Pharmacists and Opioids

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ViewsAskew
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Pharmacists and Opioids

Post by ViewsAskew »

My insurance changed in November when we moved. Then, we chose a different plan for 2021, so it changed again. Both of these plans required I use CVS or Rite Aid. In November, the insurance denied coverage of my monthly methadone prescription, saying they would cover a 7 day script instead. The pharmacist said they often do that with new prescriptions - but he noted that he could see I'd had it in 2017 at CVS. I said to forget it, that I'd pay for it out of pocket. And I did - that month and the next.

This month, I had the doc's office call in the script to CVS - this was new insurance. Was hoping all would work out fine. Except here I am writing this, so you can guess that is not what happened.

I contacted the doc's office on Friday afternoon to request the script. On Monday, I received a text from CVS saying that the ME script was pending insurance approval. A bit later, I received a text asking to text OK to accept a 3 months supply. That seemed odd - and I am still not sure WHICH medication this referred to as no medication name was in the text, but the only script that I had requested that week was the methadone (I had filled others a week or so prior).

Today, Wednesday, I had still heard nothing. My last script was filled on 1/7, so a 30 day supply would run out on Friday, 2/6. Because it is a controlled substance, you cannot fill them early, so when you fill them, you require them immediately to avoid withdrawal or issues. By today, the script was five days late. Thankfully, as most of us do, I had a small stash to tide me over in such circumstances. But, as with most of us, I didn't want to use it! It is for emergencies, not because the pharmacy doesn't fill it.

We walked the dog tonight and went to the pharmacy. Hubby stayed outside with the dog while I went in. When I went in, the person at the pharmacy told me the insurance denied covering it and the doctor's office had been contacted to provide additional information. Of course, no one told ME about this. Given that opioids almost always create dependence, this is a TERRIBLE policy in my eyes.

I told the staff person to fill it anyway and I'd pay for it out of pocket. He sent me to a different window (I was at the pickup area and had to go to drop off). A different person put the info in the computer and I left the store. A market is next door so hubby and I walked over there - he went in and bought a few things while I waited outside with the dog. We went back about 20 minutes later.

They said they had been calling my name - oh, I thought, Great! It must be ready! Except the pharmacist came over and started asking questions. Essentially, she said that she refused to fill it until she could talk to him and ensure that this was the best prescription for me. She even went so far as to say she might require I see a pain specialist for alternatives. She clearly doesn't understand anything about opioids and RLS. I had said that Dr. B had written books about it, was considered an expert, etc. She just looked skeptical.*

I was NOT happy. And, I pretty much let her know that. I told her she was not my physician and she had NO right to interfere in this (actually, she is sort of in the middle as many states now have made pharmacists go through a checklist before filling opioid scripts). I asked her why I wasn't informed of this - they'd had the script for days. I also told her that she was going to be responsible for me being extremely sick when I went through withdrawal. She seemed surprised that I didn't have any left - duh! You cannot fill the scripts early and it was five days after the script was due.

In the end, she agreed to fill it but said that if I wanted to use this pharmacy, I would have to have her talk to the doctor (as if I could prevent that). I stood at the consultation window while she went to fill it. She looked over at me after a few minutes and told me to go sit down - being contrary at this point, I said I was fine and would stay right there. She said it would be fifteen minutes. Whatever.

I asked one of the techs for a sheet of paper and a pen. I used my phone to identify the books Dr. B had written, find a few papers he published, and even identify his history - he started a sleep center in 1983 because as a pulmonologist, he saw a lot of people with apnea. He was certified as a fellow in sleep medicine in1982. His interest in RLS/WED started in 1993. I included his stint as medical advisor for the RLS Foundation from 199? to 2005. Then I included the title of the Trenkwalter study about opioids from 2014 as well as a written response from Dr. Earley about opioids and RLS/WED.

I left with the script - so crisis averted for another 30 days. The next will be that since I moved, I have to get a new primary care doc and the doc is in a different group that Dr. B, so it's possible that I will have to pay out of pocket to see him. I haven't figured that out quite yet. Idiotic US insurance rules.

