Jumping through the hoops: how hard is it to get your medication?

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Disce Pati
Regular Member


Date Joined Apr 2008
Total Posts : 61
   Posted 4/13/2008 3:04 PM (GMT -7)   
Hi everyone,

The thread posted from the moderator in Canada concerning her medication filling error by her pharmacy has intrigued me: both by the anxiety by the poster as well as the intense and reassuring responses by the readers. My curiosity is piqued by the mention of the "zero tolerance" policy in Canada mentioned and a response that in the USA there is a "triple copy" requirement for prescriptions of narcotics. I am beginning to think that I have been fairly lucky in my experiences obtaining my medications. I believe that society's views on narcotics for chronic pain greatly influences how we get and use our meds - and it frustrates me greatly, to the extent that I get quite "soap-boxy" about it. Since I became a chronic pain patient in 2000 I have run into some problems with a chain pharmacy (Walgreens) refusing to fill my 'scripts on some occasions, short-filling one on another, and "red-flagging" my name. I have since transferred my needs to another chain (Target) where a personal friend is the lead pharmacist. Since then, I have had superior service and absolutely no problems getting all of my scripts on-time and properly filled (Walgreens used to deliberately allow my scripts to out-date so they could refuse to fill them because they "expired"). For the last five years I have been on a stable dose ofmethadone and oxycocone with zofran and tizanidine as adjuncts for my pain.

I am very curious about your experiences obtaining your meds - the run-arounds, the rudeness, etc. I am wondering if someone can explain what the "zero tolerance" policy in Canada means to the chronic pain patient and what these "drug databases" that I heard about that some states use to "register" narcotic drug use and the "triple copy" requirement that someone wrote about. In my area (the midwest in USA) I have not run into any of this. The only requirement that my doc has to conform to is to see me every three months and write each script as a "new" one (not as a refill) and post-date the script as "do not fill until xxxx date" - so I get six prescriptions for each med at each visit (three for the oxycodone, three for the methadone). She also has to print them on "special" paper (a stiffer paper) rather than normal printer paper. Plus they cannot be phoned in or sent electronically (and I do not think I can get them using a mail-order pharmacy). Other than that, there are no other "hoops" that I know of.

My biggest problem has been with Walgreens. I personally think would rather not ever dispense narcotics if they didn't have to. They were very unprofessional in how they treated me the first three years that I needed the meds.

On a related matter, (maybe worth a separate thread?) I am also wondering if anyone is willing to share with me his / her opinion or advice about how much (or little) information you tell your friends, co-workers and family about your medications. For example, if medications problems come up in casual conversation with friends, etc I do not hide the fact that my meds are narcotics (my idea is that I don't want to perpetuate the idea that taking narcotics for chronic pain is something to hide). However I am also aware that some people are judgmental about these things, especially when they hear "methadone". But I truly believe that knowledge is the key to living life and for getting people to be more compassionate and understanding. I have found that I cycle in my thoughts: some times I try to hide my need for these drugs and other times I feel that I need to shout it from the roof-tops (not literally) - maybe a sign of frustration? venting? coping? I am not sure what it is all about......sometimes I am so grateful for the ability to have a way to live with my pain and at other times I tell myself that there is no way that I can live the next 40 years of my life taking 10 mg Methadone and 30mgs of oxycodone a day (or more if I develop tolerance or things get worse). I cannot help but think that this cannot be "right".

My way of dealing with things is perspective, philosophy and learning how others incorporate chronic pain into their lives.

I would love to know your thoughts!

MarleneS
New Member


Date Joined Apr 2008
Total Posts : 4
   Posted 4/13/2008 3:31 PM (GMT -7)   
Wow!!!

Great post. I too would like to know the answers to many of the questions you put out.

I lived in Texas for many years before moving to Canada where I married the most wonderful man ever. (I met him on the internet and we have been married 6 years now). I also used Walgreens in Texas and had some horrid service from them. Once they actually filled a narcotic prescription that the directions for use said take one by mouth every 4 hours. When I got the meds home they had actually filled it with suppositories. It was funny and sad at the same time. Needless to say I learned to check all meds at the counter when I picked them up. Here in Canada I have never had any problems with my meds. I take oxycodone and get vials of demerol for shots. I would like to know about the no tolerance thing as I have never heard about it. My Dr. Prescribes my meds 6 months at a time and I fill them all at once same for my DH. He gets 600 oxycodones a visit. HE is a wonderful man with dengenerate spine desease. We don't hide any facts of our medications at the same time we don't carry a sign around saying we have that amount of drugs either. I also worry about how I will cope in 5 years or so there is no way my tum tum could handle that amount of time on these meds. I already have to take gravol with them and rest till they take hold otherwise I will bring them back up. Wow I am so interested in seeing what everyone has to say. Thanks for bringing that up.

