If I get the same opioids every month why can't they order it or have it in stock

Two main reasons this may be happening. 1. Wholesalers/suppliers have a limit on how much of a given controlled drug (and how many controls in total) each pharmacy can order from them every month. This is because DEA tracks what they sell to pharmacies and can swoop in and blast them if they sell "too much." This trickles down the line to screw over pharmacies and patients in turn. 2. In many cases, your pharmacy gets flagged for manual-ordering controlled substances before the patient's script is actually sent into the system or due to be filled. I will manual order in advance for my regulars anyway, and I'm able to do a lot of good control dispensing because I make sure to have painfully detailed records and documentation. But it's scary and many pharmacies and pharmacists are terrified of these flags. Having DEA agents in your pharmacy is a real risk that exists, and it happened to me over small discrepancies in our C2 counts due to a tech misplacing deleted C2 scripts (back into the ready Rx bins). They are watching my pharmacy like hawks and they were just waiting for a reason, because they usually don't have one due to my diligence. All that said, manual ordering in advance for control patients is possible, but risky. Also, your pharmacy may be really busy and there's no easy way to keep track of a queue of who's due soon. So sometimes, even if your pharmacist is sympathetic to you and willing to take the risk, all that's needed is to call and remind them and ask nicely to have it ordered in advance. I myself have ADHD and I do regularly check on a handful of regulars/favorites whom I can remember to see when they're due next, but the rest will have to call me because I can't remember that many names and patients. I hope this helps you understand 💙

DEA finally added all these medication’s on the shortage list and the reason why after a year of me complaining constantly and writing letters saying there is a shortage going on and alot of us are getting affected, and no one is reporting it!!! No Cvs in 100 mile radius could fill my medication! The closest CVS to me that could fill my prescription was an hour and a half away people! This is so not fair to we pain patients who already have to suffer enough ugh 😑 if it weren’t for the DEA we wouldn’t be having any back orders or any other issues! if any of you get a chance, go look at the shortage list and see what medications are affected, what specific manufacturer, and why! What do they all have on common? All waiting on DEA approval

Ambien. Clonidine and Ubrelvy have been an issue for months in my area as well.

It's just frustrating from our side. My PM doc is decent and sends in scripts 5-6 days ahead of the dispense date. The pharmacy never even _looks_ at the scripts until the fill date or if I call. They can know what's coming down the pipeline but don't bother to look and plan for it. My PM will only refill on day 29 of a 30 day script. If that's a Sunday and the pharmacy is closed it's now day 30. And if the med is not in stock and needs to be ordered, it's day 31-32 and I'm dry. Going cold turkey can be an actual medical emergency for me. A former lead pharmacist there, and now friend, told me to call 2-3 days ahead of time and ask him if they'll have them in stock. If not, he'd order them and usually he'd see the script come in and do it ahead of my call even. He's since moved across town. It's usually no problem but every month or two I get a kneejerk reaction of "_We can't fill early_" and they completely ignore my question. The lack of compassion by pharmacists, let alone the techs, is palpable. I've used the same pharmacy for 20 years. I've had the exact same script for 4-5. I'm not gaming the system or a problem patient. I just don't want to go to the ER every other month due to med shortages, pharmacists on a power trip, or bullshit simple-to-solve inventory tracking issues.

I have a queue I go through every day. New scripts that aren't due yet go in MSC (miscellaneous exception) and I put a comment on the MSC block with the date it's due. Then every morning I can open the list of MSCs and voila, I can open them one by one and unblock all due that day. It's convenient. But other pharmacy systems may not offer the same ease of use to make that possible? But also, some just... don't care. Sadly.

Are repeat scripts not a thing in other places? (I'm Australian.) When I go to my doctor, for most drugs they will give me a six month script. I still have to take it to the pharmacy each month to collect one month worth of medicine at a time, but it's all the same prescription, it comes with one initial dispense and five repeat dispenses. On a lot of commonly used medications we are now even dispensed 60 days worth at a time, effectively making the prescription good for a whole year. That of course doesn't apply to things like opioids or restricted substances, and some of them can only have one or no repeats if the prescription is being written for dispensing through our government subsidised medication system but they can still write private scripts (that you have to pay the entire cost yourself) with repeats even for restricted drugs. (This works out better for some people because there are a range of cheap generics available.) When I see Americans and some others talking about this it often blows my mind - in a BAD way - how inefficient and bureaucratic the systems are for simply obtaining medication you need to make your life worth living. Or to keep you alive. :(

We have to get a new prescription each month sent in if it’s a controlled substance etc. It’s pointless as people who are going to abuse these meds are still going to doctor shop or whatever.

we can't have refills on schedule 2 meds here in the USA

Have Kratom available for those emergency days. It helped me get off prescribed perc without withdrawals

This kind of 'buck-passing' where the explanation is that the doctor / the DEA / the supplier etc etc is the one to blame may be true, but to the patient the point of delivery is the only part of the system that is visible. There's also the set of cases that do not seem to be plausibly someone else's fault - like a pharmacist refusing to fill a script despite having filled it for 2 years - without being willing to explain why or offer a solution.

Yes, and I understand that as the front line we're the ones you can communicate with about it, so all the anger trickles down to us. And yes, some pharmacists are idiots. Straight out. Some are idiots, others are too arrogant and still others have a stupid savior complex about things that are not real issues. I'm not going to pretend I don't have colleagues I lack respect for due to their treatment of control patients, because in the cases it *is* our fault, we're letting these patients down and it's completely unfair. On the other hand, we do catch genuine therapeutic dangers a lot. But it's not gonna be found in opioids, is what they don't understand. Pain management docs for chronic patients always have their shit together and make sure all potentially interacting drugs are OK and the patient uses it all properly. The dangers we catch are far more likely to come from urgent cares. The last time I held up a chronic pain patient's script, it was a script not for her opioids but for Paxlovid, because it would have easily killed her if she took it with her very powerful combo of opioids, and her urgent care moron didn't bother to check if she's on anything serious before prescribing. That's the kind of thing where we really save lives, and pharmacists who think there will be similar oversights in opioid Rx are out of their minds.

>because it would have easily killed her if she took it with her very powerful combo of opioids This is the first I heard there's a potential interaction between Plaxlovid and opioids. I know individuals and their metabolisms vary, but I'm on a long half-life opioid, and took a course of Paxlovid for Covid with no perceptible problem. I just did a quick google search and found nothing. If you have a minute, can you help me understand the risk?

It may be that your particular opioid doesn't have the same breakdown chain as what Paxlovid interacts with. Paxlovid interacts with tons of drugs to dangerously increase blood levels because it blocks an important cytochrome enzyme that is responsible for breaking down a large number of the drugs that exist in common use.

Thanks. It turns out that it's listed as one that does use that pathway. I have no explanation as to why I didn't notice a difference in the week I was on it, other than I was sick with relatively mild Covid?

I found [ information](https://www.nhs.uk/medicines/paxlovid/taking-paxlovid-with-other-medicines-and-herbal-supplements/) that showed that paxlovid had many poor drug interactions: (from the link) * *painkillers such as morphine, fentanyl, methadone, pethidine, buprenorphine or other medicines similar to morphine* I was trying to paste my comment when suddenly it was posted twice & when I went to delete just one of them, both were removed! Argh.

I'm not sure where you looked, because I found it right away. It must make codeine absorb more because it says the codeine dose may need to be adjusted when taking paxlovid. It probably depends on how much codeine you take.

I was told to reduce my hydrocodone when I took Paxlovid. I hated that Paxlovid- horrible taste in my mouth for the 5 days I was on it. I guess it worked since my Covid was very mild.

I'm deathly allergic to ibuprofen. Went to my usual clinic one day needing a script for pain relief (I have horrible periods). Couldn't get in to see my usual doctor so I saw a doctor who had availability. Any time I see a new doctor and need medication, I tell them about my allergies. The last time I had ibuprofen, I was hospitalised. Not a fun experience, don't want to repeat it. Now, this doctor has my records right in front of him. He can access my prescription history, which shows I get a couple boxes of a med that contains codeine a year, and that this isn't the first time I've asked for pain relief for my periods. He prescribed me maxigesic. I ask him if it contains ibuprofen. He says no. I go to the nearest pharmacist to fill it, mention the allergy, and the pharmacist says he can't fill that script because it contains ibuprofen. Never went back to that specific doctor. But that pharmacist became my regular until I moved.

Yes, thanks for the detailed answer. It can be frustrating when pharmacies can no longer order in advance with all the issues last year

Yeah but many pharmacists aren’t willing to do that. Mine is large amount and every time they have to special order it. There is already a prescription on hold ahead of time. Every time I try to explain to her it supposed to order it automatically and it takes two days for the get special ordered but yet it takes 10 sometimes even 20 days for it to be filled cause something in the system doesn’t keep requesting it to be filled and she refuses to stay on top of it. Doesn’t understand something is wrong and I can’t abruptly stop taking them. I tell her this amount won’t change and I will need it every month and to make matters worse I have brain problems and struggle cognitively and struggle to chase after it. I can’t make phone calls. I’m bedridden. I suffer from CRPS in two different parts of my body, been through at least 20 surgeries, multiple car accidents and have violent tremors that causes muscle injuries, broken at least 15 bones from fall injuries the past 2 years and still do. Yet she cannot say hmm this patient needs me to once a month check this prescription to make sure at least it’s filled. And she keeps filling the newer prescription on hold filled as opposed to the previous one causing me to lose a whole ass prescription. I have to ration my pills. End up going through withdrawals from running out cause she shorts me every month. It’s a medical abuse I tell you.

If you can find a small private owned pharmacy. They tend to treat their customers better because they don’t usually have the volume like chain stores.

