How do you get rid of a customer addicted to Stadol?

[Keppra]

I've recently started floating at a CVS store and about 2 weeks ago, and one of the store's regulars was a 50 something woman coming in for a refill for Stadol Nasal Spray. I looked at the patient's medication history and told her it was too soon since she just got it 5 days ago and insurance won't pay. She told me she would pay cash, but since it's still early I said no. She then yelled and screamed that we were denying her medication and what right did we have to deny her medication. I told her "no" and she would have to come back when the time was ok for her to refill it. She didn't give up, she called her prescriber to change the dose and then she hung around the pharmacy for 2 hours. I still denied her prescription since it's a controlled substance. She then called my supervisor. I told the supervisor I felt uncomfortable filling it since it was so early. That was the last I seen of her that day.

Today, I went back to the same store. She came in again for her refill of Stadol again. Same thing happened. But she hung around even longer today and kept calling the pharmacy throughout the day. Obviously she's addicted and desperate for her Stadol. It is a highly addictive drug. Has anyone else been in a similar situation? And how do get rid of this kind of customer???

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[genesis09]

All pharmacies have their "special" controlled patients.
Mine was able to get a MD to call in tylenol #3 for her children for a "toothache." She would cycle around all her children. Eventually, I caught on. By the time I realized what she was doing it was 9 months into her doing it. I hadn't been there for all that time. We call the physician's office. Apparently, the MD is not always with it. We talked with the nurse, and apparently the children never had a visit there. So, we were told to refuse to accept controlled call ins from this physician. Her latest stunt is to come in and state we wrongly filled her prescription. She got away with it once with the other pharmacist. She then decided to do it with me. She gave me this Vicodin ES bottle (10 dram) with several Augmentin in them. The Augmentin were old and cracked. The supply on the bottle was 30. There is no way 30 Augmentin 875 mg are going to fit in a 10 dram.
On top of all this, she is locked into our pharmacy because of the fact she called in fake vicodin scripts. The only way for us to get rid of her would be to call up the state and tell them to find her another store.

 

[Its Z]

Make her wait longer and longer...and let her go into withdrawal....she'll have a seizure and die...




Problem solved.

 

[Keppra]

Thats just awful....I would hate to have to get the state involved in this. Plus, the neurologist who prescribed the Stadol just wants her off his back so he enables her Stadol addiction and gives her new rx every time. I wish I was working in the pharmacy to deny any new prescriptions she brings in so I could just tell her to go to another pharmacy.

 

[MountainPharmD]

I've recently started floating at a CVS store and about 2 weeks ago, and one of the store's regulars was a 50 something woman coming in for a refill for Stadol Nasal Spray. I looked at the patient's medication history and told her it was too soon since she just got it 5 days ago and insurance won't pay. She told me she would pay cash, but since it's still early I said no. She then yelled and screamed that we were denying her medication and what right did we have to deny her medication. I told her "no" and she would have to come back when the time was ok for her to refill it. She didn't give up, she called her prescriber to change the dose and then she hung around the pharmacy for 2 hours. I still denied her prescription since it's a controlled substance. She then called my supervisor. I told the supervisor I felt uncomfortable filling it since it was so early. That was the last I seen of her that day.

Today, I went back to the same store. She came in again for her refill of Stadol again. Same thing happened. But she hung around even longer today and kept calling the pharmacy throughout the day. Obviously she's addicted and desperate for her Stadol. It is a highly addictive drug. Has anyone else been in a similar situation? And how do get rid of this kind of customer???

First off you work for CVS. In my experience CVS pharmacists are so understaffed, stressed out and busy they do not have time to pay attention to things like refill too soon. They are busy making PCI calls, answering the phone in 2 rings and things like that. So basically she is used to CVS always filling everything everytime no matter how early.

I usually tell people we are not filling there narcs early ever. If they want it early I tell them to go to the CVS across the street because they never pay attention to that kind of stuff. Problem sovled on my end! This won't work for you since you work for CVS but it is how I get rid of alot of annoying drug seeking people.

 

[rph3664]

At my last retail job, telling a customer to go elsewhere was a firing offense, even if it was a patient demanding that we break the law. 😡

 

[spacecowgirl]

Make her wait longer and longer...and let her go into withdrawal....she'll have a seizure and die...

Not from opioid withdrawal. She would just feel, really, REALLY crappy. And need some loperamide.

 

[Rebel78]

Stadol, in my experience, is one of the most addictive drugs out there. When I was an intern at Rite-Aid, we figured up that a lady had spent over 50K in about a year and a half on that stuff.

 

[rph3664]

Stadol, in my experience, is one of the most addictive drugs out there. When I was an intern at Rite-Aid, we figured up that a lady had spent over 50K in about a year and a half on that stuff.

