Chronic Pain Health — 12 September 2012

In a first of its kind protest, about two dozen chronic pain patients rallied Wednesday outside the Florida state capitol in Tallahassee, calling on federal and state regulators to require pharmacists to fill legitimate prescriptions for pain medications.

The demonstrators say thousands of patients across the state are living in constant pain or going through withdrawal because they can’t get the pain medication they need. They’re being turned down because pharmacies are fearful of losing their licenses if they fill too many prescriptions for opioid painkillers.

“People need to be aware that legitimate patients are suffering, that legitimate patients are being treated like drug addicts when they go to the pharmacy to get their legal prescriptions filled,” said Jeanne Hyatt, who drove five hours from her home in St. Petersburg to attend the protest.

Hyatt, 56, has chronic pain from fibromyalgia and bursitis, and has been disabled since 1996. She started having problems in January getting prescriptions for percocet or oxycodone filled. A CVS pharmacy that had always filled her prescriptions before turned her away, and Hyatt had to drive to several more pharmacies before she found one willing to provide her with pain medications.

Jeanne Hyatt

“Not knowing that you’re going to be able to have your medication after 28 days is a horrible feeling because if you don’t have it you’re going to go into withdrawal,” said Hyatt. “Not only are you going to be suffering from severe pain, you have to drive around the town just trying to find some pharmacy that might have it. It’s horrifying.

‘It’s not just a few people that are slipping through the cracks. It’s really affecting a large group of Floridians. And now that we’ve gotten into it, we’re finding other states are having problems as well.”

The rally was organized by Donna Ratliff, a chronic pain patient who founded the Fight for Pain Care Action Network, a non-profit group lobbying for adequate pain care in Florida.

“We’re not stopping here, we’re going to do more rallies and whatever it takes,” said Ratliff.  “What really needs to be done is the pharmacy guidelines need to be rewritten so that prescriptions written by a legitimate doctor have to be filled.”

The rally was held the day after the federal Drug Enforcement Administration said it was revoking the controlled substance licenses of two CVS drugstores in Florida. The DEA alleges the two stores near Orlando were filling too many prescriptions for oxycodone, a widely abused and addictive opioid. While the average pharmacy in the U.S. orders about 69,000 oxycodone pills a year, the DEA says the two CVS pharmacies ordered more than 3 million pills in 2011 .

CVS contends the high volume of prescriptions at the two stores is due to the fact they were open 24 hours a day and because of their proximity to a major interstate highway.

The pharmacies are no longer allowed to sell prescription painkillers such as OxyContin and Vicodin. They are still permitted to sell other prescription drugs, such as antibiotics, statins, and medications for high blood pressure and diabetes.

“Tell the DEA to back off,” says Ratliff. “They’re cutting us off and they’re creating terrible, terrible stuff.”

Jeanne Hyatt agrees.

“Everything is fear driven. The doctors are scared, the pharmacists are scared and the patients are scared,” says Hyatt. “These are people that are sick. These are people that are ill and crippled. What if this was your heart medicine and someone told you, ‘I’m sorry, we don’t have it’ or gave you conflicting information about it? But because it’s got this stigma as a drug that can be abused, now we’re all suspect. It’s gone too far and it’s not fair. “



About Author

Pat Anson, Editor

Pat is Editor in Chief of American News Report. He is a veteran journalist and a former correspondent and producer for HealthWeek (PBS), Nightly Business Report (PBS) and other nationally syndicated shows. Pat has won numerous journalism awards, including a Golden Mike award for investigative reporting.

(24) Readers Comments

  1. The piece of garbage Government we have is creating a whole class of street drug addicts these people are legitimate pain patients and many of them cannot tolerate even one day without their pain medications.Many of them will be taking opiates for the rest of their lives due to chronic severe pain. Now we have this IDIOTIC governmental intrusion that is going to make these people get their drugs off of the streets. Believe me when I say Heroin is easy to get and is a good pain killer which if I were in this position would be something I would be considering. It does not have to be injected and is approximately as strong as morphine.

