Only the pain pills please

This reminds me of when I got cussed out by the patient when I told her that her doctor denied her Vicodin refills.

I heard from someone that Vicodin + soma makes heroin in your body. Is that true?

Ever notice that when patients "accidentally" drop their pills down their bathroom sink, it is never Altace or Lipitor but always Oxycontin or Ativan? A colleague of mine and I decided that to improve compliance in North America we would make a combination pill like Caduet, except instead of Lipitor and Norvasc, it would be Lipitor, Norvasc, and Oxycontin. Goodbye metabolic syndrome!

It's gotten to the point where we just give back the prescription if the customer doesn't want the antibiotics or what have you. We also refuse to do partial fills on controlled meds. Fuckers can't keep track on their own about how many they have left and it inevitably leads to countless argumentative phone calls......

This is when it is fun to work for a big corporation that has a centralized computer system..."What, no insurance??? Want to pay cash?? Let me just type in your sad ass name along with your birthday and see what comes up. Oh what a surprise, I have a state insurance id on file from another store - let me see what happens when I bill them." The look on their face is priceless when I tell them that according to the state they had oxycontin filled the other day at another pharamacy. Pissed off they ask me for their script back - no problem, hope you don't mind the note in black sharpie right next to the directions that says this is too soon for another 2 weeks!

TAP, assholes like those people SUCK. I especially enjoy it when they come straight from the emergency department with 3 different Rx's. One for Vicoden, one for an antibiotic, and one for some other shit they inevitably didn't really need. Which one do they want? Of course they don't want all three. Just "the one for pain" even though it's for 2 day's worth and the other two meds are just as cheap if not cheaper.

The kicker is that they're like..20 something years old and perfectly healthy. They just wanna know when they can come pick it up.

Fuckers. What gets to me is that I KNOW they spent the entire day in the emergency room bitching out some poor nurse that they have pain while some kid's got fuckin meningitis or some 65 year old woman is having an MI. When I see those jerks, I tell them it's a 2 hour wait even if we're all standing around without shit to do. As far as I'm concerned, if they can spend 7 hours in the ED, they can wait 2 more. What a bunch of pricks. -e

Look on the bright side, they're probably killing their livers with all the APAP in the vicodin. Combined with the fact they aren't taking their lisinopril, we come to the happy conclusion that they aren't long for this world.

I tell these kind of patients that, if the rx's are written on the same rx blank, then it's my policy to call the prescriber to make sure it's ok to not fill one. Invariably, the doc says "all or nothin" and they fill both. If they have even half a (fried) brain left, they'll take the lisinopril or amoxicillin or whatever instead of flushing it down the toilet...

These people are idiots. Fine, don't treat your high blood pressure and die of a heart attack. Or better yet, have a stroke and end up paralyzed in a nursing home--hope you can't speak well enough to ask for your Vicodin and Soma.

I had a guy who had a huge abscess on his ass that I drained--cultured out as MRSA as I expected. You guessed it--my friendly pharmacist called because he wanted to fill the Vicodin but NOT the doxycycline (fine, let your ass rot off, see if I care). Thankfully, she wouldn't do it--some of us docs DO love you guys and appreciate what you do.

Of course, I had to try calling him and writing letters to document I told him the risks of not taking the antibiotic or he'd probably sue MY ass if his rotted off--doesn't matter he's the dumbass, not me.

Sorry Adam, you're wrong. We'll just be footing the bill for their transplants and antirejection pills then (seen it happen).

As I am on a plethora of medications, it does get a bit confusing to get all 9 of them filled at the proper time (2 Controlled). However, please don't group us all together, I treat each med the same. I am on a rather high dose of narcotic pain medication. Know what, I can move, function, walk without a cane, and hold a job. I did not ask for this, and admonish those that abuse the system. I can not count the times that doctors' dismissed me because of my age (23), until they found a the actual condition. Some of us that are on narcotics, do in fact need them, and don't abuse the system. I read the pharm blogs about every day and only see complaints about abusers. I am sure that every RPh has patients that don't ask for early refills, are polite and appreciate the service the provide, just as I hope to do. So to the profession; thank you for making my life livable, and pleasant again!

We don't lump all our patients on controlled substances together. It's just the squeaky wheels that can get stuck under your skin and leave you pissed off for the rest of the afternoon.
Let's face it. It would be pretty boring if we posted we had a day where everyone was pleasant. We had no insurance problems. We weren't out of anything we needed. And we didn't have to call to clarify or ask for refills on any scripts.
Nobody asked us to wipe their ass today because they are too stoopid or out of their minds to take care of their own affairs.
Wait, does that happen?

Yeah, but there are some out there that give you guys/gals a bad name. Love the guy we've had for 22 years-he knows his stuff and makes that his customers are treated right. Had a head on car accident and went to a big box pharmacy after the ER(only 24hour one around here), filled vicodin and flexerall(sp). Got them both, went on merry way and 4 days later I noticed that vicodin is 8 pills short(script was for 15-I got 7) and then the other was 27 out of 30. Course I call and get blasted that "she" filled them and it was correct. Since I only take them 1 time per day-and no one else knew where they were or that I had them-seems that they didn't walk themselves. So she's suspecting that I am a druggie-far from it. I am letting it go, but it burns my rear that I got shorted-when I never take drugs unless I absolutely have to-I avoid the Dr's like the plague! So one bad apple who can't count give us customers a bad taste-especially for box stores.(I work for a physical therapist and in charge of faxing scripts out) That's why I LOVE my hometown local guy-our box store pharmacies here suck. Never again will I go fill a script there at a big box pharmacy.