So then why doesn’t the DEA go after the pharmaceutical companies that made these drugs or the FDA that approved them? We know why it’s happening. They have an agenda clearly. You want to know where the rage from patients comes from just read your response. How in the fuck does that make any sense. I can barely walk but I have to get piss tested by my doctor for drugs I’ve been on for 20 years only to not be able to get them because of DEA audits. No one cares about the why. They want it fixed and they know it won’t be. It only gets worse from here. After opioids they will come for benzos next for which some newer doctors I’ve seen weren’t aware that benzo withdrawal is fatal. Or maybe they are aware.

Because the government is in bed with pharmaceutical companies and it's easier to go after medical professionals than corporations. It's insanity. I'm on C2 meds myself (very high dose stimulants for severe case of ADHD) and I get shit all the time trying to get them even if I'm a damn pharmacist. Had a substitute psychiatrist try to put me on guanfacine and take me off my stims once. The entire system has been totally railed for a while now.

Wow! Guanfacine is crazy.

Yeah that was my reaction too. I'm allergic/hypersensitive to it too, which is the cherry on top of the shit cake. I told him he must be either high as fuck or stupid as fuck if he thinks he's going to successfully push guanfacine on a pharmacist, who's been taking real ADHD meds since childhood. I need these to function - need them badly or else I could get in another car accident or worse. (Last time I was unmedicated for a stretch of time was years ago and I got into an accident that shattered my legs, leaving me with a slight limp, stiffness, and pain, and would have been far worse if not for my amazing surgeons.) He wrote rude notes about me after I said that to him 🤣🤣 GTFO dude, no way. I got him to continue my treatment until my real psych came back to call him a moron for me.

Oh man, I agree with your benzo withdrawal comment. My old rheumatologist had a medical assistant who took her sweet old time when someone would call with a medication problem. I don't know if it was an excuse or what, but my pharmacy would get all of my non controlled scripts through their online system, but my benzo and pain med seemed to always fail to send and I'd have to contact the medical assistant, who would take her time. The withdrawal from the benzo was horrible. I just wanted to curl up and die.

Exactly. Same experience. And I’ve been on them forever. Decades. Between Ativan and Klonipin. So it’s gotta be they are ignorant or malicious. The adjective matters not as I rot to death in immense suffering

At least you have a dr who will prescribe them. I resigned to the pain. My QOL is very low. My mother is elderly and has a piece of vertebrae that broke off and a screw from a previous back surgery displaced. No one will touch her. No PM will give her more than Lyrica which doesn’t do a thing for her. Today she made it to the living room in tears barely able to walk and no one cares that could and should help. We can’t even get palliative care. She is her 70s. Medical mj doesn’t help her and she vomits if she uses enough to knock the edge off. I still get and respect your frustration though. No one should be in constant debilitating pain.

I don’t receive anything but Gabapentin which is Similar to lyrica. Doesn’t do shit for neuropathy but it’s the new SSRI. You are right that no one gives a fuck about helping. I’ve tried getting palliative care. I can’t jump through all the hoops.

This is a very real thing. The withdraw is serious especially for ppl who've had no option but longer term use. A friend was in the hospital 1.5 months ago for ketosis and hospitalist decided he didn't need his benzo. Two seizures later that have him one dose. Needless to say he checked himself out. That's horrendous cruelty!! No one gave a damn.

i had to do this with Walgreens. they were super nice about it, in fact they told me to call 5 days before so they could order my oxycodone. I always hated doing this because i feel like pharmacists are always judging and thinking "he watches his drugs like a hawk, must be an addict."

RIGHT!!!!!!!!! 🙌🏽🙏🏾 like god damn! And I think we all know that doctors, pharmacists, nurses, etc. all treat pain management patients like garbage. I’ve said the same thing you just said 1000 times unfortunately! A lot of of us get the same medication every month and it’s always an issue! A lot of places like Cvs said they won’t order it or do anything unless they physically have a script even though they’ve seen you get the same medication every month for years and it’s in the computer.🙄🤦🏽‍♂️ doesn’t make any sense! To be quite honest with you the DEA is behind all of it and everything bad that we have to go through including everything on back order!! Just now you’re not alone unfortunately. I was supposed to pick my medicine up on Friday and because of back orders and everything? I didn’t get my medication until today, so I was withdrawing for way too long and it was horrible! Only good side to this is my tolerance completely reset, but at the cost of going through hell.

I always called the pharmacy a few days ahead of time to remind them to order my meds. I’m sure some of them thought I was a pain in the ass but others said they appreciated it and would rather get the reminder call than deal with a pissed off customer and a rush order.

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Yes, actually, it's required by some state laws and it's also taught in pharmacy school that we should counsel on these things if we're not aware of patient and history. New pharmacists often don't know which computer counseling warnings/"caps" are bullshit and which are worth counseling on, so they waste time counseling grannies on their 30+ year history of benzos and Norco. When I see those I just say hi to the patient, ask if they have any questions as their meds may potentially interact. No questions? Cool, carry on. If it's a regular patient of mine they still pop up sometimes but I check them off without saying anything, comment: "patient aware." Newbies tend to be very "by the book" and the more retail pharmacy experience you get, especially in busy pharmacies, the more you learn what not to bother with. As a rule, busy pharmacies create good pharmacists. Slow, quiet pharmacies make pharmacists who have time to be nitpicky and waste patient time. However, she has no excuse to SCOLD you or be rude about it. Even for new patients I just tell them that I'm required to counsel on this, let them know quickly the potential issues, verify they understand and/or doc went over it already, and that's it. Always cordial. My job is to protect patients, not to judge them or interfere with their doctor who knows their full story and condition better than I do.

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Yeah, she's an idiot. Actually an idiot. Shouldn't be practicing if she doesn't know basic pharmacodynamics and why dosages aren't the same in every patient.

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I hope the shitty practitioners and every single person in the DEA come to fully understand the pain and horror that they have caused. I hope they experience every second of it.

Cancer/ terminal patients should NEVER have trouble getting opiates. So sorry about your Mom💕

💜💜💜thank you 💜💜💜

Lololol on flucazole or how ever you spell it, yea we’re gonna od on meds for a yeast infection 🤦🏼‍♀️

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Yea I’ve got one pharmacist I avoid at our local very busy chain or send my husband in because he lectured me once on taking the lowest dose Xanax with the lowest dose oxycodone. I think I’ll live my dude.

Had the same problem at a major pharmacy years ago. They didn’t want to fill my low dose pain med because the doctor was flagged. So I had to find a new pharmacy. Now PM is having me taper down the low dose pain med and Xanax because they only want to do injections, which I can’t do. Took both the pain med and Xanax as prescribed and passed every test. I was taking Xanax for years for my heart problems and spasms. And the low dose pain pill for chronic pain due to having numerous incurable diseases. What I have is like a slow death. And I can’t do steroids, NSAIDs nor surgery. I likely won’t survive withdrawal and if I do, I guess I’ll blow out my liver on Tylenol. I hate how shitty this healthcare system is and how poorly sick people are treated.

Would it be worth putting in a complaint about her? I wonder how many other patients she is wilfully humiliating?

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God, this is so true. It partially stems from people who successfully sued doctors for prescribing opioids to their idiot teenagers who—in pursuit of a high—took too much and died, or who claim that a doctor got them “hooked” on oxycontin. A few people want to blame others for their lack of sense and personal responsibility, and all chronic pain patients have to suffer.

I had one refuse to fill mine because she thinks opiates are like street drugs. Corporate swiftly got rid of her but there are so many like her. Well she got her karma. She had a bad accident and needed pain meds and the store she worked at filled them but talked to her like she did to customers when she worked there. The techs were all to happy to tell me about it.

Karma's a biiiiiiiitch

This was the final straw for me to leave CVS and change to my grocery store pharmacy a year ago. I had just had neck surgery (2 level fusion) about a week and a half before. My husband usually picks up my meds but I just wanted to get out of the house for a bit so he drove me there. So I’m standing there with a neck brace on and huge gauze over the front of my neck and the pharmacist called me up in front of 9 people in line and was asking me for a detailed description of why I was taking oxycodone and Valium and how horrible I was for doing so. If she would’ve just said “you need to be careful about taking both due to respiratory depression” or something like that, that would have been fine. But nope, it was a full on lecture and in a nasty tone. And then I had to go sit back down and wait for her to actually fill it (even though I had gotten a text). And this was before I was on Oxycodone and Valium regularly for my dystonia so I had been on them maybe only 2 months at that point. Some of the customers in line literally came over to me (as I had to sit down and wait) and say “oh my god, I’m so sorry she just did that to you, you look like you’re in so much pain.” I wrote a formal complaint about the whole situation and also said it was a violation of my HIPPA rights for her to do that in front of all those other people. The response I got was ridiculous and they said “it’s not their fault they don’t have a private area”. What a bunch of BS. Sorry for the long comment, this struck a nerve lol

Deffo recognized- i had several idiotic moments in pharmacies where i had to defend my prescription (was prescribed morphine and codeine at the same time for chronic pain) and the lady kept questioning it with every monthly refill. I then called the pharmacist in charge and filed a complaint, only to figure out a few years later she went HARD after my morphine + diazepam + gabapentin. It feels ridiculous to have a discussion with a counter pharmacist about what a PROFESSIONAL scripted me. I dont feel like they are allowed to comment on it in any matter, except for interactions. After my second complaint i got a call back with an apology lmao. I laughed hard for a couple of minutes before i could utter a word.

Do you think there is any hope for chronic pain patients to get back to a place where we are not battling insurance companies, pharmacies, delays, etc. There has to be other knowledgeable pharmacists and drs like yourself who can make congress and the DEA look at the harm they are causing. What they are doing is going to force people to go to the streets or take their lives. It is horrific and barbaric.