  2. I am a 61 year old, disabled woman with the following ailments: end state liver disease, lupus, osteoarthritis which also affects my back cervical/shoulders, thoracic and lumbar (the entire back), I cannot kneel, stand, sit in anyone position for long periods of time without having severe pain, all over. The arthritis is disfiguring my hands and feet from the spasms and cramps, severe carpal tunnel in both hands. I have been on pain medication since 2009. Now I am going around like a junkie begging doctors to help with my chronic pain, not only the doctors buy also the difficulties with the pharmacies. This week the doctor had a little compassion and prescribed for 15 days and it took me 4 pharmacies to get the prescription filled. I understand how the other elderly folks feel. I actually saw this poor old lady with white hair, bent over from osteoporosis (completely bent over) with a walker asking why she had to go to another pharmacy. I understand controlling “controlled substances”, however, why should real sick folks pay for those who abuse drugs. I actually have gone through withdrawals several times, because even my pain management doctor all he wants to do is epidurals. I don’t want doctors sticking needles in my spine!! Can I have a medical choice? Why do I have to have needles that, I have actually tried in the lumbar because I got so tired of fighting with doctors, for the medicine injected to fade away in 6 weeks????????
    Please someone help! I wake up in pain, sleep with pain and wake up with pain. All of my autoimmune diseases are PAINFUL, especially, the Lupus. Please someone direct me, is there a petition going around? Or, maybe I should prepare one myself. Please don’t forget about your disabled with pain seniors………. if you needed heart medication to survive, would you like it to be taken away from you because others were abusing heart medication?

  3. Notwithstanding the ramifications and debates concerning euthanasia and whether it should be a liberty of personal choice or an issue of societal intrusion, I am convinced that we have another example of alleged social concern that is baseless in a society that purports itself a democracy with freedom of choice for its citizens. Have we not been bureaucratized enough? People these issues are the very reasons (or so we are told) that we fought World Wars. The freedom to drink, smoke, and eat ourselves to an addictive state that fosters all types of negative outcomes is at risk if citizens do nothing. Anybody who has suffered withdrawal from narcotic drugs understands that it is equally debilitating, dare I say horrific, as the pain of the malady that required taking the drug itself. So, when you are in a state of withdrawal and suffering additional distress, remember who put you there – your government agencies that want to protect you from yourself among other agendas, which include “pain and suffering”. That’s a legal term for any of the pain population that practice law. The fallout from this so-called “War on drugs” is that the warriors who dress up like terrorist (masks, etc.) and call their boss a Czar, has failed. Consequently, because of incompetence or failure (?), the Czar’s army is passing the buck to pharmacists, who are trained to know chemistry and its effects on biology, and trying to make pseudo-cops of them. Only in America could such a “keystone cops” approach to enforcement and/or method of operation be tolerated by its citizenry. Pain patients who are being denied a medication that was invented for severe pain need to contact their local Congressmen and get this issue on the ballot(s) so that the voters can exercise their alleged freedom(s). Also, it is more than alleged that laws (Federal, etc.) have been broken by the pharmacies who deny filling a prescription that meets legal criteria. Pharmacists need to get back to business and stop playing cop(s). The Pharmacies’ lobbyists are not fighting hard enough to prevent the implied task of mind reading and profiling customers, (following ambiguous rules & regs and other arbitrary and capricious policies ), i.e., having law enforcement responsibilities thrust upon them. In fact, the last time I remembered, profiling and discrimination (selective Rx filling) was illegal. As luck would have it, I understand that 2 stores in FL of a national or regional chain of pharmacies are losing the right to sell certain, if not all, pain meds. Now, understand what I just said, 2 stores that are legally in business to sell drugs (pharmaceuticals) of which pain meds (oxycodone, etc.) qualify are not allowed to sell what they are in business to do … . The problem was that the stores sold too much of the aforementioned pain medication; however, there was no mention whether the prescriptions met the legal dispensing criterion. I thought selling was the point in a free enterprise market (?) … .
    P.S. All of the pharmacist who feel that it is wrong to deny non-cancer pain patients medication need to likewise contact their unions and boards to lobby against this unethical treatment of some of your customers and/or patients, as you have a voice. Contact a congressperson and say it’s not right … do not be intimidated by the government agencies who are implying that you are a cop – by all means use common sense – but do not let the ambiguous rules and regs that are full of mind reads, nominalizations, etc., that lead to vague interpretations cause you to not fulfill your responsibility to your customers. Can you observe internal illness and pain, isn’t that what doctors are for? Would you stake the life of a loved one on your observations? If the Rx meets the legal criterion, then fill it. I am sure you have updates on M.D.s who have lost their licenses. Worry about the compound mixtures, chemical reactions, etc., and stop stereotyping every pain user as a criminal. It is not your job to suspect a person’s integrity. Not all of those whom you turn away are fakers. As an example of what fear of authority is possible of creating, just watch the movie Compliance, which is about what could happen if you do not question authority (a young girl gets strip-searched and raped at her place of work because a guy posed as a cop over the phone and her fellow employees [good people] did not question the imposter’s authority).

