We get nutjob customers at Costco too.

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Sparda29

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So had my first experience with a nutjob customer @ Costco. The customers are the same but the company's reaction to them is different. Here's what happened:

Customer comes to pick up Rx. It is for Xanax 1 month supply. So after searching for it in the bins, we can't find it. So we go look in the computer, we find her profile but the profile is empty. Hmmmm. So then we go look in all the other places where we would store unfilled prescriptions. Can't find anything.

So now about 10 minutes has passed and we are looking for the phantom Rx. Since it's for Xanax, we start to think that this person is trying to con us. She claims she went to Walmart and CVS first and didn't like the prices so she came to Costco, where she was given a price and she filled it.

We ask her if maybe she filled it at Walmart or CVS and forgot that she filled it there and came to Costco instead. Here she erupts into a tirade. She thinks we insulted her intelligence by saying that.

After asking her who intially helped her, we start making calls to the other employees. The employee who we call confirms that we filled it, and tells us to go back to the other computer and do a longer date search.

It turns out, the Rx is from 3/23/2010 and she filled it 4/23/2010, and never picked it up. Here we are now on 6/14/2010 and she wants us to fill it. We tell her no, we're not gonna fill it since the Rx is now expired. She claims that she has never heard of any pharmacies cancelling Rx's after 14 days and wants to know where the sign is that says that. (There is no sign, I tell her that it is the same at all other pharmacies.)

She wants to know why we didn't call her to let her know that we are going to cancel it. (I don't care at this point, I just want her out of the pharmacy since we're closing in 20 minutes.)

We say the only things that can be done now are either we call her MD and ask for an emergency supply or she goes to the emergency room, she refuses to do either and just wants the original Rx filled. We say no, and tell her good bye we're not gonna do anything now.

Now she's in a real fit and starts disrupting processes with other customers. We call the manager and tell them to call security. They take her up to the office to talk about it, complaints and all. Manager tells her that we're not gonna do anything with the script. She even threatened to call the police on us, lmao. So finally, she comes back downstairs to the pharmacy and says that if she ends up going to the ER to fill the script, she is going to sue Costco Pharmacy for the costs. We call up the district manager, put her on the phone, he hears what she has to say and just laughs at her and hangs up. ROFL! I'm dying at this point at laughter at how Costco's upper management is actually standing up for it's employees compared to how CVS would have handled it. No $50 gift card for you Ms. Problem Customer.

Total Epic Win for Costco.
 
I'm not sure why it couldn't be filled. The RX was still valid, wasn't it? If you didn't want to fill it, why not just give her back the hard copy and let her take it somewhere else?

Controlled Rx's are only good for 1 month in the glorious State of New York. This Rx was dated 3/23/10. Xanax is a CII here.
 
I had no idea NY was so strict, good for them. In AZ cIIs are good for 3 months from written and other schedules are 6 months. If benzos became cIIs all hell would break loose.
 
In the UK, Controlled Drug scripts valid for 13 weeks. However, where issued on daily pick up (mainly methadone) then valid for 14 days only.

Xanax is classed same as diazepam. IE controlled drug, but does not have to be entered in a separate register. In UK could dispense this script.
johnep
 
No refills on any CIIs + BZDs. Other stuff like Ambien, Vicodin, Norco, etc can have refills.


OK, but do the RXs for Ambien, Vicodin, Norco, etc still expire in one month? It would seem like you couldn't REFILL an expired script. Or is there just a requirement that you get the FIRST fill within one month of the date written? How many times can a controlled RX (besides CII/BZD) be refilled?
 
Controlled Rx's are only good for 1 month in the glorious State of New York. This Rx was dated 3/23/10. Xanax is a CII here.

It's the same way in New Jersey. You must fill the prescription within one month from the date of which it is prescribed. Refills expire after five refills within six months.

I'm also certain that Xanax is actually a C IV, unless NY has the ability to rearrange the Controlled Substances Act.
 
It's the same way in New Jersey. You must fill the prescription within one month from the date of which it is prescribed. Refills expire after five refills within six months.

I'm also certain that Xanax is actually a C IV, unless NY has the ability to rearrange the Controlled Substances Act.

States can be more strict - they cannot be less stringent than the Feds. At IHS Browning, MT, which is Blackfeet Nation, gabapentin is a CIII.
 