It seems I've ripped a few things from the playbooks of other folks. I will ALWAYS try to bill there insurance even when they demand otherwise. And as we all know, it was oft-times filled elsewhere. I make that notation on the back of the script and give it back to them.

I'm not sure about other states, but ours maintains a controlled substance database. These fine citizens are eventually made and letters are sent out to all pharmacies and the prescribing physicians.

lol its funny the "ill pay cash only" the other day someone came in and the doc faxed an rx for 2 percocet 5/325 and 6 valium's . she paced until she got it. i just happened to be in the pharm then. i used to abuse the system, know all the lines and everything, i see that others use them quite often. i esp like the "i lost my pills down the sink." or i flushed them.

I had a similar experience working at around 11pm on a Sunday night: Patient rolls up to the drive-thru and hands in the prescription. Before I can even look at it, "I ONLY need the VICODIN filled." So I take a look at the prescription and it's Vicodin and Penicillin written the previous Thursday at a dentist's office. Seeing the antibiotic and pain medicine I inform the patient that the pharmacist is going to require both medications to be filled. The immediate response is, "Well, I don't need the Penicillin. I already had it filled." Interesting I think to myself. So I pull up the profile and sure enough Penicillin and Percocet were filled on the previous Friday. And guess where this prescription came from...the ER. I inform the pharmacist...I also inform the pharmacist that I noticed the patient is Medicaid and will not be willing to be $7.99 for the Penicillin that will be too early. The Percocet by the way was technically not early, as the ER script was only written for a 2 day supply. The pharmacist agreed that it sucked...but the Vicodin wasn't early so the pharmacist had me just fill the Vicodin.

Guess what? I DO suffer from chronic pain. I have for 4 years now.

I am going to my Dr. monday to have my prescription changed from Lortab 7.5, 3 times a day, to Norco 10 4 times a day, because the Lortab wasn't strong enough and I was worried about all of the APAP I was putting into my system.

The new script will be 14 days before I would normally get my Lortab filled but it's a new prescription because my last refill of Lortab WAS the last one of it.

And I will get it filled because

A. I need it to control pain, I can't even sleep if I don't take my meds.

and

B. the doctor is the main authority on how my pain is managed and what should be prescribed.

So, would you think it was funny if some pharmacist got his kicks by trying to make me wait 14 days in excruciating pain just because I have a higher dosage of hydrocodone but lower of APAP and would be basically bed ridden with 2 young children to take care of, just so they could feel superior or like they 'caught' me doing something wrong (which I'm not....)

This blog makes me angry and sad in equal measures as a TRUE chronic pain sufferer.

I've also NEVER ever tried to get my meds early BTW. But I will have to when he changes them Monday because I am almost out of the Lortab as I've had to take them more and more the past few months to get relief, which is why my dosage is being changed to begin with, and the fact that I'm worried about my liver, that is unless they pharmacist wants to be evil.

I'm nervous about it and afraid I will have to send my kids to my mom's for 2 weeks because I will hardly be able to walk if the pharmacist wants to be an ass.

This comment is for Jen. Like someone previously stated, these blogs are to complain about the abusers and or sellers, not legitimate patients in pain. We want your pain controlled just as much as you do. No pharmacist is going to deny your medication because they feel want to be an ass and want you to suffer. If you have established a relationship with you pharmacist and he or she knows your condition, there will be no problem with the switch from Lortab to Norco.

Rph, I hope that's the case for me Monday.

I've left some mean comments on this blog, they came from frustration mostly, which I apologize for.

I know my anger should be aimed at the people who abuse the system and cause people to have to jump through hoops just to get their meds, not the pharmacists fault.

I have had the same pharmacist for 12 years so hopefully it will be ok. Well, if the insurance doesn't go ga-ga over my script change and 14 days lapse in pain medicine. Grrr, it just scares me that I'm going to end up in pain for a few weeks and not be able to take care of the kids.

Sorry for sounding off.

P.S. My Dr. also gives me xanax for panic attacks and has for years,but I only take one if I feel like a panic attack is coming on, he has me prescribed to take 3 a day, but I usually take about 3 a week, I'm far from out of those so will have to do the (it would seem) dreaded- "I don't need my xanax filled, just file it, I only need my pain medication."

Come on, you are on Norco for chronic pain?? Why don't you find a competant pain MD. Most doc's know jack shite about treating chronic pain (which is why we dispense so much hydro/apap) 1>

Quit treating us pharmacist like uneducated dispensing machines, and
2>get some real treatment for your pain!

This is for mom to anyone:

I'm the first to admit that mistakes sometimes happen, but I think that it is very unlikely that the counting error occured at the pharmacy. Before you get upset, let me explain. Pharmacists and technicians count by fives. This means that if there is a counting error it usually is over or under by five or a multiple of five. Many pharmacies have a double count policy on controlled meds (vicodin), so likelyhood of a counting error is even further reduced. Also, I find it hard to believe that the person counting the vicodin didn't notice that he or she forgot to put OVER HALF of the medication in the vial. It also strikes me as odd that you didn't notice that OVER HALF of the prescription was missing until 4 days later (after the first day, wouldn't you notice that you only had 4 or 5 pills left?). Now as I said before, mistakes do happen, but the likelyhood of have two counting errors (that are off by something other than a multiple of 5) on consecutive prescriptions for the same patient are almost nill. So, that being said, I think the most likely senario is that someone got into your Rx's. Either someone who lives with you or someone visiting you or another family member. I know that you say that nobody knew you had them or where they were, but to think that is just foolish. How many of your friends/co-workers/family/clients knew you were in an accident that required a visit to the emergency room? The equation goes like this car crash + ER = somebody's got some vicodin. All they would need is a couple seconds to open your purse up while you were in the restroom. What, not in your purse, that's OK, next time she walks away I'll look in the top drawer of her desk (and so on and so forth until they are located). Or, how about the teenager looking though mom's stuff for the vicodin while mom is in the shower. Basically, the only way that you could be sure that someone didn't pilfer your Rx's would be if you kept them in your pocket 24/7.

