What information can you give over the phone for controlled rx?

[Son_Goku]

To a patient.

If they call and ask if the pharmacy has it in stock or not so they can come pick it up, do I just tell them you have to come to the pharmacy for me to tell you that information?

Lol

---

Members don't see this ad.

 

[dblock05]

You can legally tell them if you have it in stock if you want to over the phone.

or you can legally choose not to.

 

[SClENCE]

You can tell them whatever you want. Most likely if they are calling to ask if you have it in stock the last 3 pharmacies they just visited have used out of stock as an excuse to deny it for presumably a good reason.

Some people will tell the caller that they don't give out that information over the phone. I personally just put them on hold then say no. Obviously you could give an honest answer and then have to deal with whatever walks through the door.

 

[type b pharmD]

To a patient.

If they call and ask if the pharmacy has it in stock or not so they can come pick it up, do I just tell them you have to come to the pharmacy for me to tell you that information?

Lol

3 options

1. be a dick and just tell them no

2. be real and check and tell them the truth

3. be real and tell them you don't give out that information

I personally go out of my way to explain to patients that other pharmacists who use option #1 are dicks, sometimes I even send patients their way when we run out. But mostly I just go with option 2. Option 3 is completely legit too though.

 

[trailerpark]

If it's a control no matter what I say "out of stock". I don't want any more of "those" types of patients. Same reason why I won't sell needles OTC. I do think drug addicts should have access to OTC needles, but they should have to go to a local health department. I hate the inventory issues with having open boxes of needles. One pharmacist said to just order 1 or 2 boxes just for OTC sales, but they always want a different size and then they hold up the line yelling about "the ones in the blue box!". Good RIDDENS eff off. No needles for you!

 

[BidingMyTime]

I always check and answer truthfully. I've never understood why people feel the need to lie (then again, maybe its old school, I remember one of my professors telling us we need to be honest and not lie about having a drug in stock.) If there is a problem with the script, I tell the person honestly why I won't fill it (sorry, you got a 30 day supply last week, I can not fill your prescription this early, or if there is a question on the prescriptions authenticity, I say "I have a question about your prescription, I can not fill it until I talk to the doctor.) Seriously, its not that hard to be honest. If people don't like it, I give their script back and they can move on. With all of the drug shortages, its common for people to call pharmacies to see if a drug is in stock before they make the trip in, especially if they have already been to a couple of pharmacies that were out of stock on the drug.

I hate the inventory issues with having open boxes of needles. One pharmacist said to just order 1 or 2 boxes just for OTC sales, but they always want a different size and then they hold up the line yelling about "the ones in the blue box!". Good RIDDENS eff off. No needles for you!

Hmmmm, the people I see buying needles usually have no preference and no idea what they want, they just don't want HIV. I just give them 29g 1ml. I am very happy to live in a state that encourages the sale of syringes to drug addicts. You do realize don't you, that every drug addict that ends up with HIV will be getting treated with YOUR tax money? Why wouldn't you want to sell syringes to them (profit for you, no cost to the state)? Do you prefer the alternative of YOUR tax money being spent on expensive HIV & hepatitis treatments? That means either YOUR tax rate will go up, or YOU will see less services that you want to see (like roads without potholes), because of the states money going for HIV & hepatitis treatments.

And don't you have open boxes of syringes anyway from filling prescriptions for syringes? Most of the prescriptions I see are for people getting insulin once or twice a day, so the box has to be opened to give them 30 or 60 syringes anyway.

 

[Momus]

The drug addicts come back like cockroach no matter what kind of reason I tell them.

1. Out of stock
2. Rx shady, all narcs, cash pt, tweaker looking dude no maintenance drug "not comfortable filling it"
3. Too soon

These low lives all keep coming back, complaining and yelling, I need to shoot them all in the face to make my my job easier >_>; All of them want Oxy 30 mg to sell and chit. One dude has Obama care insurance with no jobs just to cover Oxy 30 mg for $5 copay, amazing what you can do with #120 of them @$20-30/pill...

 

[SClENCE]

One drug addict had Oxycontin 40 eScribed today then cussed us out when we denied it, then he had the nurse personally deliver a hard copy. The diagnosis code was joint pain...

I absolutely couldn't believe it. The worst part is that the Dr. Office is putting in a corporate complaint over this and threatened to go to the state board over the denial of filling the eScript.

This was one of about 10 events today that contributed to what was one of my worst days ever

 

[Lnsean]

If it's a control no matter what I say "out of stock". I don't want any more of "those" types of patients. Same reason why I won't sell needles OTC. I do think drug addicts should have access to OTC needles, but they should have to go to a local health department. I hate the inventory issues with having open boxes of needles. One pharmacist said to just order 1 or 2 boxes just for OTC sales, but they always want a different size and then they hold up the line yelling about "the ones in the blue box!". Good RIDDENS eff off. No needles for you!

This is the mentality of a student. Once you become a provider and learn to weigh your options more seriously, you must consider that the alternative would be them using/sharing dirty needles. These addicts will get their high one way or another. Let them buy the needles. Don't try to be a white knight; it's not necessary in this scenario.

 

[marscole]

1. Just ask politely, what dosage, strength and how many they need. (Extraordinary customer service)

2. Put it on-hold. Pretend you're going to check it. (Let the customer know that they are being served!!!)

3. After that, say NO to them. (Politely reject them!!!) 😛

 

[SClENCE]

This is the mentality of a student. Once you become a provider and learn to weigh your options more seriously, you must consider that the alternative would be them using/sharing dirty needles. These addicts will get their high one way or another. Let them buy the needles. Don't try to be a white knight; it's not necessary in this scenario.

I think you are missing the point. People are not denying these needles because they believe it is in the best interest of the addicts (though the law implies otherwise), they are denying these needles because they don't want to waste time/effort on these transactions (while inheriting liability) on a customer base that grows exponentially once a few boxes are sold.

 

[owlegrad]

I think you are missing the point. People are not denying these needles because they believe it is in the best interest of the addicts (though the law implies otherwise), they are denying these needles because they don't want to waste time/effort on these transactions (while inheriting liability) on a customer base that grows exponentially once a few boxes are sold.

I mean if making profit AND preventing the spread of blood borne illness is a waste of time and effort, then yeah go ahead and refuse their sale.

 

[Lnsean]

I think you are missing the point. People are not denying these needles because they believe it is in the best interest of the addicts (though the law implies otherwise), they are denying these needles because they don't want to waste time/effort on these transactions (while inheriting liability) on a customer base that grows exponentially once a few boxes are sold.

See..this is why students should not give advices to real pharmacy practice. It's such a joke. Print-screen what you said...save it somewhere...and look at it again after you're a pharmacist. You'll realize how dumb you sound.

 

[SClENCE]

I'm not trying to give anyone advise, I'm simply stating a rationale (which I never claimed as my own) that is consistently held by every PIC and staff pharmacist that I'v ever worked with. Not to mention they are illegal to sell in my state without an injectable on file to begin... so for me there is no decision to be made.

You can argue all day about preventing blood borne illness but it doesn't change the fact that selling the needles is not lawful and the user has made a conscious decision to expose them self to potential pathogens.

 

[Dr Wario]

I'm not trying to give anyone advise, I'm simply stating a rationale (which I never claimed as my own) that is consistently held by every PIC and staff pharmacist that I'v ever worked with. Not to mention they are illegal to sell in my state without an injectable on file to begin... so for me there is no decision to be made.

You can argue all day about preventing blood borne illness but it doesn't change the fact that selling the needles is not lawful and the user has made a conscious decision to expose them self to potential pathogens.

I have been on both sides of this issue, and where a person ends up probably as a lot to do with the location of the pharmacy. An area with wealthier clientele will have less people seeking needles, so selling them to the few that do really is not a problem, but a poorer/urban area will have an essentially unlimited supply of customers. Two years ago our store sold needles to all who asked, we went through around 300 per day by the 10 pack. I remember when we got cases of the "1cc longs" and would tare though them at lightning speed. I was, and still am, an avid believer that addicts should have access to clean needles, but we discontinued selling them due to three main factors.

First, we started finding needles in our bathroom trash and in our parking lot, one day a parent told me that her five year old daughter found one by the bushes outside. Second, we were given no credit for increasing the sales of merchandise that is considered front store, the amount of time we used for these $2.99 transactions was really cutting into our already overstretched staffing allowance, so it really just did not make any sense to continue. Third, and perhaps most importantly, a fellow pharmacist told me that grandma picking up her Lipitor and Metformin does not want to stand next to the tweaker jonesing for his/her next fix, I would much rather serve grandma than deal with junkie.

