Not so hypothetical situation

I really was curious what pharmacists would do.. I mean, the whole gift card crap.. fine.. price match evil wally.. fine.. Dispense a controlled medication just 1 week afterward? What the fuck..
And yeah, I bitched and moaned and railed at the injustice of it all... and the only response was "Well... it is the pharmacist license and discretion.. yada yada yada.. you're just a tech"

Thanks for your answer(s) and help :D

I would do what TAP would do, except in SC we have something called DHEC bureau of drug control and I would call the officer that deals with our county. Our DHEC officer is a pharmacist that has gone to the police acad. and works to enforce the pharmacy practice act in SC. It's WONDERFUL!!! I've gotten SO many people arrested for dr shopping, pharmacy shopping, altering rx's, calling in fake rx's, it's WONDERFUL. The 1st time they get caught, the get PTI(pre-trial intervention). This means that they meet the DHEC officer at the jail get finger printed, booked and such and then the DHEC officer RAILS their ass. We got a dentists office on this. The receptionist was calling in rx's for herself and for the other hygienists and going to pick them up at local pharmacies. She told the hygienists that she was going through a divorce and her soon to be ex cut off her insurance and the dentist said it was ok to call in the rx under their name and use their insurance since hers had been cut off and she had the same insurance. She called in rx's under 12 different peoples names. And picked them up and the numerous pharmacys. I was doing my rotation with this Agent and when we went in and busted the dentist office, they had to shut down the whole practice for the day and all 3 of his hygienist got arrested for insurance fraud and the other lady(receptionest) got arrested too. It was AWESOME, they were all crying and upset. I can't believe they were stupid enough to let this lady call in prescriptions under their name , let her use their insurance,and let her have the drugs. NUTS! I love my DHEC agent...

Haahaa !! Love it. The Police Report thing. Yes, that usually does the trick. Reminds me of a story that I witnessed many moons ago .......

Mrs. Pill Popper called to tell us she needed a refill on her "Lorytabs" (Vicodin). So Quick Pharmacist checks and sees that they were just filled 6 days earlier. So he says , "Why Mrs Pill Popper, it looks as if you just got those a week ago."

She says .. "Yes I did. But they were stolen and YOU need to give ME some more now."

Quick Pharm says .. "Well, the law prevents me from filling things like that too soon. I am going to put you on hold for just a minute while I make a quick call and see what I can do, ok?"

Mrs Pill Popper: "That's more like it."

Quick Pharm puts her on hold. Whistles a little. Smiles some. Checks his watch. Couple minutes later he picks up the phone and says "Mrs Pill Popper? I have called the police for you. They are on their way, ok? Turn on your porch lights so they can find you."

Mrs Pill Popper stammers .."er, uh, der, ummm, ... what ? Oh, ok."

Quick Pharm says "Just tell them what happened and once we get a copy of their report, we can refill these for you, ok?"

Mrs Pill Popper .."Uh, der, ummm .. well, ok." (like, what the fuck can she say? This was something she was NOT prepared for.)

Hangs up phone. Laughs a bit. Phone rings again almost right away. Pharm says .."I got it."

Why .. what a surprise! It's Mrs Pill Popper! She says .."You need to cancel the police call. I don't live in your county. Your police can't come here. ... can they?"

Quick Pharm says...(here it comes) ..."Oh don't worry about that. See, these are FEDERAL agents. They can go ANYWHERE."

I swear, you could hear her shit over the phone.

After a deathly silence, Mrs Pill Popper then says .. "Well, I was actually calling to tell you that I looked in my purse again .. and I found my Lorytabs!"

Uh huh. Yep. I just bet she did.

Quick Pharm says "Why that's excellent Mrs. Pill Popper! Great news! Well, talk to you another time, then. Have a good night."

And we laughed all night long. The night a legend was born. Beautiful. Sweet. Priceless.

Feel free to borrow it but give credit to a Quick Pharm somewhere in TN.

we actually DID have someone yell at us that we were defacing his prescription when we wrote "refill too soon" on it. and i actually had a tech from another pharmacy tell me that we DID deface it and could face legal charges.

