Wait Times for CII's

[josh6718]

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Just curious to know how others were handling wait times for CII prescriptions. Unless it is from an ER/dentist office, we typically say it is a 2 hour wait, and while frustrating, it simply doesn't seem possible to do any quicker.

To give a little background, our store has one of the highest dispensing for hydrocodone in the district (and more than two standard deviations above the national average). There have been days we have gone through 3000 tablets of 10/325 alone in just over 48 hours. This last Monday we did over 800 prescriptions with only 3 hours of pharmacist overlap. There will be 15-20 CII's stacked up and filled, only to have another 15-20 more appear in the next hour or two.

 

[RX2090]

Just curious to know how others were handling wait times for CII prescriptions. Unless it is from an ER/dentist office, we typically say it is a 2 hour wait, and while frustrating, it simply doesn't seem possible to do any quicker.

To give a little background, our store has one of the highest dispensing for hydrocodone in the district (and more than two standard deviations above the national average). There have been days we have gone through 3000 tablets of 10/325 alone in just over 48 hours. This last Monday we did over 800 prescriptions with only 3 hours of pharmacist overlap. There will be 15-20 CII's stacked up and filled, only to have another 15-20 more appear in the next hour or two.

2 hour wait? Holy ****. If I was a customer, I'd get the hell away from your store and never return. No wonder so many stores don't meet their script budgets, these narc patients take all their meds and go somewhere else.


Very simple. Just stop filling shady scripts. Only fill scripts that are legitimate. STOP FILLING oxy 30mg #180. Yes, you will have a horrible month with complaints, but they'll go elsewhere and stop bothering you.

In my store, if they want to wait, and its legitimate, we say 15 minutes. It really shouldn't take you longer than that to count pills, check the date on the script and log it In a narc book. It really, really shouldn't.

 

[Kavina]

I work in an outpatient pharmacy that's in the same building as a pain management clinic, and near a very large cancer center. Needless to say, we do a lot of CII prescriptions with large volumes. Since I work the intake window, for CIIs I typically tell patients that it'll be about 5 minutes longer than whatever my current wait time is, to take into account the extra book keeping required by the pharmacist. So if my wait time is about 15 minutes, I'll say 20. We usually have it done sooner. We only buy CIIs in bottles of 100, so there isn't a lot of counting to do, and filling out the book doesn't take too long.

 

[Bubba98]

2 hour wait? Holy ****. If I was a customer, I'd get the hell away from your store and never return. No wonder so many stores don't meet their script budgets, these narc patients take all their meds and go somewhere else.


Very simple. Just stop filling shady scripts. Only fill scripts that are legitimate. STOP FILLING oxy 30mg #180. Yes, you will have a horrible month with complaints, but they'll go elsewhere and stop bothering you.

In my store, if they want to wait, and its legitimate, we say 15 minutes. It really shouldn't take you longer than that to count pills, check the date on the script and log it In a narc book. It really, really shouldn't.

Very simple. Define shady. 2 hours is fine.

 

[PharmNerdMatt]

I used to use 1 hour for everyone except known patients, then it depended on how busy I was (just like everything else).

I didn't worry about losing patients that only filled CIIs as they didn't count towards my script budget anyway.

 

[boriqua]

i'm surprised people still come to a pharmacy that gives 2 hours wait time. apparently all your patients are fine with it since you have the highest dispensing for hydrocodone in the district. must be really calm people in your district.

 

[doublehh03]

2 hour wait? Holy ****. If I was a customer, I'd get the hell away from your store and never return. No wonder so many stores don't meet their script budgets, these narc patients take all their meds and go somewhere else.


Very simple. Just stop filling shady scripts. Only fill scripts that are legitimate. STOP FILLING oxy 30mg #180. Yes, you will have a horrible month with complaints, but they'll go elsewhere and stop bothering you.

In my store, if they want to wait, and its legitimate, we say 15 minutes. It really shouldn't take you longer than that to count pills, check the date on the script and log it In a narc book. It really, really shouldn't.