    The DEA is our biggest problem and I wished I had addressed this more. I will make sure I do next time. The reporters are not asking us the right questions on camera. I will make sure they know that it’s not neccessarily the new laws on everything.. next time too. Yes they are too hard on doctors. But the pharmacies have issues too.
    The reason I say. Pharmacy guidelines need to be rewritten is because most ALL pharmacies in FL refuse to fill extremely too many precriptions from legitimate doctors every day. They are profiling and lying. They also are not specialists of pain either. They know plenty about medications of all kinds but many don’t understand tolerance , dependency, addiction, etc.. They are trying to tell doctors what to RX their patients, only because they have something in stock or have personal feelings about oxycodone. In which I feel is an effective pain medication for many people because it has the least side effects, such as sleepiness when people need to function during the day.. We are all different and one size doesn’t fit all. I also go by what the majority of patients say and I have heard from thousands of patients in the past year. They seek me out.
    I can’t wait until next rally. I sure hope more people come out and start fighting back. They will not bite you! If you are a legitimate patient? You have nothing to be afraid or ashamed of!
    Please come fight for your rights or drug addicts will win. Please don’t let this happen because there are 100 million people in real pain. Tomorrow? Anyone could be the very next chronic pain patient. You never know what the future holds for you, so this is a human rights issue as well. ALL AMERICANS SHOULD BE SUPPORTING THIS CAUSE, NOT JUST PAIN PATIENTS. Thanks all for your support.

  5. Thanks Pat for covering our story. I just got home and it was very tiring. The media kept us busy for the entire time we were there. I was pleased to see that we were on the Tallahassee news at noon, 5 and 6 o”clock and the 11:00pm news. I have seen several write ups of us. We will go back in January if we need to, when the new state representatives are in. We are also going to keep having local rallies to until we get the results we want. I really hope that this was the ice breaker and that more pain patients get involved! We need strength in numbers!

  6. I have to write this and many of you may not like it. After doing some reading and speaking with my RX I now understand why we are having trouble getting Rx filled. I have known my RX for over 4 years. We have become good friends. Working under fear of the DEA I can’t even imagine what they go through. To have to worry about loseing your business and ability to take care of your family. Everyone should read what they have to do and what happens if they forget to dot an I or cross a t.. I feel almost as sorry for them as I do us. So if getting my wife and my other meds filled every 30 days instead of every 90 days helps him stay out of trouble and still get my pain meds filled then thats a small price to pay. My RX is a very good man and I would never do anything to hurt him. He is just protecting his family just like we think of it that way. They are victims to. Thanks Buddy I wish you would have told me sooner.Terry

  7. My pleasure HS! Best of luck.

  8. Please help!!!!! I can’t handle the pain without medication. 9 years I hace been on it and donot want to die

  9. Dr. Fudin,

    Thank you for correcting me. I thought this was a factual statement, because the home nurse who came to her house told her this was the case. She made her immediately stop taking the other script and made the comment about bleeding.
    I’ll have to check up on my resources even if I believe they are credible before I post. Thank you again.

  10. It seems to me, after reading some article about what an Rx person is suppose to do prior to filling prescriptions, that Rxs need a better union and/or lobby — as they made you into pseudo-cops. I was really surprise how it reads — a lot of nominalization and mindreads. Now, I understand some of why I have been treated like I have. You Rxs need to lobby the boards and regulators so that you can get back to better chemistry vs. biology issues. However, I am a Christian, and I know I should not bring this up, but how do some of these Christian Rxs live with the fact they are blatantly telling lies about whether they have the drug in stock, on order, or if they even carry it, etc. — this is happening to established customers, too. Misinformation is intentional lying. I will try to find the article’s url and post it later. At any rate, I have a better understanding of what the Rxs are facing. The solution might be better screening of applicants for medical licenses. Because if the bureaucrats that oversee doctors would do their jobs, we would not have so many practicing bad medicine. The onus of finding lawbreakers should be on the police and not the Rxs.!!!