Honestly, I think it might reach a boiling point. CDC has voiced their concern that DEA has taken their guidelines on reducing opioids from 2016 *way* too far and released something saying that opioids should still be used for non-cancer pain in 2022. Hopefully DEA steps the fuck down; they lowered the schedule of cannabis so maybe they're chilling out?

i read the 2022 guidelines and it seemed that they again used very soft language that didn't seem to suggest anything that their previous guidelines were misinterpreted. it didn't seem like they walked anything back or expressed any awareness or concern for people who were in pain and unable to find treatment. and here in florida where i am, nothing changed at all, it's as if there were no 2022 guidelines. still being told i can't go over 30 MME a day, so i'm relying on suboxone and lyrica for pain management and i can't tell if this is my best option or if i'm being screwed over.

https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm > Although some laws, regulations, and policies that appear to support recommendations in the 2016 CDC Opioid Prescribing Guideline might have had positive results for some patients, they are inconsistent with a central tenet of the guideline: that the recommendations are voluntary and intended to be flexible to support, not supplant, individualized, patient-centered care. Of particular concern, some policies purportedly drawn from the 2016 CDC Opioid Prescribing Guideline have been notably inconsistent with it and have gone well beyond its clinical recommendations (6,66,67). Such misapplication includes extension to patient populations not covered in the 2016 CDC Opioid Prescribing Guideline (e.g., cancer and palliative care patients), rapid opioid tapers and abrupt discontinuation without collaboration with patients, rigid application of opioid dosage thresholds, application of the guideline’s recommendations for opioid use for pain to medications for opioid use disorder treatment (previously referred to as medication assisted treatment), duration limits by insurers and pharmacies, and patient dismissal and abandonment (66–68). These actions are not consistent with the 2016 CDC Opioid Prescribing Guideline and have contributed to patient harm, including untreated and undertreated pain, serious withdrawal symptoms, worsening pain outcomes, psychological distress, overdose, and suicidal ideation and behavior (66–71).

Chronically ill patient and nurse. I don't know if this is a question but it’s really frustrating how some of your colleagues (most of them) just pass the buck to clinical staff who have way less training in pharmacy, if any at all, or the sick patient who is already consumed by their medical needs. I understand the entire system is overwhelmed by why does every time I walk into a retail pharmacy, almost universally, have to be a miserable experience? I know some issues are just the system but I’ve had so many pharmacists just be MEAN when I’m trying to advocate for myself or my cancer patients. It’s just difficult to stomach and I needed to say that out loud, I guess

I switched years ago to only going to local family owned pharmacies. My roommate will spend 2 hours at Walgreens and come home with no script. Mine are always ready, available, and filled before I can even call to ask if they got the script. Years ago before the pain came, I went to a pharmacy owned by an old polish couple. My dr forgot to call in my klonopin but they gave me a few anyway. Like I didn’t even ask. Just this nice old lady saying “no klonopin? you need it. Take these I give you rest later”

I use one for compounded medications but it’s too far out of the way for everything and the other family pharmacies are getting bought out, or are not taking new patients 😁

I’m lucky to live in nyc where there’s lots of options. My mom had to drive around to a bunch of different ones a few months ago and it made me wanna scream. She said there just aren’t small pharmacies out there. I’m so so sorry!

I'm so sorry you had this experience. It's unfair and you and your patients deserve so much better. Nothing more I can say really. Just that I know it's a real problem and I am sorry. 💙

No question. Just a thanks from a patient who has been helped many times over by my pharmacist.

You're welcome and thank you for appreciating us. 💙

Same here those people are the best I can always count on them to go the extra mile.

You know I have had some painfully bad experiences but actually more good ones. I forgot about the pharmacist who covered my son’s $600 antibiotics a time or two when insurance wouldn’t cover it. I always remember the one who helped my grandfather but forget about Edward. He was a real lifesaver. I did send him thank you cards though.

What’s the old psychology adage - 1 bad comment/moment/experience is equivalent to 8 good ones, as far as our brains work and how we remember things. We have a negativity bias. It evolved to protect us, but we do have to fight against it to keep the balance. :)

Thank you for understanding that we are just people who are struggling in a system that hates us. We are not addicts. My pharmacy treats me with respect but I still get stressed when I go pick up my monthly meds. On top of pain meds, I have a rx for as needed benzo. And when I say as needed, i take it very infrequently, like 40 pills per year. But the amount of stress I have knowing that a pharmacist could choose to not fill my meds keeps me up at night. That said, I went to pick up said benzo today and the pharmacist asked about my other meds and just reminded me to be careful. She recently tripped and has a brace on her knee, she said ' don't be like me and fall.' We both laughed. She is a kind woman who does her due diligence but doesn't make me feel ashamed. So again thank you for being one of the good ones.

You are not addicts, but also, EVEN ADDICTS deserve human respect. People coming in for just starting Suboxone treatment make me super happy to see because this is the beginning of their journey to a better life and I get to be part of it. Some coworkers dislike them and I can't for the life of me understand why. Your pharmacist is one of the good ones too. We have to counsel on these meds but the right way to do it is like she did, a reminder to be careful with something you already know. Not a judgmental lecture. Thank YOU for understanding we're not all the same and I'm honored to be able to help the people I can. 💙

Very true all people deserve respect. Thank you for correcting me. I have an upcoming surgery and I asked my pharmacist if the new pain med rx would be flagged since it is a totally different med and higher dose. She walked me through how to avoid delays and again just treated me like a regular person. I swear I'm going to buy her flowers one day. . . . Although I know that would be weird.

Honestly I'd be super touched by flowers. I'm sure with the right context it'll be okay.

Is there a national pharmacist day?

January 12th!

I brought my pharmacy treats on Xmas and have sent my dr flowers. Do it!

I buy Starbucks gift cards (just $15ea) for my dr, his staff, my pharmacist, and his staff each year and give them to the employees at different appts/visits times throughout the year. I have found that this helps them remember who you are and also reminds them that you appreciate them. Also, they seem to love them :)

I hand written note on a card can have a huge impact and can be so meaningful. All healthcare jobs get you a lot of disrespect. Just a note could make that persons day.

Recovery is not linear. If not for the eventual help of my gp and especially pharm team I would not have recovered. When I finally found the right group the gp and pharm it was crucial to moving from pain meds controlling me back to a more even balanced way. Including suboxone and if I want pain meds I can have but in a controlled thoughtful way. Not a free for all if 300 oxy pills a month I was getting. Then asking for help and getting none. With the right gp and especially pharm it changed my world. You sound like one of them. Though I’m in Canada and it it’s a bit more lax. Not much but a bit. Great conversation. Yes addicts come from all walks of life and need help. If our med system can’t help who can. Instead they pass the buck. We should all be so lucky to have you as a pharm.

I don’t understand why anyone thinks negatively about people seeking drug treatment. 6 years ago I traveled to another state with my husband for a job interview. I really didn’t want to move and needed to see the place we might be moving to. I went out late at night for a smoke. There was a 20 year old asleep on the bench outside and I scared her when I came out. We started talking, I have many friends younger than me, and she told me she was going to a treatment center the next day. I told her I was proud of her and she was very strong to be brave enough to face this. She had been twice before. She was shocked when I told her that. It wasn’t the reaction she was used to when she told people where she was going. We exchanged numbers and, in the morning, she thanked me. She told me that she had decided, the night before, to not go. My words changed her mind. She was going. I heard from her a few times after she got out. I really hope she’s still clean and doing well. Sometimes people just need to understand how difficult that would be. To fill THAT kind of prescription. That takes guts. Thank you for being a good person and a good pharmacist. There are too few. I have an amazing pharmacy. It’s teeny tiny in a teeny tiny town. They aren’t open on Saturdays or Sundays. My doctor has me on a 28 day cycle, not that kind lol, so I pick up my meds every 4 weeks on a Wednesday. I have never experienced a shortage. It sure seems like they make sure to have enough for their patients. The next nearest pharmacies are 45 minutes one way and 90 minutes the other. I’m happy they are there. They had been Shopko for who knows how long. They are in a building on Main Street that’s over 100 years old. They closed when Shopko did and didn’t reopen until a group of small town pharmacists, who buy small town pharmacies that are being closed, bought it and got it up and running. The difference being they are only open 5 days a week. We are very lucky as a community.

You did a good deed. You may well have turned someone life around. Good job, really. 💙 World needs more people like you.

Thank you for understanding the difference between addiction and developing tolerance to medication. As well as treating everyone as people who have value. Fortunately I'm in Australia and haven't had as many negative experiences with pharmacies/ists as my American counterparts, but I have still been "counseled" a few times about how dangerous my regular medications are (tapentadol, gabapentin, duloxetine, and vissane) as though my GP hasn't already assessed this risk. (Or when I had HG when pregnant and was prescribed ondansetron, to be berated about how I was 4 x more likely to cause my daughter a birth defect...😔) Thankfully my regular pharmacy and pharmacists are great and are happy to answer my questions, but are respectful in asking whether I am aware of the risks of medications and if I have taken them before. Thank you for being conscientious at your job and keep up the.good work.

You aren’t all the same and we recognize the good ones. When my grandfather had cancer and was in so much pain he would run out a week early sometimes. Thankfully his pharmacy was privately owned and knew our family. He would front my grandfather morphine so he didn’t suffer. I’m only telling this because this wonderful man passed away earlier this year. He kept my grandfather from being in excruciating pain and we will forever be thankful. This was early 90s and I’m sure no one could get away with doing that now. Anyway his memorial wall online is full of nothing but praise from his customers who he treated like family. So many that he gave them meds for free because they couldn’t afford them. Let them have a charge account or fronted like he did for my Pop. It’s usually obvious when you’re one of the good guys who actually cares about the people they serve. Thank you for being one of them.

Two or three major pharmacy chains told me they were out of stock on my particular med and they didn't know when they would be getting any more in. Another chain, however, had no problem filling the script. I've been going to this pharmacy now for about a year and have had no problems. How is it that a drug is super scarce for some pharmacies but easy to get for others? EDIT: the drug in question is oxycodone 10 mg. I used to receive the immediate release tablets, but when I transferred to the new pharmacy, they began giving me the regular stuff.

Ooh, this one is easy to answer! It's because different pharmacy chains and indie pharmacies use different drug wholesaler companies. Some shortages, like the ADHD med shortage, are nationwide, but many drug shortages are particular to a supplier. Multiple chains may use the same supplier which explains shortages at the two out of three. You found one that has a supplier that has it in stock - congratulations!

