The Pharmacy Chick

Flying the coup in retail

Second Class Citizens?

Filed under: Uncategorized — pharmacychick at 9:46 pm on Sunday, June 27, 2010

Recently, PC had the opportunity to have an email string with a person who had some questions about being a better pharmacy customer despite her many needs including high dose narcotics.  She felt frustrated at the treatment she received at certain pharmacies when she filled her prescriptions, and tho she said she prefers to use the same pharmacy each month, they have suffered supply issues and occasionally has to find it elsewhere.  She took pains to remind me that she uses ONE doctor for all her meds and she she has never lost/stolen/ or otherwise needs “early fills”.  Never the less, she is often treated with disdain. 

In her opinion she is doing everything by the book….ordering early enough to get the stock(but not TOO early to be inappropriate), using one doctor, being polite and know..playing by the rules that we pharmacists like our customers to play by.  And yet, she described a story where she was berated by a pharmacist as being a f’n drug addict and to get the f**k out of the store.

Wow, strong words.  All things being said, I have not met her, seen her, and my only communication as been thru email.  She could be blowing smoke..but I am not thinking so.

Pharmacy Chick has a pain clinic near by so we dispense a lot of narc’s.  Ive had my own share of scum in and out of the store.  You know the kind, the ones that leave a trail of slime as they leave the counter.  They are good at working the system to their advantage and are so good at it, they could probably teach a class.  Why the doctors dont see thru this act is beyond me.

However, I also have  a sizeable client list of people who are on high dose narcotics from a lifetime of illness or injury. Henry was in a car accident…I guess you could call it that.  He was working on a car and it fell on top of him. He was broken in a lot of places and most of them aren’t fixable.  Not that the doctors haven’t tried, but he is so full of pins and screws that his insides look like a toolbox.

Ralph lost his leg at work.   It confuses him because he takes pain meds for pain in a leg that isn’t there anymore.  I told him that his BRAIN doesn’t know the leg is gone.

Steven was a police officer shot in the line of duty. 

Tim had a kidney transplant and it didn’t go every well. He has so much scar tissue pulling on stuff he was going thru 2000 oxycodone 5 per month.  Everytime they did surgery to remove the scar tissue, more came back in its place.   Eventually he was managed on Oxycontin 80mg, twice daily.  Dunno how he managed that, but he is.

Linda has bone cancer…she is fighting it like her life depends on it…because it does.  She takes a lot of pain meds to control the suffering.  She knows she is going to lose this battle by years end likely, but she isn’t giving up.

Everybody you just met, are nice people.  They use 1 doctor.  They come to me each month for a prescription.  They  never lose it. They never have it stolen.  They never ask for early refills for suspicious reasons.  They treat their meds like blood pressure/diabetes/asthma meds, like clockwork.

If there is one thing I have learned in this life is that not all boo-boos can be fixed…and some only LOOK fixed..  If you remember in school,  there is no ceiling to narcotic doses.  You dose to pain control.  What would kill me, barely holds another. 

Its wrong to treat pain management patients as second class citizens.  Now granted, there are WAY more that deserve to have the book thrown at them when they resort to sneaky ways to get their stuff.  I’m not writing about them and I don’t go out of my way for any of them.  But I also haven’t called anybody a f’n drug addict to their face, which is inappropriate on every level.  When you wear the white coat,  you can at least hold some professionalism.

At the very least, you could be wrong about the patient..and get hauled into corporate to explain your behavior…at the very worst, you could get your butt shot off in the parking lot by somebody who took exception of your tirade.

We bloggers write frequently about drug seekers and the trash that they are…lets just remember not to paint all our patients with the same brush.


Comment by chrissie

June 27, 2010 @ 10:33 pm

I find it really helps if I know the diagnosis or story in situations like this. The guy with the brain tumor – okay. The woman a little early on her clonazepam? okay, cause i KNOW her kids have been kidnapped and yeah, i might be a bit stressed too. (yes really) The 33yo guy who gets 1800 oxycontin80 a month along with Concerta, Maxalt, Zoloft… *shrug*. Yes it’s all from one doctor, but I think it would REALLY help me understand if someone would tell me wtf is up with him.

Comment by Isabel

June 28, 2010 @ 11:56 am

I get grief for filling 30 tablets of Ritalin every 30 days from my local pharmacy. I have had the same doctor for over a year now, and use the same pharmacy for every refill. I try to be understanding, as I am a pharmacy tech for a different pharmacy (that I can’t get personal meds filled at), but sometimes I just want to switch pharmacies. It would be nice to be treated like a patient instead of a drug seeker. After over a year of filling the same prescription, the same techs and same pharmacists ask the same drug-seeking filter questions. I really do need to find a new pharmacy!

Comment by another pharmacist

June 28, 2010 @ 6:35 pm

Cannot imagine calling anyone a f***king junkie to his face. I would never be that confrontational with anyone. If the pharmacist doesn’t want to fill the prescription, he doesn’t have to. Whatever happened to “not having the item in stock.”
yea I know, but she claims that is precisely what happened. I believe she took it to management and maybe the board of pharmacy. I prefer the more gentle approach you mentioned.

Comment by Debbie

June 28, 2010 @ 8:50 pm

I’m a nurse practitioner. I agree with the point of your blog entry…that we at least owe each “patient” some basic respect. As far as your comment about docs or other providers being able to get a clue about drug abusers, I can tell you it is not always so easy! We are expected to “fix” everything, and to relieve pain. As you know, pain is a subjective experience. So sometimes the judgment call for someone’s chronic back pain isn’t that easy.
And we see a certain pattern of behaviors that differentiate those that need it and those that abuse it. And you know what, we get surprisingly few calls from providers asking US what history we have in certain patients….doctor shopping, visits to urgent care centers, pharmacy shopping….etc. Just write another script for Percocet and out the door they go… Im not slamming what you do, I’m just telling you the truth.

