ATAP: What we think by looking at your Rx’s

I LOVE your blog! It’s the only “personal” blog that I bother to read. I’m not a pharmacist, but my, uh, passion? for medicine has led to the nickname “Walgreens” from some friends and coworkers… :-/
Alright, here’s my question… what do pharmacists think about people who have a buprenorphine script? I’ve never felt akward or self-concious about picking up a script until I got Suboxone. I feel like they look at me and just think, “Fuckin junkie,” and maybe even dig thru my history in the computer to see what else I could be up to. What about methadone? Is there any less judgement with it because it could be for legitimate pain?

Clearly I can’t speak for all the pharmacists out there, but if you came in to me with the Rx and I saw that it was Suboxone, I would clearly run around the pharmacy yelling “JUNKIE” while waving my hands around and throwing things at you. Then I call the police and say that you stole things to support your junkie ways..
… Or maybe not …
Unless you wanted something filled early, threw a tantrum in the pharmacy, or bugged me 100 times a day to get something filled when it was not due, I wouldn’t even give your Rx a second look or thought. I might think to myself “Shit, I hope I can dispense this whole bottle of Suboxone to her. I dont want this stuff on my shelves taking up space when I get 1 rx/month for it”.
We’re pharmacists, we are used to things like this. We work with controlled narcotics for a living. Coming in with an Rx for Suboxone isn’t really a big deal to us. Obviously if you don’t give us any grief, are on time and actually take an active stance in your care you don’t even blip on our radar (we are too busy getting screamed at by the person behind you about why we wont fill her soma early).
This would be like us thinking “FUCKING FATTIE PIG” for someone bringing in an Rx for some Actos or Glyburide or any other diabetes medication, “BAD MOTHER” for someone bringing in an Rx for lice medication for their children, “WHORE” for Plan-B or 1gm Zithromax, “DONT TOUCH ME” for Valtrex, the list could go on and on and on. We’re more mature than that (sometimes).

I’d really like to hear what you have to say about it. And just for the record, I think bupe is a wonderful drug and has helped me tremedously. I used opiates for about two years recreationally, about 8-10 months daily use, and slid into IV use about two months before I was found out and went to rehab & put on maintenence. It takes away 95% of my cravings and I don’t think I could have stayed without it.

I’ve gone to a few CE’s about it and I think that its magical as well. Its helped a ton of people get back on track and go on with their lives. It seems like its done you well too. Best of luck. :)

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36 Comments

  1. I know at our pharmacy, there are a few times we will joke about people and their valtrex or something like that. However, Suboxone/Subutex are not ones we joke about. We may talk about it though, but for many of our patients it is sympathy or pride. We have one patient who was one of our druggies for a while. Recently he brought in a Suboxone prescription and apologised for all the trouble he had given us. We talked with him for a while and let him know that he had our support. He is doing very well and will come in about 8 when we aren’t busy anymore and talk for a while with us. I am glad he is taking steps to improve his life. There are two or three patients we have that we are part of their support group. I never think duragatory things about suboxone patients. I have only respect for those who are trying to improve themselves.

  2. RJS says:

    When I see Suboxone I usually think “Good for you.”
    Same for Chantix. If I even bother having a thought about it at all.

  3. RJS says:

    I neglected to mention that I’m more likely think “Fruit loops!” when I open a bottle of Suboxone than I am to think about the background of the person I am filling the Rx for.
    I love the smell of Suboxone. :)

  4. Rebecca says:

    i am the only pharmacist who sat on the discussion panel regarding the rules for prescribing Suboxone/Subutex. It was an amazing discussion and I was blown away by the lack of knowledge by most health professionals regarding the dispensing life of a retail pharmacist. I fought the 30 patient per prescribing group caveat. I argued that no pharmacist in the real world would be able to verify the special “X” DEA number for each prescription to make sure the prescribing maximum was not violated.
    One of my interests for which I pursued post-PharmD training is substance abuse treatment and research. I have done retail pharmacy as a technician for 11 years and as a pharmacist for 6 years. I now work in a clinical capacity with our veterans and wounded soldiers (who have issues with drugs of abuse following lengthy treatment for pain management). Each person who chooses to be treated for their abusive behavior has my support. It is a difficult thing to face – not only to admit that there is a problem, but in finding a pathway to health. Up until recently, admission to a methadone treatment program was the only way. Prescribing methadone on an outpatient basis for treatment of opioid abuse is actually against the law.
    If you bring me a script for buprenorphine I guard your privacy, I respect your decision, and I quietly cheerlead for your recovery. I would never think “junkie”. I only think “junkie” when you bring me a Dilaudid RX written in marker.