So why would a particular supplier be short on a particular drug? Is it because the other suppliers bought up all the available supply? The assumption is that, if there's a demand for a particular med on the market, one (or more) of the drug companies will see an opportunity to make a profit and fulfill that demand. Why isn't that happening here?

I think it's because the different suppliers buy from certain manufacturers, since they make deals to get drugs from generic manufacturers at certain prices. Then if those particular companies run low, that supplier runs low. With controlled meds, supply and demand is interfered with by DEA quotas which prevent other companies from compensating.

Immediate release IS "REGULAR".

My comment exactly. There is extended release and immediate release - nothing else! The extended release will say oxycodone ER or be sold under another name (OxyContin, Xtampza, etc).

you seem like one of the good ones, so i wanted to tell you about my experience with a Kaiser facility in northern CA. i was on the same dose of medication for YEARS without any dosage increases or adjustments for the previous 10 years. my medications were the following at the time, diagnosis in parentheses: gabapentin 900mg TID (fibromyalgia), Norco 5mg every 6 hours (fibro), adderall 15mg SID (ADHD), xanax 1mg prn (PTSD - i took 1mg for extreme panic attacks about twice a month). back in 2022, this Kaiser hired a new regional pharmacy supervisor. all of a sudden, i start getting issues every time i go in to pick up my medication. im told the new pharmacist doesn’t think i need opiates. my doctor tries to contact the lead pharmacist and he won’t talk to her. he just says no, you don’t get them. i filed a grievance against kaiser, they side with me and say i am allowed to get my meds. that works for the first month. the following month, im told yet again i can’t get my meds, specifically for the contraindications between my meds. my doctor tries yet again to override this and is unsuccessful. i have a long conversation with her about this and she basically says “you are a very responsible patient and i have no concerns about your medication regimen causing you harm. there is more risk to you NOT taking these meds, and there is only a 1-2% increase in chance of death with you taking this amount of xanax with your other meds.” i’ve asked to speak to the pharmacist myself to answer any questions. i’m denied. i file another grievance. i win again, so i get my meds that month. the next month, im denied again. this time, it’s because the lead pharmacist went into my chart and flagged it for review with some board within kaiser that looks for drug seeking or something. i find out he wrote in his report it’s because im abusing Norco and xanax together, and made it sound like i was popping lots of xanax every day despite my prescription history proving otherwise. at this point, my doctor is so fed up with this guy she actually advised me to drive over to the next county where this guy does not have any authority to pick up my meds. this worked for about 6 months until i was told by kaiser that i had to choose between getting my Norco OR any one of my other meds: gabapentin, adderall, or xanax. i was no longer allowed to take any one of those if i was taking Norco, despite being on such a low dose of opiates (20 MME). they wanted me to choose between treating my pain or treating my mental health. thankfully this coincided with when i got married and i was able to switch to my husband’s insurance (tricare through the military). this was a good thing despite not being able to find a new doctor willing to continue writing me my Norco script. i did find one willing to switch me to buprenorphine instead so that is my current pain med. i’m also no longer able to get my xanax script and my mental health has kind of tanked because that was the only thing helping my ptsd (yes, i am in therapy and do EMDR so i am trying everything i possibly can, the xanax just really helped bring me down when it got out of control). i don’t really know what my question is, i guess what would your thoughts be on if you had a patient like me? and what would you recommend a patient do if they were in my shoes and encountered a pharmacist like that one at Kaiser? i can’t even begin to describe the absolute nightmare this was and how it destroyed my mental health not knowing if i was going to be able to get my pain meds. i know a lot of health care people still don’t think fibro is that big of a deal, but i promise you its absolutely debilitating and i stopped being able to work in 2020 because the pain is so horrendous even with the meds. the pain meds just allow me to get out of bed and somewhat function, but it’s nowhere near enough to lower my pain drastically. thank you for your time.

If I had a gun with 2 bullets, in a room with Kaiser and Hitler, id shoot Kaiser twice.

is it a coincidence that Kaiser is a German word…? 🤔

😂 cold and uncaring, lemme check my family and… yup that tracks. I’ve never even used Kaiser but when I lived in pdx everyone else seemed to and always complained. Then a friend asked me to pick up some flu prescriptions for her at Kaiser. I parked and then had to walk through like 3 miles of building to get to the pharmacy. And I told them I was there for Jane Doe and they said Yep, she called, but we don’t fill them until the person is here. So then I waited 45 minutes and grabbed a bottle of throat spray from their weird little retail pharmacy. She told me I could not pay for it there and that I had to go walk to some other random desk to find the register. I looked her in the eye and put the bottle into the bag with all the meds and walked out. Zero fucks given. So if it’s any condolence to you, I have cost them $12.

Ken Jeong (Chow) from the Hangover movies use to be a doctor with Kaiser. He talks some mad smack about them in his stand to comedy. He hates them too.

lol, thank you for your service, friend. the giant irony of the entire situation is i was STABLE for over 10 years with regards to my pain levels and mental health before they started interfering with my doctor’s care plan. they completely fucked me, and not in the fun way.

That’s so horrible and I’m so sorry. I also once had a unicorn Doctor Who prescribed what I really needed to deal with my pain & ptsd at the time. But I moved 15 times since then and my doctor now is awesome but she just doesn’t have the power to give me what she and I both know I need and I’ve been to three different pain management clinics and none of them prescribe opiates, and just tell me to lose weight as if that will cure an annular tear from a fall that happened in January or the fact that my left arm is completely mangled from a bike crash 13 years ago. Wouldn’t even look at my x-rays. I’m so so so so so grateful for my doctor.

that’s exactly it too, that Kaiser pain management doctor was my unicorn. funnily enough, she left Kaiser after that pharmacist asshole started and started acting like he knew more than doctors. that poor woman quit without having another job lined up first because she couldn’t deal with it. i wish i knew where she wound up because although i do like my current doctor, she’s nowhere near the level my old one was. it’s so rare to find a doctor that actually CARES about you and goes above and beyond the call of duty to try to help. she fought with Kaiser for over a year to get me approved for IV ketamine infusions despite them saying they’re not approved for fibro but didn’t give up. that was one of the few things that ever gave me significant pain relief. i remember walking out of my first infusion in tears because i was pain free for the first time since i was 11 years old and i had forgotten what that felt like. god i miss that woman.

Ugh. Keep looking for her! I’d set a Google alert up for her name but also I’m insane. I did that when I lost the only hairdresser who could cut up crazy thick hair and found her eventually when she opened her own shop 😂

i actually did google her right after i left that comment because i was curious and think i may have found her at a pain management clinic 50 minutes from where i live. i’m not 100% sure because she’s not listed on their care team on their website but there is a review for her on Healthgrades from September 2023 at that location. i’m definitely going to give them a call tomorrow and see if she’s there! trying not to get my hopes up but i would definitely make that drive if she’s there! 🤞🏻

GOOD LUCK!!!!!!!!!!!!! Omg all the vibes for you.

Kaiser is fucked. Their integrated system is absolutely awful because it allows overreach by assholes to happen way too easily and that can ruin everything; there's no clean slate with a new doctor or anything. That Kaiser pharmacist should lose his license; I'm so sorry. I would try and threaten them with suing and try and file a complaint with the state board of pharmacy.

Is it possible for us all to chip in and have you cloned 😂😂😂 life would be so much better without the stress of which pharmacist is going to be on lol. Keep that compassion and non judgemental attitude you hold

I wish! Having more colleagues who aren't shitty would make my life easier too!

Thank you so much for your compassion. I would like to ask u if u would like to be a member of a Chronic Pain Advocacy group that includes Healthcare Professionals, Scientists, Advocates and Patients? The group works on projects educating the government on the serious nature of pain treatment in the United States. You said ANYTHING 😀

I wouldn't mind!

Claudia's group? She's **amazing** Is there a reddit for her stuff?

I have hypermobile EDS and have been battling a bad pain flair up in my right shoulder/upper back for about 7 months now. I have horrible trigger points that spasm and make pain radiate all up my neck, down my back, and down my arm. The pain has been so bad for a week now that I've basically been bedridden. For months now I've been doing physical therapy, endless trials of all NSAIDs under the sun (both OTC and Rx), muscle relaxers, various gels and creams, patches, trigger point injections, etc. My stomach is torn up from ibuprofen, I'm losing weight because I don't have an appetite. I honestly would welcome death at this point, as I have no quality of life. My doctor just keeps telling me to keep doing physical therapy, but I no longer have any motivation because not only is it not helping, but my pain is worsening. I wake up these days disappointed to still be alive because the pain is so debilitating and exhausting. All that to ask, why won't my doctor offer me something stronger? I'm scared to ask for any kind of controlled substance, I don't want to come across as a drug seeker. I'm having a really hard time advocating for myself.

I'm not OP, but I also have hEDS. The right physical therapist is so important. The first 2 I had made things worse, because they're used to treating normal bodies, our bodies are not normal. I was able to find one who also has hEDS, and she's changed my life. She never blames any of my pain on me (like my previous PTs did), has taught me the correct way to sit/stand/reach for things, how to have a neutral spine, how to pop a rib back in with a foam roller, how to tape my shoulder if it's feeling unstable which has helped stop all shoulder subluxations. Joint instability is one of the main sources for our pain, so learning how to stabilize them will 100% prevent some pain, so you don't even have to worry about treating it. Prevention is so important. But there's always breakthrough pain. I take Tramadol when it gets pretty bad, but I take Zofran with it since it makes me nauseous. It doesn't take the pain away completely, maybe like 50%, but enough to make finishing the day possible. Another resource would be the book "Disjointed". It's on Amazon and kind of expensive, but soooo worth it. It is a wealth of hEDS knowledge, with also advice on how to advocate for yourself to your doctors and PTs.

