Buprenorphine, the generic name for Suboxone, is a medication used to treat opiate dependence – it helps minimize withdrawal symptoms. It’s often an essential part of a person’s recovery plan, mainly due to its accessibility. Users can attain it through a prescription from a certified doctor, rather than having to hoof it to a medication-assisted treatment program multiple times per month, like methadone requires.
Although it does have the potential to be abused, Suboxone is considered safe by most clinicians when used as prescribed. However, despite its many benefits, an increasing number of pharmacies are now refusing to fill these valid prescriptions. It begs the question: How is this happening – especially in light of a full-blown opioid epidemic sweeping the country?
Round and Round
The Suboxone uproar seemed to have started once the U.S. Drug Enforcement Administration (DEA) cracked down on both Walgreens and CVS, fining them millions after violating federal rules for dispensing controlled substances. As a result, both pharmacy giants established stricter dispensing rules, which led to thousands of complaints by Suboxone users.
And now we can add Wal-Mart to the list, with a North Wilkesboro, NC, store location recently refusing to fill buprenorphine prescriptions altogether. Reportedly, DEA agents visited the Walmart pharmacy and told them if they continued filling Suboxone prescriptions, they would be accused of collusion. In response, the Wal-Mart allegedly axed sales of all buprenorphine products. A subsequent phone call to the Wal-Mart pharmacy, placed by Dr. Jana Burson, seems to back up the claims. In her blog, Dr. Burson writes:
“I asked him if it was true that Wal-Mart no longer fills buprenorphine prescriptions, and he said yes, that’s true. I asked was that for all forms of buprenorphine, including the films, Zubsolv, generics, etc., and he said yes, all of them… Starting to feel a little riled, I asked him if he thought that decision would interfere with appropriate treatment of a potentially fatal illness; he just repeated Wal-Mart had decided not to stock buprenorphine at all.”
Interestingly enough, DEA spokesman Rusty Payne says the agency is not the one to blame with limiting access to opioid painkillers. “If something is prescribed for a legitimate medical purpose, we’re certainly not going to get in the way,” Payne told the National Pain Report. Instead, he points the finger at the doctors and pharmacists.
Bottom-line: Is This Legal?
The laws that govern whether pharmacists are obligated to fill legitimate prescriptions are murky. There doesn’t seem to be a clear-cut answer, other than some saying the final decision lies within an individual pharmacist’s “professional discretion.” For instance, Title 21 of the Code of Federal Regulations states that:
“The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription.”
However, others look towards company policies for direction. Walgreens now utilizes their “Good Faith Dispensing Checklist,” which mandates staff pharmacists ask every patient a number of questions before filling a new controlled substance prescription. If the patient and the prescription don’t meet all the “good faith” criteria, the Walgreens pharmacist cannot – by company policy – fill the prescription.
Whether it’s legal or not, refusing a legitimate prescription is blocking your access to treatment. If you or someone you know are refused Suboxone, contact your prescribing physician or your treatment program case manager immediately to make sure your recovery plan isn’t compromised in any way.