Once you cater to these types of people, your store will start to resemble a scene from the walking dead instead of a professional practice environment. For all of the practicality of providing clean needles (and drugs) to seekers, this simply is not what I signed up for doing my six years of schooling.

 

[Lnsean]

I'm not trying to give anyone advise, I'm simply stating a rationale (which I never claimed as my own) that is consistently held by every PIC and staff pharmacist that I'v ever worked with. Not to mention they are illegal to sell in my state without an injectable on file to begin... so for me there is no decision to be made.

You can argue all day about preventing blood borne illness but it doesn't change the fact that selling the needles is not lawful and the user has made a conscious decision to expose them self to potential pathogens.

We're not talking about legality. We are talking about you purposely turning patients away when it is legal to sell them.

 

[Wheresmyaricept]

I'm not trying to give anyone advise, I'm simply stating a rationale (which I never claimed as my own) that is consistently held by every PIC and staff pharmacist that I'v ever worked with. Not to mention they are illegal to sell in my state without an injectable on file to begin... so for me there is no decision to be made.

You can argue all day about preventing blood borne illness but it doesn't change the fact that selling the needles is not lawful and the user has made a conscious decision to expose them self to potential pathogens.

It's no longer a conscious decision at that point. You clearly don't understand what addiction is. All you see is someone trying to get high but what you don't see is what they're thinking. They don't care about going to rehab or the health risks and they certainly aren't thinking about "oh hey this is a solid way to get hepatitis and HIV maybe I should stop". All their brain can think about is getting high.

So pick your battle. You can either deny them needles and let them reuse and risk contracting a disease, or you can provide clean needles and just feel sorry for them because they're not in control of their actions. If you don't feel comfortable selling needles, that's your prerogative and I can't change your opinion, but at least have other options available. Direct them to somewhere that will sell needles or has a needle exchange program available. It might not help for that moment in time but maybe in the future it will.


In addition, it some states it is legal to sell needles without a prescription. In my state it must be for a "legitimate medical purpose". So as far as we are concerned, needing them "for insulin" is a legitimate purpose.

 

[SClENCE]

It's no longer a conscious decision at that point. You clearly don't understand what addiction is. All you see is someone trying to get high but what you don't see is what they're thinking. They don't care about going to rehab or the health risks and they certainly aren't thinking about "oh hey this is a solid way to get hepatitis and HIV maybe I should stop". All their brain can think about is getting high.

So pick your battle. You can either deny them needles and let them reuse and risk contracting a disease, or you can provide clean needles and just feel sorry for them because they're not in control of their actions. If you don't feel comfortable selling needles, that's your prerogative and I can't change your opinion, but at least have other options available. Direct them to somewhere that will sell needles or has a needle exchange program available. It might not help for that moment in time but maybe in the future it will.


In addition, it some states it is legal to sell needles without a prescription. In my state it must be for a "legitimate medical purpose". So as far as we are concerned, needing them "for insulin" is a legitimate purpose.

So you would argue that a person who is addicted to a substance has lost brain capacity/function is such a way that they are no longer making a free choice. In more resent times this has been presented as fact. It's a tough subject - I would still argue that the only known cure for such as disease is abstinence and would therefore only be comfortable contributing to this outcome.

 

[Digsbe]

Pharmacists that don't sell needles aren't bad or naive. Nearly every PIC I've been under doesn't sell unless the person has a script for an injectable or had a believable story like picking up needles for a family member we fill for that was on an injectable. They also did not stock medications like Suboxone. They didn't want the clientele that would cause the store problems, make other patients uncomfortable or deal with those liability issues. I'm all for getting addicts clean needles, but if it becomes a problem where your store is overrun with addicts clearing out your inventory that can be problematic. They should go to a health facility in my opinion where the state provides them. I'm fine with my tax dollars going to cheap needles at a safe facility that may also provide services to help quit addiction.

That being said, those who do sell needles aren't bad either and I support their decision. Really it's up to the manager to chose, with each one being a valid stance behind selling/not selling. As for me I'd sell no questions asked, but if it becomes a problem I'd set a policy in place against selling them to everyone. So long as it's based on good intentions I don't think one side is better or worse than the other.