Sigh..... I'm going to spin kick the next uppity chronic pain patient who comments on here.....

I just want to say thank you, to all the Pharmacists who are over worked, under-staffed, and hassled by those seeking euphoria. Thank you to those Rph's who cared about me, and allowed me to move, work and travel. Please don't let the daily grind get in the way of what you really do. You help people, regardless of their state of mind or condition. Please keep doing what you do. I do love the blog entries where all the scum comes to light, a personality flaw I suppose. If you don't want to get up for work, on the morrow, think of people like me, that do indeed appreciate the service. Thanks:
Josh, chronic pain, and happily functioning patient.

P.S. DAMN I WANT MY VICODIN THREE DAYS INTO THE SCRIPT!!!!! WHY NOT. ASK THE DOC. ha!

Dave---

Just out of curiousity, what would YOU prescribe a chronic pain sufferer? I have had (God knows) how many MRI's, tried (God knows) how many different medications & mixtures of meds and finally found something that works.

I would much prefer to be on Ultram because they seemed to work best, but the doc stopped giving me them because I had a seizure.

I'm not sure what exactly it is I am supposed to do. The Dr. I go to is a really good Dr. and stays in contact with my neurologist (who both practice out of one of the top 10 hospitals in the country).

I'm not sure what it is you think I should do? Tell Dr.s who are among the best in the nation that they don't know what they're doing??? :-(

I've had extensive conversations with my pharmacist too btw, who knows my history from when I was 1st pregnant 11 years ago up until today. He agrees that the Dr's are taking the right route medicine wise. His only concern (as was mine) was the amount of APAP I was receiving from the Lortab and said Norco was the logical step up and to stay awaqy from Oxycodone as long as possible. He also sorted out the constipation problem that can come along with hydrocodone. (Which I was thankful for!!!....)

I also see a chiropractor twice a week to *stretch me out* (that's what I call it!!...)

I have degenerative bone disease and really don't know what else to do.

I'm not being sarcastic at all, I would love to know what you think I should do that I'm not doing already.

Midwest Pharmer...spin kick away, this is the internet and an open blog, I would think anyone can comment on here who wants to. Maybe I was wrong, I'm not being uppity though, you don't know anything about me or my life, I just want to not be in pain every day. That would be great.

btw Midwest Pharmer, any chronic pain patients who want to speak freely can do so here....

http://pissoffpainpatient.blogspot.com/

if it helps control your rage. I should thank TAP for giving me a reason to make a place to air my own worries/anger/etc.

I'll still post here too though, don't worry. ;-)

In reply to Dave saying "Come on, you are on Norco for chronic pain?? Why don't you find a competant pain MD... Quit treating us pharmacist like uneducated dispensing machines, and get some real treatment for your pain!"

In my case, it's mainly due to the money. I have a private PPO (no state or fed. help here!), and in addition to my premiums going up continuously, so does the price for brand name medications. This SEVERELY limits my choices.

I'm already on about 10 other meds for various "issues"; and things like the Azathioprine (brand name Imuran), even being generic, for whatever reason --- my insurance pay about 1% of the cost each month. So just that alone I'm stuck with over a hundred $$ short every month until I die.

For the pain part itself, I take the "dreaded" Norco & Soma, which are both generic and only $10 per month, and lots of OTC Motrin. My point being that so far in my experiences over the last few years, I have tried the long acting ones. BUT, they are insanely expensive for many of us....

I've tried Oxycontin, which at that time did have a generic actually, but it made me quit sick. And now I hear that the generic is gone....? If it is that means a month's supply with the ever-growing-stingy insurance co's is going to be (for me at least) well over $100/mo.
Same as the Fentanyl patches, made me very sick also, but even so they cost hundreds of dollars.

I am looking currently at maybe Kadian (MS Contin), but it also is over $100 *with* my PPO. And when the Norco/Soma is working well enough for me most of the time, I haven't found a very good reason to justify spending hundreds of $$ per month versus $20/month for those.
Is there?

I just wanted to put this in perspective for some of you that may not know the cost of these things. The only other generic longer acting one I've tried is Methadone, which didn't help very much. So I go with what works --- why on earth would I not?
That's what I'm having a hard time understanding here. I realize so many of you have something against people taking hydrocodone for long periods, and esp. when combined with Soma.
*BUT* there's a ton of reasons for that other than saying "you only take that to get high". Like I said above, #1 -> It works. And after 4+ years on it, I can say without a doubt that I'm not taking it for "fun". #2 -> It is cheap.

If I'm missing something, seriously guys by all means, tell me. Because I'd be more than happy to go on the "right" path if it's possible and there's a good reason to say that what I take right now is the "wrong" path.....I'm not a Dr. or Pharmacist, so I only know what I've encountered. If anybody has some ideas, I'm all ears here. And without bias! :)
Izzy

I knew I'd get a chuckle here sooner or later!!

