Is The D.E.A.’S “War On Drugs” Hurting Nursing Home Residents?

Nursing home residents are becoming unintended casualties of the Drug Enforcement Agency’s war on drugs. According to an article recently published in the New York Times, a new level of drug enforcement intended to prevent narcotic abuse is making it extremely difficult for nursing home residents to receive the prescription drugs that they need.

In the past, medical staff from nursing homes would be able to have a prescription filled for a resident based on instructions given to the pharmacy by the resident’s clinic or physician. However, that practice is now “under scrutiny” by the D.E.A. Pharmacies are now requiring a written or faxed prescription from the patient’s doctor before dispensing the medicine and many nursing homes are unaware of the change. This means that some residents are being forced to wait days before getting the prescriptions they need if the doctor prescribing the medication is unavailable.

This was the case with Roland Lorenz, a 75 year-old nursing home resident in St. Louis, Illinois. Mr. Lorenz has surgical screws in his back and neck and a pin in his upper leg and needs to take the pain medication, Percocet. One weekend his pain reared up severely and he was taken to a pain clinic where his doctor ordered his dosage of Percocet to be increased. Unfortunately, it took two days for him to receive the medication. Nurses were unable to have the medication filled by phone as was their usual practice, and the doctor who prescribed the medication was unavailable. According to nursing home staff, their own doctor on-call would not prescribe the medication to Mr. Lorenz without examining him first. Mr. Lorenz suffered through the weekend in excruciating pain until he was finally given the medication that Monday.

According to The New York Times, the D.E.A. is “investigating pharmacies in ‘about five states’ for dispensing the drugs to nursing homes without direct written orders from a doctor”. The D.E.A. asserts that they are trying to protect patients from nurses who call in prescriptions without a doctor’s order and from pharmacists who dispense narcotics without a prescription, who both then try to get a doctor to sign the prescription after the fact even though he or she has never seen the patient.

Medical experts agree that residents in rural areas and those arriving at nursing homes from a hospital usually suffer the most. In rural areas, doctors may not have immediate access to a fax machine or any way to send a prescription from their phone. Residents arriving from the hospital may have trouble getting their prescriptions faxed due to communication problems between the nursing home and the hospital doctors.

Some nursing home critics argue that these problems would not occur if all nursing homes had on-site physicians and adequate medical care for their residents. According to the medical directors association and The New York Times, a doctor at a nursing home “writes an average of 169 prescriptions for controlled substances each month — which means ample opportunities for delays”. Many times, nurses have a doctor’s order and a resident in horrible pain, but is unable to dispense any medication. In extreme cases, nurses have been forced to illegally dispense medication from their homes’ emergency medical kits in order to ease their patients’ suffering.

While I support the fact that the D.E.A. is trying to minimize narcotic drug abuse, nursing home residents are clearly suffering from their efforts. I think that pharmacies, nursing home staff, and doctors must work together in a concerted effort to minimize the time that residents must wait to receive their prescriptions. These residents should not have to suffer due to the unavailability of a physician, communication problems between nursing home staff and hospital doctors, or the illegal actions of a handful of pharmacists. I think that if the D.E.A. is serious in changing how nursing homes receive their prescriptions for their residents, they should first come up with a workable policy for how residents in need of narcotics can have them dispensed without having to wait for hours or days. Obviously, the current system is not working, and the D.E.A. should first come up with a plan on how to prevent nursing home residents from becoming casualties of their war on drugs.