Law has caused pain, literally, for some

Regulatory rush has had unintended consequences.

SPRINGFIELD — The way the state approaches pain medicine has changed, and the changes are making patients live with their pain.

One patient of local doctor Steven Kaz, for example, says she has had her medicine reduced from three pills a day to two.

The patient asked that her name not be used because she is afraid to lose the medical benefits she receives from the state.

She has had five surgeries on her shoulders since 2000, all attempts to minimize her pain after torn rotator cuffs.

Doctors want to do a sixth surgery, but she thinks it’s pointless. The procedures haven’t helped her pain — only narcotics have. For years she has lived a normal life by taking OxyContin three times a day.

About a month ago, her doctor reduced her daily dosage. Dr. Kaz told her the change was so that he could stay under a certain limit imposed upon him by House Bill 93.

The patient’s morning pill lasts from 10 a.m. to about 4 p.m., she said. “Then from 4, I cry until it’s time to take it again, around 10 p.m.”

Susan felt she had no other choice. She had heard how hard it is to get a new pain doctor these days. Better two doses a day than none at all, she said.

But that dosage limit — 2,500 doses per month per practice — isn’t correct. It only applies to narcotics provided directly from a doctor’s office, as some “pill mills” have done.

This incorrect information has been floating around the offices of doctors who prescribe pain medicine for weeks now, along with fear instilled by a swift implementation of the law.

Dr. Kaz chose not to comment on this story, but in the course of the News-Sun’s investigation, Kaz got word of the correct interpretation of the law. The patient said she believes that she will get a prescription for a full dose after seeing Kaz this week.

She is one of many legitimate pain patients, in the Miami Valley and elsewhere in the state, who aren’t getting the pain medication they need to function.

The state medical board started a more heavy-handed approach with pain prescriptions months before the bill was signed May 20.

This year the board has issued citations for prescribing issues at four times the rate they did in 2010. The board has been disciplining doctors, which usually means stripping them of their licenses, at double the rate of last year.

The co-authors of the Ohio law say they didn’t intend to limit access to pain medication generally, but only to the people who shouldn’t be getting it.

“Yes they do say that,” said Eric Juergens. “But the reality is that ... that’s what happens.”

Juergens owns and runs Madison Avenue Pharmacy in Springfield.

“A lot of doctors don’t want and don’t need that scrutiny, so they’re just going to quit,” he said.

Another pain patient interviewed by the News-Sun has had trouble finding a doctor to prescribe pain medication.

This patient has had 11 surgeries in the past 12 years to help him recover from the effects of a severe job-related injury — and subsequent accidents he had because he couldn’t navigate the stairs in his home.

He said he needs pain medication so strong he keeps it locked in a safe so his son’s friends don’t make off with it.

In May, this man’s doctor lost his license for prescribing issues. Then, days later, the next doctor he applied to see lost his license for the same reason.

No program exists to place patients with other doctors in these situations, the state medical board said.

Now this patient has an appointment with Dr. Andreas Syllaba, who practices in Centerville.

When he first applied to see Syllaba about a month ago, the office was receiving 60 calls a day for new patients. It still receives about 30.

Syllaba’s office doesn’t have the resources to conclusively determine if all these callers are legitimate clients — that they aren’t just trying to scam the system for drugs to sell. For the initial test, his office relies on phone clues.

It’s simple: if a caller is willing to try a procedure, or “intervention” in medical parlance, he or she is likely legitimate. Interventions are generally more expensive than medication.

“If the patients just outright Аск, ‘I want medications, I don’t want anything else,’ we’re probably going to screen those people out,” Syllaba said.

Syllaba, like other doctors, thinks the intention of lawmakers and the medical board is to limit medication in general.

“Let’s say we cut in half the medications that are prescribed. It will decrease diversion,” he said. “It also will decrease the number of people getting legitimate pain care. You have to have that balance.”

Weeks ago, the male patient ran out of two of the four medications he had been taking for years. He has resorted to cutting pills in half and in quarters to ration.

Why doesn’t he turn to the street, where the medications are more expensive but readily available?

“I wouldn’t ever do that,” the patient said. “Those are the people who got me into this mess in the first place. They’re why the law was written.”