My blog is

http://pissedoffpainpatient.blogspot.com/

pissed off, not piss off....

I'll admit that did make me laugh. My Lortab must have been kickin' in eh? (that's a joke BTW!!)

Darn you pharmacists! :-o

erabbitus said:
TAP, assholes like those people SUCK. I especially enjoy it when they come straight from the emergency department with 3 different Rx's. One for Vicoden, one for an antibiotic, and one for some other shit they inevitably didn't really need. Which one do they want? Of course they don't want all three. Just "the one for pain" even though it's for 2 day's worth and the other two meds are just as cheap if not cheaper.

The kicker is that they're like..20 something years old and perfectly healthy. They just wanna know when they can come pick it up.

Fuckers. What gets to me is that I KNOW they spent the entire day in the emergency room bitching out some poor nurse that they have pain while some kid's got fuckin meningitis or some 65 year old woman is having an MI. When I see those jerks, I tell them it's a 2 hour wait even if we're all standing around without shit to do. As far as I'm concerned, if they can spend 7 hours in the ED, they can wait 2 more. What a bunch of pricks. -e

------------------------------------------

I understand that people are un pain, and they want the meds NOW - who wouldn't? No problem, maybe fill the others when you get paid tomorrow, whatever.

So they waited an hour to get seen, then pt. history, vital signs, blood draws, blah blah, then another hour for the verdict from the MD. (Most of us have been there ourselves.)

Just don't rip me a new one when it takes 20-30 minutes to process you. Besides, our ER has the Allscripts/NuCare "fun-size" vials they dispense to tide them over.

I'm doing the best I can. Believe me, I want to get you home as much as you do.

Dave said:
Come on, you are on Norco for chronic pain?? Why don't you find a competant pain MD. Most doc's know jack shite about treating chronic pain (which is why we dispense so much hydro/apap) 1>

Quit treating us pharmacist like uneducated dispensing machines, and
2>get some real treatment for your pain!

-----------------------------------------

Sure. Carbamazepine, Lidoderm, OxyContin, MS Contin and fentanyl patches are UNACCEPTABLE because they don't WORK........

This comment is to Jen,
As a pharmacist, I try to remind myself every day that I can't judge people based on how much pain medication they have to take. I know that pain is very subjective. I would hope that every pharmacist does this, unless they know for a fact that the person is abusing the medication. I am disappointed that you would write and think that your pharmacist of 12 years might be an ass about getting your medication filled. Your pharmacist should be able to see your record and know that this would be an increase dose. Unless you have given your pharmacist a hard time in the past, he/she will most likely do everything possible to make sure that you can get your medication filled.

We are health care professionals and we do care about people. However, we do get yelled at a lot and treated poorly by so many people. So please, thank your pharmacist on Monday and let him/her know how much you appreciate the care!

izzyRed,

If there is a long term pain patient I want to run into you would be it. You are able to write in complete sentences and know something other than the exclamation marks. Your post isn't full of "you don't know what it's like" and "I'm special." You understand the medication and seem to take an active and productive part in your care.

I have a couple of patients on long term endone (oxycodone 5mg instant release) that are useful parts of the community and are great people to deal with. I always enjoy it when they come into the store.

The problem we in the medical/pharmacy profession lament is the patient on the federal dime with the sores all over their body and the sunglasses (and phone) superglued to their face. They stand their bitching about how we take so long and why they can't get their meds early for the 3rd time this month. There are many people who use pain meds to treat their pain and remain active human beings. Unfortunately there are a lot of people who abuse them for the hit.
Ben from the land down under

P.S. Socialized health care kicks ass. I always feel sorry for everyone involved when I read this blog and the insurance problems you deal with.

WI Pharm D...I thought about this blog and the comments etc today when my pharmacist was filling my new prescription after i'd left the dr's office in tears because my Dr. was having a bad day (or something) and spent a good 20 minutes scolding me like a child because I was in an abusive relationship and more or less said to me 'if you'd have gotten out of it sooner you'd have had far less fractured bones at the time but you didn't so your pain will just get worse the older you get, that's life sometimes.' In a very cold way too. Which then ensued into a long conversation I'm sure none of you care about reading so I won't type out everything that was said between the Dr. and myself.

I know it sounds like I'm a wuss for crying when my Dr. kept going on and on about it but I was having a bad day too.

My phamacist filled my meds then came out and sat and talked with me for a while and told me not to let it bother me and that we all make mistakes and gave me the info (he knows I know it all by now, side effects etc, but does it anyway just incase...)

He made me feel a LOT better and, like I said, I did think about this place and I thanked him for being so kind to me over the years. He gave me a hug and said 'that's what I'm here for hon.'

When we were talking he did get pissed off about how the Dr. had spoken to me and said he had no right and started talking about finding a new doc (even offered to help me find one.) Said 'I have your records from the past 12 years and not ONCE have you ever tried to get your medicine early, been rude to me or any of the techs etc. and went on to say that the next time the4 Dr. did something like that he was going to call him personally and tell him there was no need and tell him about my pharm records etc. He is right, I do need to find a new Dr.

I said before but will say it again, I emailed him the link to this blog a few days ago ( I guess it means you have an OK relationship with your pharmacist when you email each other from time to time, he send tons of fwds. lol...)