  5. rph3664 says:

    We once had a psych patient on naltrexone, and yes, I did think “recovering addict” then found out that this person was using it off-label for OCD.
    TAP, I’m surprised you haven’t done a rant on ADD meds. When is that coming – or do you restrain yourself because you have the condition yourself? The media says it affects 3 to 5% of children (and adults, as you don’t outgrow it but rather learn to compensate) but around here, I’d say it’s more like 30 to 50%, and I have heard about school districts (not mine) who are pushing, consciously or not, to get 100% of their students on some kind of ADD medication. I’m quite aware that many parents (okay, single moms) who face being kicked off welfare are coaching their kids to misbehave in school, or act like they are retarded, so they can get SSI payments for them. This, IMHO, is not what SSI was intended for, nor was it meant for drug addicts but that’s another story.
    In addition, I have never heard of a child being evaluated for it who wasn’t diagnosed, usually by the first practitioner who saw them, 10 minutes after they walked into the door.That is, with one exception. I once worked for a pharmacist who thought his B-student daughters could be turned into A students by taking meds, and took them to 10 or 15 doctors until he found one who would write prescriptions, no questions asked. I told him what I thought, which probably contributed to my being fired a few months later but it was a temp job anyway. I later learned that this man has a long history of walking out on jobs without giving notice, and signing up to do relief work and not showing up and being unreachable.
    Go figure.

  6. Chris says:

    If it’s for Suboxone, and you haven’t caused a scene in my pharmacy or insulted my staff in the past, then the only thing I’m thinking is, “Do I have enough tablets?” I guess I’d also be thinking about how I should tell you (nicely) that you should come back here and get your script next month so I don’t have pills sitting on the shelf.

  7. Grasshopper says:

    And heaven help you if you have been on a zolpidem product for an extended period and you sudden come off it. Psychosis ensues….

  8. one_angry_tech says:

    I try not to judge people (Im just a tech though). I do agree with AP.. I would be likely to think less of someone if they were a dick, came in frequently or even worse, CALL frequently about their Vicodin/Lortab/Xanax being called in yet.. about 10 times an hour. [Yeah, we have a problem.]
    I can’t think anything bad of someone trying to get their life back on track.. good luck to you!

  9. rph3664 says:

    The other patients we joke about are the Viagra, MUSE, or Caverject patients who probably couldn’t find a sober partner if their lives depended on it.

  10. http://openid.aol.com/mikells43 says:

    I am on bupe also, i take subutex. i have a great working relationship with both my pharmicists that work at the only pharm i go to now. I pretty much abused the hell out of u people when i was using and i have made amends several times. i was that person calling and bugging and pleading if my ins dont pay for it can i pay cash. i dr shopped so much and pharm shopped i was put on lock down by my ins. i am allowed one pcp to write all my scripts, if they arn’t by that pcp they have to call and override which is a pain in the ass. so my bupe script has to be overridden. the one pharm was so neg to me back when i used, now shes a good friend of mine.. bupe is a lifesaver. it does not get u high. it makes an opiate addict feel normal, cause we are endorphine deficiant due to dumping tons of opiates on our brains.
    I take subutex, so i call a few days early and they order it in for me. I have heard of people getting put thru hell tryin to get bupe scripts filled. also the one baltimore newspaper just wrote a fucking awful article on the diversion of bupe(diversion is going to happen with anything with a c in front of it. hell it happens with viagra at 12 a tab retal priced). anyhow thanks for being so understanding, and the limit for a bupe doc is 100pts now which is great. i come from an area of high opiate abuse here by pittsburgh. please check out our bupe advocates site at http://www.naabt.org list ur pharm at http://www.naabt.org/local to help the addicts find someone that carries bupe or can have it for them. addiction is a hopeless disease as i am sure u all know by the people who call 10 times a day and come in dope sick shaking with an oxy script its sad but true. o well im going now ttyl.