When I graduated in 1994, it wasn't scheduled. You can imagine what things were like at that time.

One of my friends was given Stadol while in labor, and she said it did nothing for the pain but made her unable to articulate how she felt, because she was so dopey.

 

[Old]

At my last retail job, telling a customer to go elsewhere was a firing offense, even if it was a patient demanding that we break the law. 😡

I had a pharm sup. once who was upset that I was not comfortable filling oxy's,percocet etc early and for cash. Was given the lecture about the $'s was good for buisness. If I did not feel comfortable I should call Dr. Fellgood and get a diagnosis and fill them.

Once again I said I did not feel comfortable for the safety of the patient and the community. The patients involved were public assistance but always had 2000/mo cash for their rx's. Where is the money coming from? I told him to please write down that he wanted me to fill them and sign it so that I would understand what he wanted. He then said it was my call and do what I felt comfortable doing. Last I ever heard about it. As long as it is your license on the line they want the $'s untill they bear some responsibility.

 

[Ackj]

I had a pharm sup. once who was upset that I was not comfortable filling oxy's,percocet etc early and for cash. Was given the lecture about the $'s was good for buisness. If I did not feel comfortable I should call Dr. Fellgood and get a diagnosis and fill them.

Once again I said I did not feel comfortable for the safety of the patient and the community. The patients involved were public assistance but always had 2000/mo cash for their rx's. Where is the money coming from? I told him to please write down that he wanted me to fill them and sign it so that I would understand what he wanted. He then said it was my call and do what I felt comfortable doing. Last I ever heard about it. As long as it is your license on the line they want the $'s untill they bear some responsibility.

 

[StevePerry]

Great album man. They seriously turned a huge corner bringing in Bob Rock. Still partial to Shout at the Devil though and the hot but flat-chested blonde chick on the cover...

 

[J ROD]

I would simply tell the patient that I am not going to fill it early no matter what so you might as well not come back.

And, if the DM gets on you, tell them you will just let the state and federal authorities know about how the company likes and promotes circumventing the law.

 

[johnep34]

Following a few high profile cases in the UK, Drs now have to be licensed to prescribe addictive drugs and all scripts have to be sent after dispensing to a central office. No repeats/refills allowed. If you consider a Dr is complicit in over prescribing, then required to mention this to central drug agency office. Drs prescribing more than the average of controlled drugs are visited to find out why.
All this followed the Dr Shipman case.
johnep

 

[Its Z]

Will legalization of controlled substances turn us into a nation of addicts or is it just another attempt for a government agency to secure their jobs?

As inhumane as it seems, why not let it loose and let the natural selection process take care of itself and eliminate the "addiction genes" from our pool?

It would certainly make Juarez, Mexico a safer city to legalize dope..

I guess the biggest fear of drug lords and the DEA is the legalization of drugs!


can o' worms.

 

[Its Z]

There are 3 factors to consider in controlled substance dispensing.

1. For pain control and proper indications
2. To feed the addiction
3. Redistribution through illegal trade


imo, #1 and #2 are medically necessary and why do we feel it is our job to cure public drug addiction and use "my license is on the line" as one of the excuses?

Should we deny filling scripts for addicts?

 

[johnep34]

Prohibition of alcohol never worked and nor will that against drugs. I suggesting legalising via a script. I do not object to people being addicted, it is the associated crime that needs to be eliminated. Once dealers taken out by legal supply, addiction will die a natural death.
Will need to be treated alongside alcoholism.
johnep

 

[Its Z]

Prohibition of alcohol never worked and nor will that against drugs. I suggesting legalising via a script. I do not object to people being addicted, it is the associated crime that needs to be eliminated. Once dealers taken out by legal supply, addiction will die a natural death.
Will need to be treated alongside alcoholism.
johnep

I like the way you think Brit.

 

[spacecowgirl]

imo, #1 and #2 are medically necessary and why do we feel it is our job to cure public drug addiction and use "my license is on the line" as one of the excuses?

I completely agree. As long is the RX is valid, I don't really get too worked up about whether someone is using it for reason #1 or #2. Thankfully where I do float work now, you don't have to be the narcotic police (in SC, as mentioned elsewhere, you do). Denying someone clean needles is not going to get them off dope and neither is playing police over legitimate prescriptions.

Really, what is the difference between that and a methadone clinic? If you think methadone clinics are there to get people off of drugs, think again. The options for someone who is a functioning addict (they do exist) are practically nil. Need to go to rehab? Insurance pays for 7 days - because 7 days is enough 🙄 Need longer? Lose your job that pays said insurance among other things. It's cheaper and easier to doctor shop.

 

[ucrx]

I completely agree. As long is the RX is valid, I don't really get too worked up about whether someone is using it for reason #1 or #2. Thankfully where I do float work now, you don't have to be the narcotic police (in SC, as mentioned elsewhere, you do). Denying someone clean needles is not going to get them off dope and neither is playing police over legitimate prescriptions.

