Beneficent DEA Allows Us to Switch Pharmacies. How Gracious of Them!

By Josh Bloom — Sep 07, 2023
In order to prevent "pharmacy shopping" – something that is now pretty much impossible anyhow – the DEA has insisted that prescriptions for scheduled drugs sent to one pharmacy (or refills) be picked up at that same pharmacy, not transferred to another one, no matter how inconvenient that may be. Well, guess what? Officials "listened" to "commenters" and made a very small concession. How kind of them!
Because they can. Image: Rawpixel

Just when you thought that the DEA was planning on implanting microchips in our cerebral cortexes to record every time we swallowed a Lomotil, the agency made a change in its absurd tyrannical policy. Prior to this, the agency forbade us from picking up a bottle of, for example, Ambien (or any other Schedule II-V drug) that your physician had originally sent to one CVS pharmacy at another CVS pharmacy across town. Or even across the street. Why?

If you've ever had the pleasure of picking up any controlled drug from a sneering pharmacist at one drug store, you probably know damn well that any refill, should you be fortunate enough even to have one, better damn well be picked up at the same store, regardless of how inconvenient that might be (or possibly even if the store burned down, although there is no data to support this).

By contrast, if you have a script for an antibiotic or blood pressure medication, a pharmacist at a CVS, even a different store than where the original prescription was filed, will be only too happy to fill it. And do so "sneerlessly."

Let's look at some of the concessions that the agency has made. [my emphasis]

Patients now have the ability to request their electronic prescription be transferred to another pharmacy without having to go back to their practitioner to initiate the request... The process was taxing and time consuming for both patients and practitioners.   This revised regulation went into effect on Monday, August 28, 2023.   

Source: DEA Headquarters Division - Public Information Office, 9/1/23

Of course, there's a catch.

Under the final rule, a prescription can only be transferred once between pharmacies, and only if allowed under existing state or other applicable law. The prescription must remain in its electronic form; may not be altered in any way; and the transfer must be communicated directly between two licensed pharmacists.

 

Isn't that considerate of them? Allowing patients to pick up a bottle of Ambien at an alternative pharmacy – but only once. As if you might get your hands on an extra 30 pills and divert them! The DEA really doesn't want controlled drugs to be diverted, and they use the word a lot. It's unclear whether moving the bottle from one medicine cabinet to another constitutes "diversion." I'm working on that and will get back to you once the Ambien wears off.

These kinds of rules are part of the agency's campaign driven by its twisted obsession to know who is getting what drug (with any abuse potential, no matter how small), where, why, and how much. Of course, I'm speaking about the infamous (and grotesquely obtrusive) Prescription Drug Monitoring Program (PDMP), which is now in all 50 states despite a 2018 study published in the American Journal of Managed Care concluded that PDMPs are "ineffective at curbing overdoses."

Also in that article are a couple of quotes that reinforce what Dr. Jeff Singer and I have been claiming for years: The "iron law of prohibition" virtually guarantees that harder law enforcement will lead to harder drugs. 

“There’s no evidence to say a PDMP works...[W]hen you take away a primary drug that somebody is dependent upon, what’s going to happen in that next stage if a [rehabiliation] program isn’t provided to help those individuals?...We saw the same thing when abuse-deterrent OxyContin came out and we saw the switch in heroin overdoses. With PDMPs we seem to be finding the exact same thing.” 

David S. Fink, MPH in an interview with the American Journal of Managed Care

Can anyone use a good laugh?

Why the change in policy? I'm not making this up:

In this rulemaking, DEA is finalizing the regulatory text proposed in the NPRM [notice of proposed rulemaking] with modifications to address concerns brought forth by commenters.

Images: Pxhere, Wikimedia, Wikipedia

 

Seriously?? The DEA listens to commenters? In which universe does this occur? Or perhaps it did listen if the "comment" came from the spouse of a powerful senator who was inconvenienced by having to drive to a pharmacy a mile further than where the prescription was sent. I'm just speculating, of course, but the odds of finding a sentence containing the terms "DEA" and "listen" are vanishingly low unless the word "not" is also included in the sentence. 

And, of course, there's another catch:

It’s important to note, any authorized refills transfer with the original prescription, which means the entire prescription will be filled at the same pharmacy. 

It would seem that DEA is "uncomfortable" with people refilling scripts at two different pharmacies, an apocalyptic calamity by any measure. Perhaps there's a concern that someone might pick up a bottle of Xanax at Pharmacy A and then race over to Pharmacy B before the electrons that record the first bottle reach the pharmacist there. This, of course, requires moving at the speed of light – something that most of us haven't yet mastered – but if you're the DEA, you can't be too careful. Those damn pills are just as bad as all the heroin, fentanyl, and xylazine pouring into the country. Ask Andrew Kolodny. He'll tell you the same.

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Josh Bloom

Director of Chemical and Pharmaceutical Science

Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.

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