Methadone complications - not medical

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Rustsmith
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Re: Methadone complications - not medical

Post by Rustsmith »

While I was on vacation, one of the other members of our group was a pharmacist with Walgreens in the neighboring town. She said that the a DEA audit found that the biggest abusers of prescription drugs were located in Florida, where apparently the doctors at pain clinics will write for just about anyone. So the pushers hire the homeless, teach them what to say and then send them to the clinics. The doctor writes a script and the pushers are able to get them filled. The markup between medicaid/medicare cost for narcotics and the street value is huge.

Unfortunately, the DEA study found that the worst abuse outside of Florida is the town where I live. She explained that company policy allows them to refuse to fill prescriptions if they do not know the doctor and the individual is getting regular prescriptions (as opposed to one offs for surgery, injury, etc). Everything is in the state database, including what pharmacies you have gone to trying to get your prescription filled. If they see someone "shopping" the prescription and routinely being refused, that is also grounds for refusal.

So, I am left without the ability to get my prescriptions filled locally. That makes it imperative that I plan ahead, keep a stash and get my prescriptions filled by mail order.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Methadone complications - not medical

Post by ViewsAskew »

What "luck", Steve.

I have a stash - I've carefully built it over ten years. One time I had to use it and was SO happy I had it.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

QyX

Re: Methadone complications - not medical

Post by QyX »

I really don't know what to say.

Sometimes, like 2 or 3 times I had trouble filling a prescription but this was just because the manufacturer took the drug of the market. I had a script for a very specific 24 hours extended release pill and the pharmacy can't just change the script and give me regular extended release pills. So I had to go back to my doctor and get a new script but I live in Berlin!

Unfortunately I live in the north east part of the town and my doctor is located in the south west but I almost have a direct subway line and only 100m to walk to my local pharmacy. Also I still live in the city part of Berlin so there are literally hundreds of pharmacies on my way were I could fill the prescription.

When I phone the pharmacy (any pharmacy, not just Berlin!) before lunch time (12 a.m. I think??) I can pickup my narcotics around 4 p.m.

Bigger pharmacies also have late evening deliveries so I could call around 4 p.m. and get my drugs around 8 p.m.

It never ever takes more then half a day to get a prescription filled.

The only problem is that pharmacies almost never have opioids on stock because there are just so many companies and packet sizes and narcotics need to be stored in a safe.

So there are around 10 - 20 companies who produce regular Morphine extended pills. And every company produces packet sizes with 20 (N1), 50 (N2) and 100 (N3) pills. And we have that for Oxycodone, Hydromorphone etc. too. And it depends on your insurance which manufacturer you get although it doesn't really make a difference. But waiting half a day is no problem. Every pharmacy offers home delivery.

What they have on stock are smaller sizes (N1) or (N2) from the most common used companies to fill emergency prescriptions and injectable solutions for emergencies like when a cancer pain patient has severe pain at midnight, calls a doctor then every pharmacy is able to supply him with injectable morphine. It is the law here.

My doctor only writes scripts for N3 packages with 100 pills. The insurance companies say that doctors should prescribe N3 packages if possible for patients with chronic disorders because they are cheaper then 2 x N2 packages with 50 pills.

I also quite regularly fill scripts for Methylphenidat. At least Ritalin is something big pharmacies almost always have on stock although it is regulated under the narcotic law and needs to be stored in a safe together with Methadone, Morphine etc. . Seems to be very common.

The situation in the U.S. really scares me. I just hope doctors in Germany never start overprescribing opioids like it happened in the U.S.

2015 we had around 200 more deaths (2214 total) by overdose then in 2014. The death toll includes death from cocaine, too. It refers to all narcotic drug users.

QyX

Re: Methadone complications - not medical

Post by QyX »

ViewsAskew wrote:What "luck", Steve.

I have a stash - I've carefully built it over ten years. One time I had to use it and was SO happy I had it.