What I said to him today was long overdue and I do appreciate it being brought to my attention that they need to hear they're appreciated too sometimes. I feel embarrassed tonight for not doing it before now.

dorkyrph said:

Dave said:
Come on, you are on Norco for chronic pain?? Why don't you find a competant pain MD. Most doc's know jack shite about treating chronic pain (which is why we dispense so much hydro/apap) 1>

Quit treating us pharmacist like uneducated dispensing machines, and
2>get some real treatment for your pain!

-----------------------------------------

Sure. Carbamazepine, Lidoderm, OxyContin, MS Contin and fentanyl patches are UNACCEPTABLE because they don't WORK........

_____________________________________

dorkyrph are you being sarcastic or do they work?

And what's wrong with Norco if it works Dave?

It's all confusing, and I ask this because I really want to know. Obvously I am not a Dr. or pharmacist so the more I know the better off I am. Maybe I should just go to medical school and treat myself!

P.S. I have been told to stay away from OXY ANYTHING, which I have done. But I'm not sure why. :S

If mint-flavored tic-tacs were found out to be the best med for chronic pain I would take them and just be happy not to be in pain 99% of the time. I don't care if my meds are narcotics or not as long as they work.

When I 1st started reading and posting here I admit I was hostile and on the offensive, but the more I read the more I do learn (even if some of you are rude and mean sometimes lol...)

I am learning something here, which I'm grateful for. I guess I need to pound it in my head that it's MY body and I know when IT hurts and what works for ME and what doesn't. And take my Dr. off the pedestal just because he's the Dr. and I'm not. He may be the Dr. but it's my body right?

I'm also learning quite fast that some pharmacists (even though a lot, here at least, have a mean streak lol...) most likely know more about what's best for me, or at least know how to point me in the right direction, than my own Dr. does. Hmm.

Jen..
dorkyrph had my sentiments exactly..Norco is not exactly high on the list of stuff to use for CHRONIC pain.. I am sorry if i seemed a bit snarky, must have seen too many dopers that day..ha ha..Part of the problem with non controlled release meds is that even when you take them round the clock, you get a trought in the blood levels..it is during the trough where problems occur. Your dorsal horn (where pain impulses pass) will sensitise during the drop and pain will often come back more sharply..

The optimal regimen for a chronic pain sufferer would be a long acting med...(Oxycontin, Ultram ER, etc)augmented with a shorter acting pain med for breakthrough pain..

Listen, I am just a lightweight when it comes to understanding pain, you should talk to a few of the real pain specialists in my area..(the ones that actually study pain impulses, not the ones with rubber stamps rx's for 120 Hydro/APAP, Soma, etc)

Good luck with your treatment, and remember..pain is a part of life..It helps to ensure the continuation of the species!

I actually broke 2 bones in my foot last week. Limping around I haven't been in much pain but the ER doc did give me a script for vicodin. After giving my x-rays to my brother-in-law, an orthopedic surgeon, he suggested I get the script filled and walk as much as possible.

As a pharmacist I can just imagine the look on the pharmacists face as to why I waited 7 days to get the vicodin filled.

i hate all these damn drug seeking junkies!!!! we generally dont get a whole lot of ppl refusing their amoxil but 90% of our rxs are controlled anyways! i hate them all they piss me off to no end when they come in 3 times in a day to keep getting stuff for members of their familt that all live in the same effing house! that probably put all their shit in bowl and go ball to the wall! i wish those so called pain seekers would shut the hell up because its all crap! fake garbage! i hate them all i wish they would just take their vicodin/soma/xanax combo and pull a heath ledger!

To Jen:

I'm glad that you got the see the "real" side of a pharmacist. We (well,most of us!) DO really care about your well being. If you have a good relationship with your pharmacist, we are usually more than willing to help a patient. That is why I went into pharmacy. At my last job, I had EXCELLENT customers. We were all very close and I would do anything to help them.

However, at my new job....you just get "hardened" when all you do is fill the soma/xanax/lortab for the people that go to the local "Candy Man" every 2 weeks to get their meds. I would bet that 99% of them don't have any real problems. Another thing that turns you off is when you get one of the infamous scripts along with their state MEDICAID card. So yeah, it's hard to feel "sorry" for these people's "pain" when they're taking money out of your pockets and then making money by (more thn likely) selling the medications.

I have had many patients with chronic pain. I see them with their canes..barely able to walk in the store. And yeah, I feel for them. And also, I don't see what the big deal is with treating chronic pain with Norco/Soma. If it works, it works. If you're not abusing it and not taking it more then is prescribed, I don't see the problem.

It seems to me that being a pharmacist is very much like being part of any other customer service profession. You work in an industry that is going to attract its share of losers, psychic vampires, deadbeats, and other wise unsavory characters. Bartenders, waiters, and others who deal with the public know the routine—with this difference: your profession attracts drug addicts who are notoriously selfish, and honestly, in the grips of a form of psychosis. I’m a public librarian and our clientele includes schizophrenics, homeless people, drunks, sexual perverts, drug addicts, and otherwise wacked-out people. It gets very old to have to converse with a person who repeatedly comes into the library wanting to pursue the means to obtain a cup of blood from a “vampire club,” but I have to listen to him even though its gets to be intolerable. In the mix of all this is the sane patron who, ostensibly, the library exists for—and I’m more than happy to help when I can. In other words, as much as it’s taxing, it’s also part of the job.

