RPh to pt: your penalty for filling your opiates 2 days early every month – 9 days of cold turkey withdrawal

Hey Steve, 
I want to say thank you for you feed back. It was greatly appreciated l, but also was quite helpful! 🙂 
I did take your suggestion. I’ve reached out the VP of Publix, Dain Rusk. I wrote a lengthy email. (I even wrote that I’ve contacted the National Pain Report; a former Reputable pharmacist (you)  and to intimidate them a bit. 
So, I emailed them last night. 
This morning before my husband was about to start his work shift, he got a call from Robert Mark (I think hes a supervisor of Publix pharmacy) located in Lakeland, Fl. 
He spoke to my husband and said she had have asked you if you were out of your meds. I had a talk to with her. And he was apologetic. My husband went to tell him about his medical issues (previous motor cycle accidents)  ultimately, he said they should be working on it, and will have it ready for you. 
I cant thank you enough for your feedback and moral support on this matter. It changes lives for the greater good. People shouldnt abuse power. Clearly, that’s what that female pharmacist was trying to do.
So thank you again, Steve. 🙂 you are making the difference 
Warmest Regards,

This has got to be one of more bizarre emails that I have received over the years…  I am not going to call out this fairly large  (1250 stores) privately owned grocery store chain that is almost exclusively in the south eastern part of our country. I would think that if the VP of pharmacy services for this chain knew what this female pharmacist is doing to pts… 

This is a chronic pain pts that has been able to continue to work, but now since this pharmacist decided to “correct” the “extra” doses that this pt had filled at another one of their pharmacies and has told the pt that he needs to be in COLD TURKEY WITHDRAWAL FOR AT LEAST 9 DAYS.

Even if/when he gets his opiates back.. it is probably going to take several days for him to regain his pain management and stability back to  his life. Ignore the physical issues that he may go thru … up to and including death… here is about 10 working days that he is probably going to lose  not going to work… THAT IS FINANCIAL DAMAGE.  If he doesn’t get fired for not being at work for two weeks or being there and not really getting much work done.  FINANCIAL DAMAGES is what law firms focus on… when suing someone.

I am sure that this pharmacist will defend her position that NO ONE CAN FORCE A PHARMACIST TO FILL A PRESCRIPTION… which I will defend… however… we have a very serious and growing pharmacist surplus and I am not sure if the state that this pharmacy is in a “right to work” state which basically means that you can be fired for just about any reason.. included to the boss doesn’t like the color of your hair or eyes and many other very nebulous reasons.

I gave this pt a link to find a independent pharmacy as well as a link to all the pharmacy boards…since I don’t know which state they are talking about and I was able to find a new article with the name of the VP of pharmacy services for this privately owned grocery store chain.

 

Hi Steve, 

I read some of your blogs and see you’re a seasoned retired pharmacist. I have a question for you that you may be able to answer: 
My husband has been on pain meds that manage his broken back for several years. He also has a total left hip replacement . He has been going to the same doctor, along with the same pharmacist for a length of time. He is prescribed a opiate . Has been on the same med for years,  no changes. 
We recently purchased a home to be closer to work. Were both work as small business bankers.
He filled his rx last month to the new pharmacy that’s closer to home( same corporation to previous) our local  grocery store.  
FF to this month…
He filled his Rx this month. 2 days early, to implement his schedule, as his schedule can vary. By the time he dropped off his rx,  he came home to get a phone call from the pharmacist saying, ‘She cant fill his rx 2 days soon because the “State wont permit.” That he fills his rx 2 days early every month, and because of that….he “has to wait until the 17th of the month to fill it. (9 days out) and after that, he can then fill it 2 days early, going forward.”
That means my husband would be out of his prescription for over a week?!
That’s so bizarre!!
 Is this legal? 
 My husband is not confrontational, so he   agreed, clearly. Pharmacist said she’ll put   it in the system to be filled on the 17th.
 I find there to be some unusual behavior, as I’ve done alot of digging, and research, and never in my years have I heard anyone say that to me, him, or anyone! I cant even find anything relative on the interwebs  stating a pharmacist can delay your rx over a week out from the actual due date, due to previous early fills. (2 days) which is perfectly valid, other wise, no pharmacist would have ever filled it! Or they would have at least expressed that to him!
Please let me know what you think. I’d love to hear your feedback. 
Warm Regards 

4 Responses

  1. If my Rx is written say for the 2nd of the month and I drop it off but don’t pick it up till the 3rd my next script can’t be filled until the 3rd of next month even though the rx says 2nd. The pharmacy goes by pickup date by the patient. If you can wait till the next day you don’t need the meds. My Rx fill date has been moved back several times do to the pharmacy being out of the drug. Why would a pharmacy ever run out of pain meds when there are long term pain patients coming in every month?

