Thanks for letting me know you’re not an addict

Never fails.  I write a long rant about some addict and pain pills and no less than 3 months later I have 100 comments that all start with:

“I’m a chronic pain patient that takes 120 norco a month blah blah blah life story life story life story I dont think its fair that you say we are an addicts”.  That sounds about as smart as “Hi, I’m black, but I’m not a criminal”.  What the fuck people!

Where have I ever said “If you are on opioid x you are an addict”?  Seriously, point it out.  I’m tired of the whole “I have chronic pain so everyone thinks I’m an addict” pity party that I see more and more of.  So here is the post that sets the record straight.

Top signs that us pharmacists (or just me) that you are indeed need either some pain management consultation or just want to put gas in that escalade.

  • You cannot divide 90/3 to determine when you are due for your next refill.  90 tablets at 3 times a day is 1 month (30 days).  When you run out you are due for a refill.  Simple.
  • You appear to be either the most unluckiest (or stupidest) person on the planet.  Your house gets broken into every other day, your brother runs off with your pain pills, they are vaporized in an auto crash, flushed down the toliet, exploded, maimed, got wet, excuse, excuse, excuse.  Then, excuse excuse excuse.  “So heres what happened…. excuse excuse excuse”.  Not once, oh no, but every fucking month there is some drama or issue involving your pain pills being filled early, not late, but early.
    • Sometimes shit happens and you need an early refill once a year, thats cool, I understand.  No, this is every fucking month.  Get that everyone? Every month.
  • When I see your half-awake ass stumble into my store at 2pm and the very first words out of your mouth are “WHEN ARE MY SOMA DUE AGAIN” when you called me an hour ago and completely forgot you asked me the same thing.
  • You walk into my store loaded out of your mind.  Not just like “feeling good” loaded.  I’m talking about harvesting your blood to use in anesthesiology loaded.  Eyes are not supposed to roll back in your head or point in different directions when you are attempting to have a conversation with me.
  • When I see you walk outside the pharmacy, open up the pill bottle of soma, and GIVE A FEW TO YOUR FRIENDS OUTSIDE THE DOOR. Enough said right there.
  • When I say they are too early to be filled, you say “Well I’ll pay cash for them! I’ll pay double cash price!”  No way, bribing your pharmacist is not going to get you the pain pills early.

So the take-home message is, unless you obviously make it known that you have an issue, you have no issue. :)

Recent Entries

52 Comments

  1. Radis says:

    harvesting your blood to use in anesthesiology
    Beautiful use of the language, man.

  2. My favorite is the grandmother/grandfather that has died 20+ times and they must travel out of town resulting in the need to get their hookup….oops meds before they leave.

  3. Kristen says:

    Yep – it is never the heart or cholesterol medication that goes down the sink or in the toilet. Apparently only the control medications are the ones you open over the garbage disposal.

  4. Yup, I had a lady claim her son stole her pills, but “t won’t happen again, I kicked his ass out.” Ths was 3 days into a weeks supply. That one was early too. Her excuse for th early fill that time? “y son stole them, but it won’t happen again, I kicked him out.”
    The really annoying part was that the doctor KNEW this and STILL wrote her the new rx’s. I told her I didn’t care if God himself wrote them, they weren’t gettig filled by me. And I wrote down the date and store the last rx was at on the rx so if she went somewhere else, they could (if they gave a crap) refuse also.

  5. rph3664 says:

    The best excuse I heard? Dog kept eating her tramadol.

  6. rph3664 says:

    We once had a woman who insisted she needed her Nubain refilled early because she was going to be vacationing in [wide spot in the road, 30 miles away].

  7. I had one customer that would tell the doc that she only had enough money to fill 3 or 4 days worth of her oxycontin so she needed a new script and he’d write her a whole month supply again – every 3 or 4 days. And she’d fill the whole month worth at a different pharmacy each time. Took a few of the local pharmacies working together to figure it out, but once I turned the doc in to the DEA and state medical board, it stopped – she went to rehab, he lawyered up. Too bad he fell for her stories for so long…

  8. drh says:

    Here’s one from last week.
    Her: I ran out of my pain meds and I need a refill.
    Me: REally, Dr. X gave you enough to last until 2 days from now.
    Her: Well actually what happened is that I spilled diet coke on them (long explanation regarding piling up all her pills on her counter) and they’re destroyed.
    Me: I don’t refill narcotic medications that have been destroyed–it’s your responsibility to make sure they aren’t lost, stolen, or destroyed.
    Her: Just so you know, all of those other kinds of Percocet Dr. X gave me I destroyed when he kept changing my prescription. I didn’t take them.
    Me: Well, there’s no way for me to confirm that. In the future, you should bring them in so Dr. X can see that they’ve been destroyed. Here’s some Naprosyn to try.
    Her: You’re acting like I’m a “pill-popper”. I never asked you for narcotics. I just wanted a non-narcotic pain medicine that wouldn’t make me feel weird like narcotics. I don’t like narcotics.
    Me: Well, great, then we’re in total agreement. Go right ahead and fill that Naprosyn prescription.
    Fucking idiot. You think I don’t suspect something when your fucking story changes a bazillion times??

  9. I felt the hyperlink appropot. I dont understand the gall of some of these folks, do they just assume the pharmacist or physician is going to overlook the date? I happen to love the sig code NTE! Of course you could print it in swahili because these folks are not looking at anything on the bottle, but how many refills are there…What is the deal with Soma� anyways, I have taken it before and all it did was make me an extra from Night of the Living Dead, where is the fun in that?

  10. shanejames says:

    The one I love is the “My dog ate one-hundred and eighty vicodin all at once but is somehow still alive.” Try getting a dog to eat ONE pill, and how did he get the bottle open, and how is he not dead? Do these idiots think they’re fooling anyone?

  11. Crusty RPh says:

    I had one couple lose theirs on a train robbery. Butch and Sundance jumped off the train after the robbery.
    Crusty RPh

  12. You missed a big one. Requesting a particular brand of Lortab because ‘it just works the best’

  13. The special requesters get me…”do you have the blue Watsons?” Arrrgh!

  14. How about the ones who want the “football shaped” alprazolam? None of the seekers use the term ‘oval’ – they all say ‘football shaped’ WTF???