It’s too bad that there isn’t some kind of alternative way to deal with drug addicts because they are here to stay, never to go away. There must be a better way to corral them somewhere else like a clinic similar to those you see in England where registered drug addicts can get their heroin. Anyway, I’m sure there’s no easy solution, but there must be something different that can be done. Otherwise, these drug chasers ruin it for legits.

I love it when people tell their life stories and all that shit via comment.

Guess what people, NO ONE cares!

This is an anonymous blog. The shit you say isn't going to sway the way anyone thinks!

I remember a doctor who specialized in oral surgery...he'd prescribe a boat of drugs as a finisher. He'd call in Keflex, cleocin, dexamethasone, and hand the patient a written script for percocet and vistaril. The patient had to come in and if he wanted the percocet, he had to pay for EVERYTHING. Once a patient insisted on the percs only, and we called the doc, who said: "no, he needs to pick up everything...and give him some cipro too, because it's expensive." That guy fuckin rocks.

"We don't lump all our patients on controlled substances together."

B U L L S H I T.

I am NOT a chronic pain patient, I am a practicing physician and I am absolutely sick and tired of idiot pharmacists having a bad day calling me to tell me what I fucked up on my scripts. If I wrote a particular treatment prescription I did it for a reason. Please don't argue with me as you attempt to be so many amateur physicians. I realize that you went to 5 years of school to learn pharmacology, and I respect that. What I can NOT stand is that fact that none of you seem to respect that I and my colleagues went to school for 10-12 years and, whether you want to hear it or admit it, know a fuck of a lot more about medicine and pharmacology, and more importantly how they interact and will effect OUR patients than most of the arrogant, self absorbed, insecure pharmacists that call to tell me I can't prescribe A with B. Shut up and fill the fucking scripts unless you are damn sure there is a mistake. As I get at least two dozen calls a day between "corrective" calls about my prescribing and suspicions about my patients that I prescribe anything stronger than Ibuprofen, it gets ridiculous.

Pharm D? THAT is a fucking joke!

P.S. Socialized health care kicks ass.

Until you hit 55 and start getting denied routine treatments, but I suppose you don't care about that because as a health professional you're not subject to the rationing normal people are. *spit*

So what I am sitting here wondering is if these people are in such pain, and knowing a little something about kinetics tells me that even if I give you the tab now it is still going to be an hour before the effects kick in, why dont the emergency rooms give a shot of something for the pain so they dont have to run straight to the pharmacy? Or how about changing the law and letting the Emergency Room give out the pain meds!?!?!? Maybe then someone will keep track of how much they actually dispense and will cut back when they are paying like $20 per pill!!!

I wonder why sometimes we have a database of narcotic or controlled users if we do nothing with it!! What good is just collecting data? I have yet to see any investigations or arrests or anything come of it. Whats worse is my employer wont even link to the database on our site at work, so I have to look up patients on my private cell phone to connect to the web site to see if this patient has gotten anything filled at another pharmacy.

When are we going to get a national database!?!?!?? Come on! How much intelligence does it take to realize what a good thing this would be for everyone involved? I see posts from doctors who are all like "I dont want to compromise my patients privacy" and think screw you! If we had a national database we would be able to stop these abusers and really help out the ones who are not abusing! Think of how helpful it would be if you could log in as a physician and see Dr Joe prescribed Zocor for your patient 2 weeks ago that your patient forgot to tell you about. Do these doctors really think the patients remember everything they are on or tell them the truth all the time?!?

Anyways, I am starting the national database movement right here on Angry Pharmacist. If you are interested in signing a petition for a national RX database please send me an email to fxguy@thefxguy.com and I'll let you know as soon as the website for the petition is up. BTW the website will be at nationalrxdatabase.com

Sorry for the long post first post and needed to vent!

P.S. Is it bad that now I have to deal with telemarketers at work?>??? Get a call from Astra-Zenica yesterday about formulary changes regarding symbicort. The girl is totally a hired actor reading from a script and when I ask what the copay will be for my patients she proceeds to tell me uh uh uh we dont know, but it will be tier 2 or something like that!

One last plug Would doctors on here find a site that helps you look up a patients copay for a medication be helpful?

Thanks all! Keep fighting!

Tim PharmD
AKA The Fxguy

Hey TAP...Im a tech for a coporate piggie chain store...and I just want to tell you...you are awesome...and everything you say is what most of us think. I havent laughed so hard. Its validating a bit to hear your rants...because I live it. I dont even know where to begin on comments. This entry though sticks out, makes me also think of how the control or narc rx is always the only one that "gets stolen", "gets lost"...or my favorite "it fell in the toilet". WHY on earth would someone take thier Ambien over the toilet??? With the seat conveniently open?? We also get people who try and fill early so much, they like to try and play the call every day until I get a new person on the phone and say "so and so said it was ok if I pay cash". Yeah, little do they know ,we know the silly lame tricks and we are on it. Stupid morons. OMG!

One of my technicians caught her dog eating her Evista. Really. Little pooch chewed off the end of the bottle and was gobbling them.

The poison control center said he would be okay, and he was.

