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CVS Implements Policies Restricting Opioid Dispensing On Heels of Trump “State Of Emergency” Declaration

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Published on: September 24, 2017

And so it begins!  A little over a month ago, President Donald Trump declared a “state of emergency” in the united States because of the opioid crisis, pledging the release of federal funds to combat opioid addiction, overdose and death.

On Thursday, pharmacy retail chain CVS announced it would “limit opioid prescriptions to seven days for certain conditions and for newly prescribed patients.”

Who knew that pharmacy retailers could “play doctor.”

According to Newmax.com:

The new guidelines would also limit the daily dosage of opioids depending on their strength, and would require immediate release opioids to be used before extended-release drugs, according to a CVS press release.

The new limits are part of a wider initiative meant to protect patients against a fast-growing opioid abuse epidemic that has led to a sharp increase in overdose deaths attributed to opioids, CNN reported.

The changes will take place on Feb. 1, and will apply to all commercial, health plan, employer, and Medicaid clients, the release reported. CVS has nearly 90 million customers at its pharmacies each year at 9,600 CVS locations and 1,100 walk-in medical clinics in almost 10,000 communities in the United States.

The initiative will also increase the drug disposal collection program, give more counseling to those prescribed opioids about possible abuse, and give $2 million in additional funding to addiction recovery programs, including medication-assisted treatment programs, the release stated.

While the article reiterated that individuals can opt out of the program and this change is only applied to individuals new to opioid pain management therapy, the announcement released by CVS states otherwise.  The pertinent points are emphasized.

To support this goal, CVS Caremark will roll out an enhanced opioid utilization management approach for all commercial, health plan, employer and Medicaid clients as of February 1, 2018 unless the client chooses to opt out. This program will 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.

If you look at the sentence structure, there are three different approaches in the program.

  1. seven-day supply limit of opioids for certain acute prescriptions for patients new to opioid therapy;
  2. daily dosage limit of opioids dispensed based on the strength of the opioid;  and,
  3. use of immediate-release formula opioids before an extended-release formula can be dispensed.

It appears only the first criterion applies to individuals new to opioid therapy.

The other two criteria, based on sentence structure, apply to everyone.

If these policies were applicable only to individuals new to opioid pain management therapy, the sentence would be structured differently.

The statement by CVS is proclaiming to limit the daily dosage of opioids based on strength regardless of physician prescription orders.

This is a dangerous slippery slope;  not to mention, it is another knee-jerk reaction similar to President Trump’s.

Newsmax.com continued:

The initiative will also increase the drug disposal collection program, give more counseling to those prescribed opioids about possible abuse, and give $2 million in additional funding to addiction recovery programs, including medication-assisted treatment programs, the release stated.

The program does allow clients to opt out of the initiative, the release reported.

“Without a doubt, addressing our nation’s opioid crisis calls for a multi-pronged effort involving many health care stakeholders,” CVS Health President and CEO Larry J. Merlo said in the release. “With this expansion of our industry-leading initiatives, we are further strengthening our commitment to help providers and patients balance the need for these powerful medications with the risk of abuse and misuse.”

The narrative being pushed centers around the “opioid crisis.”  This “crisis” is based on the number of opioid prescriptions being written each year.

The announcement from CVS CEO Larry M. Merlo states, “In the last two decades, opioid prescribing rates have increased nearly three-fold, from 76 million prescriptions in 1991 to approximately 207 million prescriptions in 2013.  This remarkable volume of opioid prescribing is unique to the United States, where prescribing in 2015 was nearly four times what it was in Europe.” 

There is nothing but assumption driving the narrative.

Opioid prescriptions rose three-fold in two decades;  so, the reason must be opioid abuse, addiction and misuse.

Ignored are the factors that the generation preceding the baby boomers are elderly and may have chronic pain conditions and diseases that require opioid therapy;  baby boomers have entered the senior citizen category meaning diseases and chronic conditions requiring opioid therapy are in play;  post-surgical individuals whose surgery to correct a problem resulted in a chronic pain condition;  increase in cancer rates;  injuries from military service;  and post-surgical individuals whose surgery to correct a pain problem resulted in the opposite effect – an increase in pain.

These are not all-inclusive reasons that could explain the rise;  but, these factors have not been addressed anywhere.

Are there incidences of abuse, addiction, death and misuse?  Yes;  but, a 2008 study compiling previous research found that only 3% of individuals with chronic non-cancer pain using opioid drugs abused those drugs.

In individuals new to opioid therapy, the risk was less than 1%.

Based on this information, there is not an opioid crisis where addiction, death, abuse, and misuse occurs in a significant percentage of the population to warrant these actions.

It’s almost unbelievable that physicians, medical students, and other health care professionals are not “educated” in pain management therapy involving opioid medications as nurses were in the “dinosaur” days.

Without going into great detail, nurses in the “dinosaur” days attending the nursing school from which this writer graduated were educated on a few basic simple principles involving pain and opioid medication therapy – pain is subjective and is what the patient says it is;  proper pain management involves routine administration per physician’s orders, even when indicated “as needed”;  and, no one will become addicted to opioids when the medication is given/taken as prescribed for the condition indicated.

Since addiction is being used synonymously with “tolerance” and/or “dependence” by individuals seeking to interfere in medical treatment, these people have exaggerated the issue and created a large problem out of a small one.

Moreover, this all rests on the rhetoric that individuals using opioid medications are turning to heroin instead.

But, as with government, the best way to gain control of a part of an individual’s life unlawfully, unconstitutionally, and illegally is to address an issue from an emotional perspective, not a factual one.

With pharmacy retailer CVS developing these types of policies, which could lead to hardship on the part of the patient, it won’t be long before other chains do the same.

Yet, government nor pharmacy retailer chains look at the multi-billion dollar business of antidepressants and medications for ADHD.

As Elizabeth Wurtzel stated in her book, “Prozac Nation,” “we are living in the united States of Depression – a Prozac nation.”

Citizens are also living in a republic where the fake diagnosis of ADHD or ADD is given to children at the drop of a hat to funnel more money to “Big Pharma.”

Today, the target for intense scrutiny is an individual requiring opioid pain management therapy.

Who will be the next group targeted?

Where does the interference in the doctor/patient relationship end and where does the interference with an individual’s medical treatment end?

It doesn’t when government gets its greedy claws into health care, enabled by entities such as pharmacy chains, uninformed medical professionals, and uninformed citizens.

It only gets worse from here.

But, citizens have been willing to relinquish freedom and liberty for an illusion of safety.

Until that changes, expect more intrusion from government.

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