Some oxy 30mg are legit and obviously most aren't. You just have to know your customers. I won't fill oxy 30mg unless they're on a long-action pain medication also (and obviously have their entire profile that they fill other maintenance medications also). If it's a random guy with oxy 30mg #180 or 240 simply decline. And also RX2090 is correct. Turning away unnecessary C2s (not regular customers, shady, new customers or out of area) will help.

But wait time should vary, not just the same time you give out every time. If not busy and you're caught up, 15 minutes are more than enough. Probably would take you 5 minutes. If you have 10 waiters ahead, then say 25-30 minutes. If you do have quite a few C2s waiting, then longer than that. Just let the patient know how busy you currently are and they will understand.

Just FYI my current store was considered a narc store by every store in the distirct and they keep sending them here. When I took over, we had like 25-30 bottles of Norco 10s every week. Now, I've cut it down to 10-12 weekly. It's doable.

 

[BenJammin]

Oh you poor retail folks. At the independent I do part time work with, the wait for a C2 is the same wait as metformin or metoprolol.

 

[ExpressMaiL]

Oh you poor retail folks. At the independent I do part time work with, the wait for a C2 is the same wait as metformin or metoprolol.

IKR...

 

[Sparda29]

Oh you poor retail folks. At the independent I do part time work with, the wait for a C2 is the same wait as metformin or metoprolol.

Some dude brought in 2 scripts for Oxycodone 30mg #180, and Ibuprofen 600 mg #90. Said he was a driver for this group home or something kinda fishy. Owner of the independent told me she called and it was legit but that he was going to pay cash. Googled the doc's name, and it popped up with an address in Manhattan and a 212 area code. The script had an address in the Bronx and a 718 area code #. Called the 212 # and the secretary said that there were no patients by that name and the doc was seeing patients.

Then I call the 718 area code # and a different lady picks up the phone, when I ask to speak to the doctor she says he's busy and will call me back in 5 minutes. I told her I just spoke to the doctor in Manhattan and how the **** is he in 2 places at once. She hung up, lmao. But yeah, the scripts looked very legit but it seems like they've gotten their hands on the printer paper for the prescription and are typing up the script.

But yeah, this independent owner seems kinda fishy or very naive. Literally all I had to do was google the name of the doctor to find the address/phone discrepancy. And once I spoke to the doctor it was confirmed that he didn't write the scripts but his name/DEA/license/NPI was being used.

 

[ExpressMaiL]

Some dude brought in 2 scripts for Oxycodone 30mg #180, and Ibuprofen 600 mg #90. Said he was a driver for this group home or something kinda fishy. Owner of the independent told me she called and it was legit but that he was going to pay cash. Googled the doc's name, and it popped up with an address in Manhattan and a 212 area code. The script had an address in the Bronx and a 718 area code #. Called the 212 # and the secretary said that there were no patients by that name and the doc was seeing patients.

Then I call the 718 area code # and a different lady picks up the phone, when I ask to speak to the doctor she says he's busy and will call me back in 5 minutes. I told her I just spoke to the doctor in Manhattan and how the **** is he in 2 places at once. She hung up, lmao. But yeah, the scripts looked very legit but it seems like they've gotten their hands on the printer paper for the prescription and are typing up the script.

But yeah, this independent owner seems kinda fishy or very naive. Literally all I had to do was google the name of the doctor to find the address/phone discrepancy. And once I spoke to the doctor it was confirmed that he didn't write the scripts but his name/DEA/license/NPI was being used.

It's also a red flag when the doctor gets irritated for "being asked" and/or can't recite their NPI/DEA or even license by heart. If they really did prescribe CIIs they would understand the checks.