  15. opiateintern11 says:

    Sup guys, first post, 4th year intern… lost story short cuz no1 really cares: really f*cked up my knee at work bad, while i was actaully training for a triathlon none-the-less. I ended up on Opana ER 10 and Roxi15 just to get the edge off on a daily basis and be able to walk around the pharmacy and school…
    At my pain management place, I spent an hour with their staff during their lunch trading crazy addict stores, they had one that blows away anything we’ve heard!!! So this patient (known “past” coke user), failed a drug test and was actually on Cocaine when she came in for an appointment. She claimed she got into a fight with her daughter who is a heavy user and when she was trying to “kick her out of the house,” she was pushed into her dresser and the daughter’s coke stash fell from the top of the dresser and got in her eyes, mouth, and nose, and that is why she failed the test. hahaha Beat that one addicts

  16. I don’t know TAP, other Pharmacists on the site. You guys have to put up WITH A LOT OF BULLSHITE MALARKY but you can be quick to judgment.
    I have a one time scrip for a monster opiate from my pain management that starts with an o and ends with an “oh mY”. The CVS pharmacist straight up refused to fill it. The other meds I get from this pharmacy are prevacid, Neurontin, naprosyn, and a mild opiate that starts with a V and ends with “Nice” that was written in February by my GP and I never had filled cuz I’d rather not take it if possible. Because my GP prescribed the V and my pain management prescribed the O, I am now a fucking junkie ass pillpopper sucking cock by the dumpsters for my fix.
    I realized, duh, can’t have two outstanding narcotic orders from two docs, I ask him if this is the problem. “No”, he says lying “It is out of stock and we will not be refilling. We just don’t distribute that medication out of this store.” Even the tech is like, “What? I can just order it, it’ll be here in 3 days.” The pharmacist: “No.” Shaking his head. Then I get some story about Purdue suing Teva which may very well be true but as far as I know Teva’s are a kind of sandal made in Israel and it still doesn’t negate the fact that I’m not a fucking junkie and my scrip is written by a MD who knows about the Vic.
    I tell the pharmacist to go ahead and call the docs to cancel the vic order as they not only know about each other, my fucking GP referred me to the pain management MD in the first place. Pharmacist refuses. Then I made the biggest mistake of all time: I told him I was a nurse and his look changed from “a stubborn persian goat who won’t make eye make eye contact with me” to “you sad case of medical diversion”. He doesn’t ask me about my condition, why I need monster pain meds, nothing. I’m a junkie, despite the fact he’s been filling my scrips for 2 years.
    Seriously, sometimes you guys are harsh.
    So what ended up happening? I had to suck off some
    nasty 52 year old obese Taco Bell manager’s burrito supreme who had a pill hook up-just kidding.
    Went across the street to Walgreen’s where the current legal status of Purdue isn’t the end of the world.

  17. frusterated_tech says:

    The best excuse I ever heard was that a little lady said she was baking a pie and had a window open. Then a huge bird swooped down and stole her pain pills that were sitting on the window.
    It took every ounce of my being to not laugh.

  18. Google Account says:

    My favorite was when a guy called me and said that he was in Germany competing in a Motocross competition and needed his pills filled early so his girlfriend could pick them up and mail them to him. I told him that in the month before he left he had somehow gotten a 120 day supply and that there was no way he was getting this filled. 10 minutes later we transfered his Rx to the store across the street. 10 mins after that his girlfriend came in looking for his drugs. We told her that they were transfered out. 5 mins after that the other pharmacy called to verify the note on his rx that said no early refills and said that HE was there causing a stink. Quick flight from Germany…

  19. chemoqueenrph says:

    My cat likes to play with prescription bottles. He will dig them out of relative’s bags when they come to visit. Then we hear the rattle when he starts batting them around the house. But alas, he has no thumbs, and only succeeds in getting teeth marks all over the bottle. He’s not picky. Cholesteral and BP meds are just fine with him.
    The dog just isn’t smart enough to even try it.

  20. Generics says:

    I have a pharmacy question.
    Yes, I have chronic pain. Eat my poo.
    Anyway, I read all sorts of blogs and stupid shit and one thing I always see is that the not-so-chronic-but-likey-narcotics-patients WILL NOT take anything but Watson or brand name narcotic x.
    I take hydrocodone and could give two shits what brand they are, but I have noticed that when my pharmacy switched from Watsons to Mallikrodt, I felt a lot better. I didn’t feel like I was in withdrawal two hours after my last dose and the “mallies” as they call them on the drug addict boards don’t make me high, just help with pain.
    Do you think Watson puts some magical fairy dust in their product so junkies request them? I could NOT believe the difference…I really think this needs to be investigated.
    -Chronic Pain “Junkie”

  21. jmerph says:

    I agree with the one who hates special requesters. Nothing makes me say “no” to a script faster than when someone asks: “do you have the endo 602’s or the 512’s”

  22. karrirx says:

    I changed jobs about 6 months ago where I used to maybe go through a bottle of 500ct 5/500 a week to where I went throught TWO 500 ct 10/325 in one day. Needless to say it has been a wakeup call.
    anyhow, we’ve got a local “candyman” doc who writes for hydro/soma/xanax which, I’m sure most of them sell anyways. But, I remember the first time somebody asked me if I had the “Dan Dan” Soma. I was like, what the heck? My partner’s like, yeah, they want watson brand…I had no clue why. Then I learned about street cred.
    These people freakin’ kill me.

  23. Second Best Intern says:

    ^^
    Blue Watsons. Don’t forget the “DAN Soma’s”
    I work for a Rite Aid store in NY. My store was an Eckerd’s but was bought out last year. When we were still Eckerd’s we carried the “DAN” Soma’s. After we were bought we started to receive several other brands. Within about 2-3 months we went from filling 6-7 Soma Rx’s every day to about 1-2. It was nice though because we didn’t have to deal with as many junkies all day and the number of items stolen from the store also decreased.
    Unfortunately though, it seems that now we are actually starting to fill a decent amount of Soma 250’s though. Thanks NY Medicaid.