  11. MJ says:

    thanks all, i appreciate the feedback, it’s been very encouraging! it’s unfortunate that not everyone is as understanding or supportive, even close family and friends who are supposed to be the least judgemental of me…
    AP, thanks for sharing your thoughts, it’s really put my mind at ease.

  12. Emma says:

    What do I think? And I also tell you why. First of all I feel, then think. Must say that I feel pity for all those shit who lives on percocet, vicodin, xanax, and especially dislike even despise and scorn – adderall, concerta and retalin takers (or their parents). And therefore I think that if you have pain (severe or moderate) it is not the reason to go into opiates. Then, if your kids have attention disorder there much more (more effective) therapies that pharmacological. But after all this is my way to put food on the table, my money is weak and mind destroyed poor people, thank to all you crackers:)

  13. Mike says:

    I pretty much feel the same way as everyone else. The only negative thought I would have would be something like ‘shit, I hope I have this in stock’. Even though we all love to bitch and moan about our junkies, this isn’t really one of those times when those thoughts cross the mind. Like everyone else, the mulitiple call, screaming harrassers are the ones that bug the living shit out of me! Btw, I never realized until I worked graveyard that so many people picked up a 10-pack of syringes for ‘grandma’ at 3AM. :)

  14. Person says:

    Was Emma writing in English?
    ….just curious. Her entry reads like someone who could use a retard pill.
    Yes, I’m horrible.

  15. michelle says:

    Yikes, I hope the above pharmacist(?) counts better than she spells. Seriously, until you know anything about what it’s like to be in chronic pain, don’t judge. And until you know anything about psychology or psychiatry, don’t presume you know how to treat either.

  16. wino says:

    TAP-
    you know you are having a rough day, when you are 45 min behind, with 3 pharmacists and 6 techs. On top of that, when you call for a transfer, the other pharmacist thanks you for taking the patient away, and offers to take you out for a drink.
    I need a glass of good wine…

  17. Rebecca,
    I commend you for your work in the area of substance abuse, and especially on behalf of our veterans, who deserve the best care our country can offer. I was a V.A. pharmacist for seven years, and saw the pain our soldiers/sailors/marines bring home with them. Thank you also for watching out for the needs of the pharmacists who would be filling suboxone prescriptions. I was a retail pharmacist for 13 years before switching to hospital practice 14 years ago.
    I have only praise and respect for people seeking recovery from substance abuse. In the world of drug abuse, they are the heroes.

  18. intern2010 says:

    When people come into the pharmacy I work in, I usually try not classify them in my head as a druggie or not. Some are on some serious pain meds for good reasons, the only times I’ll classify them as a probable drug abuser is if I get a script written in marker, one that looks like a photocopy and was brought in 15 minutes before closing with them asking if they can get it in a couple of minutes, or my favorite is having “no controls” written into the address line of their central profile.
    I applaud people who are trying to get their lives back on track and live a normal life. I’m willing to give anyone the benefit of the doubt and not think they’re a drug abuser as long as they aren’t harrasing me about getting pushed to the front of the line to get their half a dozen narcotics.

  19. AmyR says:

    Been lurking here for months, Emma’s comments, once I figured out what the hell she was trying to say, really pissed me off.
    Chronic pain affects every aspect of my life, and the life of my family. Thank God for the pharmacists and techs at the Walgreens that I go to. I’ve have 12 surgeries on my kidneys in three years, 6 of them in the last year alone, losing half of one a few months ago, all to stones. Horrible, horrible pain. When it was so bad I was on a 50 mcg duragesic patch and percocet for breakthrough pain, my pharmacist gave me a hug, told me to hang in there and that it would be over soon. The narcotics dulled the pain enough so that I could make it through the day, cooking, cleaning and taking care of my children.
    Thank God you’re not my pharmacist, Emma. To think that I would have had to deal with your disdain in addition to the agonizing pain I was in, would have made me feel so much worse.
    TAP, I love your blog.