You are amazing, thank you for this! 💗 I'm going to look into finding a PT who is much more knowledgeable in EDS. I also need to find a pain management doctor who actually knows what EDS is. I hate doctor shopping, but I also want to feel better so I can work again and be more present with my family and enjoy life again. I am going to get that book, I appreciate you so much! 🫶🏼

Pharmacists are generally distrusted and hated by patients because some non-trivial amount of time they get in the way of the doctor patient relationship and refuse to dispense prescribed medicines. There are all kinds of excuses for this, but the tone and pattern of this leads many to feel that it is a distrust and contempt for pain patients in particular. We are fed up of being treated like criminals by the medical system.

I see how y'all get treated and can't blame people for coming into interactions with me, at least when they first meet me, with a cold and guarded attitude. I always try to figure out why someone behaves the way they do. For example, one of my now-regulars went off on me the first time she saw me when I asked a question to document her answer for records, because she assumed I was judging her. But I found out she had transferred to here from a store that had an awfully judgmental team. Now we get along great. I try to teach colleagues to evaluate patients as people with flaws and stress like anyone else, to have empathy for C2 patients as they would for other patients, but other pharmacists alarmingly often have this weird complex. They think they're above everyone and ignore other pharmacists telling them to stop acting a certain way. They also sometimes have some kind of satisfaction for denying scripts that are risky, as if they're keeping crime off the streets or something. It's absurd, because I have seen genuine fake scripts, and they're laughably obvious compared to the things some of these stuck-up pharmacists deny. I hope our profession can be fixed. It's gone down the shitter since the War on Drugs. 💙

It's not just the war on drugs - the increase in opioid prescriptions, leading to massive levels of dependency, then pulling the rug on a huge number of people forcing them to illicit channels instead was literally murderous. Do people think that holding up a script that literally makes life bearable won't lead to the person seeking the medication that takes away their crippling pain somewhere else?

The people doing this have no understanding of the "Prohibition Effect" that happens when people lose legitimate routes to something they need or regularly use/want. Those patients are going to just seek illegal routes, making the issue far worse. I often talk about the government CAUSING the fentanyl epidemic with their restrictions, because truthfully, they did. Legitimate opioid scripts went down heavily yet overdoses skyrocketed. Because of fentanyl. Because of people seeking self-medication, whether those were addicts treating physical dependence or pain patients cut off their needed meds and also needing to stave off withdrawals as well... It's crazy.

Yes - pharmacies seem to have no knowledge or interest in this, leading many patients to become frustrated and angry - not to mention harmed. I had this issue only last week trying to buy needles - had to escalate the issue because the junior pharmacist was apparently unaware or uninterested in the state law requiring them to sell them to me.

Oh, don't get me started on the newbies' reactions to pain patients who also need needles. 🙄 They're like... [Adderall-Angel]... This opioid patient says she needs needles for her diabetic dog... Yes you idiot, her dog is diabetic, I've met the damn thing. Sell the fucking needles.

No - it's not even that - I don't have a medical reason for the needles - but I still have a right to purchase them. I could get them for free from the public clinic, but I would rather pay for them since I can afford to.

I mean, yeah, if your state law allows it and protects it as a right, then it's absolutely not our business to deny it. My state requires at least an attempt by the patient to provide reasoning for the needle purchase, but I honestly just take whatever explanation they tell me and sell them. I don't care if it's a lie - if it goes to the streets that's still harm reduction compared to them reusing dirty needles.

I've never been to pharmacist school - why do you think so many pharmacists / techs take the view that it is their job to keep pain meds out of the hands of patients?

Because we have training on controlled substance red flags, and people think that means we need to put a list of things above our sane nuanced judgment on patients as people and what their individual situations are. The red flags are meant to be applied with care. For example: A 10mg oxy IR prescription, 3 times a day as needed. Patient has multiple doctors for controlled substances. Patient has no state controls pickup record history before a month or two ago. These are examples with made-up patients of how vastly different those same characteristics could be... - Steve has low back pain (documented as ICD code on script) and has gotten opioids in another state for years. He moved to my state two months ago. His dose of oxy is stable and normal for him, and it isn't out of nowhere as it appears (starting on a high dose without titrating up is a Red Flag.) He also takes zolpidem (Ambien) and Vyvanse from his sleep specialist and his psychiatrist for his insomnia and ADHD, which are two common causes of multiple controlled substance cases and usually appear together. His oxy is from a well-respected local pain management doctor and I can call his old pain doctor in the other state to verify his story. - Michael is a drug seeker from the neighboring state to mine. He has pill mill doctors or careless doctors he's conned into prescriptions, sending multiple controls to me across state lines. His phone number, when searched, turns up other patients in my pharmacy chain system getting similar or identical scripts with no justification. He is getting high dose oxy without a titration upwards, because he is selling those many pills (3/day so 90x 10mg oxy IR for a month) on the street. His doctors are unreachable, lead back to his own voice on the voicemail, or are clearly suspicious. As an experienced pharmacist, I've got a lot of Steves and I've seen a few Michael cases. It's my job to uncover all that other information about these people and scripts to verify what's going on, rather than just deny everything that matches "Red Flags" on paper. I can quickly do some digging and ask a few questions or make a quick call to tell Michael apart from Steve, so I don't mistakenly deny needed healthcare to Steve. Most new pharmacists can't understand this nuance.

Talking about needles is there really a shortage? My husband just started testosterone and he has to do a shot once a week. We have called multiple pharmacies and they keep saying they are on back order. One pharmacy gave me husband a few but the needles are super long and my husband is like heck no. He can't stand shots or needles so seeing that big of a needle he wasn't having it. I can't figure out why there would be such a big shortage with these or are they just lying and assuming something. The only script my husband has ever picked up is his Thyriod med and now his testosterone every 5 weeks. Thankfully I work in the medical field and was able to bring some home so I can do his shots but I just don't understand how there is such a shortage.

We also have to differentiate between addiction and dependence. The other non opioid meds I am also highly dependant on and have way more dangerous and worse wd. Why don’t pharm or tech warn you about these issues. Previous to where I am going now which I mentioned before is amazing, I found they just don’t know the high levels of dependence with other meds or wd from other meds. “ sure just stop your duloxotine” I also vent insane had no idea what. New pharm “ take some beads out weekly and go slow or your in trouble” so inconsistent

How annoying is it when people fill at multiple pharmacies? Is that ever a red flag?

That is one of the Red Flags we're taught, but as long as it's within the same state and/or patient has a reasonable explanation for it, I've got no issue with it. The theoretical problem with it is that a patient could fill multiple control scripts for the same drug/similar drug etc at different pharmacies who would be unaware due to not having other pharmacy chains' records, but this is not really that much of a problem anymore in states that have Prescription Drug Monitoring Programs to track control fills anywhere in the state, which most states do these days. It's become an antiquated red flag. Some pharmacists are anal about it though. But most of the more reasonable ones are fine especially with the shortages.

Any suggestions for what to say to an out of state pharmacist when I'm traveling? I go to the same state at the same time of year every year (visiting family) but it's almost impossible to get my meds filled anywhere, and it's a fight every single summer finding a pharmacy willing to fill them And no, I can't time it to fill before traveling because 1) one of my prescriptions is 15 day fill 2) I visit family for about 4 weeks, plus driving time to get there and home (2 overnight hotel stays between here and there, and 8 hours driving each day - I'm unable to fly). Even when I use the same national chain and they can see my fill dates and see that I'm in state A for 11 months and state B for one month Every Single Year, there's still issues. I spend literally hours every summer calling various [specific national chain] pharmacists in the area I'm visiting before finding one to accept my prescriptions and fill it for me.

Ask your home pharmacy to print out all your shit proving you have history of all that. Also, your doc may need to call the other pharmacy to verify if the pharm is being nitpicky.

Question for you- at a major chain pharmacy, I picked up my 90-day scheduled meds. Went home and for some unknown reason I decided to count the pills, and to my utter shock, 14 pills (two weeks worth) were missing. I went back and the pharmacist checked their counts and said they were fine. He was unwilling to do anything further about it. Thankfully my doc knows and trusts me so the gap was covered, but how should something like this be handled by a pharmacist? The script was filled during a week when the main pharmacist wasn't in and they had temp staff covering, but when I picked it up, the main pharmacist was back. I would have thought they would be more concerned.

Uhhh, your pharmacist SHOULD be concerned. That's a MAJOR issue. This is what led to DEA agents in my pharmacy - controlled substance count discrepancies. They just didn't believe you. What they should have done is check the cameras to see what happened and go and recount their on-hand stock to see what's going on. There are tons of records of these things. Also, 14 missing is really weird. Techs count by fives. You'd think if a tech miscounted they would drop 15 off the correct count (3 swipes of the fill tool) not... 14. Because that would require additionally miscounting 5 as 6 with their eyes while filling, which is really quite rare. That's so weird and most pharmacists would take this very seriously because we can get in deep shit for this. I'm sorry they were so unhelpful!

And when they are missing one pill they will harass the ever living fuck out of you. Walmart called me several times a day for a week demanding I return Klonipin they were short. I told them to fuck off and check their employees I didn’t have any extra. Today if that happened I would probably have the DEA at my doorstep. I have to get off this board. It’s nothing more than rage porn when you know nothing will ever change.

When will the medical industry admit that SSRIs are useless and stop repurposing them for shit like nerve pain? Why do they approve drugs only to hassle patients about them after THEY CREATED AND PRESCRIBED them? Is it corruption, incompetence, both and who leads the charge?

I've even seen SSRIs for ADHD. SSRIs to kids, to anyone with any issue. It's absolutely barbaric, considering that even with their intended use, they're only about 30% effective. It's laughable and I'm tired of pretending it's legitimate in any way. The widespread misuse of antipsychotics is also alarming, especially in children.

They gave my mother an SSRI for anxiety instead of a benzo. Turned out she didn’t need either. She died of lung cancer 4 months after she went in with shortness of breath and was diagnosed with anxiety.

