Why don’t we really care?

Yesterday, I was called in to temp at a big box store. About one-half hour before closing, a 30 something male shows up with two Rxs .. one for Xanax #90 1mg tid and # 120 HDC/APAP 10/500 QID…

Since I had only been at this particular store for a total of three days over the past two weeks… I have to ask “have you had Rxs filled here before”.. his answer was NO..  Do you have a “drug card” .. NO.. it is cash..

Let’s see.. after the prescriber has left for the day.. two controlled substances… relative high doses… CASH sale.. first time patient at this store …. RED FLAG !!!

So, I have my own personal login to the KY PMP ( KASPER).. so after logging in, inputting the necessary data points about this patient.. I got back a report.. within seconds..

This fellow got a 30 days supply 17 days before had a whole page over the last year for these two drugs mostly from the same doctor but had increasing been going to different stores to get each filled.. all showing above directed consumption of the HCD/APAP… apparently none of my colleagues have bothered to run a KASPER report on this fellow.. even though.. we would – or should have – thrown as many RED FLAGS  to me.. or maybe I was just paying attention.

The fact that he was using the same driver’s license… would suggest that he is either a legit patient or too stupid to know that all of these controlled substances are being tracked by the state.

Personally, I don’t have a problem with a pt who needs 70 mg of  HCD a day to manage pain.. I do have a concern about all the APAP that he is consuming and also a concern that the prescriber is not being honest with us.. writing and rewriting Rxs with inaccurate days supply and directions.

I called this gentleman over to the consultation area – with the KASPER report in hand – and said that it showed that he was 12+ days early on the HCD/APAP early per the state’s records and I could not – in good conscience – fill the Rx for that product today… however, the Xanax 1mg had been 30+ days ago.. and I would be happy to fill that one.

Hey folks.. we need to get our act together… you know what RED FLAGS are when you see them… if you don’t have access to your state’s PMP.. 40+ states have a active one. You need to get registered with the PMP AND USE IT!

You think that the METRICS that corporate shoves down your throat are draconian.. just wait until the DEA decides that they know best and impose more draconian metrics for you to deal with concerning controlled substances… For those of you who have not been paying attention.. right now… there is a good possibility that ALL HCD products are going to be moved to C-II… that moved has worked so well for slowing down the diversion of Oxycodone and Opana and the like…

IMO.. this is another example … if you are not part of the solution… YOU ARE PART OF THE PROBLEM !

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