 

[BenJammin]

Some dude brought in 2 scripts for Oxycodone 30mg #180, and Ibuprofen 600 mg #90. Said he was a driver for this group home or something kinda fishy. Owner of the independent told me she called and it was legit but that he was going to pay cash. Googled the doc's name, and it popped up with an address in Manhattan and a 212 area code. The script had an address in the Bronx and a 718 area code #. Called the 212 # and the secretary said that there were no patients by that name and the doc was seeing patients.

Then I call the 718 area code # and a different lady picks up the phone, when I ask to speak to the doctor she says he's busy and will call me back in 5 minutes. I told her I just spoke to the doctor in Manhattan and how the **** is he in 2 places at once. She hung up, lmao. But yeah, the scripts looked very legit but it seems like they've gotten their hands on the printer paper for the prescription and are typing up the script.

But yeah, this independent owner seems kinda fishy or very naive. Literally all I had to do was google the name of the doctor to find the address/phone discrepancy. And once I spoke to the doctor it was confirmed that he didn't write the scripts but his name/DEA/license/NPI was being used.

Very nice! There is a doctor in the DFW area who had his C2 pad stolen from his office. I've looked up the fake names on our PMP and she's gotten away with TONS. Really a shame that the pharmacists never bother to look up the telephone number of the doc who works at an ADD clinic. Why they're prescribing oxycodone 30 #180 and hydromorphone 4 #270 is beyond me lol

It's also a red flag when the doctor gets irritated for "being asked" and/or can't recite their NPI/DEA or even license by heart. If they really did prescribe CIIs they would understand the checks.

I had an ER doc refuse to give me her NPI number once.

 

[Sparda29]

It's also a red flag when the doctor gets irritated for "being asked" and/or can't recite their NPI/DEA or even license by heart. If they really did prescribe CIIs they would understand the checks.

They are even typing in diagnosis codes on the prescriptions and max daily doses. Honestly, if the guy had insurance, I might have filled it. iSTOP database search came up clean too.

 

[ExpressMaiL]

Very nice! There is a doctor in the DFW area who had his C2 pad stolen from his office. I've looked up the fake names on our PMP and she's gotten away with TONS. Really a shame that the pharmacists never bother to look up the telephone number of the doc who works at an ADD clinic. Why they're prescribing oxycodone 30 #180 and hydromorphone 4 #270 is beyond me lol



I had an ER doc refuse to give me her NPI number once.

That's too bad she's just making it more difficult for the patient. It takes <5 seconds to give that information.

They are even typing in diagnosis codes on the prescriptions and max daily doses. Honestly, if the guy had insurance, I might have filled it. iSTOP database search came up clean too.

The real tragedy is to the patient who is actually on a very high dose of narcotics and must go through the same process because others have screwed it up.

 

[PharmNerdMatt]

I had an ER doc refuse to give me her NPI number once.

You know that you can look up an NPI number online, right? I would guess that most docs don't know their NPI by heart. They almost never have to write it out as it is not a secure number like the DEA number.

 

[BenJammin]

You know that you can look up an NPI number online, right? I would guess that most docs don't know their NPI by heart. They almost never have to write it out as it is not a secure number like the DEA number.

The reason I called was because it wasn't listed on the NPI registry. Even Texas Medicaid didn't have her NPI listed so I had no choice but to call.

 

[zelman]

Oh you poor retail folks. At the independent I do part time work with, the wait for a C2 is the same wait as metformin or metoprolol.

Sometimes you need to wait an extra 30 minutes for an MD to respond to a page about a potentially fraudulent Rx. Telling them to expect a longer wait up front avoids dealing with the conversation about a delay later on.

 

[josh6718]

i'm surprised people still come to a pharmacy that gives 2 hours wait time. apparently all your patients are fine with it since you have the highest dispensing for hydrocodone in the district. must be really calm people in your district.

I wouldn't say calm, but its unfortunate with such a rampant drug abuse problem in our state. In the last year, in our district alone we had 6 different doctor's offices that were raided and arrested for their over-prescribing of controlled substances. There were even two agents that had come to our store involving a case with a former pharmacist that was diverting drugs.