This is response to Jeff-

I can see how you could relate the mix ups to the scenarios you've laid out. But none of that applies. I am not working again until Aug. 28th-none of my co-workers no I've had a accident nor have I been at work(I now drive a school bus-used to work for a PT). My meds were in a sock itself hidden at the back of the drawer where no one but me had access to them-we've had no company over since we've had the accident. My teens don't even know I am on meds right now other than my ones to control the type 2. Sorry, but the pharmacist at the big box story never even ASKED me my name when I called back about the missing pills. She just YELLED at me and said she filled them. Gee-in a store the size of that one and the amount of patients that get things filled there-how did she know who I even was without giving her my name( I called on my cell so call ID wouldn't work there)? This is why I stick to my hometown guy-he knows everything there is about me and my meds. I only went to the box store after the car accident because it's the only 24 hour one here. One time was enough to convince me never to darken their doors again. They give you guys who are doing a good job a bad name. I hope I never have to get vicodin again in my life!

rph3664...oops, glad the pooch was ok!...

veggiecat55, i know its hard to believe but people DO make mistakes sometimes...i had my sink full of dishwater not long ago and had just taken a pill and (silly me) just left the bottle sitting there with the lid off and was gonna put them away after id finished the dishes, i knocked them in the water by mistake and had just gotten them filled the day before (it was a bottle of omeprazole) so had to run and get them refilled AGAIN, they didnt give me any problem...now that also,a must have jinxed myself here by saying id never had to get my pain meds early :p..because i left my pain medication at our beach house last summer (its 250 miles away) and wasnt going back for 3 weeks, i told my pharmacist that if he couldnt refill them id run back down and get them...he said nah no porblem, just wait until *this date* to come get your next refill, called my dr (whos right across the street and got his ok so my insurance would pay for the early refill) and filled them.

*mom* i will ALWAYS stick to my local *mom & pop* pharmacy, there have been a couple of times i have had to wait a few days because they were out or needed to order something etc...but in the big scheme thats a REALLY small price to pay when you get to have a pharmacist who knows you by name and takes care of you...i never use walmart or cvs or any of those sort of places...its just not worth the hassle when i have a pharmacist who seems to care about my health genuinely and that i trust and vice versa. :)

p.s. hes a dr, i never knew that until the other day when we were chatting, im not sure what the difference is in a normal pharmacist and one thats a Dr. of pharmacology.

In response to mom to anyone:

You were treated rudely, and that's unacceptable. You say that none of the scenarios that I came up with apply. Aren't you forgetting the family member, or friend, or friend of a family member scenario. You said that your teens didn't know that you were on meds other than the ones you take for type 2. Do they know that you were in a car accident? Do they know that you made a trip to the emergency room because of said accident? If they know, I guarantee that their friends know. Like I said before they don't have to know that you got a prescription. All they need to know is CAR ACCIDENT + ER = PAIN PILLS. So one of your kids or one of their friends could have easily figured it out. The fact that you stated "My meds were in a sock itself hidden at the back of the drawer where no one but me had access to them" also concerns me. Why would you hide them unless you didn't trust someone in the house? Further, if you are the only one who has access to the drawer, there is no reason to hide your meds in a sock that's in the back of said drawer. I would be willing to bet my right thumb that someone who lives in your home or one of their friends snatched a few of your vicodin. You are just having a hard time realizing it because no one ever wants to believe that their kids (or their kids' friends) or their grandkids took their drugs.

So, here's the scenario... Teenage son/daughter at home with mom a day or so after the accident. Mom decides she needs some groceries/cigarettes/whatever. Teen stays home while mom heads to store. Teen, being a teen, knows exactly where the hard liquor, mom's vibrator, dad's playboys, and mom's pills all are located. Teen is trying to decide which stash to get into when he/she remembers that mom took a trip to the ER a couple days ago. Teen thinks to his/herself "mom's metformin didn't do anything for me when I tried one last month, but I wonder if she got any new prescriptions from the ER?" Teen checks all mom's usual hiding spots until she gets to the sock at the back of the drawer. Teen looks at vials. Teen sees a label that says "Hydrocodone/Apap" and doesn't think much of it until further down the label he/she reads "generic for Vicodin." The teen has heard of Vicodin before so he/she dumps half of it out into their pocket. The teen looks at the other new vial and reads "Cyclobenzaprine" as well as "generic for Flexeril." The teen has never hear of these before, but decides to take 2 or 3 from the vial to sample later...

to jeff-
wow you are very creative!!! the sad thing about it is that its probably a true story! "mom" may not be poppin the vico-dans but somebody surely was! i know in my pharmacy its policy to double count things of that nature and if i have a discrepency i count again and if the third times not a charm i have my rph count that would be 4 counts im sure the bottle was correct when it left the pharmacy. that leads me to a question: who picked up said rxs? if it was a third party they probably swiped them before they got home.... open your eyes mom ur kids an undercover junkie!

First off I'll say again. This pharmacist at CVS is the one that miscounted. She had too much going on that night-there were no techs on because they were all out on break. There were quite a few people waiting for their prescriptions and one person doing it all. Since we stopped there on the way home from the accident and the ER, I was the only one that had the prescriptions. I gave my hubby his and I took mine-his and her bags. I hid mine away in a sock-no one knew I had them-hubby had a 30 day supply-I was supposed to have 15-I got 7-so he had plenty and didn't need my small amount. My 10 year old sure didn't pop them. And the other two were in FL at their Grandmothers when we had the accident. Adds up that pharmacist made a mistake. Simple. I hope to hell NEVER to take them again-if pharmacists automatically label you as a druggie-I'll refuse it when a Dr prescribes it. Never mind some a-hole ruined OUR summer with injuries and now a surgery. I'll deal with pain before I'll be judged again. And me-who rarely takes a advil too. And you want to know why the public has a dim view at times of the box stores-it's why I stick with the guy who a local who's been in business for 20+ years and knows that I've never had anything but a antibiotic. Guess you live where everyone's a druggie and no one can ever make a mistake. I still say she was hiding something-since she had no way of knowing who I was on a cell phone calling. I never identified MYSELF. Sounds like she's the one with the problem.