I am just curious. How big is your stash?

I ask for a new script when I have one week of Morphine pills left. I come pickup the script the next 1-2 days and then it takes the pharmacy another half day to fill the script.

Some regular extended Hydromorphone tablets are lying around in my bedside cabinet. Probably enough to avoid withdraw for 3-4 days but I've a litte Hydromorphone tolerance so no matter how much I take I still have so many RLS symptoms that I can't sleep at night.

Okay I had this little Oxycodone stash for emergencies when Morphine wasn't working right but now all Oxy gone. But I told my doctor about it, that I had some Oxys left from Januar when I had some problems with Morphine and how I did use them. So it was no problem getting another 50 30 mg pills.

And I also do have these Hydromorphone 24 hour tablets. When I have no more Morphine I still would have around 40 Hydromorphone 24 hours pills because I need a new Morphine script after 65 days but Hydromorphone only after 95 days.

So I could survive on a combination of Hydromorphone and Oxycodone until I have new Morphine.

Hm, when I think about it ... I arranged it all pretty well.

I do know other patients ... well from discussion boards and they only get a script for 2 weeks and every pill is counted. I think they count my stuff too but they have a tolerance. So when they know my Morphine should last 70 days they don't care if I ask for a new script after 60 days because they see it as normal not to wait until you have swallowed your last pill but I heard that some doctors can be like that.

Also my doctor shares an office with 3 other doctors. They have many patients with severe neurological disorders. They can't think about abuse and addiction and they would never treat any patient with such history. They have to trust their patients and so better you don't give them any reason not to trust you. I would have severe problems if they would start to think that I'm abusing, selling or misusing narcotics in any way.

I also do have some leeway. My doctor knows that I always was a bit experimenting and adjusting the dose to my needs. She knows about my extreme history with over 50 different drugs and that I much likely know what is best for me at a specific moment. So she is more like a supervisor and as long as I don't step over her boundaries, I'm fine.

So happy me.

Though still my old doctor was much more fun ... doing all this drug experiments. My health was horrible back then but this experiments were still interesting. Now it is all boring me.

Sorry for going off topic so much but keeping a stash is normally not allowed. Not even in Germany. It kind of triggered some thoughts...

Rustsmith
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Re: Methadone complications - not medical

Post by Rustsmith »

Qyx, that is a question that I am not willing to answer - even with the anonymity of this board. We are not supposed to have more pills that the remainder of the current 30 day prescription because the government fears that we will sell them on the street. However, because of the current regulatory system for dispensing medications that the government feels must be highly regulated (which includes your Ritalin as well), it can take as much as 21 days to fill a prescription that can only be written for 30 days of pills. Without a stash, there is a very high probability of running into the type of problem that Views described earlier in this thread. For "normal" meds, running out for a couple of days wouldn't be a major problem. However, for DAs and opiates, running out of medicine for even a day isn't something that I even want to think about.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

QyX

Re: Methadone complications - not medical

Post by QyX »

21 days??? What when a patient really really needs his medication because there is some kind of emergency or he / she is travelling in 10 days to Europe?

You really need to plan ahead.

yawny
Posts: 264
Joined: Sun Nov 08, 2015 4:20 pm

Stashes

Post by yawny »

A bit off topic, but speaking of stashes and the fear of running out of medication...there has been an increase of home burglaries in my neighborhood (double from last year) and it made me realize that my medication would be very expensive and time consuming to replace after a theft. I mainly use medical marijuana and sometimes benzos. So I purchased a hotel style security safe off of Amazon.com and screw mounted it on the wall of my bedroom closet. That is where I keep my stash now.

Rustsmith
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Joined: Sat Sep 28, 2013 9:31 pm
Location: Colorado Springs, Colorado

Re: Methadone complications - not medical

Post by Rustsmith »

Yawny, when I did an internet search on the street price of methadone, I immediately got up and moved my stash into my safe. I keep a supply that is good for a few number of days out with the rest of my medicine and the rest stays locked up. The last thing that I need is for someone to break in and steal my supply.