  24. blargh! says:

    Unrelated rant here, but is anyone as ticked off about Xyzal as I am? We sell otc generic zyrtec for 25 cents a pill, and Xyzal is over $3 per pill. We already had one doctor (who is apparently a god damn moron) write for it.
    Of course the customer yelled at us because insurance requires a prior auth and she’s going on vacation. The prescription wasn’t written today and we didn’t choose her insurance and her doctor is Sanofi’s bitch, but yeah that’s totally our fault.
    P.S. “Xyzal” sounds like that LL Cool J song. Za za za za za. Za za za. Zazazazazazaza.

  25. izzyRed says:

    When I was younger, I worked at a couple different retail stores [not pharmacies], but places where the evil public won’t stay away from :)
    At least in my experiences and from what I always see on blogs in every industry, people/customers are all the same. The majority are HUGE a-holes. But there are also some very nice ones that you see often and actually look forward to seeing again.
    I would guess that most people here that are in a direct customer-related business feel at least somewhat similar?
    Anyways, my point of this post was to ask a question.
    And before anyone thinks I’m posting for a pity party or to kiss butt, I’m not :)
    I’ve only posted a few times on this blog, mostly just on a post a while back that TAP is referring to :)
    I’m one of the chronic pain patients that takes many controlled (and prescribed) medications. But, again, not the main point of this post so I am shutting up about my background now…..
    Over the past few years, and especially this recent year [and going], I’ve had lots of issues, and made lots of calls to my very friendly doctors and pharmacist. I hate pestering people, and hate calling. But when I’m taking 10 medicines, and have a new one added – I always look it up online [and yes, always find the 10 pages that say “don’t take with basically anything”]. So before killing myself with a mistake, which all humans make from time to time, I check — and have caught a couple fairly major interactions that could’ve turned out really bad otherwise.
    …hmm I can’t seem to get to my real point here…..
    OK, my point is – my doctors and pharmacist have been very, very nice and patient with me and helped a ton over the years. And I’d like to say thanks to them — just to say THANKS, not some imaginable suckup gift to the pharmacist in hopes of getting 10 pounds of vicodin…I know how your minds work here 😉
    I just want to let them know that I appreciate their help, something that I’m doubting they get much of.
    So my last real question and finally to the point:
    TAM — do you ever get Thank You cards randomly or does your staff? Or does anyone know if doctors do? Or is this just not an appropriate thing to do and might make them feel uncomfortable? I’d love to hear anyone’s thoughts or experiences with this. Thank you.
    Izzy

  26. izzyRed says:

    Ok I gotta just ask, why is the vicodin/lortab + soma “combo” always posted so much on here as being the worst thing ever created? Obviously I know people use it to get high, but it’s also a valid working combination that *works* for a ton of people, myself included.
    Lately my doctor has literally been trying to shove higher doses of Morphine (Kadian), oxycontin, and the fentanyl patch which nearly killed me when he talked me into it long ago. I’m not trying to be a smart ass, but would genuinely like to know why it’s talked about so often as the medications from hell? Surely on the street to those selling it or taking it themselves, wouldn’t they prefer morphine or something like that vs. a lowly little vicodin and muscle relaxer? And yes, this is a genuine question that keeps showing up and makes me quite curious.

  27. dorkyrph says:

    Izzy,
    Thank You cards/notes/comments? Are you high? It’s more like “Thank you very much for doing your fucking JOB.” They kiss the physician’s ass right on the hole for that caring attitude (ie, the fistful of narcotic Rx’s), but the dipshit pharmacist is only in it for the money.
    Fine. If that’s the way you feel (pardon ME for trying to help), just keep the paychecks coming, and I’ll hold up my end of the deal.
    Sorry, I’m having a bad day.

  28. PharmDawg says:

    IzzyRed,
    Long before switching over to Nuclear Pharmacy I worked at a small town independent pharmacy. To answer your questions, yes we got random thank you cards and they completely made our day. We posted them in the back room and cherished every one. We even had one fantastic elderly women who relied on our pharmacy delivery service (read me in a little ford ranger) for her meds. Once or twice a month, her “younger” 84 year old friend would drive her to the pharmacy so she could deliver fudge or a cake to us. Those days completely made up for the days that we spent all day battling insurance companies, doctors, and general stupidity. A well placed thank you note is NEVER inappropriate!

  29. Last Thursday, about an hour after filling Topamax for a guy who lives in a group home (and telling him for the second time that we couldn’t fill his Lorazepam early for him, it doesn’t matter if it’s not in the dresser drawer, he’s on Masshealth and they don’t do early fills), the phone rings. It’s a guy who owns a subshop down the street…Topamax has been run over by a car in the parking lot, should subshop owner send grouphome guy back to us? I said “I guess so, it shouldn’t be your problem” and he said “Do you know grouphome guy?” – yes, I do. he smells so bad that if I don’t hold my nose, I will gag if not vomit on him while he fishes out his change to pay for the $3 Topamax copay.
    GHG comes in an hour later, with the crushed pill bottle. What do we do – no early refills. This is the first time he’s filling it. I told the pharmacist that since he hasn’t been on it before, he can wait until he can fill it again and just start taking it then. What are the other options? We’re not giving him a whole new prescription for free. Next tech comes in, and she ends up conning the pharmacist into giving the guy 8 Topamax ($26) for free, so GHG doesn’t “get really upset”. Umm, upset? He’s been sleeping in the waiting area for an hour, he has no idea what’s going on, and we could’ve just told him to go home and come back in 3 weeks. So instead, tech gives him enough pills to last through Monday…then what’s going to happen? Will Masshelath suddenly decide to do an early refill? Or are you going to give him the other 32 pills for free? Or make him pay for them? Friggen idiot (tech also then tied GHG’s shoe…I could barely wait on him when he was on the other side of the counter because he smalls so bad. I guess the other tech is a better person than me).

