Nearly a year after a sweeping opioid settlement imposed requirements on the companies that provide medications to pharmacies, patients across the nation are having difficulty obtaining drugs to treat many conditions, including anxiety, attention deficit hyperactivity disorder and addiction, the New York Times reports. The $21 billion settlement, brokered between the three largest U.S. pharmaceutical distributors and the attorneys general of 46 states, was designed to correct practices that had flooded the U.S. with prescription painkillers, contributing to the opioid crisis. Distributors are placing stricter limits on drug supplies to individual pharmacies and heavily scrutinizing their dispensing activity.
The oversight is not limited to opioids: It applies to controlled substances that have the potential to be addictive or habit-forming, such as muscle relaxants or medications like Xanax, used to treat anxiety and panic disorders. As a result, tens of thousands of drug orders have been canceled, disrupting the flow of medication nationwide as the distributors navigate the line between implementing safeguards and making necessary drugs available. Ilisa Bernstein of the American Pharmacists Association said that the controls, which took effect in July, had created “havoc” for some pharmacies. “They have patients coming in to get medication, and they can’t have it,” she said. “It’s disrupting patient care.” The distributors use algorithms that cap the quantities of controlled substances a pharmacy can sell in a month. Before the settlement pharmacists could explain to a distributor the reason for a surge in demand and still receive medications past their limits. Now the caps appear to be more rigid: Drugs are cut off with no advance notice. As a condition of the settlement, distributors cannot tell pharmacies what the thresholds are.