*What is it about pharmacists who refuse to use Google or another search engine? All she had to do was to put in his name and she'd have found ALL of that on her own in about 30 seconds.
Ann - Take what you need, leave the rest

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Polar Bear
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Re: Pharmacists and Opioids

Post by Polar Bear »

Ann, what a frustrating, upsetting and infuriating situation. Sometimes pharmacists take too much on. I can't understand them questioning the decisions and prescription of your doctor. It distant happen here as far as I know. It means you have to battle with the doctor and then still not be sure of getting your medication if the pharmacist decided to question.
I can just imagine having convinced the doctor and got his agreement and then walking to the pharmacist in trepidation.
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
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ViewsAskew
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Re: Pharmacists and Opioids

Post by ViewsAskew »

Polar Bear wrote:
Thu Feb 11, 2021 8:50 pm
Ann, what a frustrating, upsetting and infuriating situation. Sometimes pharmacists take too much on. I can't understand them questioning the decisions and prescription of your doctor. It distant happen here as far as I know. It means you have to battle with the doctor and then still not be sure of getting your medication if the pharmacist decided to question.
I can just imagine having convinced the doctor and got his agreement and then walking to the pharmacist in trepidation.
It was all of the above, PB. She basically said that if I wanted to get this script at this location, I had to do what she wanted. And, honestly, I don't care so much because Dr. B will tell her, but she didn't even ask if I was out of meds, could go through withdrawal, etc. they'd had the script for 5 days - since you cannot fill early or have extra, that should have been her first question then to say, Hey, tell me more and I will work with your doc.
Ann - Take what you need, leave the rest

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debbluebird
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Re: Pharmacists and Opioids

Post by debbluebird »

Oh wow. I'm so sorry you are having to go through this. I have been lucky. I found a pain Doctor and a pharmacy. I am so looking forward to weaning off of methadone for that very reason. Having to fight with Doctors and pharmacies.

Rustsmith
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Re: Pharmacists and Opioids

Post by Rustsmith »

Ann, I suspect that some of that has to do with CVS's draconian corporate policies for dispensing opioids. This is the sort of thing that we get with corporate bureaucrats and politicians start telling doctors and pharmacists how to do their business. I suppose that it is like any other position, if you don't care about your customers or patients, then you simply follow the rules and don't wander one millimeter outside the guidelines and also don't exercise any compassion if it runs contrary to those rules.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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Yankiwi
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Re: Pharmacists and Opioids

Post by Yankiwi »

That is so bad—punishing you for having a condition that can be controlled with medication they don't like!

ViewsAskew
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Re: Pharmacists and Opioids

Post by ViewsAskew »

Rustsmith wrote:
Fri Feb 12, 2021 11:14 pm
Ann, I suspect that some of that has to do with CVS's draconian corporate policies for dispensing opioids. This is the sort of thing that we get with corporate bureaucrats and politicians start telling doctors and pharmacists how to do their business. I suppose that it is like any other position, if you don't care about your customers or patients, then you simply follow the rules and don't wander one millimeter outside the guidelines and also don't exercise any compassion if it runs contrary to those rules.
So many issues with our current medical system.

My insurance requires I use CVS or Rite Aid. There may be one other - I need to look. No idea what it's like to work with Rite Aid.
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.

ViewsAskew
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Re: Pharmacists and Opioids

Post by ViewsAskew »

Yankiwi wrote:
Sat Feb 13, 2021 7:00 am
That is so bad—punishing you for having a condition that can be controlled with medication they don't like!
One of the worst parts - to me - was that she didn't do ANY research herself and just decided it wasn't OK. It says right on the script who the doc is and what it is for. Two minutes on the internet and she'd have seen who my doctor was and how RLS is treated with opioids. The only thing she did OK was agree to fill it once I said I had no more (another thing she should have known) and would go through withdrawal.

My husband and I have talked of moving to another country when we retire...except how could we? I cannot imagine going through this in another country especially if English wasn't spoken as a secondary language!
Ann - Take what you need, leave the rest

Managing Your RLS

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Yankiwi
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Re: Pharmacists and Opioids

Post by Yankiwi »

And if the other country has socialised medicine you would likely come against other road blocks. No system is perfect.
Also, at least in New Zealand you need to be under a certain age and retirement age isn't it.

ViewsAskew
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Re: Pharmacists and Opioids

Post by ViewsAskew »

Yankiwi wrote:
Sun Feb 14, 2021 5:55 am
And if the other country has socialised medicine you would likely come against other road blocks. No system is perfect.
Also, at least in New Zealand you need to be under a certain age and retirement age isn't it.
I have a friend who wanted to buy a farm in NZ - they were rapidly approaching the age limit :-). For now, we are definitely staying put.
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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