what happens when a Pharmacist has little/no clinical experience in a particular area nor empathy ?

Dear Pharmacist Steve

I read your article posted on the National Pain Report website because I was searching for information regarding what to do when denied pain meds. 

I would like to share our experience with you. Please note that both my husband and I are Senior citizens and he is Disabled. 

On Tuesday Dec 18, 2018 I was  informed by our Pain Management doctor that Scripts had been sent to Martin’s Pharmacy in our hometown for both of us and were to be filled that day. Over the course of the next three days multiple attempts were made and we were always told they were not yet ready.

On Thursday December 20, I received a phone call at our home. The voice did not introduce himself, rather he rudely asked who I was and I replied and asked who was calling. He said: Martin’s Pharmacy and wanted to know who James was.I told him he was  my husband. I asked for the man’s name at this point and he replied: Thomas Harsh and then began a diatribe, first stating he questioned the fact that my husband has. been prescribed  four different Controlled Dangerous Substances from not only National Spine and Pain Center, but by two other Physicians. He stated he would not fill any of these because he questioned whether each Doctor was aware of the other’s prescriptions. He also then advised me “and I’m not filling yours either.” I also have a degenerative fractious spinal condition. 

As a result my husband was without two very crucial medications that keep his pain level to about 4 at best.He was without the medications from the date the Prescription was due to be filled, Tuesday,  December  18, until the  Prescriptions were submitted to a different local Pharmacy by National Spine and Pain Management of Cumberland; they were finally filled at 6PM the evening of  December 20, 2018.

During that lax in pain management coverage, the result of Pharmacist Thomas’s refusal to fill my husband’s prescriptions was that the coverage of the medication dwindled to none and he began withdrawal, i.e.  sweating, nausea, and vast searing pain (well over ten on the pain scale) with convulsions.  

On that Thursday evening I considered calling an Ambulance to take my husband to the local Emergency Room for pain relief. My husband is personally involved at our local NewsTalk  Radio station, where he has produced  many outspoken announcements about the fear of addiction. He is fully aware of the current Opioid  Epidemic and how seriously it has  ravaged our community. Yet, for him there are no other options, having had seven Back Surgeries and metal implanted  from his lower back to his  neck, nerve damage, diabetic Neuropathy, Parkinson’s Disease etc. 

In  short, our Martin’s Pharmacist could offer no way at all to resolve this situation to restore our medications. 

This was the day before we were to leave for Christmas Vacation in the Cleveland, Ohio area, where we had prepaid  reservations Friday through the following Wednesday at Holiday Inn Express, Mentor Ohio, and tickets to various events and other family Holiday gatherings. 

Unfortunately, after three days off of Pain Meds, receiving meds only after a switch from Martin’s to another local Pharmacy,  my husband’s pain  was soaring, severe and sharp.  He was finally able to resume pain management meds late Thursday but by Friday the 21st Dec, he was in no condition to make the trip. He stayed at home in Cumberland with my sister assisting him and we paid a friend to drive me to Cleveland, as I do not drive. 

I feel my husband and I have suffered undue pain, humiliation, and financial loss, the result of the Pharmacist’s negligence. 

Certainly, as a result of our long term customer status it would have been more prudent to advise us “Mr Drake, and Ms Melotti,  I have some serious questions about your Medications and the way they are prescribed. I am filling these Prescriptions and I am giving you notice that you must provide me proof in writing from your Prescribing Physicians BEFORE I fill such again.”

I also feel notice like  this should have been done in writing, requiring our signature of acknowledgement. This would have given us a chance to speak with each Doctor and secure such information for Martin’s Pharmacy. 

We have been customers at Martin’s Store and Pharmacy for some time now; certainly long enough that a simple review of our Pharmaceutical records should have justified any immediate question of our integrity. 

In addition to this first event I then called in a refill a week later for my husband for another one of his scripts, Clonazepam.

The auto refill system said it would be ready after 7 pm that same day. The following  morning I called Martin’s  pharmacy and spoke with a woman that said it was not yet ready but that she would take care of it and that she would send me a text message when the script was ready. After receiving three text messages advising us to come pick up my husband’s meds, I went to the  pharmacy on Park St at 5:30 pm and  was then told that the script was not ready and to wait. After waiting, the Pharmacy Clerk told me  that the pharmacist had refused to fill the clonazepam.

Again, this is a medicine that me husband cannot stop ‘cold turkey.’ We were  therefore again compelled to request that my husband’s  neurologist send a new script to a different local pharmacy. The humiliation suffered at the counter this time was witnessed by two other people.

Can this Pharmacist do this? This has been a nightmare for us. We are two solid citizens of our community and feel that we have been wrongfully discriminated against. Fortunately I have managed to switch all our meds to a different pharmacy and I do feel like I am in control again of our lives but I really feel we have been wronged and would appreciate any help of information you can provide us.

Thanking you in advance,

 

9 Responses

  1. I’m sorry you’ve had this experience. Unfortunately, while you can certainly file a complsintvwith the pharmacy board- since you are long-standing customers with a history of receiving these medication ms with no problems-you certainly could suggest that this sudden, abrupt disruption, particularly without any alternative, presented a dangerous and unreasonable disruption in care. However, you are unlikely to get very far. Opiated and benzodiazepines are generally not supposed to be prescribed together outside of a hospital setting – and never ever to the elderly – it goes against the standard of care, and a pharmacist can be held just as liable for dispensing these medications as a doctor can for prescribing them. Additionally, pharmacists in nearly every state have near complete autonomy to refuse to dispense ant medication to any patient that they feel unsafe dispensing (or that they feel goes against their moral code – see a myriad of cases in which pharmacists refuse to dispense birth control or emergency contraceptives).