 

[PikminOC]

This is a very interesting thread. I had no idea about the needles being sold at all.

 

[owlegrad]

I have never had more trouble from suboxone patients than I had from say viagra patients. The trouble is from how expensive it is.

Actually benzo and opiate patients are much, much worse imo.

 

[Dr Wario]

I have never had more trouble from suboxone patients than I had from say viagra patients. The trouble is from how expensive it is.

Actually benzo and opiate patients are much, much worse imo.

I would tend to agree with that except for that one guy who has a prior auth and gets 1 tab/film filled at a time and the doctor finally does the PA 2 weeks later and the guy wants each purchase refunded.

 

[BenJammin]

This is the mentality of a student. Once you become a provider and learn to weigh your options more seriously, you must consider that the alternative would be them using/sharing dirty needles. These addicts will get their high one way or another. Let them buy the needles. Don't try to be a white knight; it's not necessary in this scenario.

Not only are you completely wrong but you give addicts way too much credit. You think addicts are going to use clean needles all thanks to the pharmacy? Please, join the real world asap.

 

[Digsbe]

I have never had more trouble from suboxone patients than I had from say viagra patients. The trouble is from how expensive it is.

Actually benzo and opiate patients are much, much worse imo.

I haven't either, but that was my PIC's decision. Most of my problems come from the people on the Trinity (Soma, Xanax, and an opioid). I'm in the southeast though where there is rampant prescription drug abuse, so many of the PIC's here have a more cautious approach to things.

 

[SClENCE]

Are you kidding me? Suboxone patients are the worst. Someone who is upset about Viagra will either not take it or have us fill the script for 1-3 pills.

A Suboxone patient will completely hulk out and then start their classic rant with the words "This medication has saved my life" before threatening to sue the shirt right off your back

 

[owlegrad]

Different people have different experiences obviously. Most of the patients I dispense suboxone to are perfectly pleasant, and when they aren't they are no more unpleasant than any other patient. Of course there is probably a certain amount of confirmation bias going on.

 

[Lnsean]

Not only are you completely wrong but you give addicts way too much credit. You think addicts are going to use clean needles all thanks to the pharmacy? Please, join the real world asap.

How do you tell someone their opinion is wrong on a matter that is not fact? I don't get the credit nor the authority that you give yourself.

 

[BenJammin]

How do you tell someone their opinion is wrong on a matter that is not fact? I don't get the credit nor the authority that you give yourself.

Denying real world experience? You must be a student.

 

[NateRobinson]

One drug addict had Oxycontin 40 eScribed today then cussed us out when we denied it, then he had the nurse personally deliver a hard copy. The diagnosis code was joint pain...

I absolutely couldn't believe it. The worst part is that the Dr. Office is putting in a corporate complaint over this and threatened to go to the state board over the denial of filling the eScript.

This was one of about 10 events today that contributed to what was one of my worst days ever

May I ask a question?

Why are you calling him a "drug addict" exactly? If he had oxycontin 40 mg eprescribed, and the physician did it (I.E. its not a fake prescription), then what gives you the right to call him a drug addict?

The FDA has approved drugs like oxycontin to be prescribed. It's not an illegal drug. I know, I work for the same company as you and the company is going extremely hard on opiates and cracking down, and telling us to look for red flags, but this is going overboard I think. It seems everyone is calling everyone a drug addict these days.

For all you know, the patient in question has very very very bad joint pain (might even have sickle cell anemia???) that doesn't respond well to naproxen, meloxicam or anything else for that matter. Maybe they have been using oxycodone for a while now and that isn't exactly helping anymore so the dose needs to be upped.

My general logic is, if the medication is a legitimate prescription, which it is in your case, E-prescribed, and its not too soon to fill or the patient isnt paying cash, then I really probably should fill it or I'm harming a patient by not giving them adequate pain relief. In your case the god damn nurse offered to deliver a hard copy, which means that they are adamant about the patient getting the drug.

Some RPH's need to get off their high horse and do whats right. Red flags are red flags, and this certainly isnt one.

 

[NateRobinson]

Are you kidding me? Suboxone patients are the worst. Someone who is upset about Viagra will either not take it or have us fill the script for 1-3 pills.