Back when I worked in a regional chain in NYC, a cop who dealt with this sort of stuff showed me what a real lost property report looks like. He said, basically, that the con artists aren't likely to try and get those, because possession of a forged instrument (viz., the report) had a heavier penalty than mere narcotic/Medicaid fraud.

So I started using this method on the customers trying to get early refills. "Why are you refilling this Xanax after only one week, when you had a month's supply?" "Uhm, I lost it/it was stolen." (fill in whichever is appropriate) "Okay, go down the precinct and get a lost/stolen property report." Usually we don't see them again.

Not always, though. One guy had the balls to come back with a hand-written paper torn from a spiral notebook, that said, verbatim, "To whom it may concern: This is to certify that [Name Of Imbecile] lost his medication on the bus. Signed, the 26th Precinct."

Shyeah right. I wonder if Epstein's Mother works there. "What was the name and badge number of the officer you spoke to?" "Uhhhh,..." "Get out of my store." This guy was the worst liar, and by that I mean "not good at it". He was always coming in with one BS story after another, trying to get his Celebrex early (not a control, but he was Medicaid; probably selling it). One day he left it in his aunt's house in North Carolina. Another time he was living in the Bronx with his aunt, and they had a fire, and the firemen weren't going to let him back into the apartment for another month and they were staying by the Red Cross. "I thought your aunt lived in North Carolina? "Oh, um, this is a different aunt." "Okay, get me a letter from the Red Cross." None was forthcoming, obviously.

I also used to run "cash" scripts on their insurance, just for the hell of it, back when I worked chains; there's a pretty good likelihood that with over 6000 locations in the Chain of Very-large Stores I worked at, they've been to one of them at some point or another. It's harder to do that now I'm at an independent and don't have access to a national database (if patient is new to me and tells me they have no insurance, I can't verify that). What I can do, since all the independents in this town are on speaking terms, is call around and find out who filled what when, if I have suspicions. I did catch one woman filling Fioricet at three pharmacies from three doctors; when I mentioned to her that I was aware of this fact, she stopped bringing those here. I dunno where she's filling them now, and don't much care as long as she's a pain in someone else's ass rather than mine.

(National databases are fun. I scared the Hell out of one guy, back in the old RA days. I tried to enter him in, RADS said he was already there. I widened out the zipcodes and found him in South Carolina somewhere. Asked him casually, "Did you used to live in SC?" and he turned pale. "No, I was never there in my life, you must have me confused with someone else, I don't know what you're talking about..." he was going on and on about it. I said, "OK, fine, it must be someone else with your name, your date of birth... your social security number..." (OK, I didn't say that last part out loud.) But it did make me wonder who was running after him down there. Outstanding arrest warrant, delinquent child support, maybe some girl's father with a shotgun?)

As far as the Angry Tech's question: It depends on who filled it. If it wasn't the RPIC (SP, whatever they call it in your state) who did it, it might help to let that person know what's going on in his/her store. (Might be better to have *your* RPh make the call, rather than yourself. Be tactful, although I probably wouldn't.)

If it *was* the RPiC, that's another ball of wax. I probably would have shrugged and said something like "His license, his problem. I can police my own store; if someone overrides me here I can and will take action, but if someone else beyond my control wants to violate the law that's between him and the state board." Depending on how pissed off I was, I might have a quiet word with my pharmacy supervisor as well.

Shalom

Had this 20-something guy come in with his hot (she clearly thought), snotty little girlfriend wanting Vicodin for his horrible back pain. Asked my usual--have you gotten any vicodin/percocet/hydrocodone/oxycodone
/codeine or any other pain medications from any other doctors in the last year? No. When did you last have any of those? Never. Checked Walgreens--he had frickin' Vicodin the day before, plus a bunch of other times from a bunch of other docs.

Confronted them with this information. They became very ticked because someone else must be getting these in his name, and the snotty little girlfriend acted all freaked and concerned. They wanted to know what to do about this--call Walgreens? No, if someone is going all over the city getting Vicodin in your name, you should call the POLICE. Should've seen her face then. They shut the hell up and left.

My only regret--not picking up the phone in the exam room and dialing 911 and handing them the phone. That would have been PRICELESS.