  11. Dr. Fudin. With all due respect…. We have every right to say what our opinion is here. We may not have as many letters after our name as you do, but we have been silenced by enough people. Terry’s question is a good one, and you do not need to defend every pharmacist and doctor. Obviously, we know there are excellent, compassionate, competent doctors around. No one is attacking any pharmacists, either. People are chronically ill, and systematically being denied treatment, going into painful withdrawal, and even committing suicide from untreated pain. I understand your point about having our information accurate, before posting anywhere, but you already made that point! PROP is far from accurate, and they are sending things to the FDA! We are scared, in pain, and being discriminated against because of our health conditions. Please. Stop being so critical! Not all patients are “innocent victims”, and not all doctors and pharmacists are either! People are just telling their stories!

  12. Terry and all; I’m not saying it’s right or wrong. I’m just trying to clarify some points for the group. Unfortunately there is bigotry, arrogance, and lack of knowledge wherever there is justice, intelligence, and ignorance in all walks of like and every profession from coast to coast and worldwide. I am not trying to justify any wrongdoing on the part of anybody. I just want everyone to understand that when you attack a group of physicians and pharmacists, many of them are not at fault and are actually on your side, it is not helping your cause. I can tell you for sure that pharmacists and doctors have been held at gunpoint (usually pharmacists), many of whom have been killed over drugs. I don’t blame any of you, but can you imagine going to work thinking that at any time someone might come in and shoot you on the one hand, and on the other, someone might take away your license? Believe me, they do not want to be in that position, and certainly they have nothing to gain by watching patients beg for drugs or suffer in pain. You should all think twice before you type…PLEASE!

  13. Dr Fudin I have been taking the same scrip for the 4 years I have been here in Florida.I see the same doctor take a drug test when ever ask and only fill at the same pharmacy . Last time I went they told me from now on I would have to have 6 other scrips of non controlled meds filled every 30 days in order to get my pain meds filled. Between me and my wife of 49 years we only have 4.They did fill my meds this month but next time I have to have our blood pressure and colestrol changed from 90 days to 30 days with 2 refills.I really don’t understand what this has to do with getting my pain meds filled but thats what I have to do.Does this make any sense to you?

  14. Kim & HS. I hear what both of you are trying to convey. Kim: you are SO right, that this mess with Pharmacies refusing to fill legitimate prescriptions from credible doctors, doesn’t really have anything to do with their responsibilities as a pharmacist. They are either profiling people, and misjudging them based on what they have been prescribed, or they are acting out of fear from the (very real) threat of the DEA & sanctions against them. Patients are being lied to, hassled, even told to “go get their DRUGS somewhere else!”. No pharmacist should HAVE to do anything that they are seriously concerned about in regard to patient safety, etc.. BUT this isn’t the issue here. This is simply denying people their medication based on the TYPE of med it is. This isn’t routinely and systematically happening to to diabetics, heart patients, and others. This is specifically happening to patients trying to fill opioid medications.

    HS… I hear you too. The specifics may have been incorrect, but you’re is SO true that many doctors are telling patients to take dangerously high amounts of both acetaminophen and NSAIDS, on a daily basis, in order to avoid prescribing opioids at all costs. No one seems too bothered by all the ulcers, heart attacks, strokes, and liver & kidney failure they can cause….. As long as their not giving you a ” dangerous narcotic”!!

    Terry! I think the same…. Has anyone considered the enormous elderly population in Florida? Do any of THEM have a legitimate need for opioid medication? I would think so! The database question is a good one. Is anyone using this to weed out the ” doctor shoppers” OR are people being denied because they have a PATTERN of filling opioid prescriptions monthly (even from the same doctor & pharmacy). Maybe the “chronic” users are being profiled?! Sounds more like it, perhaps.

  15. you said it Terry there is a CAUTION right? i was NEVER questioned, cautioned, OR DENIED GETTING THEM FILLED ONCE however i have been on same med for 2 years and another one added and this is nothing to be cautioned about no problem combining the two NOW i get denied , profiled , etc… I said they are not to be combined after reading alot of things online about mixing the two. If they were SO concerned about patients safety why was i never warned or denied once in 2 years? and for having a pain med i am ? makes no sense and it is discrimination or whatever you wanna call it but there is NO basis to be treated like this whatsoever.