 

[BidingMyTime]

Sometimes you need to wait an extra 30 minutes for an MD to respond to a page about a potentially fraudulent Rx. Telling them to expect a longer wait up front avoids dealing with the conversation about a delay later on.

I've never had a problem with just being honest. The tech gives them the normal expected wait time (usually 20 minutes). If there is something questionable about the script, then I tell them I will need to verify the script with the doctor and won't be able to fill it until I do. If they don't like that, they can have their script back. But 99% of the time they understand and either wait patiently or come back later. Most of the scripts I see are from area doctors and/or for regular customers and don't have any red flags.

 

[zelman]

I've never had a problem with just being honest. The tech gives them the normal expected wait time (usually 20 minutes). If there is something questionable about the script, then I tell them I will need to verify the script with the doctor and won't be able to fill it until I do. If they don't like that, they can have their script back. But 99% of the time they understand and either wait patiently or come back later. Most of the scripts I see are from area doctors and/or for regular customers and don't have any red flags.

You'd rather hand someone a fake prescription to fill elsewhere than help the police get them out of our hair?

 

[BidingMyTime]

You'd rather hand someone a fake prescription to fill elsewhere than help the police get them out of our hair?

Prescriptions are considered the property of a patient, if a patient wants it back, I am legally required to give it back to them.

 

[zelman]

Prescriptions are considered the property of a patient, if a patient wants it back, I am legally required to give it back to them.

Wrong. Valid prescriptions are either the property of the patient or the government depending on the state. Fake prescriptions have different rules.

 

[BidingMyTime]

Wrong. Valid prescriptions are either the property of the patient or the government depending on the state. Fake prescriptions have different rules.

In my state, unless I know 100% that a script is fake, then it is the patients property. If a patient wants their prescription back for any reason (they've decided the wait time is to long, they've decided the cost is too high, etc.), then I do not have a legal right to keep their prescription just because I've decided to check to see if its a valid script or not. Obviously, if I have already verified its a fake script, then I'm not giving it back, but clearly in the scenario we are talking about, the question is a script that seems unusual. Unusual scripts are the patients property until proven otherwise.

 

[Whereismynorco]

so what do u guys do in this situation??
-Patient comes from local ED with an rx and after you check dispensing history through state website (istop,PMP), you called the ED Dr., told Dr about history and then same Dr decide to cancel rx.
Do you legally required to give Rx back to patient?

 

[trailerpark]

so what do u guys do in this situation??
-Patient comes from local ED with an rx and after you check dispensing history through state website (istop,PMP), you called the ED Dr., told Dr about history and then same Dr decide to cancel rx.
Do you legally required to give Rx back to patient?

I called when a patient wanted us to fill a tramadol when she just filled a 30 day Norco supply from another doctor and the nurse working for the doctor who wrote for tramadol said the doctor wanted to cancel it so I just wrote "void per dr" on the tramadol script and gave it back to the patient.

 

[Dr Wario]

In my state, unless I know 100% that a script is fake, then it is the patients property. If a patient wants their prescription back for any reason (they've decided the wait time is to long, they've decided the cost is too high, etc.), then I do not have a legal right to keep their prescription just because I've decided to check to see if its a valid script or not. Obviously, if I have already verified its a fake script, then I'm not giving it back, but clearly in the scenario we are talking about, the question is a script that seems unusual. Unusual scripts are the patients property until proven otherwise.

I would love your source on this.

 

[zelman]

In my state, unless I know 100% that a script is fake, then it is the patients property. If a patient wants their prescription back for any reason (they've decided the wait time is to long, they've decided the cost is too high, etc.), then I do not have a legal right to keep their prescription just because I've decided to check to see if its a valid script or not. Obviously, if I have already verified its a fake script, then I'm not giving it back, but clearly in the scenario we are talking about, the question is a script that seems unusual. Unusual scripts are the patients property until proven otherwise.