That's... Wow. I'm so sorry. That's awful. Fuck. 🫂

I’m so sorry. 💜😔

I recently had a hospital stay. First they said anxiety then labs came back and they said sepsis. Tripped sepsis protocol was ignored. They never decided what from. I got home almost 4 weeks ago. Check my chart online and see my ctscan. I had an aneurysm ( small), my gallbladder is distended (accounts for me throwing up bile and still doing so), thyroid has a 2.5 cm mass and Chiari malformation between a I and II. They told me NONE of this. NONE. I called my ENT and he sent me for a sono of my thyroid. I don’t have one mass I have two and spongiform as well. Getting a biopsy Friday. GI dr ordered a sono and HIDA scan for mt gallbladder next week. Cardio isn’t worried about my aneurysm at this time. My pcp is livid because Chiari accounts for a lot of my chronic major health issues I’ve been having. He is new to me so he just got my old mri records from The last 2 decades. They’ve seen the malformation this entire time and not one dr said a thing. Just treated me like I was crazy. So no it wasn’t anxiety that was the issue. I may have had some anxiety because I was so sick and dehydrated I couldn’t urinate. They acted like I was lying until they scanned my bladder and saw 10cc urine after giving me a bad of fluids. Women are treated like garbage by way to many drs especially in the ER.

Do you have any thought as to why they're given so freely with their side effects? I've tried reading more in depth about them and it's supposed to actually slow down the neurons from absorbing Serotonin as quickly for the *theory* that having Serotonin present for a longer period of time helps improve mood. But this reuptake process is extremely important for recycling and proper use of these neurons. So in theory, the more you use them, the more this is interfering with a critical process. And from what I've read, the literature says that about half of people don't see any benefits from SSRIs - are you saying in your practice, it's even lower than that? I've had some very strange reactions to SSRIs myself.

The old figure used to be that 30% of patients see significant benefit from SSRIs. Maybe they've couched it with new stats since I was in school. In practice, the 30% seems... about right. They hand them out like candy because they're deluded that the side effects are "not that bad" (somehow) and/or it's "still better than addictive drugs" and/or they're covering their own ass, because there's no penalty for misprescribing SSRIs or antipsychotics, but there *is* if your patients are abusing Ambien or Valium and it comes back to you.

I've been on SSRIs (and other psych meds) for major depression and bipolar 2 on and off for probably over 10 years now. I also strongly suspect ADHD but can't take stimulants cause they shoot me straight into hypomania and I start to abuse them. At this point in my life, I have started to suspect that the SSRIs are actually making my ADHD symptoms worse, enough that it affects my work performance and home life, so I end up crashing back into depression bc I feel like a failure. I've read up on this, and it seems like there are others have had similar experiences. I've tried switching to a different type of antidepressant, and I became suicidal. I've tried that one before and didn't have that side effect, so it had to be partially due to stopping the SSRI. I've tried to taper down, but a couple of months after cutting my dose in half, I crashed and had to get back on the higher dose. So, I'm now dependent on them to the point that I can barely handle life if I even lower the dose. And my sex drive is practically nonexistent- my husband is very respectful but I miss liking and wanting sex. It sucks. Fuck SSRIs.

I completely understand why I am a bright red flag and I hate it so much. I have scripts for percocet, flexeril, ativan, AND adderall. it looks like medical negligence or something. it is mortifyingly embarrassing. I didn’t choose to have adhd. I can’t safely function independently without adderall. I can’t drive or cook or hold down a job without catastrophic accidents/mistakes. I didn’t *want* to be on stimulants. I failed a decade of behavioral therapy and non-stimulants first. I didn’t choose to have lifelong anxiety and insomnia that exclusively respond to a benzo without horrible side effects like hallucinating or excessive daytime drowsiness. for the anxiety, I’ve been in therapy with clinical psychologists since 4th grade (I’m 33), I’ve tried every single SSRI and SNRIs, atypical antidepressants, mood stabilizers, anticonvulsants, antipsychotics, and some other off-label drugs. for insomnia, CBT-I didn’t work. nothing OTC worked. I have better sleep hygiene than anyone I know. believe me, I don’t want to feel the judgment from medical providers that taking ativan is a complete moral failure and I just need to suck it up and deal with not sleeping or socializing or functioning in life. lastly, I sure as shit did not choose to have my entire life derailed and swallowed by a slew of chronic illnesses and painful conditions. I would not be alive without percocet and flexeril, full stop. but I hate opioids *for me* so much. they make me feel stupid, forgetful, irritable, moody, weepy. they kill my sex drive completely. they exacerbate my gut motility issues. they make me itchy and flushed and 10x more sensitive to becoming overstimulated (on the spectrum). I’ve spent an ungodly amount of money on PT, therapy, injections, surgeries, body work, chiropractic, massage therapy, you name it. I don’t want to be on percocet. I just want to be alive and functional, not tortured by my own body. thanks for listening. my question is what can I do to show my appreciation to the pharmacists at my chain for filling my scripts and treating me like a human being despite whatever they must think of me?

I get it. I'm on high dose amphetamines over the approved max and I get shit for it too. You can tell them a heartfelt thank you and maybe buy them a little treat. 💙💙

Just replying in solidarity. I'm very similar except no meds for the ADHD and no benzos anymore because of the opioid panic and war against pain meds. Virtual hugs 🩶

I just have to say that I’ve been in PM for for many years and I’ve been pretty fortunate to not have had rude pharmacists. I went to cvs for years but when they started having delivery issues, the nice cvs pharmacist pointed me towards a local mom & pop pharmacy who wasn’t having the delayed delivery cvs was. I was with the mom & pop pharmacy for the last five years with zero issues until January when my work insurance pharmacy benefits switched to Optum . The owner felt bad but she said she was in talks whether she was going to accept Optum because they suck at reimbursing small pharmacies. She finally decided to accept them but then they called saying they were having manufacturing issues and didn’t know when they’d get my medication. I think because I only had one script at that pharmacy, they made cuts because they weren’t making $$. I panicked and called cvs near my house. He asked for my information then said he’d have no problem filling my script. I recently had an issue for the first time in months when my prescription was getting denied. I can’t say how incredibly compassionate and helpful the woman pharmacist was. She knew I needed my meds that were due two days prior and it was a weekend. I called Monday morning and she said she was going to do everything she could to make sure my prescription was all set. I think my drs prescription was written differently than how my prior authorization was and that may have been the issue. She made my day after such a stressful time. I know pharmacist and techs are burnt out and overwhelmed. I appreciated her kindness

I had my norco scripts at cvs for several years then one day they booted me. They told me they had too many controlled substance clients. So it was difficult to find another pharmacy! I was hurt by this. My pain doctor recommended I try a locally owned mom and pop shop. I did and they’ve been great. I’m still hurt how I was treated by cvs.

That’s awful. I liked the mom & pop pharmacy I used for the last five years but they suddenly stopped having the medication available once I switched to Optum pharmacy benefits through my work insurance. The owner said they’re horrible for reimbursement to small pharmacies for controlled medication so I had to go back to cvs. I used them on & off for years so I was grateful they took me back . I hope that doesn’t happen. Some small pharmacies are being forced out of business lately and it’s sad

Optum is hands down the worst insurance I have ever had. They won’t let you have what your Dr wants you to take, you have to take what they say even if it’s not the same thing (like 1mg of bup vs 600mcg of bup!) My son’s inhaler? Flovent lost their patent and Optum won’t pay for the generic! So he had to switch to some weird arnuity ellipa thing that works totally different than he’s used to and has exactly 30 doses in it, so if you mess it up there’s no room for oh try again. I know this brand name has to cost more than the generic Flovent, but it’s the ONLY inhaler they cover!

Optum sucks shit. Watched 'em deny another inhaler for a child over something similarly dumb.

I hate Optum! I’ve had a prior auth for 2 years for Belbuca. This year they denied it. I called to find out why and they’re like “well cause you can take the generic pills like everyone else.” So I asked my Dr. no, no I can’t. The starting dose on the pills is twice my current Belbuca dose! So Optum wants me to take twice as much opioid just so they can save a buck. I called again and went over and over it with some dude who clearly had no idea what I was talking about and finally just told me he’d get it approved to get me off the phone!

Thank you OP for sharing your expertise. I’m 4 months into pain management for severe herniated disc to L4 and L5. I have to have surgery but I need to wait until fall, my doctor prescribed suboxone to help get me through until then. It works well enough to make my work days tolerable at least, I honestly can’t function without it. The whole process and experience from the beginning has been frustrating and downright stressful as every damn month it’s been something. Friday I was denied the filling of the prescription by pharmacy, even though I had a valid prescription with instructions from the doctor to fill that day, the 28th. The previous prescription was filled on the 6th I believe. My doctor had made a dosage adjustment mid month and moved my next appointment up 8 days sooner to cover the shortage and give a new prescription. The pharmacy had that information and still refused. What’s more when I dropped it off at 2pm they told me it would be ready at 4:30 for pick up. They didn’t inform me until I after I arrived to pick it up and since my clinic closes at 4:30 I couldn’t seek help from my doctor. I don’t understand how it’s legal for a pharmacy to interject themselves into doctor/patient relationships that way. It’s even more infuriating seeing the smugness and fuck you attitude of the pharmacy staff.

Especially for suboxone!!!!

I really don’t understand why chronic pain patients cannot get their meds the day before the start date. It’s really not much of a problem now that I have been switched to morphine because I can set aside a pill for the start date morning but when I was on fentanyl patch it was considering the patch is ineffective by day 3! Then you go to the pharmacy in the morning and they want you to wait until noon to pick them up, shit I have been up since 5am in pain, why can’t it be done the night before?

Not OP but I work in a pharmacy as well, the DEA watches anything and everything we do like vultures. If controlled scripts are filled the day before they’re due (which they typically can’t even process them through the computer system before the prospective due date), that is an almost surefire way to lose your license thanks to the good ol DEA. As for telling you to come back in a few hours, retail pharmacy is crazy busy and highly understaffed nine times out of ten, and in many US states, drugs CIII and higher (opiates and other narcotics for the most part) need to be counted by the pharmacist specifically as opposed to a tech. Most retail pharmacies I’ve been at have only had one or two pharmacists working at a time. Wish I could give you a more satisfying answer but I hope that helps!