  30. Jen says:

    That is a nice post izzy, but to be fair, there isn’t ONE pharmacist I’ve read on here so far that I’d waste a stamp on, they all seem to be complete A-Holes!!!
    I have however sent my Dr and his lovely wife cards on their anniversary, birthdays and xmas.
    And hes not even a pill-pusher, just a nice person! :o)
    My reg. pharmacist is nice too and would be appalled and embarrassed that he shares the same profession with some of this lot I would wager.
    I guess I’ve never sent him any thank you cards or anything because he’s just a worker bee dispensing something a professional has prescribed me iyswim.
    Although it is something to think about because he always has a nice chat with me about how his kids are and asks about mine when I have to pick anything up. maybe I will send him one now that you mention it. I am grateful for him after finding this site hehe!!!

  31. rph3664 says:

    I’ve had customers who gave us thank you notes, as well as sent us flowers and baked us cookies, just for doing our job. One cookie lady said they were for me “and take them home to your husband and kids.” I told her I didn’t have a husband or kids and would share them with my co-workers, which I did.
    That never happens when you work in a hospital.
    Anyway, kind words were appreciated just as much. Hearing “You are the only people who keep all your promises” or “I can’t believe you sent me to that other store and lost a sale” (when the person NEEDED it that day!) was always nice.

  32. What’s so funny – not really – about the people who this post started about (the non-addicted addicts) is that they make it virtually impossible for anyone in real pain, with a decent, responsible doctor, to get anything! I’m a pharmacist, I have a torn rotator cuff, and although I’ve seen the same doctor since 1989, it’s been a total BITCH getting a refill of 30 lousy Vicodin to get me through 15-16 days until my appointment with the surgeon. (my doctor did apologize for the pit bull nurse that asked my tech why I needed the refill – to which my tech said – read the MRI report, I bet it’s in the chart!)

  33. http://openid.aol.com/rgregg78 says:

    I’m a pharmacist and am out 8 weeks getting paid for having a bunionectomy(it’s really nice too). Anyway, podi put me on 1-2 vicodin es’s q4-6 prnp, the shit doesn’t work! I don’t see how people can get addicted to the crap. The last pain med I had was d-n-100 7 mths ago when I had my little one and we all know what kinda crap d-n-100 is. I mean the ibu 600 helps me better than the vic’s… Oh well, I just take it at night anyway. Time to go put my foot up and kick back…OOOOOHHHHH how about we had a woman getting her PETS!!!! Xanies!!!!! I kid you not and the pet had died like 6 mths b/f!!! We called to verify with the vet and the vet said the animal died!!!! I also love the family member passing away and the family member trying to get them filled…

  34. http://openid.aol.com/cmppharmd says:

    This is the best!!! How about when they ask for the generic percoet by number!! “yo, you got the 502?” WTF!!

  35. izzyRed says:

    TO JEN:
    Yes I know what you mean. I wouldn’t necessarily give THESE pharmacists a thank you card 😉
    But mine is quite nice and has helped me out a ton over the years. Same with my doctors. Heck, I give the mail man/lady a card on Christmas, so why wouldn’t I give a thank you to these people that deal with me directly every single day?
    I think I will :)
    And TAP, you can rip on pain patients all you want, but I posted yesterday regarding my certain circumstances and why *I* use Norco for chronic pain. In short: Because it is CHEAP. It is not hundreds of dollars per month (even with insurance) like Oxycontin, Kadian, et al. The same goes for Soma. It is only $10 each compared to in the ballpark of $200/month for “long acting” brands. On top of my insane insurance premiums already, I’m sorry, but I just can’t afford that right now.
    So “right or wrong”, I don’t think that really applies here. It is a matter of necessity versus not having anything at all. As I asked on the other thread, if someone here knows of a generic long acting pain medicine, please share —-because by all means, I would like to look into it. My searches have led nowhere, especially with the recent oxycontin generic being pulled. So I say it again, there *is* a very valid reason to use Norco for chronic pain; otherwise please tell me what options there are, I would greatly appreciate it! (not being sarcastic either, I really would like to know if there is a generic option better than Norco, and if so then I will truly 101% check into it). Thank you again everyone.

  36. KDUBZ says:

    Jen,
    In all fairness, this site is called the angry pharmacist….so I don’t think your going to find flowers and sunshine here. This post is specifically dealing with narc-heads that lie, waste our time, and believe it or not make life difficult for all the legitimate pain patients out there. These people represent a sore spot to us, and if you have ever had a pharmacist question a narcotic script, realize that these people are the reason why.
    These people are seldom polite, lie so much they can’t even keep things straight, and cost the rest of us time and money.
    You seem like a nice person, and I am sure even you have people that irritate you. I don’t doubt that most of the posters on here interact with their patients in the professional and courteous manner to which you are familiar with. Unfortunately, we have to mind our tongue when we encounter these patients and give them the benefit of the doubt. As such this site amounts to nothing more than a good Bitch Session insuring that even in the most trying times we maintain that professional demeanor.
    As for cards, they are appreciated, but not required. A simple friendly hello really can go a long way for a pharmacist. I also like donuts, not that I’m trying to plant ideas….

  37. http://openid.aol.com/rgregg78 says:

    JEN
    I can’t believe you got away with this statement, “I guess I’ve never sent him any thank you cards or anything because he’s just a worker bee dispensing something a professional has prescribed me iyswim.” In case you don’t know, I’m talking about you saying a pharmacist is NOT a professional. This is the problem with the ignorant public about us worker bees. We are infact professionals that have had more drug training than your beloved professional Christmas card getting MD and have saved his/her butt more times that you’d EVER know b/c we wouldn’t want to betray the MD/pt relationship, that would be, what’s the term? UNPROFESSIONAL! How funny would it be if your pharmacist actually read this blog. You would never know if he/she did, b/c we wouldn’t tell you. You see, everyone no matter what their job, has things about their job that make them angry and they need to vent, it’s life oh and if they don’t then they’re probably on drugs so that they can cope with life. Grow up honey, put on your big girl panties and deal with it and while you’re at it grow a set! I personally LOVE all my patients, the only ones I don’t care for(but you’d never know it) are the 65-80 y/o retired armed forces men that talk down to all females(assholes), but they would NEVER know how I feel about them and are treated just like they were my mother, with gloves! This blog is great and if you don’t like it stop reading it!