OK, but do the RXs for Ambien, Vicodin, Norco, etc still expire in one month? It would seem like you couldn't REFILL an expired script. Or is there just a requirement that you get the FIRST fill within one month of the date written? How many times can a controlled RX (besides CII/BZD) be refilled?

The first fill has to be within one month of the date the script was written, after that I believe the refills are good for 6 months. Some doctors have been writing scripts without dates so that the patient can just bring it in to the pharmacy when they want to and then date it. Of course, we tell them that without a date, the Rx is invalid.
 
The first fill has to be within one month of the date the script was written, after that I believe the refills are good for 6 months. Some doctors have been writing scripts without dates so that the patient can just bring it in to the pharmacy when they want to and then date it. Of course, we tell them that without a date, the Rx is invalid.

You can tell a great deal about a company by the way they deal with irrational, rude and verbally abusive customers. Everyone says Costco is a great company to work for. They pay their employees well and treat them with respect. In my mind your example reinforces this.

If this were any other company they would have kissed this ladies ass, given her a gift card and probably made the pharmacy staff write a letter of apology. That tells you a great deal about how unappreciated, mistreated and beat down the employees are at places like Kroger, Safeway, CVS and Walgreens. It is a bad environment to work in when management does not stand behind its employees.
 
I'm also certain that Xanax is actually a C IV, unless NY has the ability to rearrange the Controlled Substances Act.

Yeah, FEDERALLY, its a C-IV, but NYS treats it with more stringent laws, along with other medications other than BZD. Benzodiazepines are under the DRSH [drugs/rx requiring special handling) list, so yeah, although benzodiazepines are C-IV substances, its treated almost in a category of its own.

Other C-IV, yes, can give refills, but BZD, no refills are permitted. C-IV in general, md could call in up to 30 days supply or 100 units (whichever is less) and mail a cover rx, whereas BZD, a MD can only call in an emergency 5 day supply and mail through postal service a cover rx along with another rx to fill for a 30 day supply if need be. A lot of work when the patient is being an ass to you. And is it really an emergency if she went without it for more than a month? Tsk.

But in general, ALL controlled rx is valid for 30 days for initial fill. Outside the time-frame, we reject the rx.

---

At CVS, with this whole "Oh, by NYS law, we can't fill it. It's expired." I've actually had patients from out of state telling me "I've never heard of this. Is CVS just making up laws? Quit lying to me and fill it. It's your job."

Where do patients get the idea that any pharmacy could make up laws...? =/
 
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Thanks for shedding light on this, thats all very interesting. I wish that we had laws on BZD in New Jersey; we go through Xanax like there is really no tomorrow.
 
Yeah, FEDERALLY, its a C-IV, but NYS treats it with more stringent laws, along with other medications other than BZD. Benzodiazepines are under the DRSH [drugs/rx requiring special handling) list, so yeah, although benzodiazepines are C-IV substances, its treated almost in a category of its own.

Other C-IV, yes, can give refills, but BZD, no refills are permitted. C-IV in general, md could call in up to 30 days supply or 100 units (whichever is less) and mail a cover rx, whereas BZD, a MD can only call in an emergency 5 day supply and mail through postal service a cover rx along with another rx to fill for a 30 day supply if need be. A lot of work when the patient is being an ass to you. And is it really an emergency if she went without it for more than a month? Tsk.

But in general, ALL controlled rx is valid for 30 days for initial fill. Outside the time-frame, we reject the rx.

---

At CVS, with this whole "Oh, by NYS law, we can't fill it. It's expired." I've actually had patients from out of state telling me "I've never heard of this. Is CVS just making up laws? Quit lying to me and fill it. It's your job."

Where do patients get the idea that any pharmacy could make up laws...? =/

Apparently, the reason why she didn't pick up the Rx was because she already had pills at home. I don't get this part.

I saw this a lot at CVS as a reason why people don't refill their prescriptions or want to be on automatic refill or why they never pick up their stuff on time. Apparently, doctors give out samples of the drug, the patient brings the Rx to the pharmacy to fill it, leaves it there, and comes back when they are out of samples to pick it up.

Why don't they just stock pile their medications? I probably have like 6-8 tubes of Differin, Epiduo lying around in my house, as well as probably over 300 tablets of Tramadol. I rarely use it, but once I see the refills available, I refill it as if I am using it every day, just in case my insurance ever runs out. (Which it did 3 months ago.)
 