Comment by Phat

June 28, 2010 @ 10:44 pm

We have several patients who meet that criteria. They’re never rude, always on time and don’t appear to be the problem.

My general rule is if you’re new and show up with a bunch of narcs, you’re on my radar for a while. It takes a while to come off of it because I have dealt with some really really sneaky people, but I have never been that course.

I ran into one of our regular, and good, pain patients the other day at a store. I’ve known him for six years, he’s always been very pleasant, but always comes in with his cane looking like he is in a ton of pain. He didn’t look any different when I casually ran into him, but I didn’t expect him to. I finally asked him what happened and he told me and it was a rather tragic tale. He said that so many people abuse the drug’s he’s on that he prefers to be humble that others don’t think of him like that.

Then there’s the guy who gets his #240 Oxy filled early every time who comes in the store in the same manner… and then I see him jogging later that night as he lives on the same block as me. Funny how that works.

yea funny. we got this guy who gets 240 Percocet 10 each month..(always trying early) comes in like he is a suffering soul..what he doesn’t know is that we are members of the same health club…and I see him playing tennis..rather agressively…boy that percocet sure does a good job doesn’t it. “Hobbler to Heavy Hitter”…

Comment by Sara

June 29, 2010 @ 10:59 pm

Thank you for the statement you’ve just made here. DH and I are both migraine suffers, and for that reason we have fills for some questionable (nausea and triptan meds-rarely anything narcotic). Our pharmacy is great to us, but I know there are many migraine sufferers who’s doctors and pharmacists are very rude about their pain needs.

You don’t have to publish this, I just wanted to let you know.

Comment by Katie

June 30, 2010 @ 3:41 pm

I have become interested in topics such as this because two years ago I had to enter the chronic pain world and began putting up reg flags all over because I didn’t know the “rules” of pain management. Also, they couldn’t figure out what was wrong with me, sending me from one doctor to another, all giving me pain medicine and telling me to come back if it still hurts. I eventually found out I have Ehlers Danlos which is incurable and very painful.

I also want “PHAT” to know that I look pretty well put together. I don’t limp, I don’t use a cane, I dress nice, I’m not overweight, I fix my hair and makeup everyday. You would not think I’m in pain. I also walk 2 miles everyday, swim, I could jog, but my doctor says “no.” Ehlers Danlos is that way. I have some days I feel I could run a marathon and other days, I can’t get out of bed. However, our only chance for good pain relief is to keep our large muscles strong to keep our loose joints in place.

Comment by RN Mom

June 30, 2010 @ 5:25 pm

My daughter has chronic pain from endometriosis and is on 2 different narcotics (long acting and for breakthrough). She is very careful to keep the lines of communication open with her primary physician, does not doctor shop and uses the same pharmacy. Yet, she has been treated like a drug seeker at the ER (after she was referred by her primary for pain control from a flare), forced to put up with their rude attitude, less than professional behavior and extreme lack of knowledge regarding her condition. She even informed them that her primary physician said that they could contact him, since he was on call, so that he could verify her history and current medication. They refused.

My daughter left the ER completely distraught. Mistreated not only physically but emotionally from their attitude, she was in worse pain than when she arrived. Her physician was in complete disbelief that they had not only not contacted him, but failed to treat her adequately as he felt she likely needed to be admitted.

Yes, I recognize that there are drug seekers, but there are also patients with legitimate pain that need to be treated adequately.

Comment by Lisa

June 30, 2010 @ 8:26 pm

I wish pharmacists were able to act as health care providers instead of retailers. I’m a migraine sufferer, though I have managed it enough to only be debilitated by a few a year. I have an addictive personality and stay away from all narcotics. I asked my doctor for a non-narcotic prescription and he wrote one. One month, I was struck by migraine after migraine and had to get two refills as my doc usually only prescribes a few at a time since they are expensive. The pharmacist was horrible to me on my second trip….right in the middle of a migraine that was causing me to vomit.

If pharmacists were health care providers, they’d be able to discuss with patients what illness they suffer from, patients would have more respect for them, and they would be able to provide a patient with suggestions for other drugs that may work better. I suspect my pharmacist knows a whole lot more about drugs that my doctor as she is dealing with them everyday, but most pharmacists seem to take the retail approach: “You are here to buy a product, not consult about your health.”

I wish American pharmacies ran like pharmacies in other countries. They are called chemists, you go in and any sort of medication is behind the counter. You speak to the pharmacist about your condition and he can give Tylenol, cough meds, etc or you take in your prescription. He is a doctor, a health care provider and not at all a retailer. The only other things apart from pills to buy in the store are health related items such as face masks, toothpaste, vaseline, etc.

Comment by saddened

September 9, 2013 @ 8:50 am

Because of people who abuse the system and make health proffeaionals bitter- unfortunate situations arise. I got ill at work passed out – I went to the ER and stayed for a month – what first they thought was menengitis turned out to be a rare illness that a virus is destroying my brain at a rapid rate- by months end of my stay I have vision impairment – dementia ( at times) my heart goes into a dangerous rhythm – and at times the pain can be so bad I sleep for 30 hours- one day I will not wake up my disease is a death sentence- so I.get released go to the pharmacy with allot of meds – the women behind the counter (I have no drug history) rips them up and says ” I don’t know what game your playing but your not doing it here” being so sick I.couldn’t defend.myself – I.staggered to my car – told my boyfriend – he called my doctor – my doctor went to the pharmacy and destroyed this women – I let him tell her what was happening to me – she apologized I did not accept it – it just saddens me.what has happened

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