  38. izzyRed says:

    Not to beat this topic silly, but yes I definitely have to agree that Pharmacists are in most cases given much less credit than they certainly deserve. Unfortunately I guess the public majority most likely *does* see them as just taking pills out of a big bottle on the shelf, counting and repackaging them into a smaller bottle, slapping a label on it, and taking their money.
    While I can’t say either way if I thought like that in the past — I really can’t remember [and I’d like to think that I didn’t, but sadly, I probably did] — dealing with them so much over the past few years has definitely opened my eyes.
    I can personally attest to at least 2 major incidents that the pharmacist caught a very *bad* combination; 1 of which was prescribed by the same doctor, on the same visit…So I fully understand and respect the value of the Pharmacy profession. Just like many other jobs/careers, the customer only sees a tiny fraction of what that trained worker is doing; and if everything goes smoothly [as it actually *should* every time in an ideal world], that customer never has to, or needs to see all of the behind-the-scenes tasks that went into putting the pills in the bottle. And probably most unrecognized — are the years of knowledge, expertise, and real world experience that a Pharmacist [and most staff….or “Techs” I guess they are called?] has inside their brain.
    Like I said before, that knowledge literally saved my life on a few occasions. I don’t know exactly how bad 2 of those “catches” would have been, but I am 100% positive that at least on the first occasion, my Pharmacist’s training and wealth of in-depth knowledge about the workings of these chemicals and their interactions is the sole reason that I did not end up falling over dead later that night. And that is something that I will never forget, and I truly mean that.
    So like many things, in the end — I guess most people just don’t recognize someone or something until they have a problem with it. But when/if they do, they will be absolutely thankful that there is an educated professional with years of schooling, etc. to help. It’s just a shame that so many things go so unnoticed, and even then – it’s usually just the bad apples that come to light.
    Argh……I always type way too much, sorry guys.
    And yes this is the ANGRY Pharmacist, and I found this site by accident. I’ve stuck around because it is usually quite humorous. Yes, he [she?] can definitely be quite mean, judgmental, and rude at times; but like someone said above — I’m sure EVERY one of us could vent very similarly about the frustrations in our own lives; so I give a bit of slack :)
    And yes, I will definitely give a thank you card to the wonderful guys/gals at my pharmacy this year; if not now, surely for the holiday season. Hopefully it will at least let them know for a split second that at least 1 of their customers does truly appreciate them. If not, well, I guess it’s a $1.50 well wasted.

  39. KDUBZ says:

    IzzyRed,
    Are you completely retarded…. I mean what part of the disclaimer at the start of the post stating that this does not pertain to legitimate pain patients are you too doped up to understand? If you are indeed an honest to goodness chronic pain patient (which I am starting to doubt since this post obviously hit a nerve) then we are not talking about you. Quit popping norco, sober up and read the post for gods sakes!
    Jen,
    I am glad someone pointed out what you said in your post, I apparently missed it! I am willing to bet that as a pharmacist I am more educated than you. Thus I would ask… if I am not a professional, then what the hell are you?

  40. izzyRed says:

    KDUBZ,
    Sorry for offending your professional pride, actually no I’m not, as you obviously have none worth shedding. If you are truly a pharmacist, I feel for every single one of your customers. I’m also sorry for trying to share a bit about myself that was not exactly in-line with the original post 38 comments back.
    Jesus, is there no such thing as a discussion here? Just regurgitated insults such as the ones you posted? Perhaps that is all that is said here, sorry for assuming there was a bit more to the “professionals” such as yourself. It seems that the more rude one is here, the more “professional” he/she must be. And please don’t spew the typical “This is the ANGRY Pharmacist blog” as an excuse to constantly submit 3-line insults because everyone here MUST be ANGRY 100% of the time. Blah blah. I must be just way too high and doped up to get the humor, and be filled with false dope-hope at the possibility of ….. LISTENING to someone else’s opinion on a given subject. Once again, sorry for invading this sacred space and sharing, god forbid, my own personal experiences.

  41. http://openid.aol.com/rgregg78 says:

    IZZYRED,
    No, I’m not going to string your butt up! :) I’m just going to say that a card is a lovely idea and we love food too :)

  42. izzyRed says:

    I thought about some candy for Christmas……..I mean ‘holiday’, but these days I don’t think I’d even eat it. Ah well, they’ll get something at least :)

  43. KDUBZ says:

    Wow, how do I respond to that post….lets see. I am glad you feel for my patients, obvioulsy not enough to stop calling every hour to see if your SOMA will go through, thus not allowing me to devote to them my full attention. I’m not going to remind you of the title of the blog, you should know by now. Instead my reponse to you is this “Bad Izzyred, no early SOMA fill for you!!”

  44. rphwgreatrack says:

    I had a fake Rx phoned in for a customer last week …. I suspected that it was fake when the customer called later to ask if it was ready, I asked for his address and he said he lived on “happy” boulevard in “pleasantville” …. xD

  45. joe customer says:

    The really amazing thing is that the admin of this blog has managed to create an entire site where there is exactly one topic of discussion:
    “Like, OMG, someone wanted an early refill and it was for a sched IV drug! What, it’s a weekend and the person is an epileptic and is taking 5mg of klonopin a day and might have a seizure? HA! Screw you, drug abuser! I think people who take any form of narcotics are losers! But most importantly, I think anyone who ever wants an early refill is a loser!”
    Seriously- how many times can the angry pharmacist and his phalanx of angry commenters say “OMG early refill!!” before the topic gets old?
    At least come up with some new material.
    The most hilarious thing, though, about this blog is that your Google ads are all for “Get Free Soma Samples Now!”

