Opiod abuse

[eagles22]

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As far as the other part goes, if the doctor signs off on it (I believe) you absolve yourself of any liability. Sure, there are "pill mill" docs out there. I wouldn't begin with the phrase "With all the...." it sounds biased and a little jaded, although you may live in an area where it happens more often But on the other hand, refusing to fill a script on your own opinion or suspicion of "pill milling" may carry consequences. There are already precedents for job loss or discipline for refusing to fill a doctor's orders. The waters get foggier with opioids, and maybe there are some laws or rulings which cover this already that I am not aware of. But from my point of view, I know that a physician can be successfully sued for pain and suffering in denying a patient pain meds who they wrongfully suspect of seeking, so I would assume a pharmacist who suspects either the doc or the patient is also not immune.

That precedent you cited refers to moral objection to filling birth control, not refusal to fill opioids for suspicious behavior. Those are completely different things. Additionally, pharmacists do get sued when people fill rxs the doc okays. Pharmacists are there to check the doc's orders, not blindly follow them.

"Hooks v. McLaughlin: This case was decided by the Supreme Court of Indiana in 1994. McLaughlin sued Hooks SuperX (hereinafter referred to as Hooks) pharmacy and two of its pharmacists, claiming that they breached their duty of care by not refusing to dispense McLaughlins prescriptions because the pharmacists knew or should have known that McLaughlin was consuming the drugs so frequently that it posed a threat to his health." http://uiwpharmacyreview.com/index.php/uiwpr/article/view/16/25

 

[BidingMyTime]

That precedent you cited refers to moral objection to filling birth control, not refusal to fill opioids for suspicious behavior. Those are completely different things. Additionally, pharmacists do get sued when people fill rxs the doc okays. Pharmacists are they to check the doc's orders, not blindly follow them.

Good point on the difference, refusing to fill a prescription on ethical grounds is legally, a different situation from refusing to fill a prescription on medical grounds. (Not to mention, losing one's job for refusing to fill a prescription for any reason, is a completely different issue from having one's license brought before the board for refusing to fill a prescription.)

For SpecterGT260:

Difference, refusing to fill Plan B because one is against all birth control, as opposed to refusing to fill Plan B, because it was prescribed by a dentist and clearly out of their scope of practice.

Difference, refusing to fill opiods, because one is against all pain-relieving medications, as opposed to refusing to fill opiods, because based on their history, the pt has been getting different RX's from different physicians.

Of course, many situations are not all that clear-cut, which is why the pharmacist needs to be documenting the factual reasons why they are refusing to fill a prescription--ideally, those reasons would be based on medical facts (unless one lives in a state where they can refuse to fill a prescription based on their ethical beliefs.)

 

[SpecterGT260]

Thanks for the link. Yeah I know it isn't exactly the same. My point was just that the ambiguity of law makes it a possibility without any pre existing judgements. I don't have any experience in torts but did patent law for awhile in UG (summer internships) and was just drawing from the similarities there. But it does appear that a pharmacy was sued for filling 👍



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[SpecterGT260]

Unfortunately, when trying to look to see if there are cases of pharmacies getting hit in a similar fashion to physicians in denial of specific treatments (and to reiterate, there are cases where physicians have been sued for denying opioids to a patient in pain) it seems that google will be entirely unhelpful.... 😕

Following through with the search gives cases of state agencies getting sued for discrimination . Maybe that means if google doesn't know about it that it isn't a thing

 

[Digsbe]

I was told by a pharmacist that the dispensing pharmacist making the call on an early refill can be sued for an early refill if the patient claims that the pharmacy was contributing to their addiction by allowing an early fill. It can also be troublesome dealing with the DEA from what I have heard.

 

[SpecterGT260]

I was told by a pharmacist that the dispensing pharmacist making the call on an early refill can be sued for an early refill if the patient claims that the pharmacy was contributing to their addiction by allowing an early fill. It can also be troublesome dealing with the DEA from what I have heard.

That sucks.... That is similar to the story that eagles posted as well. IMO there is something to be said for personal responsibility... The "you're liable for giving me what I actively and consciously pursued" argument is absolutely insane to me.

 

[radio frequency]

I was told by a pharmacist that the dispensing pharmacist making the call on an early refill can be sued for an early refill if the patient claims that the pharmacy was contributing to their addiction by allowing an early fill. It can also be troublesome dealing with the DEA from what I have heard.

This isn't surprising to me at all. If bartenders can get sued for providing alcohol to people who later drink and drive, pharmacists allowing for inappropriate opioid dispensing (regardless of whether a script was okayed by the doctor or not) could easily be sued as well.

It's a professional liability. As professionals, we are required to use professional judgment, not peg everything on MDs.

 

[eagles22]

That sucks.... That is similar to the story that eagles posted as well. IMO there is something to be said for personal responsibility... The "you're liable for giving me what I actively and consciously pursued" argument is absolutely insane to me.