  20. Crazzy says:

    As a pharmacist, I know that I must leave my preconceptions of people at the door when I go to work; if I want to be as compassionate and helpful as I can. If I don’t, I shouldn’t be practicing this profession. Sure, there’s plenty of bad people out there who abuse the system to get a free chemical ride, but, in the end, they pay for it sooner or later. The way I see it, Suboxone, Methadone and a lot of psychopharmaceuticals are only helping people function in society. No one is perfect so why judge? You can’t cast the first stone if you are addicted to something: TV, money, food, beer; whatever. I could go for a cigarette right now tho’ Cheers

  21. limari says:

    Just saw this:
    >>RJS said:
    I neglected to mention that I’m more likely think “Fruit loops!” when I open a bottle of Suboxone than I am to think about the background of the person I am filling the Rx for.
    I love the smell of Suboxone. :)<<
    Oh…I love the smell of Benicar. Some say, “mmmmm….popcorn!”, I say, “mmmmm…cake batter!”
    I once worked with a tech who loved the smell of KlorCon 10 mEq. Said it smelled like “childhood”. Wha…??? She said: “Yeah..kinda like..ummm…construction paper and crayons?” Oh. Ok.
    And…jaded old CPhT’s that we are, when we get a newbie tech, we make ’em sniff a bottle of Armour Thyroid and ask for their opinion. After they stop gagging, they’ll usually go with the “rancid raw bacon” smell..every time.
    Heh Heh…cruel, I know.

  22. rph3664 says:

    I’ve always loved the smell of Midrin. The generics have a similar odor, but they don’t measure up to the real thing. Thank heavens I don’t have to take it!
    Ever gotten a whiff of Geocillin? How could anyone swallow that? (Yes, I have dispensed it – once.) But nothing can top Chemet, not even acetylcysteine! You can even smell Chemet through a sealed glass bottle – it’s that strong. Oh, and with one exception, every time I’ve dispensed that, it was for a dog. Interesting.
    Procalamine’s pretty nasty too.

  23. Misty says:

    I just came across this site and it is really awesome!
    I too am on Subutex due to being on Lortab for 2 years straight for herniated disks with a compression fracture at L1. One day I just woke up and decided I was so sick and tired of being on the Lortab. I felt like I was in a fog, although it did take away my pain. I wanted to see what it was like OFF the narcotics, so I went and was put on Subutex.
    I actually go to CVS because I had a really bad experience with Walgreens and it wasn’t even for narcotics. My son was diagnosed with ADHD by 3 different doctors (yes, I wanted SEVERAL opinions before putting my child on anything controlled). A new pharmacist was hired at the Walgreens right by our housing addition and boy was she a feisty one! Basically told me I was a bad parent and bordered on abusive by giving my child Metadate (note that he had already been on it for about 2 years and doing absolutely PERFECT). I wrote a formal complaint, which I’m sure sat on a desk somewhere. I swore to never use Walgreens again and I haven’t.
    The pharmacist I took my first script of Subutex to was absolutely WONDERFUL. We talked for about 15 minutes about it and he just made me feel completely comfortable.
    Just thought I would put my little story in.
    BTW…I think the bad pharmacists name was EMMA. You seriously need to find another profession…oh say one that involves a BROOM maybe?

  24. Efficacious-T says:

    I intern in an urban pharmacy. I love patients who are picking up their Suboxone. I make an effort to be attentive to them and to make sure that things are going OK. It takes guts to give up addiction.
    In fact, I’ve even teared up while filling a script for Suboxone. I think it’s powerful that we Americans are slowly embracing the theory that addiction is a disease and that its treatment is being mainstreamed.
    Keep coming back.

  25. such-a-pharmacist says:

    Oh yes I always shed a tear for the local Drug Addict….The other day a couple of, lets just say Dirt Bags come in for their first Suboxone scripts and proceed to tell me how wonderful the drug is and how much better it is to take than the Vicodin,morphine and methadone that we were having to pay CASH for at every pharmacy arround. yeah its great to getget off drugs just call me when you do. Take the time to do it right and go cold turkey. Its the only way. I just want to tell them if they have any plan to stop is stop now and gut it out.. What gutless wonders. But the sure could score 3 or 4 prescriptions in a weekend if they tried.

  26. jimmy says:

    I don’t care what my pharmacist thinks when I fill my suboxone presciption. Or the fact its filled with valium and carisoprodol 😉
    All I care about, is that although I made some shitty choices in the past (young and naive), I’m back on track and living a great life now.
    BOOYAH!

