioids, non-opioid therapies, and back pain. While some of the components necessary for an adequate pain curriculum are available, the content is seldom organized in a manner that makes it possible for students to successfully integrate the knowledge acquired in a classroom into clinical practice." (Pain Management Task Force, Final Report, pg. 64)
The foot-soldiers in the battle against chronic pain, our primary care physicians, receive substantially more training on how to spot a drug seeker than they are trained on how to diagnose chronic pain. Unfortunately, true chronic pain patients also often exhibit what is believed to be “drug-seeking” behavior.
The criminal element is formidable and it preys on medicine at every level. The Emergency Department, the practitioner’s office, and the pharmacy are all targets of a barrage of drug-diversion techniques. Furthermore, countless true pain patients exhibit “drug-seeking” behavior, or at least what the Federal Government defines as drug seeking behavior, because the patients are pseudo-addicted to the wrong medication to properly treat a chronic pain condition.
According to the University of Wisconsin-Madison;
Pseudo-addiction describes what happens when healthcare workers perceive addictive behavior in a pain patient's requests for more or stronger pain medications. In fact, the patient's behavior may be a response to inadequate pain management.
Many patients only want help, freedom from constant and insufferable pain, but the patients also feel like the deck is stacked. Because of the stigma on pain medication, patients feel ostracized or even demoralized by something as simple as a “problem” with a prescription from the local grocery store pharmacy. Speaking of problems at the local pharmacy, recently, the Kroger Company entered the “drug enforcement” arena.
In Colorado, reportedly a “test state” for the program, King Soopers’ pharmacists are “blacklisting” certain Colorado physicians and no longer honoring their patients prescriptions.
A pharmacist at the Kings Soopers on 58th and Wadsworth (Arvada, CO) was contacted by phone on March 14, 2013 and asked, “As a patient, how do I find out if my doctor is on the list?”
The Kroger pharmacist responded,
“You have to find out the hard way. Unfortunately, we are not allowed to divulge that information.”
The pharmacist went on to explain that there was nothing for patients to worry about, the list of physicians was short... and it was provided by the “DA.” He added,
“The ‘blacklisting’ is not Kroger’s policy as many doctors seem to believe, we’re just following the ‘DA’s’ policy.”
Still, many in the medical community do not like what is going on. In an interview on Wednesday, a top Denver Pain and Addiction specialist posed several questions;
“How do we [the physicians] get on this list?
“What are the qualifications or parameters that must be met for a doctor to be placed on the list?
“If a doctor gets on the list not of their own doing, how do they get off of the list, and how long will that ‘black-mark’ hurt an innocent doctor’s career?” (Interview, Mar 13, 2013 with top Denver Pain and Addiction Specialist)
The specialist asked to remain anonymous for the time being, most medical professionals are leery of making too much noise and attracting the unwarranted attention of law enforcement, but questions like the specialist asked are becoming increasingly common in the medical community.
As a side note, Friday, March 15, 2013, a Kroger customer service representative at 1-800-576-4377 denied the existence of any company policy toward “blacklisting” physicians. During the recorded call, the representative was further questioned about the comments of the Kroger pharmacist (mentioned earlier) but continued to deny any participation.
Want to know more? Pick up the phone and call:
Inquiries about KROGER’s Policy:
U.S. Attorney John F. Walsh
1225 17th Street
Denver, CO 80202
Tel: (303) 454-0100
Fax: (303) 454-0400
Durango Branch Office
AUSAs James Candelaria, Todd Norvell and Dondi Osborne
103 Sheppard Dr. Room 215
Durango, CO 81303
Tel: (970) 247-1514
Fax: (970) 247-8619
Grand Junction Branch Office
AUSA Michelle Heldmyer
205 North 4th Street, Suite 400
Grand Junction, CO 81501
Tel: (970) 257-7113
Fax: (970) 248-3630