All health care providers have a duty to make sure that the patient isn't going to be harmed by their treatment. A plastic surgeon may be found guilty of malpractice for doing the 7th nose job on someone with body dysmorphic disorder even though the patient requested the surgery. The argument that the patient pursued the treatment is no sufficient defense. The healthcare provider is ultimately the one with the final say and expertise to determine if treatment is appropriate.

 

[SpecterGT260]

All health care providers have a duty to make sure that the patient isn't going to be harmed by their treatment. A plastic surgeon may be found guilty of malpractice for doing the 7th nose job on someone with body dysmorphic disorder even though the patient requested the surgery. The argument that the patient pursued the treatment is no sufficient defense. The healthcare provider is ultimately the one with the final say and expertise to determine if treatment is appropriate.

I understand that. I was just expressing my irritating with the litigious nature of our society. I never attempted to present that statement as a valid legal defense but rather an appeal to common sense (which... sadly, has little to no place in the legal arena)

 

[SpecterGT260]

This isn't surprising to me at all. If bartenders can get sued for providing alcohol to people who later drink and drive, pharmacists allowing for inappropriate opioid dispensing (regardless of whether a script was okayed by the doctor or not) could easily be sued as well.

It's a professional liability. As professionals, we are required to use professional judgment, not peg everything on MDs.

This is another example that irritates me for the same reasons. This crap is out there, but IMO that doesn't make it right. These rulings establish absurdly fine lines. When is it ok for me to sue the liquor store for a similar outcome? Does observing the consumption define the arbitrary line between the two? I find the whole thing silly...

 

[radio frequency]

This is another example that irritates me for the same reasons. This crap is out there, but IMO that doesn't make it right. These rulings establish absurdly fine lines. When is it ok for me to sue the liquor store for a similar outcome? Does observing the consumption define the arbitrary line between the two? I find the whole thing silly...

It may be silly, but it's the standard we are all held to. Good luck challenging it in court. Besides, I do think it's a standard pharmacists should be held to. We have the training and the knowledge. Why wouldn't we be liable?

 

[Digsbe]

This isn't surprising to me at all. If bartenders can get sued for providing alcohol to people who later drink and drive, pharmacists allowing for inappropriate opioid dispensing (regardless of whether a script was okayed by the doctor or not) could easily be sued as well.

It's a professional liability. As professionals, we are required to use professional judgment, not peg everything on MDs.

True, we all have our area of liability. I don't ever plan on pushing blame on the MDs, I plan on working with them and as far as my license is concerned only doing what is comfortable for me under what I would be directly liable for.

That sucks.... That is similar to the story that eagles posted as well. IMO there is something to be said for personal responsibility... The "you're liable for giving me what I actively and consciously pursued" argument is absolutely insane to me.

I completely agree. I think our healthcare system is sue-happy. When oxy changed it's formulation where if it is crushed or altered it turns into a paste I had a patient call the pharmacy and their first words were "Expect a lawsuit, I am suing you for giving me these messed up pills." After explaining that they were reformulated to prevent abuse she drastically shied away from the conversation though.

Could you imagine what it would be like if healthcare practitioners could sue their patients over some of the stuff they do?

 

[SpecterGT260]

It may be silly, but it's the standard we are all held to. Good luck challenging it in court. Besides, I do think it's a standard pharmacists should be held to. We have the training and the knowledge. Why wouldn't we be liable?

I think you are misunderstanding me. One can express a level of distaste or personal disagreement with something without arguing that it doesn't exist. I am perfectly aware of this in reference to physicians, and am now (since yesterday's post) aware of similar circumstances for pharmacists.

I didn't state that liability was relative to training or knowledge, nor did I state any intention to challenge anything in any court. 👍 I just said it's stupid. And it is 😉

 

[SpecterGT260]

True, we all have our area of liability. I don't ever plan on pushing blame on the MDs, I plan on working with them and as far as my license is concerned only doing what is comfortable for me under what I would be directly liable for.



I completely agree. I think our healthcare system is sue-happy. When oxy changed it's formulation where if it is crushed or altered it turns into a paste I had a patient call the pharmacy and their first words were "Expect a lawsuit, I am suing you for giving me these messed up pills." After explaining that they were reformulated to prevent abuse she drastically shied away from the conversation though.

Could you imagine what it would be like if healthcare practitioners could sue their patients over some of the stuff they do?

lol that's awesome. Some time's I kinda wish we could. Honestly I find the "standard we are all held to" to be artificially inflated in such a way that it takes nearly all responsibility off of otherwise fully functioning adults to simply be accountable for themselves. There are all sorts of ethical complaints to firing patients as well. Lawsuits are filed more often when someone is just pissed off than when something is actually done wrong. That doesn't seem right to me. So much about the legal aspect of healthcare just pisses me off