  46. Bunny says:

    I stumbled on this site after googling a new allergy medication I was prescribed today to read up on it. I get so distracted when I’m surfing — one link leads to another and another and then…WTF was it I was originally searching for? LOL Anyway, I love this blog!
    Gotta tell you that with Buerger’s Disease, RA (with carpal tunnel, tennis elbow, ankle and foot problems), COPD, Diabetes, HTN, previous spine surgeries and a spinal fusion coming up, Neuropathy, Nephropathy (and probably a couple -opathies I’m forgetting), I take a LOT of medicine — probably over 20 different kinds daily. I really think the Lyrica and Cymbalta help on an overall basis every bit as much as the Kadian I take and think they ought to be mandatory for chronic pain patients. I do receive enough short-acting pain medicine (Ocksee IR*) to take one dose daily should I need it.
    *Not trying to be cute, but I saw someone use blanks for letters and thought maybe we weren’t to type the actual name of that kind of med.
    I normally have leftovers every month, but tend to go ahead and refill that one with all my others to save trips. So a few weeks ago, I’d just gotten a refill and put my leftover dozen or so doses in the new bottle. I had a lot of pain one day and was trying to get my numb, stiff fingers to work to open the bottle. Flew right out of my hand and bounced off the wall across from me, popping off the already mostly opened cap, and — I KID YOU NOT — all but 4 or landed in the cat’s LITTERBOX! Oops! LOL
    So I scoop them out and throw them away — don’t wanna have to rename Fluffy to “Nadine” (that jacked-up Cheri O’Teri character on SNL). I told my husband about it when he got home and said I hoped I didn’t hurt too much the rest of the month because I sure as hell wasn’t gonna call my dr. and report that story — even though in the ten years he’s treated me, I’ve never asked for more of a medicine or asked for it early or lost it or anything.
    I mean — “They flew outta my hand into the litterbox, doc, and I didn’t think it would be safe to take poopy/pee-pee pills” — even a patient with a perfect record would sound like a drugged-out pill freak to phone up with that kind of tale! Hubby told me I was being stupid, that the dr. knows I would never make up something for drugs. I told him I’d rather suffer than be thought of as a dopehead. And I did!
    So, thanks a fucking LOT to the real dopeheads who DO call in with the crazy-ass stories — you make it too humiliating for a bonafide blonde with bad hands to report a legitimate accident with the meds.
    And to that person going on about there not being any generic long-acting drugs — how about morphine sulfate ER (generic for ms contin, I think it is). That’s what I began on and I’m pretty sure it was inexpensive. Wouldn’t consulting with your own doctor and pharmacist rather than the blogosphere be a little more likely to help you find alternatives?
    From what I understand, it’s not good to take those short-actings for your main relief on a long-term basis. Besides, the long-acting just work much better to control it. Of course, those don’t give you a buzzed high feeling like short-acting can, either…could that be why she just can’t seem to figure it out? Sheesh.
    I feel like my short-acting isn’t working very well anymore (stupid sciatica from the herniated discs and stenosis is frickin making it hard to get anything done other than hurt, but have other-side-of-the-country relatives coming for visit next month and am trying to wait til cooler weather since I’ll be in a brace for a good while after the fusion — let’s hope third time’s a charm!). Anyyyyway…all that rambling is to get to this point: I’ve got a ways to go til the surgery and, hopefully, relief! BUT, I’m EMBARRASSED to ask for more medication or different or whatever it is I might need because I don’t want anyone to ever think of ME as some drug-seeking loser, and I resent the hell out of the assholes that make it that way for me and others who have never once abused their medicine.
    So, for anyone that takes pain medicine you don’t need (or don’t need as much of), or you insist that only one kind will work for you (that’s bullshit), or you want only short-acting, you doctor-shop, steal meds from others, lose your pills, ask for early refills, scam the system…I really can’t stand you. I’d like to ask for appropriate relief, but you make me so embarrassed to do it that I’d rather sit here totally debilitated and just hope the next time I go in, the dr. will ask me how it’s working or notice on his own that it’s not!
    I know I shouldn’t feel that way, but I do. I know I’m going to be on these types of meds the rest of my life, and I don’t ever want to give my doctor even the tiniest bit of reason not to trust me. Can’t you losers just get crack on the street or something and keep outta the whole prescription process altogether? 😛 Jackasses.

  47. izzyRed says:

    Bunny:
    Like I’ve said here a few times before to people that have found the ‘magic medicine’ combination that works for their needs (pain or otherwise); saying that a blanket-label to EVERYONE else in the world that takes something different or not what you ‘think’ they should take due to your personal experiences is well, quite ignorant to be honest.
    In the ideal world of bliss, there would be 1 pill for about 5 major illnesses/symptoms/whatever, of course only 1 pill is needed for every single person in the world suffering from say, pain, and it works exactly the same and perfect for every one of us. Of course you know I hope, that isn’t the case.
    Fast acting pain medicines do indeed have many uses in chronic pain patients depending on certain individual factors. Try to imagine someone with a respiratory problem like sleep apnea taking 24 hour pain meds which last all through the night at 100% strength. Very dangerous.
    Instead, taking short acting pain medicines during the day and lowering the dose at night makes a lot of sense and avoids a potentially fatal reaction during sleep that could occur with long acting, round the clock pain medications.
    I could name many other special cases that short acting medicines make sense for, in chronic pain patients.
    So before you blast the world for their stupidness and label them all as obvious drug abusers that should stop ruining the system and buy their crack on the street; please think about the overwhelming possibilities that just MIGHT apply to people; and that do NOT apply to you.
    Izzy