I agree- as long as the prescription is reasonably safe. I'm not going to fill a script so someone can take a borderline lethal dose for their addiction.

I also get frustrated with doctors who refuse to treat a patient's pain because they have an addiction. So what? They're still in pain. Your job is to treat it. This is worse inpatient- what do you think they're going to do when you give them one dose at a time?

 

[Doctor M]

what's a borderline lethal dose? would you have an issue filling these south Florida pain clinic scripts we get presented to us all day every day for #240 oxy 30mg and #120 oxy 15mg? the people presenting these are 90% of the time in their 20s-30s and look like stereotypical junkie/pillheads who are paying cash.

it's definitely the most frustrating thing for me as a new licensee down here.

We are in the same boat here in st pete...Its easy to tell when they walk in the door what they are there for...We arent taking anybody new for oxycodone, in fact we are "discharging" a few of them...

 

[owlegrad]

We are in the same boat here in st pete...Its easy to tell when they walk in the door what they are there for...We arent taking anybody new for oxycodone, in fact we are "discharging" a few of them...

I was at today's BOP meeting and this came up. Apparently two pain management pharmacies were shutdown just this week in south Florida. Supposedly the DEA came in with guns drawn and everything. Anyway the FL BOP is defenatly aware of this issue and are trying to get ahead of it.

 

[Doctor M]

I've recently started floating at a CVS store and about 2 weeks ago, and one of the store's regulars was a 50 something woman coming in for a refill for Stadol Nasal Spray. I looked at the patient's medication history and told her it was too soon since she just got it 5 days ago and insurance won't pay. She told me she would pay cash, but since it's still early I said no. She then yelled and screamed that we were denying her medication and what right did we have to deny her medication. I told her "no" and she would have to come back when the time was ok for her to refill it. She didn't give up, she called her prescriber to change the dose and then she hung around the pharmacy for 2 hours. I still denied her prescription since it's a controlled substance. She then called my supervisor. I told the supervisor I felt uncomfortable filling it since it was so early. That was the last I seen of her that day.

Today, I went back to the same store. She came in again for her refill of Stadol again. Same thing happened. But she hung around even longer today and kept calling the pharmacy throughout the day. Obviously she's addicted and desperate for her Stadol. It is a highly addictive drug. Has anyone else been in a similar situation? And how do get rid of this kind of customer???

So how many bottles of stadol was she getting at one time? each 2.5 ml bottle gets like 10 doses. The dose is usually 1 spray in one nostril, but a 2 dose sequence may be used...in essence one bottle will last 5-10 days...and depending on severity of pain, the 2 dose sequence may be used every 3 to 4 hours...i hope that the day supply was correct in your computer...The pat may receive anywhere from 3-6 bottles per month...

 

[Doctor M]

I was at today's BOP meeting and this came up. Apparently two pain management pharmacies were shutdown just this week in south Florida. Supposedly the DEA came in with guns drawn and everything. Anyway the FL BOP is defenatly aware of this issue and are trying to get ahead of it.

We stay away from the 20-25 yr old range who come in for 180-240 30's, 90 15's, soma, xanax...etc etc...no thanks...When they come in for just oxycodone, we always ask what else are you taking...we're looking for maintenance drugs, BP, GERD, Diabetes, anything like that...Not just Oxycodone...85% that walk in the door, dont take anything else...we turn them away...we just arent interested...Ive had some come in and say "we have cash"...we bluntly tell them that we are not that kind of pharmacy....please leave...

 

[owlegrad]

I just want the BOP to get hoppin on the drug monitoring system here.. I'm from Ohio and loved the ability up there to log in to the board's secure site and see what people had dispensed at other pharmacies, who the prescribers were, etc (1-2 week lag but still very useful). It's not so much the 1 pain clinic Rx filled, it's when they're seeing 5 docs a month who prescribe all the same things.

www.FLPrime.com

Should be up sometime this week, if the person who was giving a report to the board can be believed. (And if I understood correctly, I was bored out of my mind.)

 

[owlegrad]

We stay away from the 20-25 yr old range who come in for 180-240 30's, 90 15's, soma, xanax...etc etc...no thanks...When they come in for just oxycodone, we always ask what else are you taking...we're looking for maintenance drugs, BP, GERD, Diabetes, anything like that...Not just Oxycodone...85% that walk in the door, dont take anything else...we turn them away...we just arent interested...Ive had some come in and say "we have cash"...we bluntly tell them that we are not that kind of pharmacy....please leave...

"Are you the type of pharmacy that fills prescriptions or not!?!"

 

[Doctor M]

"Are you the type of pharmacy that fills prescriptions or not!?!"