  2. I’m so sorry that the pharmacist ruined your holiday plans & that u had to suffer unjustly!! This is so wrong!!! I don’t know if u could call the medical board about a pharmacist (as I know people call for Drs normally), however, I probably would go ahead & try. I don’t think it would hurt. I know being disabled it’s very hard financially & or retired as well sometimes, so it’s reallt messed up that your whole entire holiday was ruined for no good reason! I am so so sorry!! I think I might also send yr letter to the big dog that owns or manages the pharmacy. This is so so wrong! It’s not like u were coming there for the 1st time! Uuuggghhhhh

  3. Disgusting!!!!
    I would check with an attorney about whether the pharmacist has some minimum requirement to contact your prescribing doctors before making a decision not to fill your scripts. Whatever the lawyer’s advice, I would at least contact the state licensing board to file a complaint about the way you were privately & publicly mistreated & disrespected by this pharmacy.
    I have never heard of the CDC making state specific guidelines, let alone requirements, on the dispensing of medications. Doing a Google search only comes up with the following: FDA ADVICE & WARNINGS on prescribing opiates & benzodiazepines together:

    5.6 Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants
    Profound sedation, respiratory depression, coma, and death may result from the concomitant use of
    ROXICODONE with benzodiazepines or other CNS depressants (e.g., non-benzodiazepine
    sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics,
    other opioids, alcohol). Because of these risks, reserve concomitant prescribing of these drugs for
    use in patients for whom alternative treatment options are inadequate.
    Observational studies have demonstrated that concomitant use of opioid analgesics and
    benzodiazepines increases the risk of drug-related mortality compared to use of opioid analgesics
    alone. Because of similar pharmacological properties, it is reasonable to expect similar risk with the
    concomitant use of other CNS depressant drugs with opioid analgesics [see Drug Interactions (7)].
    If the decision is made to prescribe a benzodiazepine or other CNS depressant concomitantly with an
    opioid analgesic, prescribe the lowest effective dosages and minimum durations of concomitant use.
    In patients already receiving an opioid analgesic, prescribe a lower initial dose of the benzodiazepine
    or other CNS depressant than indicated in the absence of an opioid, and titrate based on clinical
    response. If an opioid analgesic is initiated in a patient already taking a benzodiazepine or other CNS
    depressant, prescribe a lower initial dose of the opioid analgesic, and titrate based on clinical
    response. Follow patients closely for signs and symptoms of respiratory depression and sedation.
    Page 8 of 27
    Reference ID: 4321294
    082017-1

    Advise both patients and caregivers about the risks of respiratory depression and sedation when
    ROXICODONE is used with benzodiazepines or other CNS depressants (including alcohol and illicit
    drugs). Advise patients not to drive or operate dangerous machinery until the effects of concomitant
    use of the benzodiazepine or other CNS depressant have been determined. Screen patients for risk
    of substance use disorders, including opioid abuse and misuse, and warn them of the risk for
    overdose and death associated with the use of additional CNS depressaPersonally, I would talk to an attorney. I would think the pharmacist has some minimum requirement to contact the prescribing doctors before refusing to fill a prescription. There must be a state licensing board to who complaints can also be filed.
    Never heard that the CDC ever made individual state guidelines, let alone must follow directives on prescription drugs. As far as some law directly forbidding a patient to be on both opiates & benzodiazepines, all that’s available on Google search is the following FDA ADVICE & WARNING:

    • My pain management doctor told me they can not prescribe any benzo with any opioid. It’s either one or another. If there is an exception I can give my pain management doctor…please send it to me. I haven’t slept longer than 3 hours a night for the past year. I’ve spent $100’s of dollars a month on OTC meds and prescriptions that do not work. Severe anxiety, panic attacks, PTSD and esophageal issues and sleep issues, my pain doctor refuses my Xanax

      • He lied. Find your state laws regarding opioid prescribing. Its not illegal to rx both, only another foolish lie to crank up the hysteria.

        • The DEA observes what substance abuser/addicts do and then they applies it to everyone taking the same medications… of course the substance abuser/addict takes them all together in much larger doses that the person taking it for legit medical purposes and maybe throws
          in some other drugs – especially alcohol – and OD… the typical OD’s toxicology shows 4-7 different drugs… so the DEA has determined that there is no VALID MEDICAL NEED for those three meds or categories of meds have any valid medical use.

  4. Isn’t the pharmacy supposed to call the doctor if there’s a question or need paperwork and not the patient? Also, it’s been around for a year now that nobody is allowed a benzo with their pain meds. I think everyone I know had to quit cold turkey. Including myself. I have been told by many therapists, I need them to live a somewhat normal life and yet, nobody cares. I still can’t get them. I know Steve, you have sent me alternatives to anxiety meds but for the things I have been under my entire life, no OTC crap works. For over a year now, I still don’t sleep more than 3 hours. I often wonder what it’s like to sleep again. But anyway, I think their doctor needs to be updated on these conditions before ruining peoples lives. Maybe send her a list of the new CDC guidelines for her state? Just a thought. Going cold turkey is no fun.

    • Why not try kratom a green vein addicting be very relaxing

      • I’ve tried Kratom. Didn’t do anything for me. Except cost a lot of money. I have hypothyroidism and many medications don’t do as they are supposed to. I have a hyper sensitivity to certain medications and then allergies to others. It only gets worse the older I get.

Leave a Reply

%d bloggers like this: