Today’s story in the NY Times on chronic pain writes about the practice of some to encourage chronic pain patients to go to multiple pharmacies:

The red flags that rightly alert regulators to potential misconduct by doctors are, paradoxically, the very features that can also mark responsible care for intractable pain. These include prescribing high volumes of narcotic painkillers for extended periods, prescribing potentially lethal doses or prescribing several different drugs. In some regions, patients use several different pharmacies, at their doctor’s instruction, because some pharmacists are reluctant to dispense large quantities of the medications.

A reader responds to this little tidbit:

The NY Times article mentions that some physicians are instructing their chronic pain patients to go to more than one pharmacy. In my opinion, this violates the standard of care for the treatment of chronic pain with opioids. In fact, I consider this to be malpractice. Chronic pain patients taking opioids should get all their pain prescriptions from one doctor, and have all their prescriptions filled at one pharmacy.

I’m not sure which regions in the country promotes this practice. With chronic narcotic treatment, strict “pain-contracts” are signed to prevent abuse, specifically stating that one doctor prescribes, and one pharmacy fills. Anything else would be an open invitation for abuse.