THE BURNED OVER DISTRICT

Can be very painful for those in Florida who suffer debilitating diseases that require heavy duty pain medicine like Oxycontin. Thanks to a crackdown on the freewheeling pill pushers who would dispense pills by the bushel to anyone walking through the door, it is now very difficult to get the medicine they need.

The 35-year-old mother of three from Florida suffers with lupus, an inflammatory disease that causes bone loss and joint problems. She has a ruined knee that will soon need replacing, and herniated discs in her back. Until last year, Diaz, a nurse living on disability benefits, had no trouble getting the painkillers and anti-anxiety medicines -- OxyContin, roxycodone and Xanax -- her doctors regularly prescribe.

That’s now changed after regulators clamped down on Florida’s lax prescription controls to halt an epidemic of painkiller abuse that kills more people nationwide than heroin and cocaine combined. Drug distributors and pharmacies hemmed in by new regulations are limiting the pain medicines they keep on hand and who gets them, making Diaz and hundreds of other patients like her collateral damage...

While the Florida crackdown has been successful in fighting abuse, patients with everyday pain say it has also had a chilling effect on their ability to fill prescriptions that are legally obtained, appropriate and necessary.

In some cases, they say, pharmacies carry limited supplies that often run out, and some businesses only want to deal with long-known patients. New faces, particularly those from outside their immediate neighborhoods, are often not welcome, said Colleen Sullivan, a 29-year-old muscular dystrophy patient.

That’s a particular problem for people who, like Sullivan, live in isolated areas. Sullivan’s home is in Marathon, a town in the Florida Keys with few pharmacies, she said. When they run out, Sullivan often finds herself traveling miles to find the drugs since pharmacies will no longer tell her over the telephone if they have a supply on hand, she said.

Paul Doering, a professor emeritus at the University of Florida College of Pharmacy in Gainesville, has worked with regulators on how best to control prescription use. Legitimate patients are in an awkward spot with drug sales now drawing strict monitoring, he said.

Distributors such as Cardinal Health Inc. (CAH), the second-largest by revenue, are delivering fewer drugs because of both lower demand and concerns they may be blamed for any oversupply going forward, said Doering. At the same time, pharmacies that faced tough questions about outsized sales in the past now often refuse to provide the drugs unless they they know a patient’s background, he said.

Until the state and the distributors work out a better system, those in need will continue to suffer.