    • Educated guess as to why this is… is because a pt gives a tech a new Rxs or one sent in electronically and they processed the Rx… and it is sent to the PDMP.. and then the pharmacist – for some reason good-bad-ugly- lie – they don’t want to fill it… and while the Rx was reversed in the pharmacy computer system.. there was no easy way – or any way – for that submission sent to the PDMP to be reversed… so the pt takes their Rxs to a different pharmacy and gets it filled…and some point in the future… some bureaucrat or next time a pharmacist pulls a PDMP report on the pt .. it will show that the pt got the same controlled substance Rx – from the same doctor – on the same day and had it filled at two different pharmacies. It is unlikely that whoever runs into this will try to spend their “valuable time” tracking down the truth.. they will just believe that the PDMP is the truth and act accordingly… the pt could be kicked out of their prescriber’s practice… black balled at a pharmacy or pharmacy chain…and on and on … The chains don’t want any “unnecessary inventory dollars ” sitting on their shelf. A PIC (pharmacist in charge) job I had about 10+ yrs ago… the typical pharmacy back then turned their inventory 12 times a year. I was told on being hired that they expected 24 turns a year. This was a brand new in house pharmacy for a very large out pt mental health facility… within 6 months of being open… my turns were in the mid 30’s. and volume was growing 20%-30% month to month. After 6 months… those monthly growth $$$ were getting real serious. At 24 turns they expected me to buy/sell the value of the inventory every 15 days… I was buying/selling the value of the inventory every TEN DAYS….but they got fixated on the fact that my inventory value was above a particular $$ figure. Never mind that I exceeded the inventory turns by 50% as what they told me they wanted me to meet. meaning that their ROI (return on investment) was 50% greater than they considered a minimum and they expected TWICE the industry standard. Most pharmacist would have walked away from the job when they were told that they had to do 24 turns a year – twice in the industry norm… They never said it, but I think that they wanted me to get the Rx order from the prescriber/pt… then order the med from the wholesaler and mail the med to the pt… meaning that pt may have to wait a few days before they started their medications/therapy. This was unacceptable to me…. and was not in the best interest of the pt. I had sold my independent pharmacy about 10 yrs before and had spent that 10 years for me and Barb to travel around the country in one of two different motor homes and putting some 70K-80K miles on them and was in every lower 48 states. I had got bored/restless and this job peaked my interest…. so I took it.. at the time there was a serious SHORTAGE of Pharmacist claimed to be 6000 empty pharmacist job slots with no one to fill them. I did not need neither the job nor the salary… but… presented me a interesting challenge.. before the first year was up… it became apparent that the company could care less about bending/breaking some/many laws … some that I believe could have a adverse impact on my license and my reputation. So we parted ways. I then connected with a temp service that staffed long term care pharmacies – that serviced nursing homes… and worked as a independent contractor. I worked for that company for some 5-6 yrs and as I approached 67.. I attempted to retire for one more TIME… and that was 6 yrs ago and this time it seems like it is really going to stick. Since I had sold my store in 1996, the practice of pharmacy had changed dramatically mostly – IMO – at the drive of corporate pharmacy and their hyperfocus on increasing market share, profits and share prices… pts were just a vehicle/conduit for the chain corporations to reach those goals. IF some law firms get serious about pursuing civil rights discrimination, I would entertain helping them in those actions… otherwise I will remain on the sidelines and hopefully help to educate and motivate pts within the community to collectively change the path that they are on ….

  2. Just when I thought I knew it all Are you serious when you say a Pharmacist doesnt have to fill a script? How I mean what uh umm what about the owner of the pharmacy? I mean if they can do that how many times can you do it before you effect the bottom line? No disrespect Steve but they count pills n put them in a vial. Like ER schmucks I mean Drs they want to play “drug police” instead of doing there job Who gave them the power to be able to do this? Its gonna take 100 years to get society back to normal with all these braindead in positions they shouldnt be in There goes my B.P. ………

    • It had gotten so bad in Florida in 2015 that the Board of Pharmacy down there instituted a new regulation that every Pharmacist must take 2 continued education hrs every 2 hrs… to quote the exec VP of the board stated at a June 2015 meeting that the board wanted to teach pharmacist COMMON SENSE… bottom line is that they were suppose to not start looking for reason NOT TO FILL A RX when it is presented to them by a pt. Anybody can find a reason – or make up a lie – as to why they can’t fill a Rx… “i” not dotted… “t” not crossed…. don’t have any inventory on hand… 30 yrs ago … 75% of the retail pharmacies were independent pharmacies – ran by the pharmacist/owner and most/all of the board members were also independent pharmacist owner. Today the board are typically stacked by non practicing corporate pharmacists and they are not going to do anything that will work against corporate pharmacy… they might be aggressive competitors in the marketplace… but when it comes to places like the pharmacy board… they will turn a blind eye, deft ear to something that does not give the chain pharmacy good optics. Today, about 70% of the retail pharmacy outlets are chains… Their Rx business keeps growing,they cut deals with insurance companies to be a preferred pharmacy for a insurance/PBM… the chain pharmacist gets paid every two weeks … regardless of how many control meds that they turn away… as long as their total Rx volume grows. It takes more administrative time to fill a controlled med – especially a C-II and each year the major chains will see their Rx volume grow 10%-15% and they will reduce Rx dept staffing hours by 5%-10%. A recent article claimed that 100,000 pts/yr died from medication mis-fills. when you consider we fill some 4 billion Rxs/yr… 100,000 fatal errors is just 0.0025% rate. Computer companies shoot for 99.999% mean times between failures. Pharmacy fatal error rate is 1:40,000.. which means that your typical pharmacy has one or two fatal errors per year. When a chain pharmacist is expected to work 12-14 hr days with no scheduled breaks and one – maybe two techs each working a 8 hr shift. Filling 400-500 Rxs, giving flu/vaccine shots, answering the phone, and untold other interruptions and generally interruptions are the genesis of errors

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