  48. Bunny says:

    Izzy, please re-read. The people I am pissed at are:
    “…anyone that takes pain medicine you don’t need (or don’t need as much of), or you insist that only one kind will work for you (that’s bullshit), or you want only short-acting, you doctor-shop, steal meds from others, lose your pills, ask for early refills, scam the system…”
    Unless that applies to you, you have no reason to be offended. And you certainly shouldn’t be offended that someone offers information it looks like you were trying to find (generic long-acting).
    I didn’t pull the information about long-acting vs. short-acting out of my ass. Hopefully, someone in the field of pain management will weigh in on this issue.
    From doctors themselves, other patients and research, time and time again I’ve read and heard that short-acting should not be used as the sole means of pain control on a long-term basis for significant chronic pain; that the patient should have a base, long-acting medication supplemented by short-acting when needed. I think most pain doctors now would also like for their patients to at least try Lyrica/Cymbalta and/or other meds, too, when they’re not contraindicated.
    No one ever said there was a one-pill-for-everyone remedy as you asserted. In fact, that’s one of the things I argued against (those who tell their doctors nothing else in the world except med-xyz will work for them). If you took the opposite from that, then I’d say you might want to reassess where the ignorance you referenced actually lies.
    There are standard practices and protocols in pain management. Within that, there is a large variety of medication to work with. One size does not fit all, obviously, and I certainly didn’t ever say that it did.
    There is always the rare exception to every medical situation. But, by and large, people who engage in what the blogger was talking about and the behaviors I listed above are not any sort of legitimate exception. They are drug seekers who make it difficult and embarrassing for people who follow the rules to speak up for themselves for fear of being viewed in the same light and not receiving appropriate treatment because of it.
    If you have links to reputable medical literature stating that it’s often better for longterm moderate-to-severe chronic pain patients to take only a short-acting med on a multi-dose-per-day basis, I’d love to read it. All I’ve read and have been told by doctors (both my own and those within our social group) indicates otherwise.
    Sometimes patients aren’t offered the options they ought to have in a pain management plan. You (the generic “you”) really have to look out for yourself by digging deeper and becoming as educated as possible, then taking what you learn, talking it over with your doctor and coming up with a comprehensive plan that might include medicine, but also might include extensive and appropriate testing, physical therapy, injections and other procedures, self-help and exercise or even surgery when it might help.
    A lot of people assume that whatever a doctor initially gives them is all there is to try and don’t advocate for better for themselves. As a result, they suffer unnecessarily.
    If you are interested in links to pain management protocols, I will be happy to provide them (here or in email, if you prefer so that we don’t clog up the comments any further). There’s so much we can learn to help ourselves, and it can make a huge difference in the success of treatment.
    You might be very pleasantly surprised at the difference that even a VERY low dose of long-acting can make in your overall comfort without any ill effects on your respiration unless your lungs are in horrible shape. I actually don’t have to “imagine” the patient with sleep apnea taking long-acting meds, Izzy — because I *am* that patient. I also have asthma and chronic bronchitis (nebulizer, whole nine yards). I stupidly allow our cats to sleep in the bedroom because I don’t have the heart to turn them away when they want to cuddle, too; even with all that, no problem whatsoever with respiratory depression.
    Doctors weigh risk/benefit factors with any medication. Someone would have to have some extremely horrible lungs for that to be the sole reason they’re precluded from taking even the lowest dose. Again, as I said, there are always a few exceptions to every generality. I think that you, however, are not very well informed, Izzy.
    There are so many options in pain management. It may take several tries and a willingness to get past initial side effects (or lack thereof when someone feels that the med isn’t working because they don’t “feel” it). I wouldn’t ever tell someone to expect a nirvana of pain relief with long-acting — it doesn’t get rid of it — but a good plan at least takes the edge off and can improve quality of life immensely.
    You sure were defensive for someone who doesn’t fit the criteria I listed in the quoted paragraph. You ended your post with an additional misrepresentation of what I said. I did not “blast the world for their stupidness [I think you meant “stupidity”] and label them all as obvious drug abusers that should stop ruining the system and buy their crack on the street.”
    You haven’t argued what was in my post at all, Izzy, but rather things that came entirely from your own head. Not that paranoia and hyper-defensiveness aren’t attractive in a red-flag sorta way, but you missed the mark totally. CLEARLY, I was referring to those who ABUSE the system as I outlined in that quoted paragraph, Izzy — DISHONEST people who ABUSE the system, not honest patients.
    Here you go, one more time: I do not appreciate addicts, recreational users and people looking to sell their meds (again, DISHONEST people who ABUSE the system), and I wish they’d get their goodies on the street instead. For that, I certainly won’t apologize!
    Regards,
    Bunny
    *I will, however, apologize to Angry Pharm for the long post. Can’t imagine I would have anything else to say on the matter and don’t plan to revisit it unless it’s to provide helpful educational links to the other commenter as offered, if she wants them.

  49. Carol says:

    Do they think you were born yesterday?

  50. Biz says:

    Seriously, people are so stupid!
    I have a pain problem and have been taking Norco on and off for about 4 years (mostly on).
    Made me laugh that I get 120 at a time.
    To all of the people that are commenting that “they aren’t addicts” I cry BULLSHIT!
    It is an opiate, and if you are taking them for an extended period of time you ARE addicted in one or more ways, at the very least you are physically addicted, try stopping suddenly (super sucky!).
    On that I think if yu are denying addiction you are not only physically addicted, you qualify as a doper too!
    So with that, I guess I fit into the dirtbags described above. It sucks, often I see the withering look from the pharmacist. (they may have dealt with a few of you above before I showed up) I look normal, I have a great job and function is society. I do not get ANY meds for free and pay a great deal of money for my crappy ass insurance, but I digress…
    I am guilty of refilling a few days too early, yep I admit it. If it is a week too early, I don’t bother to try to refill, I know the answer! Why make yourself look stupid, and make up some lame ass excuse? Hello Mr. Angry my dog ate my Norco, the spilled down the drain, I fed them to my two year old.
    For me sometimes it is because I took a few too many, more pain – same scrip for 4 years (tolerance people).
    More often than that my ex-tweaker doper dad begs them off of me. I finally started to lie and tell him I don’t get them anymore.
    I would rather my HMO fix the vertebrae that you can see sticking out with the fucking naked eye.
    I would love it if they actually looked at the part that hurts – so far they have x-rayed, poked and prodded every part of me but the part you can see and that hurts. (Off on a rant again sorry)
    Anyway I guess the moral to my Norco clouded, Phentermine fueled rant, is GET A FUCKING GRIP! They have heard it all before, you are just making yourself look stupid and making those of us who are self aware enough to realize yep – it IS addicting but serves the purpose – look bad too.
    I was wondering why my pharmacist was such a dick, now I know. I am going to make sure he gets to read this blog, and am most definately going to print out the angriest pharms answer to why it takes so long to fill a scrip.
    God I feel dirty for taking my pain meds just from reading your stupid “I’m not an addict” posts. DUMBASSES!