A Suboxone patient will completely hulk out and then start their classic rant with the words "This medication has saved my life" before threatening to sue the shirt right off your back

Just wow, bro. This is horrible thinking. It makes me so sad that people like you have professional degrees and are in charge of dispensing medications.

Someone I know ACTUALLY HAD THEIR LIFE SAVED because of suboxone. He had a huge heroin habit and the only reason he didn't stop earlier was because of the withdrawals. They were so bad that he couldn't bear it. Then some doc gave him subs and he was able to kick the habit with no withdrawals due to the sub.

It really is a miracle drug for heroin addicts. Shame on you.

 

[type b pharmD]

As a PIC I think it is in both the business and patients interest to restrict sales to only significant quantities .. I would never sell a 10 pack , I am liberal on this issue , but that is insane.

I would give a few 10 packs away to a person in need who spends $10k/month on insulin in my store.

 

[Lnsean]

Not only are you completely wrong but you give addicts way too much credit. You think addicts are going to use clean needles all thanks to the pharmacy? Please, join the real world asap.

Obviously, if they are making the effort to come into the pharmacy...they are trying to use clean needles.

Denying real world experience? You must be a student.

And what makes your real world experience the standard for the profession? What gives you the authority to say that another person's experience is completely wrong? I don't get it.

 

[SClENCE]

Just wow, bro. This is horrible thinking. It makes me so sad that people like you have professional degrees and are in charge of dispensing medications.

Someone I know ACTUALLY HAD THEIR LIFE SAVED because of suboxone. He had a huge heroin habit and the only reason he didn't stop earlier was because of the withdrawals. They were so bad that he couldn't bear it. Then some doc gave him subs and he was able to kick the habit with no withdrawals due to the sub.

It really is a miracle drug for heroin addicts. Shame on you.

He didn't quit heroine because of the withdrawals? Would never have guessed. If he was going to taper off of Suboxone over a 6 month period then great. I personally have never seen a Suboxone dose lowered and I assure you that your friend will be on it for life. He's an active addict but at least his doctor will enjoy the profits of your friend's bi-weekly/monthly visit for the rest of his life.

I'm sure I could kick my Norco habit if the doc gave me some Percocets

 

[PharmdA07]

Wow...this thread seems to turn into a shouting contest between the soon-to-be pharmacist and the current practitioners.
I think everyone is entitled to their opinions and the way they practice. That's why we all went through several years of schooling to understand the law and know how to interpret it in a way that fits our practice ethically and, of course, financially. When I was a student, I worked with both PIC's who refused to sell (due to beliefs similar to those aforementioned) and who were eager to sell regardless (due to profit reasons) and who would sell upon proof of true needs (insulin vials, Rx for injectibles, etc.). Now I am an RPh and at my main store (which is in an affluent area next to a women hospital), I have no problem selling it (my state allows me to do so); but at the store I am a relief at on the weekends (which is in a so-so middle-class area), I always ask for proof of true needs. I don't do Suboxone--sorry but too much liability and legal requirements, I will, however, refer them to the state health central place where they can get it. For controlled Rx asked over the phone, I will say I don't have it on the phone from the get-go (Of course for show, I will put them on-hold to "go check" and then politely say "no!"). I learned from hard experiences in the past when I told them to bring me the Rx first, I was swamped with yelling-and-screaming-and-cursing line of people in the store. Of course, one out of these ten people may have been legitimate but I can't sacrifice my time rather spent on other patients who truly need me.
As far as the scenario where the doc's office deliver the hard copy Rx: yes it may be true that it's legitimate, but I would need more infos on the prescriber and his/her practice to determine a true patient-prescriber relationship and more infos on the "joint pain" Dx. Yes, joint pain associated with conditions such as sickle cell or maglinant metastasis may need opioid; however, if that's the case, the Dx should mention the primary condition (e.g. cancer, sickle cell) and not its sequelae. Additionally, is there proof that this pt has tried other Tx such as topical, oral nsaid/tramadol/DMARS, injectible steroid or lidocaine? As you can see, it all depends on the situation and information that can be obtained. Just because the doc's office e-scribed and later sent me a script with tactics of pressure does NOT mean that I have to fill it. They are welcome to contact the board if they want and see what the board would tell them.