I used to get around this by dispensing 100 days supply, which gives the maximum MAC for a maintenance medication. But, since I am now evaluated on the #rs/week (not an independent, obviously) I use the 30 day supply as often as I can & let the corporation ride the $$ until the TAR is approved. I don't let the patient go without - I just let the corporation carry the debt. The whole damn process is crazy!

Its bad economics, for sure! But, not as bad as MediCal allowing only the brand name Zoloft rather than sertraline (we need a TAR to continue a generic when someone moves from another state), or allowing only Sandoz brand amoxicillin on one of the speciality county Medicaid plans.

So - who is in who's pocket & why? But....the gubinator wants to cut the lifeguard staff in half to balance the budget (for a state who has nearly half their boundary on the coast!!! and the lifeguards make a pittance!!!). So - go figure - with that kind of thinking, he can't make heads or tails out of rational medication management.

Angry Tech,

Your not allowed to "change the script" in any way. (Do some reading on your state board of Pharmacy site, it's very clear) If Pharmacists are not allowed, what gives you the right? Next time I advise that you just have your Pharmacist explain to the customer that it shows up in the computer that they have had it filled somewhere else, unless it's obviously a fraudulent script, then call the Authorities pronto. Don't put your career on the line for something like this, it's not worth it, even if you FEEL justified, don't let your emotions run the situation and (don't take this personally) you don't have the education that prepares Pharmacists to deal with these and other type of situations (another reason why your not allowed to counsel on a med) Remember, there are always other ways of handling situations, when in doubt..hand it off to the Pharmacist in charge.

I hate to sound niaeve but why are controlled substances so alluring, is it the 'street' value? I hate when I get an RX and they give the price on the sheet and it show's it costs more through my insurance copay then it would have if I bought it for the cash price. I beleive that you should have the right to pay for your medicines how ever you want.

I agree if you just got something a few days ago and it's supposed to last 30 days, then the patient has no business getting more or trying to refill it early. I hate the shit that we have to go through. I feel like $10 copay for 10 pills isn't worth it. I'd rather cash pay it or get 30 days for my copay. I look at it from the Business Expense side and not the pain in the ass aspect.

Why are these med's so alluring though?

Quick Pharm Somewhere in TN ROCKS!

Quick Pharm somewhere in TN is my hero. He ROCKS!!!

Or sometimes, their insurance refuses to cover it. I was pegged as a drug seeker for paying cash for mine and my son's ADHD prescriptions because insurance picked up a piece of everything else. Only...I couldn't get approval for my son's prescription despite going to a Tier II appeal for over two years.

They finally just approved it this year. No drug-seeker, I, and it was humiliating to be pegged as one by a harried, tired pharmacist.

I think we should have a hypothetical situation of what you would say to someone that bitches about your prescriptions not being $4 if you didnt have to worry about getting fired

I don't know, A.P., you're kind of crossing over into prick territory here. Who gives a shit if they're drug addicts playing drug addict games? You still get paid, and seriously, some shitball vicoden humper isn't going to get your license taken away.
Don't be a prick. These people have enough personal problems without a bored pharm busting their dopamine-receptor challenged assess.

Truthfully, don't you enjoy watching how fucked up they get themselves? LIke noticing the changes from month to month. Bigger bags under thee eyes, amazingly even saggier skin tone, the aura of complete emotional instability. That's comedy to me, because they are doing it to themselves, intentionally. Waiting 16 hours for a bullshit sickle cell crisis in the ER, where they get sickle cell confused with epilepsy, so "when I get the sickle cells I have seizures. It hurts so bad". But you can't say no, or "you are so obviously full of shit" because then you become a racist and get sued. So fuck it man, get em high!! Don't be a prick, be an enabler and let the comedy come to you!

What is so alluring? The high, sweetie.
Why do people want money? What is so alluring about sex? What an idiot.

For you self righteous pharmacists, I have a funny story. I was 6 days early filling a prescription for hydrocodone. This snobby individual like yourselves said she wouldn't fill it and proceeded to pull out a calculator. This person didn't need it (at least I hope not) and used it for dramatic effect.

Since I didn't want to get dope sick (the worst feeling in the world, combination of flu and head cold, mixed with anxiety and an overall feeling of dysphoria) I headed over to a residence I knew that held a cancer patient.