  27. tech_grl_in_red says:

    jimmie are you kidding me! “its filled with soma” what a joke. we have turned in ppl like you that take suboxone and soma or ultram its just not cool. how are you getting back on track if you are still using? we have had some irritating suboxone ppl and i hated them ALMOST AS BAD AS I HATED THE JUNKIES! they would call every few days for their mini fills because they could only afford a few at a time… jerks… but then on the other hand we have nice ppl whom i love and enjoy having them as customers

  28. anthony says:

    This the first time to this website. For the most part, pharmacist are kind and caring people.
    But there is a few on here that are absolute a-holes. I have 12 screws holding a metal plate in my spine. I have severe pain. Try “toughing that one out at 3 am”.

  29. just another junkie says:

    I just went through this again at my local Rite-Aid. There is no way on earth that my insurance is saying, “refill too soon” if I had 30 days worth of Suboxone

  30. Casen says:

    Hmmm…much to say.

  31. Casen says:

    Wow…I spent half an hour writing a reply to the ever so vigilant redtechchick, or whomever, and it got lost. I feel so “un”-validated.

    I’ll try again.

    What the f are you talking about, girlfriend? (My first attempt was a lot more diplomatic, but now I’m frustrated…too bad a “tech” wouldn’t let me fill my klonopin and subutex). Oh, wait…she did. And my zanaflex. I guess I’m just stupid and didn’t realize I was living in Amerikkka, home of the chronically stigmatized.

    You see, once a chronic pain patient grows weary of taking more and more prescribed pills that have become increasingly less effective, they can now try suboxone, or, perhaps, subutex. Thankfullly, the field of pain management has left the dark ages…for some. The pain is still there, (where would it go?) but either drug will do a pretty darned good job of handling it…to a degree. Bup does have that pesky little antagonistic qualitiy to it, but that’s what makes it so loveable…and gives us “quality of life” back. I think that’s the mechanism, but not sure. Not sure amyone’s sure.

    Regardless, you don’t feel loopy. At least to the degree of b.i.d. er opiate behind door number one, or two, (you’ll go through them all, eventually), augmented by the four times daily “breakthrough” meds (really messes with one’s circadian rhythm).

    Of course, you’re still a chronic pain patient, so a rather innocuous muscle relaxer added to the buprenorphine helps (’cause unlike the opiate pain management protocol, “bup” kinda picks you up…in fact, in the days of yore, ambien was prescribed for the sleeplessness. I think that was taught during that two day seminar). My zanaflex takes care of that, so BAM, redtechgirlfriend! I get to sleep AND not have muscle spasms. I am SO lucky!

    The klonopin helps with my anxiety. It seems I was once attacked by knife-wielding fiends looking for an ultram fix…those junkies will slit your throat! They are simply the worst. (By the way, our neighborhood watch would really love to have someone with your due diligence to help out with the “crack” problem. Got time?).

    So, to summarize. One can be opiate tolerant while the pain is getting worse and the pill count gets higher, or one can go through the HORRIBLE SIGMA of those who share the NOW unvonventional wisdom that suboxone and subutex are only given to addicts. What’s in a word, anyway? How about this…let the people with over a decade of education under their belts do the “brainy work”. And I’m pretty sure you come out with the short stick there, tech_red_girl.

    Peace.

  32. andrew says:

    @ tech_grl_in_red: Suboxone is very expensive. And just because someone is poor and can’t afford to fill it all at once, doesn’t mean they are jerks or junkies. Think before you speak

  33. dee says:

    Thank you andrew

  34. Alexandra says:

    So many of you people need perspective. I just wish you could walk around in the shoes of the people who take suboxone or who have been addicted to opiods. You honestly wouldnt know which was up at the end of one day. I just want to say that those “junkies” that you hate oh so much that come in every few days or even every day most of the time for their “mini fills” dont at all want to be coming in to deal with your ass, they dread it even more than you…. they do it because they have to if they want to stay on the sraight and narrow. . .AND HERES WHY: Since most doctors make their suboxone patients come in every month for a new script, after a lot of the time having to spend money on the gas it takes to drive over an hour away to see the one doctor who prescribes suboxone, it costs them (with or without any insurance) on average $50 just for the clinic visit to get the doctor to spend two seconds writing another script… then since suboxone films and tablets cost $400 for a ajust one months scrpts they have to buy them one at time, never knowing if theyll have the $10-$20 for just one days dose. YOU COULD NEVER IN YOUR WILDEST DREAMS EVER IMAGINE WHAT PEOPLE WHO ARE IN THE SITUATION OF NEEDING TO TAKE SUBOXONE GO THROUGH ON A DAILY BASIS and the judgemnets they face from everyone around them. The next time you see a patient come in for their script of suboxone, do them a small kindness and just pull them aside and let them know that your on their side. Belive me, the first thing a suboxone patient thinks when they take their script to the pharmicist or the tech is that by the look on your faces i bet yall are thinking to yourselves that im a feening, stupid and incompetant jsckass thats just here to make your lives harder. (And by reading these blogs thats exactly what the techs and pharmacists are thinking – because as evidence by these blogs you self consumed techs and pharmacists live in a world of your own in a land called cvs or walgreens where your priorities and ideas of things are unrealistic and backwards which revolves around a situation in which people who are coming in needing your help are suppose to remain calm and make yall feel comfortable and for fuck sake – dont get on your nerves. These people are addicts who are trying to maintain this constant (in their minds) stability in which they have to take those vicodin in order to not want to kill themselves or fall into withdrawls and in the mind of an addict its panic all the time because they are constantly trying to mainain the same level of high which gets complicated because we all knw you have to take more and more to maintain teh same high which causes them to run out early and freak out. you have to understand that theyre not in a sane stae of mind – and the funny thing is i havnt seen one person on this site refer to the real problem here, which are the doctors!!!! This is a disease and a constant battle that they feel like is between the pharmacy and them to get their pills. But unfortantely a lot of the time patients getting on suboxone are judged and treated like lepers in the same way. Its a shameful cloak that WE people who have been on suboxone wear, but the irony of it all is that the ones who should be ashamed and who are so pathetically ignorant are the ones who are throwing the stones in this hypocritical world. We definitely are forever persecuted and scarred but what only we come out with on the other side is incredible wisdom, unconditional non-judgemental outlooks on every thing and everyone and infinite kindness and empathy that the people who have not been through what we have been through will never have or know. I use to be a hard, arrogant and simple mided person just like you and 90% of the people who wrote these blogs.
    P.S. sorry for such a long meessage… but this is such a small summary of what i and so many others feel and want everyone out there to know and understand. PASS IT ON

  35. Dave says:

    I have been on suboxone for almost 3 years. It has helped me get my life straightened out more that I could have ever imagined. I have even given up smoking cigarettes over 6 months ago. I usually don’t have a problem getting my medicine filled. There was one pharmacist at Rite aid that was very rude because of what I was getting filled but I haven’t been back there because of that. To the pharmacist that really cares about the patients they serve I am very thankful for the hard work that they do, but to the rude and judgemental ones they need to realize that addiction is a very serious disease and need to work on there attitude, the fact that addicts are taking suboxone is a big step in there recovery. I personally hit rock bottom and realized that I needed help and decided to admit that and that was the first step for me. So please treat suboxone patients like fellow human beings and in return you will be treated with the same respect and also appreciated for caring enough to help dispense the medicine to people who are on the road to recovery. Thanks

  36. Songster says:

    I have been on Suboxone for about 8 months now. It has completely changed my life. There have been two occasions where I have run out of medicine early because I took too much. The first occasion was about four months ago when I got my first kidney stone. I was in dire pain and no matter how much I took it would barely help. I ran out five days early. When I went to see my Dr. he made a note on the prescription to go ahead and fill. The pharmacist would not comply saying, “The DEA doesn’t care about the Dr. I am the one who will get in trouble for filling this early. The next three days I had to call in sick to work because I was in the bathtub in withdrawals. As of recently I found out my GF was cheating on me with my best friend. The worst part is we both live together and have a lease on the same apt. I have been taking more than I should because I reverted back to my old thinking that I needed something to make me feel better. I am going to the Dr. tomm. I will be trying to fill two days early. I am thinking about going to a different pharmacy. I really don’t know what to do. The pharmacist that I deal with have no compassion because they don’t realize what the withdrawls are like. I was hoping to hear from a few pharmacist I wonder if you can help me with this. I have never used drugs since I started Suboxone and I haven’t felt the need to take more than I should except for twice. Even my Dr. say’s that after a while you don’t feel any euphoria. The mental obsession is the thing that has done me in. I am always nice to my pharmacist and never cause a scene. What should I do?

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