Chutz
Veteran Member


Date Joined Jan 2005
Total Posts : 9090
   Posted 4/14/2008 8:50 AM (GMT -7)   
Hi Disce Pati!

That's a very powerful post! One area I'll address is what and how much we tell our friends and family. I chose very carefully who I tell. It's pretty much on a 'need to know' basis otherwise I keep quiet. I've seen what happens to those who share and there's no way I want to open myself up to ridicule and shunning. Obviously my hubby knows exactly what I take. My grown kids know sort of what I need. Doctors and other health care team members and that's about it. I do let a couple of people at work, whom I trust, know that I take some strong pain meds sometimes but they don't need to know more than that.

If I have bad pain at work and need a strong dose of meds I always let one particular person know that I've taken something and that it may make me sleepy...just in case. I always report back to them when I'm leaving for the day and driving home. When I get home I email back in to let this one person know I made it home. It's out of respect for the people I work with.

This works for me,
Chutzie
Co-Mod Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, collapsed disk, dermatitis herpetiformus, osteo arthritis in spine and other locations.
***************

The only difference between genius and stupidity is that genius has it's limits. Albert Einstein: (1879-1955)


Disce Pati
Regular Member


Date Joined Apr 2008
Total Posts : 61
   Posted 4/14/2008 2:34 PM (GMT -7)   
HI everyone,

Thanks for participating in my ponderings and indulging my curiosity. If I understand the "zero tolerance" policy correctly, it seems that if a pharmacist or physician thinks the person is somehow not complying with the script in any way - altering it, or somehow creating a false impression, etc then that patient can never be prescribed pain meds again? Is there an appeals process? or a way to defend yourself if an explanation is needed? or is it, any doubt, accusation and you're out? Seems extreme.......and scary.

And Gramps, I had no idea that some states sold DMV info to other people to use for solicitation. That makes me even more uneasy and mad about the "registration" requirement that these databases use......to me it seems like an overt HIPAA violation. While I do not feel that I need to be ashamed of my medication use, neither do I believe anyone else has the right to know. Not even my employers. However, I am not so naive to think that my records are completely secret. Unfortunately, my employer is my health care provider so while they make a big fuss over HIPAA, I know that it is extremely easy for anyone on campus to sneak a peak at any of my records. But I like to believe that the honor code is healthy at our facility (for the most part I believe that it is; I am continually amazed at the power of ethics in this profession; even though I am also completely aware of the scum that somehow survives and thrives here too).

Another very interesting point was brought up about physicians, surgeons and other health care workers being the partners in law enforcement for "drug abuse prevention". I just read a very interesting article on the moral and ethics of that attitude and how that is inappropriate in the health care setting. I found the whole debate fascinating and am wondering if this is the type of information that I can post on this board so we can voice our opinions on this evolution of health care attitudes. I would love to excerpt some quotes from the article but am unsure if this board accepts the standard referencing protocol when using published literature as part of a discussion (standard protocol requires that the quote is accompanied by the author's name, publication name, date of publication and name of journal). If this is not allowed then I will paraphrase the information for the sake of discussion if anyone is interested in learning how nurses and doctors are choosing to become unofficial law enforcement agents. This article contains some very thought provoking information and explains alot of the attitudes that we are encountering I think.

Oh well, I got off on a tangent but I really appreciate the input / responses to my rambling thoughts of yesterday!

wmnak
Veteran Member


Date Joined Jul 2006
Total Posts : 1123
   Posted 4/14/2008 3:42 PM (GMT -7)   

Pati,

this is a great thread.  i would certainly vote to hear what these "professionals" have to say about their role in helping "Big Brother."

i am always reluctant to give out personal information for the reasons chutzie has stated.  i would rather a person or organization get to know me first, my strengths and weaknesses, and then, if and when appropriate to divulge some additional personal information. 

once i was an active member of an organization for several years.  after being elected President the third year, i subtley let them know i was jewish.  "my god," one of them said, "you don't look, act, or talk like a jew!"  i replied, "maybe your concepts of what a jew is needs changing."

the same is true of taking narcotics for pain.  my wife and i were with some friends at an auction once and one of them asked if anybody had an asperin.  my wife said, "no, but we have some morphine."  cracked everybody in our group up.  they now know that i take narcotics for my pain.  myh wife and i have known these people for about four years.  they still don't know that i'm jewish.  one trauma at a time, i always say.  lol

warren


That light at the end of he tunnel?  It's an on-coming train.
 