 

[NateRobinson]

He didn't quit heroine because of the withdrawals? Would never have guessed. If he was going to taper off of Suboxone over a 6 month period then great. I personally have never seen a Suboxone dose lowered and I assure you that your friend will be on it for life. He's an active addict but at least his doctor will enjoy the profits of your friend's bi-weekly/monthly visit for the rest of his life.

I'm sure I could kick my Norco habit if the doc gave me some Percocets

Are you a pharmacist? You dont taper suboxone for 6 months. That's not what its used for. Sure, suboxone's manufacturer would love for you to do that, but that's not how it works.

ALOT of heroin addicts (ALOT, ALOT) at this point only use heroin because they get sick as hell if they dont use. I know so many people from high school who use, and like i said, one of my very good friends was a heroin addict. He told me the first 15-20 times he was in paradise when he used, and got high, and it felt good, but then he stopped getting high. One day he had to use so much that he nearly died. That's when he realized that he needs to stop. But, if he went more than 36 hours without it, he would have projectile diarrhea, chills and rigors that were worse than the flu 10x over, fierce sweating, "pain in places he didn't even know he had places" and nasty coughing. The worst feeling in the world. All it took was a small injection into a vein, and what do you know, within 5 seconds, it all stopped and he felt normal again. He used at that point to FEEL NORMAL. Not to get HIGH. And this is what happens to most heroin addicts.

So, he got a script for suboxone, came to me, I filled it for him, and he used it for 3 weeks and then jumped off. It saved his god damn life. Not only did he have stop buying it from shady people, and abuse it via needles, but he actually felt good. All it took was an 8mg strip under the tongue and the withdrawals were gone for 24 hours. He was on 8mg for a few days, then 4 mg for a week or so, then the last 2 weeks he kept slicing the strip down until he was at like 0.25 mg. When he finally jumped off, he still had minor chills and a little diarrhea but nothing compared to heroin withdrawals. It SAVED HIS GOD DAMN LIFE. He now has a job as a hedge fund manager and he makes bank, got married, has 2 kids with one along the way. He hasn't used since. He hurt himself badly a year ago and he refused percocet. He said he would manage with Aleve.

You need to get off your ****ing high horse and do your job. You are a pharmacist. Your job is to make people better, and at the risk of sounding like a CVS cliche, lead people on their path to better health. EVERYTIME YOU TURN A SUBOXONE AWAY THAT IS LEGITAMTE, YOU RUN THE RISK OF RUINING SOMEONES LIFE FURTHER. Instead of looking down on addicts, you should take them to the consultation window and talk to them about addiciton. Tell them you can help them. Tell them to taper the subs and they'll feel better.

Everyone commits sin in this life. Nobody is perfect, man. My friend got into heroin because he was depressed, had no family and thought he would never make it in life. Stop judging people. Stop assuming everyone is a junkie bitch who wants to get high. I'm just imagining what would have happened if I disowned my friend when he called me that one night crying because he was in withdrawals and didn't know what to do when his connect left him high and dry. He would have probably committed suicide.

 

[wezvidz]

Just wow, bro. This is horrible thinking. It makes me so sad that people like you have professional degrees and are in charge of dispensing medications.

Someone I know ACTUALLY HAD THEIR LIFE SAVED because of suboxone. He had a huge heroin habit and the only reason he didn't stop earlier was because of the withdrawals. They were so bad that he couldn't bear it. Then some doc gave him subs and he was able to kick the habit with no withdrawals due to the sub.

It really is a miracle drug for heroin addicts. Shame on you.

The problem is, do you live an area with HUGE opioid abuse and tons of Sub docs that have NO TAPER PLAN for the patients ever as to collect monthly or bi-weekly cash copays from them? As much as we get swamped with enormous opioid dose scripts for "joint pain", we get swamped with Sub patients that can be big problems/aggressive/giant time sucks. The ones who wants us to run 14 discount cards to see which one gives the cheapest copay on their 2 strips being dispensed.

Sure it helps from the right docs, but for a lot of people it's just as bad as being a patient at a pill mill.

 

[wezvidz]

The problem is, do you live an area with HUGE opioid abuse and tons of Sub docs that have NO TAPER PLAN for the patients ever as to collect monthly or bi-weekly cash copays from them? As much as we get swamped with enormous opioid dose scripts for "joint pain", we get swamped with Sub patients that can be big problems/aggressive/giant time sucks. The ones who wants us to run 14 discount cards to see which one gives the cheapest copay on their 2 strips being dispensed.