How much was the copay? When I worked retail and there was a PRN script, sometimes the patients couldn't afford to get their meds on time. Not everyone can pay the 10 dollar copay every month when they still have pills at home. Like museabuse said, here in AZ, all hell would break loose if the scripts were limited to a one month expiration date. It has been a while before I worked retail, though...I thought CII had a one month expiration date here and everything else was 6 months. Guess it has changed.
 
CII's have a 1 year expiration here in WA, but CIII-CIV are only 6 months. Makes perfect sense. . .😕
 
How much was the copay? When I worked retail and there was a PRN script, sometimes the patients couldn't afford to get their meds on time. Not everyone can pay the 10 dollar copay every month when they still have pills at home. Like museabuse said, here in AZ, all hell would break loose if the scripts were limited to a one month expiration date. It has been a while before I worked retail, though...I thought CII had a one month expiration date here and everything else was 6 months. Guess it has changed.

She doesn't have insurance. Costco was gonna charge $11 for 120 pills of Xanax.
 
Relating to angry customers and controls, anyone else find themselves calling ER doctors to verify if the patient did in fact make them aware they were getting pain meds already from a pcp or pain management doc? I run into this when taking new scripts and noticing its a refill too soon due to a script from a different doc. Gets real fun when I tell them the ER doc told me to void the script...🙄
 
CII's have a 1 year expiration here in WA, but CIII-CIV are only 6 months. Makes perfect sense. . .😕

Really?

That's strange...

So an RX for Percocet or something is "active" longer than an RX for Xanax?

Now WA is super weird. I thought NYS was the only pain in the ass state.
 
Really?

That's strange...

So an RX for Percocet or something is "active" longer than an RX for Xanax?

Now WA is super weird. I thought NYS was the only pain in the ass state.

This would something interesting to look into...what is it about NYS patients that their benzos have to be more controlled than their opioids?
 
In PA, CII-V expire in 6 months. CIIs have no law limiting their validity. In theory, they have no expiration date, only that they are to be dispensed in accord within the confines of common practice.

Hooray for gray areas!!!
 
This would something interesting to look into...what is it about NYS patients that their benzos have to be more controlled than their opioids?

I guess they think that when it comes to psychiatric disorders, like what BZD's treat, the patient must be seen by a psychiatrist every month. However, if someone has chronic pain due to cancer or some other terrible disorder, it's alright if they are seen every 6 months (unless it is a CII, then they have to be seen every month).
 
I guess they think that when it comes to psychiatric disorders, like what BZD's treat, the patient must be seen by a psychiatrist every month. However, if someone has chronic pain due to cancer or some other terrible disorder, it's alright if they are seen every 6 months (unless it is a CII, then they have to be seen every month).

Interesting theory...

It would be sneaky of a psychiatrist to make a patient come in every single month for maintenance meds, though...I mean, once the patient is stabilized and everything. Maybe it has more to do with the level of abuse?
 
The DEA has set expiration date for C-3-5s, but not C-2s.

In WI, C-2s are valid for 60 days and all other controls are valid for 6 months.
 
So how would you order BZD in NYS? with 222 forms? or just invoices? and do you have to draw a line over the face of the BZD rx to cancel it?
I always thought NJ is strict being that CDS rx are only good for 30 days. But BZD being classified as CII in NYS is just amazing. As a pharmacist, I love this NYS law...lol
 
How much was the copay? When I worked retail and there was a PRN script, sometimes the patients couldn't afford to get their meds on time. Not everyone can pay the 10 dollar copay every month when they still have pills at home. Like museabuse said, here in AZ, all hell would break loose if the scripts were limited to a one month expiration date. It has been a while before I worked retail, though...I thought CII had a one month expiration date here and everything else was 6 months. Guess it has changed.

People will just have to get used to it if one day AZBOP decided to place a 30-day restriction on initial fill.
All hell breaks loose when different jurisdictions have different laws and you happen to be close to the border. People get really confused about the different laws in different jurisdictions. In the case of the tiny DC, CII's are only good for 30 days while Maryland gives it a 4 month validity. I've had people dropped off their CII in time, then the rx gets returned to stock after 14 days, then patient came back on the 31st day to ask me to fill it again. Of course I refused to fill it since the CII RX has already expired per DC law, and then the customer said I made this 30 days rule up myself and threaten to file a complaint to my super and DCBOP because he's had it filled in Maryland before. What an idiot!
 
