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Some pharmacies have stopped filling prescriptions for a narcotic used to treat pain and addiction to opiates and other prescription drugs, a move doctors say will be detrimental to patients.
The state Narcotics Enforcement Division, part of the Department of Public Safety, recently discovered a 2012 law that prohibits doctors from prescribing suboxone for the purpose of opioid detoxification or maintenance. The law allows doctors to dispense and administer the drug to patients, but not to prescribe it.
“There are at least 1,000 patients in the state on this drug. If they are not able to get refills … these people are going to be in withdrawal. They’re going to go immediately back to heroin or other opiate use,” said Dr. Gerald McKenna, a Kauai psychiatrist, addiction specialist and president of the Hawaii chapter of the American Society of Addiction Medicine.
“It’s the main drug for people to address the huge opiate dependence problem we have not only in Hawaii but all over the country.”
The Narcotics Enforcement Division regulates the prescribing of opiates and any other classified drugs in the state, but for the past 14 years McKenna said he has had a federal waiver to prescribe suboxone, which is being used across the country to manage the opiate dependence crisis.
Suboxone is considered much safer than methadone to detoxify and help patients get off opiates in a medically controlled way, or as a maintenance drug to prevent the use of other narcotics, he said.
“They’re not overdosing and dying (on suboxone). Many of them take it every day and it stabilizes them so they don’t need to go take other drugs,” McKenna said. “(Pharmacies) are no longer filling prescriptions for suboxone unless they are written for pain. That would mean that all of us that prescribe would have to lie on the prescription form and put down pain rather than addiction.”
A spokeswoman for the Narcotics Enforcement
Division said the state hasn’t determined whether it
will continue enforcing the 2012 law.
“NED has asked the Department of the Attorney General to review the statute at issue … to determine how the law should be applied,” said Toni Schwartz, a spokeswoman for the Hawaii Department of Public Safety. “While the attorney general is conducting that legal review, NED will not prevent physicians from appropriately prescribing suboxone for the purpose of opioid detoxification.”
However, Schwartz did not know when the NED planned to inform pharmacies that they are able to fill prescriptions while the case is being reviewed.
As of Friday, at least one pharmacist at Walgreens said she was notified last week by the state that she could no longer fill suboxone prescriptions for opioid dependence.
“It’s a real nightmare for some people. You can’t imagine how people suffer and panic if they can’t get this replacement,” said Dr. Dale Adams, a Kailua internist. “We’ve been prescribing this for some time with no questions. There’s a glitch in somebody’s information. I think that’s an old law.”
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