Sure it helps from the right docs, but for a lot of people it's just as bad as being a patient at a pill mill.

And as to the syringe issue, I was all about "public health" when I was first licensed. Then everyone knew my store was where you scored needles so between every nice little old lady in line at pickup was a junkie. Got old real quick. Now I sell needles by RX only.

It takes one occurrence of being on duty as the RPh selling needles freely when you then have to kick down the men's restroom stall door to give CPR to someone overdosing to stop. This happened. Not to mention the needles all over the parking lot. Forget it.

 

[zelman]

Are you a pharmacist? You dont taper suboxone for 6 months. That's not what its used for. Sure, suboxone's manufacturer would love for you to do that, but that's not how it works.

ALOT of heroin addicts (ALOT, ALOT) at this point only use heroin because they get sick as hell if they dont use. I know so many people from high school who use, and like i said, one of my very good friends was a heroin addict. He told me the first 15-20 times he was in paradise when he used, and got high, and it felt good, but then he stopped getting high. One day he had to use so much that he nearly died. That's when he realized that he needs to stop. But, if he went more than 36 hours without it, he would have projectile diarrhea, chills and rigors that were worse than the flu 10x over, fierce sweating, "pain in places he didn't even know he had places" and nasty coughing. The worst feeling in the world. All it took was a small injection into a vein, and what do you know, within 5 seconds, it all stopped and he felt normal again. He used at that point to FEEL NORMAL. Not to get HIGH. And this is what happens to most heroin addicts.

So, he got a script for suboxone, came to me, I filled it for him, and he used it for 3 weeks and then jumped off. It saved his god damn life. Not only did he have stop buying it from shady people, and abuse it via needles, but he actually felt good. All it took was an 8mg strip under the tongue and the withdrawals were gone for 24 hours. He was on 8mg for a few days, then 4 mg for a week or so, then the last 2 weeks he kept slicing the strip down until he was at like 0.25 mg. When he finally jumped off, he still had minor chills and a little diarrhea but nothing compared to heroin withdrawals. It SAVED HIS GOD DAMN LIFE. He now has a job as a hedge fund manager and he makes bank, got married, has 2 kids with one along the way. He hasn't used since. He hurt himself badly a year ago and he refused percocet. He said he would manage with Aleve.

You need to get off your ****ing high horse and do your job. You are a pharmacist. Your job is to make people better, and at the risk of sounding like a CVS cliche, lead people on their path to better health. EVERYTIME YOU TURN A SUBOXONE AWAY THAT IS LEGITAMTE, YOU RUN THE RISK OF RUINING SOMEONES LIFE FURTHER. Instead of looking down on addicts, you should take them to the consultation window and talk to them about addiciton. Tell them you can help them. Tell them to taper the subs and they'll feel better.

Everyone commits sin in this life. Nobody is perfect, man. My friend got into heroin because he was depressed, had no family and thought he would never make it in life. Stop judging people. Stop assuming everyone is a junkie bitch who wants to get high. I'm just imagining what would have happened if I disowned my friend when he called me that one night crying because he was in withdrawals and didn't know what to do when his connect left him high and dry. He would have probably committed suicide.

This is called an n=1 study.

My sibling quit heroin cold turkey. Now we have n=2 and your alpha > 0.05.

 

[trailerpark]

I love how everyone on this site knows someone who is a hedge fund manager making bank. God forbid he gets off drugs and works his way up to a Denny's supervisor. I also agree I could beat my Percocet habit with some Dilaudid.

 

[SClENCE]

I think you story is great and 100% ideal, but when I say that I'v never seen a patient come off of Suboxone I'm not kidding. Maybe the doctors in my area to blame but heck I'v actually been starting to see patients titrating up on Suboxone it's crazy

If even a few cases were such as you described I think my outlook would have been different

 

[trailerpark]

Yeah and as soon as the dose or strength changes and you try to explain they need a new PA, oh boy...

 

[SClENCE]

Yeah and as soon as the dose or strength changes and you try to explain they need a new PA, oh boy...

Or they buy a 1 week supply, they are notified that the PA is approved, and come to pick up the rest the day after getting a 7 day supply and your in that awkward situation. not to mention the refund you have to do. Dose changes are not an issue for us because every patient is on the max dose allowed by the state.