What really bugs me is that first off-one child is a whopping 10-so nope it's not that one-the other said kids where at sleepaway camp when the accident occurred. I hid them because of the dangers of all you've pointed out-I don't trust anyone that comes into my home and I don't have a locked box for my meds-which will be remedied here now. But being that no one came over at all to see us after the accident-I have to believe that the mix up was at the pharmacy because of the lack of techs on-because it was break time and the pharmacist was too damned busy picking up the slack-it's a CVS-to me that says volumes to because all of ours around here suck big ones-but we had to use this one because it was a 24hour one. Maybe your used to dealing with people with drug problems, I've know a few in my life. But believe me-I KNOW exactly how many pills I always have for any medication-that's why this one threw me off. For the pharmacist to accuse me when I called on a cell and no WAY for her to know who I was when I called-for her to rip me a new one-just a little off for me. Guess what-some of us are honest and have kids that damned well know better NOT to take anyone else's meds-I have never spared the rod in my house! Not everyone is a pill popping junkie-not every kid will filch off Mom because they have it. Simple answer in my book-the pharmacy made a mistake because she was overloaded that night and couldn't own up to her mistake. It's people like her that give the good pharmacists the grief. My guy I've used for 20+ years never ever has questioned my meds-I only use my type 2 ones-never-ever have I had this one before. I know now to refuse viocodin if I EVER get a script for it again-I'll suffer first because I won't be labeled a junkie by a pharmacist. With attitudes that everyone's got a drug problem-it's no wonder I don't trust anyone in the medical profession. Bad enough I had a a-hole ruin my summer, my spouses summer, none of us can work and I face surgery because of a bad driver. Then I look like a pill popping Mama because of injuries. So-thanks for the eyeopener. I won't be filling that type med ever again.

wow, all these pharmacists should be ashamed of themselves calling people with med problems and people coming out of surgery or something taking meds instructed by the doctor assholes who should die. I don't personally care for how pain killers make me ill so I don't deal with them, but holy hell, if I ever landed in the emergency and had to take something, fuck you for making me feel bad for doing what the doctor says-go back to school and become something worth it like a doctor-a pharmacist is just someone who is too lazy to go all the way

Hello everyone, I am a 26 year old addict who not to long ago was battling with my addiction to opiates. After reading the comments on here I have mixed emotions. I would first like to say I have been clean and have not taken a pain pill for over 120 days. It will be 5 months on 9-8-08. I was the patient that did all these things you have all mentioned on here and when I read the comments you make I am not upset at all. You are right, infact at least for me I was so guilty all the time while I was using because I knew it wasnt right, that I always assumed you were thinking that about me anyway. I just didnt really care at the time because I didnt really care about much of anything except getting the drug in my system. I would get so mad at the pharmacist when they didnt buy my story or for any other reason I didnt get my RX. Today I am so thankful for that very reason I used to get mad. By being cautious and paying attention to red flags and little things that dont add up dont necessarily mean you dont care about people and want to make their life hell. It shows you do care and dont want them to make their life hell. Thanks to a pharmacist who finally caught me in my little game I am alive and clean today. If I hadnt got caught I would have continued my secret addict life and I KNOW it would have killed me. That pharmacist was able to bring my issue to the attention of those that could offer me the help I needed. However the part of the commenting that does hurt is that even though I am an addict and I have done some horrible, unthinkable things, I am still a human being. I will give you the fact that while using my behavior was more that of an animal. I hunted for survival or at least what I thought I needed to survive. But see I did not ask for that to happen to me, infact everyday I hated myself, my life and the fact that a substance had controll over it. If I could have easily quit I would have, its not that easy. My point is that even though I did horrible things, I am not a horrible person. I was the cheerleader that got good grades and never did a drug in my life. That changed when I was prescribed vicodin for kidney stones... that was the beginning of the end for me. The end of the life of the girl I once was with morals, honesty,, ect... I am that girl I once was again today. Not all your piece of shit customers are hopeless... so instead of HATING them and wishing death upon them ( because believe me if they are anything like I was they are not to far from it) why dont you try exactly the opposite of what your doing now. Getting mad, being short and rude, making them wait on purpose and then still being pissed off about it when you get home( pissed off enough to write hateful blogs) try reaching out to them, they need help, they are in over there head and dont know what to do..most of them want to get caught just so the secrets out and they can get out of that vicous cycle they call their life. Hey maybe you will even be happy when you go home from work instead of pissed off because you will leave work with that feeling of I may have saved a life today. Trust me it happens I am LIVING proof... thanks to some stranger that unexpectadly interfered with my life who just happened to be a pharmacist..

http://www.craigslist.org/about/best/sfo/301345524.html

Here's another perspective.

I have to say I have sat down to this site and want to say that one thing that I think is it doesn't matter what a pharmacist thinks he should fill the script if its being paid for thats his job his job IT"S not to judge or put his opinion in to place making things difficult. He wasn't the patient and he wasn't the doctor so if they abuse them then none of his brain cell should be waisted in the situation and the other thing is maybe people have the antibiotic at home and don't need anything but the pain meds I know I have a shit ton of antibiotics right in my cupboard!! OH and by the way I am not on pain meds and I was injured in a doctor during one of the 5 delivery's I've give along being in other situations where I was injured so I need them some time I can't even get up from my legs and back refusing to move