Another day, another ?????

It would seem that the world of retail pharmacy is one where the wonders never cease. While the DEA is imposing ever stricter regulations on dispensing of prescription opioids with the hope that it will resolve the current opioid abuse crisis, the FDA is approving a brand new single-entity hydrocodone product – Zohydro.

One cannot help but wonder if the two agencies ever talk to each other. Do we really need another hydrocodone preparation? Maybe, maybe not. Arguments can be made both ways, and while I am personally not a big fan of this product, it may have its place in the current lineup of opioid products. Can it be abused? The answer is unqualified YES! Will it be abused? Very likely. This brings me to the reason for my post.

Few days ago, a patient called the pharmacy inquiring about this product, namely about price and if it can be dosed higher than the common HC/APAP combinations. To quote the caller: “…I want to get as much of the hydro-stuff, but do not wan to kill my liver…” Nice to know that he is concerned about his liver, but not so much about the other adverse effects of long-term opioid use. To top it off, the caller stated: “…I am going to the doctor today and I will tell him to prescribe it for me (emphasis is mine). That left me wondering what kind of relationship does the patient have with his doctor. Who is doing the prescribing here? Is it truly the physician after evaluating the patient’s condition and treatment needs or are there some other forces in play? Just another day in paradise…..

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