I admit, I work for Walgreens.
I also see drug seekers who sell on the street day in and day out. Once a month even we have 8 people come in with the same exact prescript
ion from the same doctor all together, but we have no proof that there is anything untoward as the doctor has provided all we asked for. On the other hand, doctors are being shut down all over around here - ones we refused prescript
ions from for not meeting our "standards." Pharmacies are being fined in my area if the DEA does not think the pharmacy has done "due dilligence" to make sure that the drugs were "properly" prescribed, and the pharmacist could easily lose their license.
It happened in a few stores and a distribution center in Florida - that was the 80 million fine. The pharmacists were allowing non-stop oxycontin, hydrocodone, soma, xanax, and more go through and their numbers of Oxy script
s shot up over 300% very very quickly. The doctors and pharmacists involved lost their licenses, and the pharmacists were not getting paid to fill those on the side or anything - trust me, I know someone that was working with them directly. When I was in FL, this issue state wide just started, and my manager only allowed pain meds and most controls from doctors in our city and the city next to us unless it was from a hospital or cancer center. Most doctors we refused are no longer in business because of the DEA crackdowns.
As for the steps we not have to go through? I hate them. Pharmacists HAVE to use their best judgement, but the DEA has basically forced Walgreens into making these extra steps, and corporate makes us do them for many many drugs. In Michigan, we have to run MAPPS each time with certain controlled pain meds, and are supposed to for any new patients or patients with odd med combos. It stinks for those that need their meds, but the street value of many of these drugs is good enough that we have to do this to make sure we don't get more fines or lose licenses. Heck, if I do any thing that I know is questionable with one of these script
s *I* can be fined by the government! But the pharmacists could still use these same steps and refuse them before - now it's just mandatory in certain cases.
Oh, and Hydrocodone? Yeah, it works great for many peoples' pain, but it's also popular on the black market in many areas. It works quite well for my husband's pain, but if he skips around pharmacies with his rxs it is VERY VERY questionable for doctors and pharmacists. It's also a reason for the DEA to look closer into what's happening and why places with or will not fill things and when.
It is really annoying, and the patients that NEED these meds have a hard time getting them because of all the steps we have to do to make sure that the meds aren't used illegally. Although 80% of the script
s are legitimate for sure, 18% are legitimate but look iffy, there are up to 2% we see EVERY DAY that are either fake, written by a doc that doesn't care and is just getting paid for writing it, or for a patient that is getting pain meds from 3+ docs and 6+ pharmacies each month and nobody knows about
the others until we ran MAPPS. (BTW, MAPPS is an electronic state record about
the patient's controlled medication prescript
ions - who wrote, what, how much, where filled and when) We also recently found someone getting one med from the VA who drug tests each month and then hydrocodone from us monthly - the VA doc said she tested negative for the med they got from us and it was from a doc that wasn't aware of the VA doc, so she obviously was not taking the hydrocodone herself.
These are not the majority we see, but we do turn away numerous prescript
ions daily. We also tell people that their prescript
ion for 30 days can not be filled again 10 days later even if they pay cash unless we have the doctor's OK and it makes sense to the pharmacist to fill it again. (lost meds, trip, etc - dosage or direction changes are not issues with a new prescript
ion).
It's tough to help patients and still meet all the legal requirements, of which many are unclear at times as well. :(
Even though I work there, I still run into issues with my husband's meds. For example, doctor wrote take 1 per day instead of 1 three times per day. The next time with the right directions, the pharmacist STILL checked with the doc for why the change because of the documentation requirements. It took 2 days, and he had no meds for those 2 days. Pharmacist understood the situation, but we STILL had to document with the specific details of one of the regulations. Didn't matter, had to do it even when my husband was suffering.
And as for the red flags? Those are just indicators that there MAY be a problem - if we don't know the patient or their situation, it usually means we just talk with the doctor to make sure we understand and document everything. We have had many patients on the same or similar meds/dosages for years, yet we still have to go through the steps because of the agreement with the DEA. Even new patients with red flags often just need to talk with the pharmacist before we fill them, though other times we call the doctor to verify information.
Heck, Michigan for awhile was pushing an old law that stated that any amphetamine medications required a diagnosis code on the prescript
ion for anyone 18 years old and older - it was REALLY tough, as we couldn't do anything without the doctor writing it on the hard copy! After a few months, the state changed it's interpretation of the old law to only require it from the doctors' offices and not at the pharmacy on prescript
ions. *sigh*
(BTW, the big question is what IS a legitimate prescript
ion - it's hard to tell. My husband has gotten meds from over 30 different prescribers because of urgent care visits over the past 2 years - one hospital won't prescribe controls for him because of it without a current letter from his PCP on file to explain why! It's with his pain issues he need Toradol shots on occasion and they'll give short bursts of soma or valium to help with the pain issues to combine with everything else he's on. Luckily we only go to one pharmacy for EVERYTHING other than compounds - otherwise it would be too "fishy" for most pharmacists to even touch him with a 10 foot pole!)
Post Edited (Buggzter) : 10/7/2013 7:19:56 PM (GMT-6)