So it has come to this. Across our country pharmacists and other health professionals are being murdered while in their stores by people wanting drugs. In New York State, the number of armed robberies rose from 2 in 2006 to 28 in 2010. In Florida, they increased nearly six-fold, from 11 to 65. California saw 61 robberies in 2010, Indiana had 45 and Tennessee had 38. In most cases, people have not been injured but no more. The bar keeps being raised and in Medford, Long Island, NY it hit the highest level yet.  Haven Drugs, about 60 miles east of New York on Long Island set the sad record. An alleged drug user David Laffer, 33, walked into the drugstore a week and a half ago and opened fire without warning. “He did not announce a robbery,” Assistant District Attorney John Collins said. “He simply shot first after engaging the pharmacist in conversation.” Laffer shot 45-year-old pharmacist Raymond Ferguson once , then killed 17-year-old store clerk Jennifer Mejia before he pumped two more shots into Ferguson. Then he started pulling Norco and other hydrocodone drugs off the shelves, Collins said. When customers Bryon Sheffield, 71, and Jamie Taccetta, 33, walked into the store, Laffer sneaked up behind them and killed them. Collins said. Execution style, no witnesses. My guess is he was pretty high. Feelings disappear when stoned, just ask a crack addict selling you their baby for a twenty dollar bill. 

We all agree, this is horrible. But in throwing our hands up, we do not do enough. We must all take a step back and admit we are part of this. At least those of us that have ever written a prescription for drugs with the potential to get you stoned or more than that, drugs that we know now lead to real abuse. If we are still writing for these drugs, like it or not, needed or not, we are part of the story. Yes, those Tylenol #3s and those oxycontin we wrote last year were only half used. The rest were taken by a 15 year old girl who wanted to numb another type of pain. She graduated one day to a better way to numb herself and then at 18 was arrested. Maybe she is the lucky one.

The IOM has just said that chronic pain effects 116 million of our population. I understand that well but consider that in 2007, there were only four pain clinics in Broward County Florida. Today there are over 150. I understand that especially in Florida we PAs and NPs have had little to do with that problem, but it is a symptom of the world we have been born into. Don’t blame me you say. I disagree, we are ALL to blame. Physicians, PAs and NPs. And clearly we ALL are part of the solution.

So where do we go from here? I am not an addiction expert but I do know we have an epidemic. NPs and PAs can do something starting today. Firstly, let us try our best not to prescribe pills that are addictive. Use OTC meds for pain, in most cases they work. And if you do prescribe something addictive give the least number possible with no refills. Think about that exact number needed before you write. 

For those who really have chronic pain, get a second opinion or have the tough ones seen in a real good pain center. All of us can decrease the amount of these drugs on the street today. Secondly, as writers of controlled drugs we PAs and NPs through our organizations should call for tighter and tighter controlls on all prescribers and manufacturers. Maybe a national summit. More can be done and as the new kids on the block we should take this opportunity to lead. 

They don’t call them painKILLERs for nothing............. 

Dave has been a PA, and later NP, leader for thirty years.  He strongly believes that NPs and PAs must work together to insure a better future for both professions.  Most recently Dave has been busy launching another dream; Clinician 1, the first internet community for PAs and NPs.  In October 2008, Dave was honored by the New Jersey State society of PAs with its “Lifetime Achievement Award”.

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