"We've been through this ma'am. I can't refill your Vicodin early. Handing out a 30 day's supply of Vicodin every 15 days is a good way to lose my license"
I've found that's the best way to phrase these conversations. It depersonalizes the problem. It also happens to be the truth. I really don't give a rats ass on a personal level if you take handfuls of Vicodin until your liver catches fire, just don't put my license at risk.
"I've been taking more than I should I know, but it doesn't seem to help."
"Then you really need to talk to your doctor about this ma'am. Maybe he'll want to try a different medicine for you, but the rate you've been going through the Vicodin can be hard on a person's liver, you can't keep this up"
"I see, well can I have this one filled then?" She then hands me a vial from another corpo-pharmacy chain.
"Sure. I'll have to give them a cal......." Then I see the med she wanted transferred. Naltrexone. For those of you in the profession that's all I need to say. For the rest of you read on:
The woman was a recovering alcoholic. She was given a prescription for Naltrexone from her treatment program to reduce her cravings for booze. Naltrexone also is an opioid antagonist. The woman's regular doctor had given her a prescription for Vicodin, an opioid, to treat pain. One doctor had given her a prescription that kept the other from working. Neither doctor knew what the other was doing. Neither corpo-pharmacy chain knew what the other had dispensed for her.
I straightened out the whole sorry-ass situation and the woman is more than likely pain free tonight. In pharmacy school, they tell you this is the type of thing you'll be doing all the time. If by "all the time" they mean "once a year, in a good year" then they would be right. Damn good thing too, as dusting off my DUR chops meant I was a good hour behind getting anyone else's pills out the door for the rest of the night.
One happy customer resulting in dozens more screaming "Why does it take so long!!??" That's why I will never take Naltrexone or anything else that reduces my craving for scotch as long as I live.
6 comments:
Yay, I'm not alone!
Maybe one day all my procrastinating and wasting time online will come to fruition and I'll blog too. Not. ;) You can just do it for me!
-vancouverlori
Well, you may hate some of us, but this story is story is why most of us love you.
We have a local pharmacist (owns his own drug store, not a chain) in a small town who works these kinds of small miracles on a regular basis.
We're covered by Tricare, and DOD wants to force all beneficiaries to obtain prescriptions through mail order. A big no thank-you to that...I want to talk to my pharmacist face-to-face and will gladly pay the higher co-pay to do so.
Thanks for all you do. I know you say you hate us, but I think you care.....you really, sniff, care!
Heh, naltrexone. That shit rules.
I've always though it would be a good idea to crystalize some Narcan and pass it off as heroin. Think of the laughs you could get by some junkee shooting up a syringefull of Narcan thinking it was smack!
Eh, it wouldnt kill them, just make them really unhappy for a while. :)
Quote from Sassenach:
Thanks for all you do. I know you say you hate us, but I think you care.....you really, sniff, care!
I agree. The DrugMonkey does care very much, and that makes such a difference to all of us.
I've learned more about drug uses and interactions, med safety, all the ins and outs of drug advertising, all the tricks played by addicts, and all other people's strange habits from the DrugMonkey than from any other place on the internet.
And probably more info than I care to know about other things like politics. But that's fine. I'm getting educated thanks to the DrugMonkey!
Thank you.
hahaha! That was funny. Thanks for dumbing it down for those of us who are not in the Pharma-industry.
It's not any better in the hospital, unfortunately. My favorite case was the 85 lb opioid-naive 90 y/o patient started on Duragesic 50 mcg/hr. Breakthrough med? You guessed it. (How that even got verified I can not begin to guess.)
One week after they stopped the PRN dosing, her respiratory rate dropped to 6 breaths/min and they had to reverse her with Narcan and transfer to ICU. No one could figure out what went wrong. I swear I wanted to jump out the window after I got called onto that case.
Love your blog, as always!
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