when did pharmacist become judge and jury

[Midnightmarathon]

I was put on 5 mg of methadone 3 years ago by a doctor at John Hopkins. It has been a miracle for me however the stigma of being on this drug is HUGE. I have been assumed to be a drug addict by so called medical professional so many times I can’t count.
But I’ve held my head up and done what I had to. Unfortunately, during this time my chronic migraines have become so severe that Iast month I had them continuously for 22 out of the 30 days. I have been told that the methadone is not good for the migraines, so I finally got an appointment with a movement disorder specialist up here with the intention of getting off of the methadone, at least for a while.
He prescribed Valium 5 mg at night and 8mg neupro patch (which I did not tolerate. I went to 6).
This is when all hell broke loose. My insurer had made me move all my scripts from my local Rite aid to a Walmart (I did keep the methadone script at RA because the pharmacist there told me it would be a major hassle to get it form Walmart). These new pharmacists don’t know a thing about me. When I got the Valium script, I explain to one of the Walmart pharmacists that this was replacing methadone and she initially said it no problem.
But when I went to fill it the 2nd time she refused to fill it and at suddenly she had a major attitude, telling me I was on METHADONE!! My God, You street junkie. That was her attitude and it hasn’t changed.
This month when I went to fill my methadone at rite aid, they informed me that they had just converted to Walgreens and wouldn’t have license again for 4 weeks. I had to call JH, wait another week to get through to them and they sent a new script to Walmart (who knew I was on this). I called beforehand and they said they would have to order it but could fill.
But when they got it, the pharmacist refused to fill it!!! OMG!! I called and asked what the issue was, and she said, “well are you on this for drug addiction or pain?” I have told her many times why I take it. I told her once again it is for RLS and she says, “well I never heard of that before”. I said well you’re not a doctor, are you? And she hung up on me!
SOOO, bottom line – can a pharmacist can just arbitrarily do this to us??? With a script from a reputable place like john Hopkins?

Helpless in Bloomingdale

PS. I have never had a drug or alcohol issue in my life. I even drink caffeine much less alcohol at this point.

[Taco Bill]

I had the same thing happen to me with methadone, buprenorphine, and hydromorphone. The response was, "Well, I've never heard of this!" Each time at first I thought they weren't going to give them to me but luckily they eventually did. It took a lot of persuading on my part. Her attitude and second guessing the doctor pissed me off. Since then I bring in the blue book Clinical Management of RLS and the Mayo Clinic article. I had to point out that one of the authors is the one who prescribed it. Even with that it was still a pain.

[Rustsmith]

I had to move my methadone prescriptions from Walgreens to Express Scripts because of issues exactly like what you experienced, including insurance. Express Scripts hasn't questioned my prescriptions, but it is a MAJOR hassle since it takes a week for the mail to get the paper to them, they take 10 business days to process it and then another week for the delivery service to get it to me. So it is time to start a new prescription as soon as I receive one.

One suggestion would be to print off a copy of the Mayo Clinic paper on the use of opioids to treat RLS. In the pharmacists defense the lack of knowledge and not the attitude), even the CDC and the FDA were not aware of the use of opioids to treat RLS until 18 months ago. So maybe if you educate the Walmart pharmacist, you can get your prescriptions filled and also receive better treatment. Here is a link to that paper. I would highlight the line in the abstract about RLS not being a chronic pain condition.

https://www.mayoclinicproceedings.org/a ... X/fulltext

[debbluebird]

I'm so sorry this has happened to you. I've been taking Methadone since 2010. We moved in 2011. I started taking my script to Safeway. Luckly I have never had a problem. They know us by name. They know we are going to get meds filled every month. My husband takes oxycodone. The only problem I will have is if I ever move again. More than likely I will have issues.

[badnights]

Unbelievable as it may seem, it's actually legal in some states: "Six states ... have laws or regulations that allow pharmacists to refuse to dispense medication for religious or moral reasons without any obligation to the patient, such as transferring the prescription to another pharmacist or pharmacy"

A common moral complaint is with birth control prescriptions. To finish the quote:

"Eight other states explicitly require pharmacists to provide medication to patients even if there are objections, and seven others allow pharmacists to refuse but prohibit them from obstructing access to the medication....The rest...have no legislation on the matter." (from this site)

Sometimes a company can override a state law - - for example, Walgreens has a policy allowing employees to refuse to fill a prescription on moral grounds but requires them to refer the presciption to another pharmacist so that the patient's needs are met "in a timely manner", even if the state law does not require a referral.

I think this policy/law - that allows phamcists to refuse to fill a prescription on "moral" grounds - encourages pharmacists to make moral judgements about a person based on nothing but the prescription they hold and their appearance. The moral character of a person cannot be revealed by the medications they take, nor by their appearance or the sound of their voice. It is impossible to have a moral objection to the fact that someone uses a medication. There is no morality involved. The actual moral objection is to a baseless perception of what the other peron's character is like. In other words, the pharmacist thinks he's objecting to immoral actions, or upholding his beliefs, but actually he has used scant facts (the prescription, the patient's appearance) to judge the patient's moral character, and has found it wanting.

It would be different if the pharmacist objected to the medication itself - e.g. if child labor was used to make it. That would be a moral objection to the medication itself. But that's not the same as objecting to a person using the medication; such an objection always involves a moral judgement against that person.

Bodies like the American Pharmacists Association say they "support the right to refuse" but fail to recognize that pharmacists who exercise that right are refusing on the basis of prejudice, not morality. Refusing to fill or refer because a person is using a medication necessarily means the pharmacist has judged the patient's moral character without a shred of evidence.

I wonder what moral or religious objection there is to opioid use? I see nothing but judgements on perceived moral character.

The important part here:
"If a patient does encounter a pharmacist who won't fill their prescription, experts say the patient should ask for another pharmacist at the store to fill it for them, or if there isn't one, get their prescription slip back so they can have it filled elsewhere. Each state has its own board of pharmacy, which reviews complaints, if a patient feels their rights has been violated." More on complaints later from a great blog I found.

There is another reason a pharmacist can refuse to fill - if she thinks it might harm your health. "A pharmacist can refuse to fill a valid/on-time prescription for a controlled substance if doing so would harm the patient, such as when the patient is allergic to the medication, the medication would adversely interact with other medications that the patient is taking, or the prescribed dose is above the recommended dosage, although some specialists can and do prescribed above normal doses for a patient and the practice is perfectly legal." (from this wonderful blog). You should ask on what grounds your fill is being refused, moral or health? If health, the pharmacist has a duty to get clearance from your docto, which usually takes til the end of the day, but can take longer if your doctor is unavailable for some reason; if moral, then I would say she has a moral duty to refer you (ha) - no, seriously, ask for another pharmacist, and so on, as outlined above. If none of that works, more below on complaints.

Regarding out of stock medications, you shouldn't have to wait longer than a day at most places, according to one website. An exception to this is if the pharmacy is rationed - I don't know if they're still doing it, but some major drug companies were rationing the amount of opioids each pharmacy could get. It doesn't sound like that was the case with you.

Here again is a link to the blog that has instructions for filing complaints (if you're not officially disabled, you can skip the first page): https://www.drugtopics.com/blog/when-va ... re-refused. I've copied some of his ideas on how and where to file complaints that might be effective in stopping pharmacists from acting on their prejudices:

Only the patient can help rectify these issues, by filing complaints with appropriate governmental agencies. The patient does not need an attorney. Individuals can go to the websites listed below and complete a complaint form.

Boards of Pharmacy: The permit holder/store owner, the pharmacist in charge, the pharmacist who refuses to fill a prescription, and the wholesaler are all licensed by their state’s Board of Pharmacy. A complaint for unprofessional conduct can be filed against each with the appropriate Board of Pharmacy.

Medical Licensing Board: Some believe that persons who refuse to fill valid/on-time prescriptions are in essence “practicing medicine.” In that case, a complaint to the state Medical Licensing Board may be appropriate.

HIPAA: If the prescription department staff has disclosed a patient’s private health information (PHI) in a manner that someone else could overhear, the patient may be able to file a HIPAA complaint.

State Boards of Pharmacy: http://www.nabp.net/boards-of-pharmacy

ADA complaint form: http://www.hhs.gov/ocr/privacy/hipaa/co ... index.html

Medical Licensing Boards: http://www.ama-assn.org/ama/pub/educati ... medical-li censure/state-medical-boards.page?

HIPAA complaint form: http://www.hhs.gov/ocr/privacy/hipaa/co ... index.html

[ViewsAskew]

So sorry you are going through this. So wrong to put you through this.

[Midnightmarathon]

I had to move my methadone prescriptions from Walgreens to Express Scripts because of issues exactly like what you experienced, including insurance. Express Scripts hasn't questioned my prescriptions, but it is a MAJOR hassle since it takes a week for the mail to get the paper to them, they take 10 business days to process it and then another week for the delivery service to get it to me. So it is time to start a new prescription as soon as I receive one.

One suggestion would be to print off a copy of the Mayo Clinic paper on the use of opioids to treat RLS. In the pharmacists defense the lack of knowledge and not the attitude), even the CDC and the FDA were not aware of the use of opioids to treat RLS until 18 months ago. So maybe if you educate the Walmart pharmacist, you can get your prescriptions filled and also receive better treatment. Here is a link to that paper. I would highlight the line in the abstract about RLS not being a chronic pain condition.

https://www.mayoclinicproceedings.org/a ... X/fulltext

Thank you Steve. this is extremely helpful! I am going to give this to my new pharamacist.

[Midnightmarathon]

Sorry for the delay in response. I have not slept more than 4 hours a night in the last 5 nights. I am so out of it I can barely walk.

The info from the Mayo Clinic is great! I had found the Steve Ariens blog on my own a few days ago and I am in the process of filing a complaint against this pharmacist.

This is just horrible what we all are going through. I feel on the verge of a breakdown right now.

[Midnightmarathon]

thank you all for your support and the wonderful info and suggestions. I am filing a complaint against this pharmacist.