 


Hound-Dog
Regular Member


Date Joined Oct 2005
Total Posts : 183
   Posted 4/15/2008 1:36 AM (GMT -7)   
In my Province,there has been a triple-script procedure for narcotics for at least 15 years.One copy for the pharmacy,one for the Dr.'s records,and one for the Provinces records.I think the new laws are being put in place to standardize all the Provinces onto the same system.I doubt that legitimate pain sufferers have anything to worry about with this latest legislation.

Muzz
Regular Member


Date Joined Mar 2008
Total Posts : 395
   Posted 4/15/2008 4:18 PM (GMT -7)   
I live in the States, the 1st pain doc I had would phone in my rx for hydrocodone and I saw him every 2 mths for a quick consult. This new one I've been going to since Sept is a diff story, I have to void in a cup every other mth, have to pick up my rx personally, even my hubby can't, and I had to sign a "contract' with the doc that I won't get narcotics from any other do ad must use the same pharm. He says it's the DEA cracking down, but I have friends who get narcotics from their PCP w/o jumping thru hoops, don't understand he diff. I'v never abused drugs and  have always used to same pharm for 15+ yrs. Maybe some docs are just more cautious or have had bad experiences with abusers, I don't know.
I take the Lortab 4x a day, and my family and friends know that I take meds, no biggie, they know the pain that I have.
I am not my pain, it does not own me.


Disce Pati
Regular Member


Date Joined Apr 2008
Total Posts : 61
   Posted 4/16/2008 10:09 AM (GMT -7)   
After I posted the follow-up I went "under the weather" and spent the day in bed yesterday fighting a weird flu-like thing...so I haven't had a chance to post that info I mentioned. I am assuming that it is ok to post quotes as long as they are properly referenced since I haven't received a horrified "no can do" advice. I will get my info in order and present it as a separate thread. I think the data will stimulate some thoughtful discussion - I know it kinda demoralized me in a philosophical way.

Warren - I am appalled that in this day and age you feel that you have to hide that you are Jewish! I cannot see how that can be a problem one-way-or-other. I thought we had matured enough in our society to realize that we are all in this together and that we need each other's differences to make us stronger. Life would be boring if everything and everyone had the same thoughts, humor, philosophy, language, creativity, etc. I love your joke about the morphine! I can just imagine that the first couple of seconds you probably could have heard the proverbial pin drop right before the quaffs of laughter!

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 4/16/2008 11:03 AM (GMT -7)   
Disce Pati,
The only thing I'd suggest is reading the rules before you post. There are some guidelines there. I know recently a post involving a copywrighted article was deleted by the administrator. You could e-mail one of the moderators to ask, also.

wmnak
Veteran Member


Date Joined Jul 2006
Total Posts : 1123
   Posted 4/16/2008 9:14 PM (GMT -7)   

pati,

this is just FYI.  when we moved to this small town in alabama, the first question we were asked by everyone we met was, "and where do you go to church?"  i felt like telling them we didn't, or that my schul is in huntsville, or that my mosque was in birmingham.  but i  smiled and my wife said that we were still looking.  one pulmonary dr i see has an entire pamphlet devoted to how he would welcome helping any patient to find Jesus.  sometimes i get so angry with this christian thing i could scream.  then i remember that i participated in the decision to move here to be closer to our daughter and that i knew what i was getting into.

i don't have any problems with people of any faith or belief so long as they don't hurt themselves or others.  i've been friends with wiccans, baptists, methodists, muslems, mormons, etc.  when we become friends we sometimes have even shared our thoughts on our respective religions.  but i refuse to inflict my beliefs on anyone and i resent anyone inflicting their beliefs on me.

if everyone had your attitude, this would be a much safer, well-balanced world.  maybe we could all pray to our gods for that level of understanding and tolerance.

warren


That light at the end of he tunnel?  It's an on-coming train.
 
 

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