Oxycodone is in short supply in some Colorado pharmacies because of a quota imposed on the powerful painkiller, which is abused by both the sick and the slick.
Good-faith efforts to keep the pills away from addicts and pushers are also keeping them away from those who desperately need them, say some Colorado pharmacists.
"We have customers who bring in a prescription from a doctor every month ... and now we can't fill them," said Dennis Mantas, owner of Wheat Ridge Pharmacy. "It's a big problem."
Jeannine Hawkins, 68, of Littleton, who needs 150 oxycodone pills a month to deal with the pain of cancer treatments, nerve damage and knee surgery, used to be able to get a 30-day supply at a time.
This week, "the doctors today told her they could give her just a 10-day supply because of the shortage," her husband, Wayne, 69, said.
He's worried that the next time he goes back, there will be no pain pills available for his ailing wife.
The Drug Enforcement Administration limits the amount of oxycodone and Oxycontin (the leading brand name) manufacturers can produce, says Val Kalnins, executive director of the Colorado Pharmacists Society.
Each year, the DEA estimates how much Oxycontin is needed to meet the "legitimate medical, scientific, research and industrial needs of the United States," then sets the quota accordingly.
Oxycodone is an opioid, as is heroine, codeine, fentanyl and morphine, says the DEA. Too much inventory heightens the chance of diverting it to illegal uses.
But Mantas says the DEA must not have taken into account that the population is getting older, and that means more aches and pains and cancer treatments that need to be treated by Oxycontin and other pain medications.
A recall by Mallinckrodt and cutbacks by Ethex have exacerbated the oxycodone shortage, which started about December, say pharmacists.
Oxycontin, also called "Oxy" or "hillbilly heroin," contains the active ingredient oxycodone and first was made in 1996.
By 2001, its use had increased 20-fold.
The DEA says that more than one in 20 seniors in high school use it — mostly illegally.
Doctors are prescribing more pain medication, mostly because people legitimately need it, says Mantas.
Certainly, thieves try to steal the supply, and there are some doctor shoppers out there, who may get a 30-day supply three times for the same knee injury, say pharmacists.
"But you know your regular customers, and you know their issues," Mantas said.
"We have customers who go to their doctor once a month, and stay right on time, right on task," he said. "We can't fill them. They try to switch to something else, but sometimes it's not covered by insurance.
"We're not going to fill prescriptions willy-nilly for anyone who walks in from the street. The DEA's intentions are good, but they're hitting the wrong end of it."
If the policy causes a shortage, "It doesn't solve the problem of people with all these pain issues."
He worries that if people in real pain can't get the medications, "they'll end up finding pain medications wherever they can find them" -- overseas or, illegally, on the black market."
"I don't know what the answer is," Mantas said. "But whatever they are doing now is causing more problems."
Wayne Hawkins, Jeannine's husband, said his wife really needs the 150 pills a month, but that "every time you mention oxycodone, everyone thinks you're a drug dealer."
There ought to be a way to make more oxycodone to ease the shortage, and not have any extra supply inevitably be siphoned off into the black market, he said.
He can't stand seeing her in pain, and would rather deal with curing a possible addiction than letting her suffer.
"She needs to take pain medication toward the evening before getting any sleep at all," he said.