Qyx, narcotic prescriptions in the US must be transmitted on paper and can only be for a 30 day supply. My doctor is 160km away (each way) so my prescriptions must be mailed, so that takes about 3 business days from when I request a refill. Since no local pharmacy will fill the prescriptions, I have to mail the paper script to my mail order pharmacy - another 3 business days. They process it, which takes another 3 business days and then mail it to me - 3 more. Since the package must be signed for and I live in a condo, the mail person must leave a note in my mailbox so that I can then go to the central post office the following day to pick up my package. The only thing that I can think to do if something happens and I run out will be to go to the hospital emergency room suffering from withdrawal pains and HOPE that they will give me a few pills to hold me over until I can get my normal supply.

As for travel, yes that takes a lot of planning ahead. I have a 3 week vacation coming up next year and will have to plan far enough ahead to have a large enough supply for before, during and after the trip.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
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Re: Methadone complications - not medical

Post by ViewsAskew »

You know, a safe is a great idea.

As Steve said, I'm not wiling to share either. It angers me that I have to have it and that by having it, I could be in trouble. That said, I highly suggest everyone find a way to have one and make it as big as you need it should you run out in any situation - traveling, change in doctors, etc.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

yawny
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Joined: Sun Nov 08, 2015 4:20 pm

Re: Methadone complications - not medical

Post by yawny »

And natural disasters...I live in earthquake territory and it dawned on me several years ago that the aftermath of an earthquake could prevent me from getting my thyroid medication filled so I asked my doctor for an extra 30 days for this reason and he refused. My husband then ordered some on the internet from a pharmacy in India. I have no intention of using the meds but if I'm desperate I'll have to. This feeling of lack of control over my own health is very frustrating, and anxiety causing.

ViewsAskew
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Re: Methadone complications - not medical

Post by ViewsAskew »

Yawny - terribly frustrating, isn't it? I get that doctors can't truly know our intentions, but...
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Yankiwi
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Location: West Coast, South Island, New Zealand

Re: Methadone complications - not medical

Post by Yankiwi »

I, too, take thyroid medication and live in earthquake country. A 30 day supply is a good idea and my doctor would do it.
As far as opiods go, thieves could be anywhere. My husband was on large doses of oxycodone and oxynorm for quite a few months. When picking up a script the pharmacist normally asks for a street address but with those they just pointed to what was on the script and asked if it was right. They didn't want to risk the wrong person overhearing the address in relation to the drug.
Very sadly, my husband no longer needs the drugs. He took his last breath on December 10.

Rustsmith
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Re: Methadone complications - not medical

Post by Rustsmith »

Yankiwi, my most sincere condolences. I know that you have been through quite a lot recently (outside of RLS) so I fervently hope that things start looking up for you from this point forward.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Yankiwi
Posts: 548
Joined: Wed Sep 10, 2014 7:20 am
Location: West Coast, South Island, New Zealand

Re: Methadone complications - not medical

Post by Yankiwi »

Thank you, Steve. I'm sure there will with a few bumps along the way but things will be looking up. We were both optimists so there's no reason to stop now. My husband went down in 172 days from first visit to the doctor to his final breath which came very quickly after only about a day in a coma but with very vigorous breathing until it stopped completely. It's been a wild few days since December 10 with the funeral yesterday. They say cancer is a word not a sentence but in his case is was a sentence with undifferentiated metastasized cancer. His radiation oncologist said his time would be measured in months not years and he was right. Radiation didn't work nor did chemotherapy but his will to live was so strong he was willing to endure terrible pain just in case he could get better for even a while. He was a real trooper and my hero.

ViewsAskew
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Re: Methadone complications - not medical

Post by ViewsAskew »

Yankiwi - my condolences. He sounds like he was a wonderful man. You must miss him tremendously.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

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