Here is something that actually happened to me:

I was working as a floater late Sunday night. It was maybe 90 minutes to closing time at 8 pm. Wait time is 20 minutes. I get a prescription for #360 methadone. Patient is a regular. This is a regular Rx for them. Patient provides a seemingly legit ID (per state law). The Rx is on legit hospital stock paper. I paged the on call doctor to verify (I don't recall my exact reason for doing so). After two pages, I get a response and MD on call says it's not her patient, she'll need to get to a computer to check the hospital computer system and call me back. She calls back and doesn't see the patient or medical record number in their system, but it's a very large health system and there's one small clinic that uses a different system that has to be checked separately. We're at 30ish minutes now. Patient offers to take the Rx elsewhere and I make up something to get them wait just a little longer (printer trouble or something). When I get the 3rd call back from the doc, she's determined the Rx was fake as well as the previous ones for hundreds of tablets of methadone that had been dispensed. I called the cops and reported her, but she took off just before they arrived at minute 45-50ish. If she had been given a 60 minute wait time, they would have picked her up then and there.

So, you would have felt A-OK giving the patient the Rx at 30 minutes, before the MD made that final check? Just because there was the slimmest possible chance that it was legit?

 

[ChalupaBatman86]

 

[ExpressMaiL]

Interesting, never thought that a drug addict would browse these forums to become "educated" on filling their counterfeit scripts.

 

[BenJammin]

I would love your source on this.

Go check the law book in Oklahoma, it's available on the internet. States that valid prescriptions belong to the patient.

 

[ChalupaBatman86]

Interesting, never thought that a drug addict would browse these forums to become "educated" on filling their counterfeit scripts.

It's from Reddit

 

[zelman]

It's from Reddit

It's actually from here: http://www.consumeraffairs.com/rx/walgreen.html

 

[genesis09]

If I thought the rx might be fake or tampered with, I would always make a copy before talking with patient. So, regardless of what happened, I could always later determine if it was legit or not.

 

[BidingMyTime]

I called when a patient wanted us to fill a tramadol when she just filled a 30 day Norco supply from another doctor and the nurse working for the doctor who wrote for tramadol said the doctor wanted to cancel it so I just wrote "void per dr" on the tramadol script and gave it back to the patient.

This and this.

If I thought the rx might be fake or tampered with, I would always make a copy before talking with patient. So, regardless of what happened, I could always later determine if it was legit or not.

I have done both. Write void per dr across the script & give it back. If there is a possibility the RX is fake, make a copy.

And the guy who went to prison over a fake RX, that seems more the exception then the rule. At least 3 times, I can remember calling the police over a completely fake RX....in all 3 cases the person was arrested, but the charges ultimately dropped, because the person picking it up was different from the name on the script and they claimed they were just picking it up for a friend and didn't know it was fake or because it was a fake called in script & the person claimed that they had no idea the script was fake. So given, that, I'm not too concerned if someone does get a fake script back, because I didn't have time to look into it. Because my experience is, other than the inconvience of getting arrested, its unlikely anything will be done to them anyway. (maybe your jurisdiction spends more time on that, prosecutors in my jurisdiction apparently have more serious crime to deal with.)

And ultimate, I'm a pharmacist, not a police officer, I don't have the police officers training or weapons. I'm not going to risk my life by pissing off a possible psychotic person, by refusing to give them back a prescription because I haven't verified 100% that its a valid prescription, and which I don't have a legal right to keep anyway.

 

[BF7]

I would love your source on this.

Source? GUESS wrong one time and keep a patient from their LEGIT RXS and an attorney hired by the wronged patient will create enough of a headache in your life ( personal and professional) that you'll never contemplate " guessing" if a prescription is fake again...

 

[zelman]

This and this.



I have done both. Write void per dr across the script & give it back. If there is a possibility the RX is fake, make a copy.

And the guy who went to prison over a fake RX, that seems more the exception then the rule. At least 3 times, I can remember calling the police over a completely fake RX....in all 3 cases the person was arrested, but the charges ultimately dropped, because the person picking it up was different from the name on the script and they claimed they were just picking it up for a friend and didn't know it was fake or because it was a fake called in script & the person claimed that they had no idea the script was fake. So given, that, I'm not too concerned if someone does get a fake script back, because I didn't have time to look into it. Because my experience is, other than the inconvience of getting arrested, its unlikely anything will be done to them anyway. (maybe your jurisdiction spends more time on that, prosecutors in my jurisdiction apparently have more serious crime to deal with.)

And ultimate, I'm a pharmacist, not a police officer, I don't have the police officers training or weapons. I'm not going to risk my life by pissing off a possible psychotic person, by refusing to give them back a prescription because I haven't verified 100% that its a valid prescription, and which I don't have a legal right to keep anyway.

Fake Rx possession may or may not be worth getting arrested over. That's why you sell them the drugs after the police arrive. Then they've got a much more serious problem with controlled substance possession.

 

[trailerpark]

At Walmart they tell us if the cops tell you to fill a fraud script so they they can arrest the perp we are absolutely not supposed to fill it even if told by law enforcement. My DM made a point to tell me that straight up. He also mentioned how Walmart does NOT loan or trade drugs with other pharmacies, not even another walmart, I guess they're strict about that too. I live in a state that borders Canada (MN). I'm assuming I can't fill Canadian scripts or transfer to an from Canada???

 

[BidingMyTime]

Fake Rx possession may or may not be worth getting arrested over. That's why you sell them the drugs after the police arrive. Then they've got a much more serious problem with controlled substance possession.

It is illegal in IL for a pharmacist to fill a prescription that they know is fake. Even as part of a sting to catch the police...completely illegal for the pharmacist to do. All we can do is call the police and let them know that we have verified a fake/altered RX, and that we can identify the person who brought it in. Your state may differ. But seriously, even if that were legal, I can see so many things that could go wrong from a liability standpoint, that I would not do it.

 

[BenJammin]

At Walmart they tell us if the cops tell you to fill a fraud script so they they can arrest the perp we are absolutely not supposed to fill it even if told by law enforcement. My DM made a point to tell me that straight up. He also mentioned how Walmart does NOT loan or trade drugs with other pharmacies, not even another walmart, I guess they're strict about that too. I live in a state that borders Canada (MN). I'm assuming I can't fill Canadian scripts or transfer to an from Canada???

That's done for a very specific reason. What happens if there is a drop somewhere in the store? The phony gets arrested with zero drugs in his possession and now you have a narcotic out on the streets. What happens if the phony pops the cap and ingests all of the drugs right then and there?

All that matters is that the state board of pharmacy and any prosecuting attorneys will have 100% proof that you knowingly filled a forged prescription. Say hello to the DEA exempt list.

 

[zelman]

At Walmart they tell us if the cops tell you to fill a fraud script so they they can arrest the perp we are absolutely not supposed to fill it even if told by law enforcement. My DM made a point to tell me that straight up. He also mentioned how Walmart does NOT loan or trade drugs with other pharmacies, not even another walmart, I guess they're strict about that too. I live in a state that borders Canada (MN). I'm assuming I can't fill Canadian scripts or transfer to an from Canada???

It is illegal in IL for a pharmacist to fill a prescription that they know is fake. Even as part of a sting to catch the police...completely illegal for the pharmacist to do. All we can do is call the police and let them know that we have verified a fake/altered RX, and that we can identify the person who brought it in. Your state may differ. But seriously, even if that were legal, I can see so many things that could go wrong from a liability standpoint, that I would not do it.

That's done for a very specific reason. What happens if there is a drop somewhere in the store? The phony gets arrested with zero drugs in his possession and now you have a narcotic out on the streets. What happens if the phony pops the cap and ingests all of the drugs right then and there?

All that matters is that the state board of pharmacy and any prosecuting attorneys will have 100% proof that you knowingly filled a forged prescription. Say hello to the DEA exempt list.

If it was supposed to be easy and risk-free, we'd all have flak jackets, tazers and handcuffs. If you want to get things done, sometimes you need to do whatever it takes with the tools you have available.

 

[BidingMyTime]

If it was supposed to be easy and risk-free, we'd all have flak jackets, tazers and handcuffs. If you want to get things done, sometimes you need to do whatever it takes with the tools you have available.

Hmmmmmm, interesting that a lawbreaker would be so gungho on catching a fellow lawbreaker. I guess there is no honor among thieves.

 

[Dr Wario]

Hmmmmmm, interesting that a lawbreaker would be so gungho on catching a fellow lawbreaker. I guess there is no honor among thieves.

So you are saying it should be against the law for a police officer to solicit the purchase of illegal drugs/weapons in the attempt to expose criminal activity? I'm not saying that I would purposefully fill a fraudulent script, though the reason would not be out of fear of breaking the law, it just simply would not be worth the hassle.

 

[BidingMyTime]

So you are saying it should be against the law for a police officer to solicit the purchase of illegal drugs/weapons in the attempt to expose criminal activity? I'm not saying that I would purposefully fill a fraudulent script, though the reason would not be out of fear of breaking the law, it just simply would not be worth the hassle.

Well, I was actually referring to Zelman's encouragement of giving epinephrine shots without a prescription, based on his own out out-of-scope-of-practice diagnosis. If he thinks its OK for him to give prescription medications based on his own diagnosis, then logically why doesn't he think everybody else should have that right as well?

As a side note, yes, I don't approve of police using bait & stings. In theory, they sound good, in practice there are a lot of problems. I don't believe they are an effective way to stop crime, for a myriad of reasons. But that is irrelevant to this discussion, since police officers *are* legally allowed to break the law in an effort to catch criminals, pharmacists do *not* have this same protection.

 

[zelman]

Well, I was actually referring to Zelman's encouragement of giving epinephrine shots without a prescription, based on his own out out-of-scope-of-practice diagnosis. If he thinks its OK for him to give prescription medications based on his own diagnosis, then logically why doesn't he think everybody else should have that right as well?

If I thought nobody besides me should do it, why would I have posted it on this board? I was suggesting that there was a legal loophole wherein pharmacists (not everyone) could technically administer epinephrine to a patient who was dying.

As a side note, yes, I don't approve of police using bait & stings. In theory, they sound good, in practice there are a lot of problems. I don't believe they are an effective way to stop crime, for a myriad of reasons. But that is irrelevant to this discussion, since police officers *are* legally allowed to break the law in an effort to catch criminals, pharmacists do *not* have this same protection.

What is your superior solution to stopping crime? If we think someone is raping children, rather than a "to catch a predator"-style sting, should we just set up some cameras and see what happens? Or is setting up trap cameras too unfair? Maybe wait for a child to be raped on the set of a live news broadcast with cameras already rolling?

 

[BidingMyTime]

If I thought nobody besides me should do it, why would I have posted it on this board? I was suggesting that there was a legal loophole wherein pharmacists (not everyone) could technically administer epinephrine to a patient who was dying.

They why are you against druggies self-medicating? The vast majority of drug abusers have deluded themselves into thinking they will die without their medicine.

What is your superior solution to stopping crime? If we think someone is raping children, rather than a "to catch a predator"-style sting, should we just set up some cameras and see what happens? Or is setting up trap cameras too unfair? Maybe wait for a child to be raped on the set of a live news broadcast with cameras already rolling?

Do you really think stings are catching child predators/rapists? There have been plenty of exposes about the kind of people being caught in these stings...men have been arrested for being child predators because of sex talk with someone on-line who told them they were of adult age (and they actually were of adult age), on the basis that they were pretending to be a child even though they lied about their age and that someone how the guy should have been able to know that. Or after 6 - 8 months of conversing with men, the police sting will have their on-line character announce that she is only 15, and at that point if anyone communicates with her, even just to ask if she's serious or being real, they will arrest them. Seriously....that is what our tax money is being spent on. Think how many real criminals could have been caught if the time spent trying to trick people who have no interest in being with a child.

 

[zelman]

They why are you against druggies self-medicating? The vast majority of drug abusers have deluded themselves into thinking they will die without their medicine.



Do you really think stings are catching child predators/rapists? There have been plenty of exposes about the kind of people being caught in these stings...men have been arrested for being child predators because of sex talk with someone on-line who told them they were of adult age (and they actually were of adult age), on the basis that they were pretending to be a child even though they lied about their age and that someone how the guy should have been able to know that. Or after 6 - 8 months of conversing with men, the police sting will have their on-line character announce that she is only 15, and at that point if anyone communicates with her, even just to ask if she's serious or being real, they will arrest them. Seriously....that is what our tax money is being spent on. Think how many real criminals could have been caught if the time spent trying to trick people who have no interest in being with a child.

Thinking you might die and actually dying are different. You get that, right?

 

[BidingMyTime]

Thinking you might die and actually dying are different. You get that, right?

Of course they are. I only question your qualifications at determining whether someone is in danger of immediate death. Actually, I DO trust your qualifications far more than I would trust the average junkies qualifications. But legally, neither of you would be considered qualified. Even in most (all?) states, paramedics can not diagnose death of someone who is obviously dead, only a physician. can.

 

[PharmNerdMatt]

Of course they are. I only question your qualifications at determining whether someone is in danger of immediate death. Actually, I DO trust your qualifications far more than I would trust the average junkies qualifications. But legally, neither of you would be considered qualified. Even in most (all?) states, paramedics can not diagnose death of someone who is obviously dead, only a physician. can.

This doesn't translate well as I think the discussion started with Epi. In at least my state, we are required to have an Epipen with us if we are immunizing and are expected to be able to recognize anaphylaxis and administer the epi we determine it is needed.

 

[BidingMyTime]

This doesn't translate well as I think the discussion started with Epi. In at least my state, we are required to have an Epipen with us if we are immunizing and are expected to be able to recognize anaphylaxis and administer the epi we determine it is needed.

Yes, same here. However in the original thread, Zelman stated that if he saw anyone in his pharmacy that he diagnosed as needing an epinephrine shot, he would give them a flu shot at that point, so that he could pretend their breathing problems were caused by the flu shot, and then he would be able to legally (according to him) give the person a epinephrine shot. This is what I was referring to as practicing out of his scope of practice.

 

[zelman]

Yes, same here. However in the original thread, Zelman stated that if he saw anyone in his pharmacy that he diagnosed as needing an epinephrine shot, he would give them a flu shot at that point, so that he could pretend their breathing problems were caused by the flu shot, and then he would be able to legally (according to him) give the person a epinephrine shot. This is what I was referring to as practicing out of his scope of practice.

You misunderstood. I said that by giving them a flu shot, I could legally give them epinephrine. I do not wander my store holding two syringes looking to diagnose people. This would typically be in the case of someone who came to the pharmacy and informed me of their situation. One (true) example of such a person was a young child gasping for air while apologizing to his mother who was holding a half eaten snickers and the mom informed us of his peanut allergy. I would feel more comfortable with the risk of an adverse effect from giving them an epipen than the risk of watching a mother watch her son die while we waited for EMS. I was still an intern when that happened, so my pharmacist dealt with it. But as a professional I need to be prepared for that to happen to me. Also, I wouldn't intend to "pretend their breathing problems were caused by the flu shot" as my protocol doesn't require that the epinephrine be given to those having allergic reactions caused by the flu shot. Only that they have received an immunization and afterward had a life-threatening allergic reaction. It's called a "loophole". A Loophole is where one can follow the letter of the law to accomplish something not intended by the lawmakers.