What is Day 1?

[DangerDolan]

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Your customer filled a Sched II last month for a 30 day supply.

Do you consider the fill date, Day 1?

If so, do you make the customer wait until Day 31 before filling the next Sched II for the same dosage?

Why or Why Not?

Thanks!

 

[Sine Cura]

I know most druggies/sellers eat/sell all their narcs in a couple days max but to take the question seriously:

I tell my team to consider the days AFTER the pickup date. If the script calls for dosing with a frequency greater Q8H, 30 days AFTER the pickup date is the day the script would run out if taken as "scheduled."

 

[DangerDolan]

I know most druggies/sellers eat/sell all their narcs in a couple days max but to take the question seriously:

I tell my team to consider the days AFTER the pickup date. If the script calls for dosing with a frequency greater Q8H, 30 days AFTER the pickup date is the day the script would run out if taken as "scheduled."

So you are saying, "No One should ever take a full day's dose on the fill date, even if they had the Script filled in the AM."

Do you tell your customers this or do you just call them druggies and sellers?

I see an issue with this method unless you are notifying the customer. Any customer that takes the dose as prescribed would need to be at your Pharmacy, in the AM, on that Exact day, and be there regardless of their work schedule. That is unless the customer is not taking the Sched II correctly and saving/selling medication.

Anyone selling doesn't have a problem with waiting until Day 32, because they would not be the ones that are dependent.

 

[wucool33]

Is there a way to immediately lock any thread when a customer comes on here trying to justify getting their fills early?

 

[wagrxm2000]

I think someone doesn't know what use as needed means.

 

[CetiAlphaFive]

I think someone doesn't know what use as needed means.

I just hope "He who shall not be named Steve" doesn't show up.

LOL

 

[Sine Cura]

So you are saying, "No One should ever take a full day's dose on the fill date, even if they had the Script filled in the AM."

Do you tell your customers this or do you just call them druggies and sellers?

I see an issue with this method unless you are notifying the customer. Any customer that takes the dose as prescribed would need to be at your Pharmacy, in the AM, on that Exact day, and be there regardless of their work schedule. That is unless the customer is not taking the Sched II correctly and saving/selling medication.

Anyone selling doesn't have a problem with waiting until Day 32, because they would not be the ones that are dependent.

Yeah if they don't like it they can go somewhere else.

Let's say someone picks up Ambien 10 mg #30 in the AM today and they have no previous Ambien, so yeah they would take the 30th tablet on the 21st of Feb and on the 22nd they can pick up another 30 without interruption.

Same applies to multiply dosed opioids.

I do let people pick up one day early so they can pick up the evening before the 30th day if they work overnight etc.

 

[DangerDolan]

Someone with degenerative disc disease and multiple surgeries has to miss a flight because they are expecting a pharmacy to fill on the evening of Day 29. The Doctor, Script, and Bottle have never said to use as needed. That person has been told to take the medication as prescribed. Once the patient has done this for a while, they are dependent to take the meds as prescribed.

This is just a simple discussion that I wanted to bring up because I have seen this situation play out. This isn't to bash on other pharmacists or label people. It was only meant to better understand the industry as a whole and how regulations may be affecting judgment and practices.

I haven't heard of this being their company's policy and I thought this was left as a grey area with the DEA for a reason.

 

[Dr. Pill]

It’s not an issue with the DEA, per say. Law will allow an early fill up to 3 days but it is at the discretion of the pharmacist. Some will do it 3 days early, some will not. The decision has less to do with the legitimacy of each individual customer or patient and more to do with the pharmacist likely being jaded about misuse/abuse in general.

 

[DangerDolan]

Thank you all for the input.

 

[zelman]

...I thought this was left as a grey area with the DEA for a reason.

You’re right. But the reason isn’t to help patients. It’s to arrest pharmacists.