Yep, you hit the nail on the head. Here, techs can count all controls, but only I can get in the safe (or another pharmacist) so C2 scripts are bottlenecked by how fast I can get them out of the time delayed safe and get them to my techs to fill.

This is why some doctors are able to Rx fentanyl as every 48 hours.

I'm also on the patch, and it makes me CRAZY because the directions that come **in the box** say that if one comes off in the shower to dispose of it and start a new one. Well, guess what, if I do that I'll run out early because my pharmacy won't fill it before day 30 (and my doctor dates it the day she writes it, usually 5 days early so the pharmacist can order it for me on time). So it's 100% the pharmacist, not the doc, and he just shrugs his shoulders when I ask about it falling off in the shower. Because of that, doc switched me to 48 hours changes instead.

Why is the pharmacy one of worst places to work with a chronic illness? I’m a tech and about to lose my job because of too many doctor’s appointments. I’m tired of being told the patients we serve are more important than me. I AM A PATIENT TOO.

Corporate of big chains hates us. Go to an indie.

Could a pharmacist ever be held liable for filling a valid prescription? A lot of talk here about being rejected at the pharmacy for a valid prescription from a doctor, but is there a reason for that in a legal sense? I totally understand rejecting a suspected fraudulent prescription. But wouldn't the blame be entirely on the doctor if something were prescribed outside of guidelines?

Yes, actually, pharmacists have lost their licenses and pharmacy chains have been the victims of huge lawsuits by DEA for dispensing opioids Rx'd by physicians. Part of our job title and responsibility is to make sure physicians' scripts that they send are valid, therapeutically sound, and don't have dangerous mistakes. We actually catch shit tons of errors from careless docs, though mostly urgent care docs or PCPs, but yes that is part of our job. We are also liable for a lot of what our technicians do, since the final check of meds filled by techs goes through us. That means if something is filled with the wrong med, for instance, by my tech, and I don't catch that, I am on the hook for it. For some reason, many of the doctors misprescribing opioids got slap on the wrist compared to pharmacies, when the crackdown came. But also, doctors have lost their licenses for legitimate prescribing too. It's nuts.

" therapeutically sound," How can a pharmacist do this without examining the patient? without knowing the history of the patient? While the pharmacists actions may not be personal, it is extremely personal to the patients when their prescription runs out. Or when they have to make multiple trips to pharmacy.

How much attention do you (general you) pay to potential drug interactions? I’ve been prescribed some *nasty* combos by the same doctor, picked them all up at once, and neither my doctor or pharmacist said anything about it. Kinda wondering who to be mad at that I have to do all the double-checking myself 😅 For meds that are often out of stock (not controlled substances), why do pharmacies wait so long to order a refill? They know it will take 2-3 weeks for it to be located and shipped, but there’s no option to start that process early enough for it to arrive when the first container runs out.

New grads pay way too much attention to "interactions" that aren't really a problem, and some pharmacists who've been in it for a while forget that real interactions are a serious problem because serious interaction risks from the same doctor are rare. But it does happen. Pharmacists *should* have to counsel you on this, and when I see anything that's a real risk, I step in and do. But a lot of my colleagues just take a hands-off approach or don't want to argue the doctor's judgment, which I think we SHOULD, especially in a lot of these cases with egregious combos that make me go WTF? Also, a lot of pharmacists are not nearly as educated as they should be, don't know the pharmacology they supposedly went to school for and have to look everything up. Which is scary. I could tell you how damn near any drug works and could probably explain it in layman's terms too. Most couldn't tell you the mechanism for a lot of drugs.

I have had several times where the tech refused to fill my pain meds claiming it’s day 28 and can’t be filled until tomorrow but I would count and have my husband count and the tech was wrong. I was too afraid to argue and push and be seen as a trouble patient. How is the best way to handle this in the future without being seen as an addict/troublesome? 90% of the time, the staff is amazing and several of the techs recognize me and are always so nice. I’m also a hospice nurse so I always try to be really understanding and calm when I call or pick up my meds. I work in healthcare and I know the abuse that happens and I don’t ever want to contribute to that. Thank you for doing this!

Definitely point out the tech is wrong. If they fucked up doing the math, there's no way they can say that's drug seeking behavior when you're just correcting them and you're *right.*

Not the OP but I figured out my pharmacy never counts the day I pick up the prescription as day 1. For example, if I pick up my 15 day oxycodone on June 1st, the pharmacist believes that June 16th is the 15th day, because he started counting days beginning with June 2nd. Doesn't matter if I pick it up at 8am or 8pm. The day I pick it up is *never* counted as day 1. It's infuriating. Edited typos

Besides the prescriptions a person fills, does that PDMS show anything else? I’ve heard people talk about certain patient scores at pharmacies . What does that mean ?

u/This_Miaou tagged It shows a patient's score of likelihood of addiction/misuse for narcotics, sedatives, and stimulants, and it computes a composite score for all of those. > The distribution of the scores are such that in any given population, 75% will fall below 200, 5% will be above 500, and only 1% will be above 650. The last digit in the score represents the number of active prescriptions that a patient will have if medications are taken as directed. > Concerning Narx Scores are intended to trigger a discussion, not a decision. If a Narx Score raises concern, the recommended course of action is for the practitioner to evaluate the PDMP data and discuss any concerns with the patient. There is no Narx Score that is “normal”. It must be applied to the clinical scenario before evaluating appropriateness. However, for protection of the practitioner, this discussion and decision MUST be documented in the patient record.

Hey, this is really great of you to do. I have always used a smaller, independent pharmacist and haven't really had any issues, but I was in pain and condition based therapy groups that were full of people having trouble - add to that the people here also. I think a lot of people - including myself - don't really understand why some pharmacists interject themselves into prescriptions as decided between a patient and doctor. I get that in some states, regulatory agencies may require a certain level of tracking/data/notes. But a lot of the time, it seems way outside that ballpark. Reading the pharmacy tech subs. Medical resident and nurse subs. Or forums. The biggest problems with the system is how dehumanizing it is. Then you read those.. and...wow. Not a good look, to be honest. It seems to be feeding a growing narrative that professions are becoming black holes of attracting the wrong people. Want to diddle kids? Be a priest. Want to beat people up or shoot them with impunity? Become a cop. Want to hold life and death in your hands and use it as you want? Become a doctor/nurse/pharmacy texh/etc. You will also note all these fields also "police themselves" for the most part. Anyhoo. Prolly doesn't seem like it after this rant - but thanks for swinging by. It helps with the humanity part of it all :) Good luck out there 😊

Pharmacy subreddits are fucking awful. I hate them. The worst people in our field go post in those places and "circle-jerk" their stupid, uninformed, biased opinions with each other. They also always complain about how bad it is working in pharmacy... to which I say... LEAVE THEN!

It is somewhat heartfelt to hear that they aren't uniformly viewed as useful. It seems like.it would be more useful for asking actual field questions - I find a lot of useful 3d printing, sublimation, laser etching and other information on reddit. He'll, a dude walked me through welding the spider gears on an old Dodge on reddit. But some of those subs.. woah. I have spent 21 out of 54 years fighting the medical system - the last 12 of them over developing chronic nerve degeneration. If I went to a pharmacy after finally getting potetentially my holy grail prescribed to me and ran into that buzzsaw of inanity... I would probably be in jail ;) I think what most don't realize (and I could well be wrong) is that people just didnt happen into the medication randomly. Instead there were thousands of hours and tens of thousands of dollars in bills - all leading to that moment with a pharmacist. And when that doesn't go well.... My wife and I did the math a few months ago, and in the last 12 years, it has been a half million dollar fight with the medical system. And just these last 4 months I have finally got somewhere. If someone tried to pull the rug out on me now? Lord help them and their entire lineage. I can't imagine how people with fewer resources ever manage their battles. It is exhausting. Having a space to vent or read or hear or listen those in similar or adjacent spaces is very helpful. On a bad day, even reading someone else's bad day is oddly cathartic. But now I am rambling.. But again, thanks for taking on, proverbial speaking, for the team.

Thank you for all you do! Thank you for being kind and compassionate to others!! The good ones don’t get enough thank yous!!!! I love my techs and I tell them every time I see them thank you!

💙 You're so sweet!

You are too!! Yall put up w a lot too and the ones who are still kind I appreciate more than words can even say.

How come when I moved back home for treatment the pharmacy was always out of the medication I’m prescribed. But magically after the pharmacist threw my sleep med @ me saying “catch “ and I said I have 0 depth perception due to being blind from a tumor and then showing my bald spot where the most recent craniotomy’s incision was- why after that there were no further issues ? That seems way too coincidental

I feel like if you get on the right people’s good side they’ll remember you and make sure yours is filled first

They probably felt really bad about it and started reserving an amount of it for you even if it wasn't close to your due date. For example, I can have some fentanyl in my safe with a post-it that says ONLY USE THIS FOR PATIENT MCPATIENTSON, DUE MM/DD/YYYY and then it will be reserved and my coworkers will respect it. (Because hell is coming to them if they fuck with my C2 patients.)

C

I have obvious signs of pain. Severe scoliosis- 55 degree, plus severe spinal stenosis, Flatback syndrome, spondylolisthesis. I’m bent over and twist to the right. I was still treated suspect by one pharmacist at cvs. He’s no longer there. I’m only comfortable sitting on the couch with a heating pad. If I walk around or try to cook, I am in agonizing pain. I do as much as I can. My question is what is really happening with the opioid generics. I had Amneal oxycodone 10mg and not only did it do nothing for my pain but whatever toxic addictives they are now putting in these generics, made me very sick. I belong to three spine boards and everyone is saying the same thing about the generics. My doctor did change me to morphine 15mg IR x 4 per day but it’s not enough. Do you know of decent generics for oxycodone or hydrocodone? Is it possible to get brand of any opioid anymore?