125-150rx per day, open 1 year...yes we fill rx's...🙄

 

[owlegrad]

125-150rx per day, open 1 year...yes we fill rx's...🙄

I was just quoting my favorite druggie question. I have seen it come front end (as in a phone call asking me that) or back end (as in when we tell someone we won't fill their 240 oxy 30's). Cracks me up every time. Nope, we don't fill prescriptions here!

 

[Doctor M]

I was just quoting my favorite druggie question. I have seen it come front end (as in a phone call asking me that) or back end (as in when we tell someone we won't fill their 240 oxy 30's). Cracks me up every time. Nope, we don't fill prescriptions here!

 

[KARM12]

125-150rx per day, open 1 year...yes we fill rx's...🙄

Awesome! That was more than the grocery chain I interned at did in a day.

 

[phathead]

I once knew a whole family that was hooked on that stuff.

We had several patients that we refused to fill their controls until it was within a day of two of their due date. We flat out told them, if they had a problem with it they were welcome to go elsewhere.

In which they usually did, but they would come back in a few weeks because they would have gotten tossed out of another store.

I personally don't take this kind of stuff lightly. I won't allow a patient to pay cash for a control if it is too soon to fill per insurance. In fact, in a state I worked in a while back, it was illegal to do so.

 

[Doctor M]

Awesome! That was more than the grocery chain I interned at did in a day.

Thanks...

 

[Menon5505]

I'm a Stadol user for chronic cluster migraines and ran accross this post and really felt the need to reply. See, I've been on the receiving end of this and had a pharmacist tell me that he couldn't refill that it was too soon - even though my Neurologist gave specific instructions on my Rx. This happened to me on a Friday so I had to wait till Monday to get ahold of my dr to get this straightened out. I was WITHOUT my medication and at the mercy of urgent care for 3 days because a pharmacist wanted to play my Doctor for the weekend. End of story - Neurologist called District store mngr and made complaint. Asked if we needed to use a different pharmacy? And now by some miracle I can get my meds as directed by my physician. Also, this entire time my insurance pays every 7 days for the nasal spray!!

SO - Insurance covered it 7 days after the last refill, Neurologist requested the refill and STILL that pharmacist didn't want to back down. His district manager though.. different tune. Haven't seen that pharmacist since either.... hummm

 

[Hibiclens]

I'm a Stadol user for chronic cluster migraines and ran accross this post and really felt the need to reply. See, I've been on the receiving end of this and had a pharmacist tell me that he couldn't refill that it was too soon - even though my Neurologist gave specific instructions on my Rx. This happened to me on a Friday so I had to wait till Monday to get ahold of my dr to get this straightened out. I was WITHOUT my medication and at the mercy of urgent care for 3 days because a pharmacist wanted to play my Doctor for the weekend. End of story - Neurologist called District store mngr and made complaint. Asked if we needed to use a different pharmacy? And now by some miracle I can get my meds as directed by my physician. Also, this entire time my insurance pays every 7 days for the nasal spray!!

SO - Insurance covered it 7 days after the last refill, Neurologist requested the refill and STILL that pharmacist didn't want to back down. His district manager though.. different tune. Haven't seen that pharmacist since either.... hummm

There are a lot of details missing in this scenario so no one can clearly comment on what happened. Out of the 10's of thousands of pharmacists out there we have established that there are some that are simply subpar...so that is a possibility no doubt.

Also this thread was last posted on 6 months ago...how did you run across it? Just curious.

 

[ronkoshy]

...

 

[swatchgirl]

Too bad you're banned. I was gonna ask you how your Stadol addiction has played out for you... Migraines all gone now? Cured by Stadol? Living happily after? Are you still using that one pharmacy to fill all your Stadol scripts? Please post an update so I'll know what to advise customers that are in the same boat as you were.

I'm a Stadol user for chronic cluster migraines and ran accross this post and really felt the need to reply. See, I've been on the receiving end of this and had a pharmacist tell me that he couldn't refill that it was too soon - even though my Neurologist gave specific instructions on my Rx. This happened to me on a Friday so I had to wait till Monday to get ahold of my dr to get this straightened out. I was WITHOUT my medication and at the mercy of urgent care for 3 days because a pharmacist wanted to play my Doctor for the weekend. End of story - Neurologist called District store mngr and made complaint. Asked if we needed to use a different pharmacy? And now by some miracle I can get my meds as directed by my physician. Also, this entire time my insurance pays every 7 days for the nasal spray!!

SO - Insurance covered it 7 days after the last refill, Neurologist requested the refill and STILL that pharmacist didn't want to back down. His district manager though.. different tune. Haven't seen that pharmacist since either.... hummm

 

[Sine Cura]

I know necro-post and all but "do I need to send my scripts to another pharmacy?" would be music to my ears.