  16. Yes Terry, you are correct! The intent was to weed out the Pill Mills. Unfortunately, politicians are often misinformed or over-predict or can’t predict what the fallout of new regulation will be. No reasonable person would dispute that the Pill Mills had to go, that corrupt doctors, pharmacists, nurses, nurse practitioners, physician assistants, businessmen/women, perhaps political connections, corrupt law enforcers, and others needed to be squelched and thrown in jail. But, to create a “Police State” I the process without due diligence towards good patient care and protection of the innocent seems to be, at least to some extent, the fallout from rounding up the corruption. It’s easy for politicians to hang their hat up as “do-gooders” to the community at large and perhaps reign in votes. But, it will be up to all of you brave painful heroes to see that the voices of pain patients echo loud and clear to the community so that voters realize that tax-paying citizens need to be protected and cared for; it is a balance between regulatory agencies and good medicine. Pill Mills were a problem created in large part by political inaction and apathy among law enforcement and politicians. The people of Florida need to understand that your politicians are not heroes just because Pill Mills went away. While they deserve their due credit for that, they also need to be reprimanded for ignoring the unfortunate citizens that have been hung out to dry while they smile for the press and take credit a half-filled glass of success.

  17. Congratulations to Donna Ratliff and all the other dedicated and inspirational advocates who rallied in FL. Thank you for bringing awareness to the current difficulties some patients are having with getting their medications refilled. The important thing is that each patient must be evaluated on a case-by-case basis. There are too many stereotypes out there about opioids and opioid users, including in the medical community where people should know better. Each person is an individual, with a unique personal history and reason for being prescribed opioids. The demonization of these very useful drugs and those who use them must end. We can not end drug abuse by discriminating against people who are using opioids responsibly.

  18. DR Fudin isn’t that what the data base was supposed to do weed out the bad guys and take care of the good guys.I have a great doctor.They even told me that at the places I went to fill my scrips.They looked him up and said he was a very well respected doctor.But still could not fill mine

  19. Does anyone think maybe the reason for the high volume of prescriptions could be do to the high volume of old people like myself living here in Florida. I am retired construction superintendent with a lot of pain due to work.I am not a drug addict or a dealer.

  20. HS and KM,
    The both of you and all others that are advocating for yourselves and pain patients are to be commended. However, it would be prudent to make sure your statements are factual before posting them for the world to see. Each time an incorrect statement is made, it minimizes your credibility as individuals and for your group. I cannot overstate how important this is.

    HS: “…2500 mg of [acetaminophen] a day on top of her other blood thinner. She’s a dialysis patient. If she would have gotten a cut she could have bled to death…” FYI, 2500mg of acetaminophen per day is considered low dose and acetaminophen does not thin the blood, nor is it especially problematic for dialysis patients. You are confusing it with NSAIDs such as ibuprofen or naproxen. And, even with NSAIDs, often times once a patient is already on dialysis, you don’t need to worry about the kidney toxicity from NSAIDs because the kidneys are already fried. There are however other reasons that you may not want to use NSAIDs in a dialysis patient, but it’s too complex for this forum.

    KM: “…I later read you are not supposed to combine [the] two [drugs]. Also not true. For sure, a hypnotic drug such as “Xanax” needs to be used with caution when combined with an opioid, but it is not a contraindication. It is a WARNING. It is not at all uncommon for a physician to prescribe the combination for many different reasons. I’m certain that if you check with some of the chronic pain patients, you will find, that although the combination needs to be prescribed (and dispensed) with caution, it is not a wholly unreasonable combination and presumably many of the chronic pain readers could confirm that.

    PLEASE, be careful and thoughtful about what you say and who sees it in order to maintain credibility. You owe that to yourselves and your fellow pain sufferers.

