Posted by Cam W. on October 17, 2001, at 3:28:37
In reply to Re: Big Brother At The Pharmacy » Gracie2, posted by Elizabeth on October 16, 2001, at 18:22:15
Elizabeth - I wish I were a "cool pharmacist". In some cases I will fill controlled drugs early unless the doc absolutely specifies an interval. It basically comes down to common sense and "treating" my "patients" ("customers" buy gum and pop). Some pharmacists are so anal that they follow rules to a tee. Some stores have policies dictating such matters. I think that the "analness" is beaten into pharmacists at school, and they are scared that they will lose their licence if they don't follow the rules "to the T". That is crap, and causes unnecessary anxiety for both the patient and the pharmacist. The trick is to "get to know" your patients.
There are some who abuse drugs, there are others who have had a rough week, and took a couple extra Xanax; big deal. You just get to know which is which (ie who is abusing, and who is medicating responsibly). I will give the patient the benefit of the doubt, as long as they are honest with me. I can usually tell a if someone is feeding me a line of crap, or if they are being sincere.
Also, a pharmacist must make a point of getting to know the doctors, including their preferences, and their policies. If someone is constantly coming in early for an abusable drug, I will consult with the doctor to see if a change in dosing is appropriate. If the patient is abusing for "escape from life" purposes, I will control the use of that drug; but only with the doc's authorization. I will also counsel the patient (again with the doc's blessing) on how to control their use of certain drugs. There are many nondrug ways to control anxiety, and I will point these out to the patient. In benzodiazepine overuse (which seems to be the most common form of abuse - especially in self-induced anxiety cases; I find that most people, especially those with bipolar disorder, do not abuse benzos), I can usually tell if the overuse is legimate or escapism.
I think that being a good pharmacist comes down to common sense. Sometimes it is not in the best interest of the patient to give out prescriptions early. It comes down to the individual case, at that particular time. Like I said, I will give the patient the benefit of the doubt, but if you screw me over and lie to me too often, you will be controlled; but this control will not be imposed by me; it will be imposed by the treating physician.
Now, that said. I do not fill my own prescriptions. Since I do not work in the city where I live, I have my prescriptions filled where I live (and I also get Air Miles on the total bill, even though I have 80% coverage). My doc had increased my Effexor dose, so I went in to the pharmacy with a new prescription (with a new prescription for my Dexedrine, as well - Effexor bogs me down until about noon, and I find that the Dexedrine Spansules cut throught the fog so that I can actually be productive without being wired or dragging my ass). I was a week early on my Dexedrine, but I thought I'd just pick it up at the same time. The pharmacist gave me a song and dance on how the computer wouldn't let her fill my prescription a for a controlled substance a week early. I know that this was a lie because I have used the same computer system. I told her that my cat ate them and that I needed them now, because I was going to a concert that night. You should have saw her face. I took my Effexor and left.
I evened out my prescriptions by getting samples from my doc the next month and told him what had happened. I think he did ruin everything by phoning the pharmacy and telling the pharmacist who I was.
The next time I went in, she was really overly polite and said that I had gave a lecture to her class in third year. She was ever so nice. The next month I thought I'd see if the computer would "control" my prescription again, so I purposely went in a week early to get both prescriptions. Surprizingly, I got both prescriptions and not a word was said about it. She did ask me about what to do in a case of Paxil withdrawl that one of her other customers (I don't think that she has any patients). Sometimes you just have to shake your head. - Cam
poster:Cam W.
thread:81378
URL: http://www.dr-bob.org/babble/20011015/msgs/81463.html