Wow NY is strict... I think here in Florida the C-II's expire in 6 months, the rest are 1 year... and Benzos are also C-IV in accordance with federal law, which I always thought was really weird, but whatever floats their boat I guess.
 
Wow NY is strict... I think here in Florida the C-II's expire in 6 months, the rest are 1 year... and Benzos are also C-IV in accordance with federal law, which I always thought was really weird, but whatever floats their boat I guess.

NY is a pretty ass backwards state when it comes to their laws. FL is pretty relaxed when it comes to their laws, no wonder all the druggies around the country come down to Florida to see the pain management doctors who give them a prescription for a whole months supply of meds after a $400 fee.
 
NY is a pretty ass backwards state when it comes to their laws. FL is pretty relaxed when it comes to their laws, no wonder all the druggies around the country come down to Florida to see the pain management doctors who give them a prescription for a whole months supply of meds after a $400 fee.


No kidding - there has been two major "stings" in the past month concerning the pain pill market. Looks like thr law makers are trying to put a stop to it.

I think Oregon owns the record for most lenient state though.

Medical marijane - check
Death with dignity - check
CII expiration - none (seriously)
 
No kidding - there has been two major "stings" in the past month concerning the pain pill market. Looks like thr law makers are trying to put a stop to it.

I think Oregon owns the record for most lenient state though.

Medical marijane - check
Death with dignity - check
CII expiration - none (seriously)

****ty job market - check
 
No kidding - there has been two major "stings" in the past month concerning the pain pill market. Looks like thr law makers are trying to put a stop to it.

I think Oregon owns the record for most lenient state though.

Medical marijane - check
Death with dignity - check
CII expiration - none (seriously)

This will probably open a whole can of worms but perhaps they should just legalize MJ and tax the hell out of it.
 
In NYS...

BZD's are ordered like other C-IV since a 222 is a federal form.
BZD's were treated this way due to their high potential of abuse, at least this is what I was told. I guess it's up to interpretations and conjecture to assume that valium has less/more abuse potential than lortab

We also don't have to line across the face of a C-II, just endorse like any other control

Also in new york, anabolic steroids are also treated the same as C-II just like BZD's. No refills, valid for 30 days from date written. Only fillable for a 30 day supply unless the have a Code.

Are Codes for longer than 30 days a federal thing? in NYS, placing a code on an RX allows Controls to be filled for 90 day supplies expest steroids which can be filled for 180 day supplies
 
So how would you order BZD in NYS? with 222 forms? or just invoices?
...
But BZD being classified as CII in NYS is just amazing. As a pharmacist, I love this NYS law...lol

BZD are ordered by invoices, not 222, since 222 forms are FEDERAL and BZD is just treated different by NYS laws.

NYS laws are interesting, some pharm students think its a pain in the ass since we need to differentiate between federal and state laws on exams. And, hey, even anabolic steriods are treated as C-IIs in NYS. Hurrah!

Are Codes for longer than 30 days a federal thing? in NYS, placing a code on an RX allows Controls to be filled for 90 day supplies expest steroids which can be filled for 180 day supplies

I think coded prescriptions is a federal thing, but I could be wrong.
 
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If I remember right, that bzn loophole was closed a year or two ago and now all benzos are treated like C-IIs

I had to look it up and wow.

You're so right. As of 11/26/2008...

So I got that questions wrong on my exam 🙁

Thanks
 
Im pretty sure that controlled need to be re issued by the doctor every time a refill is given. It is a simple as a email sent to the doctor at Kaiser and the doctor then sends the rx to the Pharmacy for pick up when it is up for refill anwyay
 
In PA, CII-V expire in 6 months. CIIs have no law limiting their validity. In theory, they have no expiration date, only that they are to be dispensed in accord within the confines of common practice.

Hooray for gray areas!!!

I think this is the same in CT.
 
Im pretty sure that controlled need to be re issued by the doctor every time a refill is given. It is a simple as a email sent to the doctor at Kaiser and the doctor then sends the rx to the Pharmacy for pick up when it is up for refill anwyay

Except patients wait until they are out of pills to come in for refills.
 
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