Working with one hand behind their backs, it's how some Valley doctors feel as they try to get a handle on the opioid crisis.
It's a terrible epidemic in Arizona, and they're now asking the state for help. Doctor Zaheer Shah is a physician in Tempe, but today he's in Phoenix, pushing for change.
"Treatment of any disease is unique to the individual," Dr. Shah said. "We can not take a cookie-cutter approach to the treatment of disease in general."
Dr. Shah says right now there's only one buprenorphine/naloxone medication he can prescribe his patients on Arizona Health Care Cost Containment System (AHCCCS) without pre-authorization.
"Your options are Suboxone Film or Suboxone Film," Dr. Shah said. He says not every patient can take that medication. "If that works for you, great. If it doesn't work for you, tough luck."
On Tuesday, a group of medical professionals spoke to the Pharmacy and Therapeutic committee, urging the group to add medications to the "preferred" list.
"In reality, there's no one best medication," said Nick Stavros, the CEO of Community Medical Services. "The best medication is the medication that works for that patient."
It is possible to expedite a pre-authorization, so a patient doesn't have to wait but Dr. Shah says when it comes to opioid addiction, time is everything.
"By the time your provider goes through all the regulatory hoops to get you an alternative medication, chances are pretty darn good that you've already relapsed," Dr. Shah said.
The committee will make a recommendation to the state on what it believes is the best route to take.