Advocacy

Availability of Prescribed Medications

Adoption Date:
April 1, 2007

Public Policy Statement on Availability of Prescribed Medications

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Background

The American Society of Addiction Medicine’s Public Policy Statement on the Principles of Medical Ethics states:

Society's response to alcoholism and other drug dependencies has reflected a history of stigma and prejudice towards persons who suffer from these illnesses and their families. The addictionist therefore has a special role as advocate for those changes in law and public policy that will improve the treatment of addiction, reduce stigma, and protect the rights of those affected.

Addictionists have particular reason to oppose actions by prescription dispensing agencies to refuse to fill specific types of prescriptions and to support legislative and regulatory actions designed to provide maximum assurance of access to prescribed medications.

While the American Pharmacists Association’s “Pharmacist Conscience Clause” “recognizes the individual pharmacist’s right to exercise conscientious refusal and supports the establishment of systems to ensure patient’s access to legally prescribed therapy without compromising the pharmacist’s right of conscientious refusal,” organizations such as the American Medical Association have correctly supported state legislation requiring that the refusing pharmacist “provide immediate referral to an appropriate alternative dispensing pharmacy without interference.” In situations in which a pharmacists’ refusal leaves the patient without recourse to a prescription dispensing agency within a 30-mile radius, the AMA also supports state legislation to allow physicians to dispense the medication.

Furthermore, reported instances of patients with substance use disorders being denied prescriptions on grounds which cannot be claimed as an exercise of “conscientious objection” suggest even more strongly the need for additional protection.

Recommendations

Therefore, ASAM opposes selective refusal by prescription dispensing agencies to honor physician prescriptions, unless state law or regulations ensure that:

• the prescription is returned to the patient;
• the prescription fulfillment agency informs the prescribing physician;
• the prescription fulfillment agency provides the patient and the physician with the name and location of an alternative source for the prescription; and,
• the refusal by the prescription fulfillment agency can clearly be linked to the exercise of “conscientious objection.” Failure to satisfy this condition should be considered grounds for reporting the agency to the supervising state agency for disciplinary action.

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