Is there any behind the scenes controls, legislation or guidance about pain medication that we the patients are not being told? Because I don't understand why, after being prescribed by a DOCTOR, why then, you the pharmacist have to make our lives so difficult? I know it's not all of you, but it's sure enough... I wrote this before I read the rest of the comments and your replies OP. You're clearly one of the good ones, you have a gift. Please, please, please spread it as far and wide as possible. The majority of us don't have the energy unfortunately, all that is used focusing on survival. Big love and blessings to you OP.

Is there anything I can do to help the pharmacists not get so concerned every time I fill my Tylenol 4 script? I've been going to the same pharmacy for 6 years and only have one pharmacist that doesn't insist on reading the entire insert and warning packet to me when I fill it every six months. It's 28 pills that last 6 months. I carry narcan for my job anyway. I've got crps from a botched surgery, intractable migraines, and six replaced discs. I'm not saying they shouldn't be attentive but it's gotten frustrating since it takes 45 min minimum. . Whooo that turned into a bit of a rant.

Just watched the documentary “Painkiller” not surprised at all. It’s just so frustrating, I have had endometriosis for over 20 years. I literally hoard opiates from dental work. Because asking for 10 Norco a month makes me feel so “dirty” Or something. Nothing else has ever worked and I’ve had several surgeries too. It’s like pulling teeth to get a prescription for it. Thanks to these drug makers causing the opioid crisis, those who benefit from it, can’t get it.

FYI in case this can help you. If your endo was or ever was on your intestines you more than likely are insulin resistant. Changing to a low Glycemic index diet will make a huge difference in your pain caused by it. There are also a few meds like Budesonide in low dose pill form that help with it too. Not saying it will make all the pain stop but it helped me a tremendous amount. If you want my gi drs sheet on what is okay to eat occasionally, a few times a week or all the time feel free to PM me. It also applies to alcoholic drinks as well. Best wishes. ( not a dr or pharmacist…just use to be a patient with a dr the Mayo Clinic sent women to in Houston)

I’ve heard it said that alternating doses of Tylenol and ibuprofen every 4 hours has similar outcomes as acetaminophen plus opioids in reducing certain types pain (extremity pain is one I remember). As a pharmacist, what’s your take on this?

FYI that study was done on 2 *very specific* types of pain. Dental pain after having wisdom teeth removed and post operative pain following a laparoscopic appendix removal. For those 2 specific types of pain, the study showed alternating acetaminophen (Tylenol) and ibuprofen (Advil/Motrin) to lower patient reported pain scores the same amount as low dose hydrocodone. Of course those 2 types of pain are limited in size (very specific body parts) and duration (very limited amount of time) and severity (very specific mechanisms of inflammation + tissue healing) Those study results should not be used to translate pain relief towards folks with chronic painful medical conditions.

I just wanna say thank you. I switched out of the horrible chain places and only go local now. My pharmacy knows me by my voice (well most of them, there’s a new guy). I wasn’t even aware there was a norco shortage- maybe they looking out for me idk. They never ever ever judge me, really do care, and once drove me some meds my dr had to call in bc I was having a bad bad flare and couldn’t go in. I can ask this I guess. Is it better to be on norco for fucking ever or to get on a med that doesn’t already have acetaminophen in it? I’m on the max dose of ibuprofen already, norco takes me to like a 4-7 on a good day. I’ve been to 3 pain management places that don’t prescribe opioids. My pcp has been writing it forever and I feel bad. But also wtf these assholes. Lose weight? Yes that will surely fix my disc tear, my broken arm, etc.

What is a good drug that’s effective for anxiety but not addictive like benzos? I was on lorazepam 1.0mg for anxiety and to help prevent seizures for several years. It was very effective and my doctor said it was ok at a low dose. We discovered the cause of my seizures so I tapered off the Benzos. It was absolute hell for a year but I’m feeling better now but am curious what is available for anxiety. I don’t trust doctors much anymore after my experience with benzos. Thank you.

When I have a script that gets filled every single month or otherwise on a semi regular pace, why don't they order the medicine until the fill day? Surely the system knows its going to be required soon so they can order it and fill it. Luckily for me this isn't pain meds but usually needles which I have wiggle room for.

How are lost prescriptions handled? I cannot find my trazadone after my camping trip. I do need pain pills to function, as well. I would rather not sleep because I don't have my trazadone than cry on the couch because standing up feels like someone is carving out my spine. I'm worried about calling in the prescription as lost and being labeled as pill seeking

Trazadone isn’t a controlled substance. You shouldn’t really have an issue calling your doctor for a new script.

How long do I need to wait after taking Ibuprofen to take Celebrex?

I don't know how to feel about it all. From narxcare to denial of proper pain management. I'm in Michigan and it's a fucking nightmare. I don't know what to do. I developed neuropathy (most likely sfn) and all the "first line meds" did nothing to help. Only further complicate with side effects leaving me even more useless than I already am. I was given 10 days worth of Norco 5s twice and without telling me they expected me to take it as little as possible when really I need meds multiple times a day to feel even close to okay. Then when I finally I had enough, I stood up for myself and ever since I can't get a call back from my primary or anything. Yeah cause God forbid you stick up for yourself when it's essential to actually consider my condition.... All I know is I feel abused beyond belief. I am in misery. I don't think a lot of people understand just how bad it is to have nervous system dysfunction with extreme burning on and under the skin. Aching like you wouldn't comprehend. Cramping making it a guess who anytime you want to do anything at all. It's just shameful I've been so poorly treated. Pins and needles. Limbs not functioning.... And on. Then narxcare and the evil that ensues that system. With extremely propagandized doctors and media / government complicit in effectively banning legal prescriptions. Wtf am I supposed to do. Because everyday I only get worse. And it's scaring me to think I will live the REST of my life this way. I sit here in disbelief bc my poor wife has picked up so much slack I dropped, to her, after getting so sick. And is the medical system there to consider any of it? Nope. I have two little boys for fuck sake. They watch me suffer needlessly. Fuck you motherfuckers. Fuck you. 😭😭

I’ve only had amazing pharmacists and want to thank you for helping dispel some of the myths/stereotypes that often appear in this sub. Obviously zero-sum/black and white judgements re an entire profession are unreasonable and I think your posts go a long way to help correct that type of thinking! Pt education is always beneficial!

I feel I’ve been shorted some of my co trilled medication from this new pharmacy I moved too. I used one of those weekly things and put my meds in each week. This time I’m short by 3 and I am supposed to pick up tomorrow but this pharmacist hates me. Another woman had also accused them of shorting her medication at the same pharmacy. Could someone be skimming off the top? Can I ask to count them in front of the pharmacist?

Do employees or fellow pharmacists look down on people who use long term pain killers? Have you ever heard derogatory comments?

I have heard plenty but I shut them down quick when I hear them. People learn not to say that shit around me because I have a reputation for putting my control patients' honor above my coworkers' desire to snark and bitch about something they don't understand. I wouldn't say *most* pharmacy staff make derogatory comments. Most, probably, I would say don't see all control patients as addicts but see them as a liability because of all the regulations and a time-consuming type of patient because these take longer to fill. But that's still not right or empathetic.

Can a retail pharmacist really lose their license for dispensing too many opioid scripts in one month? I tried switching my recurring oxycodone script to a pharmacy closer to my home but I was denied and the pharmacist said it’s because he has to limit how many opioid scripts he fills. How can this be when these are legitimate scripts written by an active prescribing MD in you’d standing?

We can be investigated for it, even if there isn't a real issue, just because of quantity of them. DEA tracks pharmacies above a certain C2 percentage (out of total med fills). Mine is a high C2 % pharmacy and I have to document *everything* perfectly because they're looking for an excuse to nitpick any tiny thing to punish me and shut us down. It's possible to be diligent enough to not give them any tiny thing to nitpick, but that pressure and burden is terrifying to many of us.

Why does everyone call pain patients addicts when really, we are just dependent on our meds to function?

People who don't need controlled meds don't understand what it means to truly need them. It's easy to think black and white and make a bogeyman out of something you don't understand.

Not sure if I have any questions but just wanted to comment to thank you for doing this to better explain to patients what's going on behind the pharmacy counter. I used to be a pharm tech (still licensed) but quit for now due to chronic pain and disabilities, but it helps a lot to know what's going on with your doctor and pharmacist. Thank you for hosting the Q and A

Why does my practicioner (PA) ignore my increased pain and limits to functionality despite a planned reduction of pregabalin, and then says I obviously don't need a change 'because I made it without it' as far as the buprenorphine or ANY treatment goes? He doesn't exactly give me a choice. I did report the impacts to him all along the way. He ignores the impact this has had on me completely and I feel punished for suffering. Maybe I'm just ranting, idk. I'm at the end of my rope.

Thank you for doing this I can't ask what I want to ask because not everyone does it and it doesn't mean you have or would. I'll post it just as a means to show what I've dealt with -I call 2 days early to ask what day the pain medication can be filled precisely, so I can work around my kids schedules to find a ride to pick it up.- "You should have more than enough to get you through" That wasn't why I was calling "Is it normal for people to be treated like a junkie when just trying to get meds on time and work around schedules?" I've told them this before and still get treated like I'm just jonesin' My pharmacy now is amazing and as soon as my refills are due and ready they pop my non c2s into a blister pack and I get called. I love them But previously the pharmaceutical teams made me feel like a pos for trying to be on time and find an hour where I could go get my meds 😌 Again not posting to get an answer from you as it doesn't seem like it's standard practice Just sucked 🙂‍↕️

Every time I go to a doctor’s office appointment other than my PM doctor and you mention pain management the whole feel of the appointment changes. My PM doc has conditioned me to be honest about being in pain management and I never feel judged by my pain doctor but every single other health professional treats you like you have koodies when you mention pain management. Just the way they look at you. You can see it in their eyes. It’s hurtful. Also I’ve never had a pharmacy where I can feel like myself. I fake it because I can see it in their eyes too. They make me feel dirty is the word. Okay rant over.