Ski mask on, I kicked in the door and grabbed her fentanyl and hydromorphone. Unfortunately, this person awoke and I had to hit them on the head with my flashlight. She was 70 years old or so and very feeble with her disease. But, I got what I needed and was never caught.

Thank god that pharmacist didn't fill my prescription early. Something bad might have happened.

You people are stupid. If an addict gets denied one place, do you really think they go home and sulk? Like I said, a person will do ANYTHING to avoid withdrawals.

Think about this next time you think it is "funny" to turn away an obvious drug seeker.

"The lesser of two evils" Remember that.

Here's a thought, what if these "drug Addicts" aren't drug addicts? But are people who have the misfortune of having medical conditions, (some debilitating medical conditions) that are, treated with narcotics? And its not drugs they are seeking but some quality of life that the drugs provide they are seeking? And they are being given minimal quantities of Vicodin, Codeine, adderall whatever the case maybe because of this country's preoccupation with "drug addicts"? From 2yrs-about 21yrs of age Iwas a steroid dependent statisasthmatic. At age 23 I was diagnosed with Narcolepsy with cataplexy. There are few drugs that provide any speakable relief. The one type of drug that has to some measurable degree worked are opiates. Now these are drugs that are typically sedating pain killers that a lot of people like. They are also the drugs that allow me to take my son to football practice or read directions to put together his toys. They allow me to be awake and alert for 2 or 3 hours to get things done. But being able to get the meds is a major deal, and I have felt like I am asking for somebodies life fortune or something to get it. I feel so angry, so cheated because I have missed so much of my kids lives. I have no life of my own, no friends, no career because Ive been asleep most of the time. And to know that there is no good reason for it.
Bottom line is when I don't get the meds, my son doesn't go to football practice or games. He's been late and missed a lot of school and school activities because I don't have the medication or enough of it do it. Because the drugs are opiates, and if they make me feel better I must be an addict looking for a fix.
To label someone as a "drug seeker/drug addict" the way you people have described is presumptious at the very least. I'll be willing to bet that there are a lot of other conditions that could be treated with these drugs that are yet to be discovered that will explain a lot of why people look for some of these drugs.

Sleepstate...that's a very sad story. And it is unfortunate that people abuse medications that are so helpful for you. You seem to understand that the medications you are on are being used in your case for a very specific reason. Is this something you've ever talked to your pharmacist about in a reasonable manner (ie: not in the middle of the busiest portion of the day or right after your insurance has rejected an early refill?) You seem to understand your need for these medications. I would advise that you make sure that the physician you go to understands your needs clearly and write your prescriptions accordingly. Then BEFORE filling prescriptions with the pharmacy let them know what your condition is. This will clue us in on whether there are going to be possible insurance problems. If there are insurance problems...take care of them accordingly. Which means...not yelling at the pharmacist because we are withholding the medication that will help you get your kid to practice. You need to get in contact with your insurance provider and have them arrange your benefits according to your needs. Or perhaps the physician needs to explain to the insurance company why you need more of a controlled medication. In any case, if you are level headed and reasonable with the pharmacy, we will be much more likely to try to accomadate your situation.

QuickPharm in TN is my hero as well. I did copy that situation and will be printing it out to take to work today. I'll make sure to give credit to QuickPharm in TN for the lovely scenario! Thanks again!

By the way *Anon* - You should read a little bit more closely before you start asking the technician, "What gives you the right if a pharmacist can't do it?" The person that said this quote:

"Sometimes they demand the Rx back (to try another store). Before I give it back I write on it in pen "Filled [date] [quanity] [store]" on the front of it. Is that an asshole move? Yup. Do I care? Nope. Whats the doctor going to do, bitch at me that I defaced his Rx that he gave to someone who is fraudently doctor shopping? Yeah, lets call the police on that drug dealer that put borax in my cocaine while we are at it. I mean seriously, if there is so much deception going on that they need to outright lie to me, what legitimate purpose do they have trying to get it filled?"

-was TAP.

For the record, we do the same thing at my pharmacy and every pharmacy I've ever worked in throughout the state. This is a method of *controlling* a *control* medication.