  21. I commend these patients (& the ones who were there ‘in spirit’, but we’re too sick to make it) for fighting back & trying to get their voices heard. What is happening in Florida (& other states) is an absolute disgrace. This “war” on drugs has failed miserably. People with serious pain conditions are treated as GUILTY until proven INNOCENT, like criminals for being sick & needing treatment. I live with chronic, Intractable pain from a genetic connective tissue disorder, called Ehlers-Danlos Syndrome. There is no cure, but my symptoms like severe pain are “managed” with opioid therapy. I cannot imagine having to do the “pharmacy crawl”, or not being able to have my legitimate monthly prescriptions filled. I have been hearing more and more stories about legitimate pain patients being treated as sub-human, with no respect, decency, or dignity. Most recently, in Kentucky, a woman who suffers from the same condition I have, was “thrown into a detox” after her doctor “accidentally” urine tested her for the wrong medication which obviously meant she wasn’t taking it. This lead to one nightmare after another for her. She has always been a ” compliant” patient, has never abused her medication, has been on the same dose for YEARS, and automatically….it is ASSUMED that this woman is diverting & selling her medication on the street. She finally received an explanation and apology about the mix-up from her doctor, and was ” released”, but the damage is done. She now has severe untreated, intractable pain, dangerously high blood pressure, and is BEDRIDDEN because of the nightmare she was put through. She is refusing any opioid medication for fear of being thrown into a locked unit somewhere, and having her rights taken away…. AGAIN. All because of a mistake, and the new KASPER law that has physicians suspecting all their patients of illegal behavior, misinterpreting the laws, and being terrified of DEA scrutiny & loss of licensure. I pray she doesn’t commit suicide, but she cannot live without treatment. THIS is the NEW reality for legitimate pain patients in 2012.

    I thank you, Dr. Fudin, for your advocacy & creation of PROMPT! I have become somewhat familiar with your work through Pain-Topics & Stew Leavitt. I commented on your blog at, and on your story at pain-topics. I thank you, especially, for your willingness to speak out publicly against the PROP agenda and FDA
    petition. For any patients who haven’t been following this, I urge you to check out Dr. Fudin’s blog, and the development of PROMPT (Professionals for Rational Opioid Monitoring and Pharmaco-Therapy). You won’t believe this folks, but there are actually doctors, pharmacists, researchers & other healthcare professionals who CARE about people in pain! So, if you are feeling like you need an ounce of HOPE in this mess, please see what’s happening!

    To all of those people in Florida who are suffering and advocating for people in pain, I hear you, I’m with you,
    and am so very proud and appreciative of you. I pray that you get better access to the treatment you require for
    your pain, that you have your voices heard loud and clear, and that you start getting treated with respect and dignity. You deserve better. We all do…

  22. Not true jeffrey! Not until this bs started w the dea did any pharmacies do this profiling bs a while back I had a dr writing me pescriptions for vicon as well as XAnax I later read you are not supposed to combine there two drus not ONCE did I have ay poblem filling in over a year of being on them. Don’t make excuses for them please.

  23. Thank goodness that a few brave people are speaking out. I alone know at least 25 to 30 people who have had some kind of issue due to this crisis. A friend had surgery and couldn’t get her script filled but had never had a prescription for pain pills in the past, my mother had a hysterectomy to remove a cancerous tumor and surgery on a broken ankle in the same month and they increased her usual script for another condition by 5 mg. They were so afraid to give her a stronger med without acetaminophen in it that they ended up giving her 2500 mg of acetomenophin a day on top of her other blood thinner. She’s a dialysis patient. If she would have gotten a cut she could have bled to death.
    The fear must end. We must stand together and fight. What is the difference between cancer pain and non-cancer pain… Nothing.

  24. I am extremely compassionate towards Donna Ratliff and have come to know her through my advocacy for her group and many pain patients throughout Florida and nationwide. I have admiration for all of the pain patients that traveled to Tallahassee from near and far…it’s difficult enough for non-pain patients to make that trip! Kudos to all that have been working to make things right.

    But, I must clarify one point. Regarding the statement, “What really needs to be done is the pharmacy guidelines need to be rewritten so that prescriptions written by a legitimate doctor have to be filled.” Patients need to realize that pharmacists spend a significant amount of time evaluating prescriptions from all therapeutic classes (not just pain medications) for appropriateness, drug interactions, dosage, etc. and communicate with prescribers constantly to ensure the best care for the patient. This is generally appreciated by clinicians and patients alike. I suspect that Ms. Ratliff is speaking from frustration (and pain). There are checks and balances and the days are long past that any healthcare provider accepts blind orders from anyone. The day that a pharmacist is REQUIRED to fill ANY prescription from a physician, or a physician is REQUIRED to provide medication by DEMAND of a politician or patient, is the day the safety wall crumbles and I leave practice.