  51. Lea says:

    I’m with Bunny. I have had a chronic pain condition for 15 years, the last five years of which I have been using narcotic pain meds for. The last two times my back went out, I had to put up with it because of liars and scammers. The first of the last two times, my low back was out and I literally was dragging my leg across the floor, screaming with every slight move I made, just to try to get across the room. And the last time it was my neck, and it was frozen in a looking down position. I couldn’t raise it up and it was hell. If I’d gone to the ER, all I would have gotten is an anti-inflammatory shot, which does not work! How do I know? Because that’s what I got the next to the last time. It was a joke! In addition, for the year and a half that I was on Vicodin, it sucked. At first it didn’t because it helped my pain. But before long it stopped working. So then I was put on the Fentanyl patch, which worked way better than Vicodin, however I got nothing for breakthrough pain. My dumbass neurologist doesn’t even seem to know that such a thing exists. In fact when my back was out I asked if I could have a few pain pills, but he seemed to think that pain pills in conjunction with the patch would kill me! He said that I should take a Tylenol. Yeah, that’ll help when you’re dragging your leg across the floor! And now that the patch isn’t working as well (I’ve been on it for 3 and a half years) I bet he won’t change my meds to something different either! I haven’t bothered to ask because I have learned better. I also must ask this. When my husband was laid off from his job, we lost our insurance. I knew there was no way we could afford the patch on our own, so I called my doctor’s office to ask if he could give me something in place of it. I got a call back, and you know what he said? One Vicodin a day! Is it just me, or is one Vicodin a day nothing near equivalent to a 100 mg. fentanyl patch? Please let me know what you think. This guy confuses me! Maybe it’s because he’s a foreigner, maybe he doesn’t understand what I am saying? Like I said I get confused when I think of it!

  52. Timothy Ferris, MD, MPH, Associate Professor of Medicine, MGH says:

    This a very interesting blog. I was forwarded to me by one of my students. Please keep in mind the difference between additions and dependence. There are many dependent people who are being unfairly labeled, punished and injured because they are being treated as drug addicts. There are countless legitimate medical issues for which opiate medications are the only available, an often still lacking, option. I see many incoming war veterans suffering from PTSD, Head Injury, Sphenopalatine Ganglioneuralgia, Trigeminal Neuralgia (FKA, “Suicide Disease”), etc., who too, will have a tendency to suffer from increased tolerance problems, taking medication at a faster pace than desired, and lying about lost pills, vacation needs, etc.
    My experience, which is vast and well published, has been that no matter whether or it an addict, dependent, diversion agent “vector”, or other, they all end up having to use the same anecdotal excuses when they run into the same anecdotal problems. The fact is, there is no way to tell which patient is an addict or dependent, both of whom need the medication equally but with differences in the propriety in the drugs being used to help them. Addicts won’t likely benefit from opiates, especially alone, and dependents are generally using them properly (e.g., cancer, trigeminal neuralgia “suicide disease”).

    As with everything else in life and people, it takes much more to know and understand people and especially know the truth about something they are embarrassed to talk about, they hide or for which society has unfairly ridiculed for which they are ashamed to confess being a member of. Maybe, just maybe, this is an issue that needs to be addressed socially, compassionately and honestly. Many of my most productive, decent people require opiate medication. Several require amounts that many pharmacists would immediately assume my (the medical school/Pain Center’s)patients were part of this sinister deceptive pool of horrible drug seekers. However, and staying within HIPPA rules, several of these legitimate dependents on opiate medications are well know (not celebrity)highly functioning socially active and important. One of these “dependents” played a key role in keeping our country’s economy alive and without doubt millions of people employed. This “opiate dependent” individual, 12/2013 statistics have shown, was individually responsible for creating an economic model that has probably resulted in thousands of pharmacist from losing their pensions, as well as, saved billions of dollars of insurance benefits that have and will continue to pay many pharmacist salaries.
    Now I am going to likely get attacked by extremist and irrational individuals already too scared by their past experiences to clarify what they see; however, my humble opinions are:
    1) Unless you have fully examined the patient, know the patients complete history and you have made a diagnosis for a condition that you are legally and intellectually qualified to make, then DON’T ASSUME ANYTHING NEGATIVE OR DETRIMENTAL TO THE PATIENT!! No matter how many horrible lying frauds come in prior. It is not fair to them and the only guarantee will be that the unethical, immoral and evil person is the pharmacist.
    2) If they are coming in early, or showing a pattern of losing pills, etc. THEN CALL THE TREATING PHYSICIAN!!! The person who knows the patient best. The pharmacist could be the greatest savior the patient could have. Often times this occurs when the patient’s tolerance is changing and they are too afraid to say anything because they fear the false stigma (which this website is rooted in) that they are seeking more addictive drugs. Therefore, they just try to make too little fit too long. This call can help us (The patient, M.D. and Pharmacist) find a solid solution that prevents diversion temptations, doctor shopping and illegal acts that are all from a benign fear that it is dangerous to talk to your doctor about changes in opiate medications, etc).
    3) STOP LOOKING AT PATIENTS ON OPIATES AS EVIL OR SUSPECT. If opiates and Schedule II are evil, then pharmacists and prescribing M.D./D.O.’s are to carry most of the blame because we are participating. (drugs with dependency risks are not evil or bad. The evil is in ignorance, disregard for the truth and society’s false opinion and stigma). Eliminate the prejudice and stigma, and you eliminate the vast majority of the deception. Why would a patient be honest with me or a pharmacist who immediately makes it clear that we think horrible things about them and that judgment is being passed saying that they are lesser, immoral and weak? Of course they aren’t going to be honest and admit they are having problems? Who wouldn’t? The problems are really created when they stop going to the doctor or pharmacist (who are trying to help them get better) and start depending on outside sources who want them to get worse and more profitable.)

    There is so much more to so, but maybe this is enough to chew on. All the best to everyone.

    Students who referred this site to me: My grammatical mistakes and lack of proofreading does not excuse any of you from using proper grammar on exam essays.

    Timothy Ferris, MD, MPH,
    Associate Professor of Medicine,
    Harvard Medical School
    Harvard School of Public Health.

Leave a Reply

 

The Angry Pharmacist is Stephen Fry proof thanks to caching by WP Super Cache

%d bloggers like this: