Bad Faith Prescription Policies

What follows is a very long rant. You've been warned.
So, I filled my prescription for my usual pain medication the other day. The DEA's recent "crack down on drug abuse and diversion" has been causing no end of trouble lately for a lot of people. The DEA says they're targeting prescription drug abusers, but in reality, the majority of people being who are being affected are people with severe chronic intractable pain, like me. Those of us who suffer with severe intractable pain have typically been in horrendous pain for a long time (more than 17 years now in my case), we've been through countless doctors, procedures, medications, alternative therapies, etc. I am incredibly lucky in that I found a wonderful doctor after years of agony. He specializes in pain management, with the main focus being on the patient's quality of life. It seems ridiculous to have to state the obvious, but stupid people abound, so I have to: None of us enjoy being in pain all the time, would you? We don't particularly enjoy being poked, prodded, cut open, feeling weak and useless, and answering medical providers' endless questions about things we'd rather just forget. We don't enjoy having to take medications, whether they be narcotic or not. We're not strung out drug seekers, looking for a high. So why do so many people think these things? I mean, really.

I've been on the same medicine from the same doctor for about 12 years now. It's a schedule 2 drug, with lots of restrictions regarding it's dispensation. Some of these rules make sense, some do not. There is a stigma attached to my main pain medicine, which happens to be Methadone. A lot of people associate Methadone with heroine addicts, but actually, Methadone is first and foremost a pain medication. It happens to be an effective treatment for heroine addiction, as it's a long acting, slow release medicine that maintains a relatively constant level in the body, and doesn't produce a "high". In my case, it's been the most effective medicine for my pain, it does a good job of keeping it at a bearable level throughout the day, and it does it without the side effects other medicines tend to have. It's also pretty inexpensive, which is a really good thing without insurance. The stigma attached to Methadone is really unfounded, and is perpetuated through ignorance. I quickly learned to keep the fact that I take this medicine quiet, and will only tell people I trust, and then only on a "need to know" basis. I can talk about it here because, well, nobody will read this stuff anyway.

I haven't had all that much trouble at pharmacies until fairly recently. First, I used to fill my scripts at Walgreens, as they where nearby and convenient. Walgreens stores are very much like cockroaches around here, there's lots of them everywhere, and if you see one, there's always another nearby. When I moved, I started going to a nearby CVS. One day, the CVS didn't have enough to fill my prescription, so I ended up taking it to the pharmacy at the Frys grocery store. The prices on the medications ended up being a lot less, so of course, I switched to Frys. I filled my prescriptions at this one Frys for a couple years. One night, I go to pick up my meds, and am told that they can't fill my Methadone because the head pharmacist has made a ruling that he wants to personally call the doctor for all controlled prescriptions. Only, the head pharmacist isn't in, won't be in for a couple more days. Of course, they didn't bother to tell me this when I dropped off the script, nor did they bother to call me and let me know they weren't going to be able to fill it tonight. Since I had been going to the same pharmacy, filling the same prescription from the same doctor for the same amount, I was rather irritated. I went and got the prescription back and took it up the street to another Frys pharmacy. They filled it without incident. I told my pain doctor about this, he said that wasn't the first issue he'd had with this pharmacist, that he'd given other patients a rough time, that he just didn't like the doctor or approve of him. Apparently, my doctor had even offered to meet up with this pharmacist somewhere for lunch or something, to talk to him and educate him a little on pain and pain management. Apparently, the pharmacist ignored him. So I just wrote him off as being a dickhole and took my scripts to the Frys pharmacy a little further away.

I used the second Frys pharmacy for a few more years. There was one incident where around 1/3 or the pills where missing from the bottle when I picked it up. I reported it to my pain doctor and the head pharmacist, a report was written up and the missing pills where replaced without trouble. I was very shocked and disturbed by the incident as nothing like that had ever happened to me. I had never had trouble at this pharmacy before, and the staff had always been courteous to me. After that, I was careful to check my prescriptions when picking them up. Almost a year went by with no further trouble. Then one day I go to drop off my prescription, and they tell me they can't fill it. They say they can't fill any controlled prescriptions from my doctor. They said the DEA wouldn't allow them to. I suspected they where lying about that, but checked anyway, and of course if was a bunch of bullshit. I was furious to say the least. Frys pharmacy management had decided for whatever fucked up reason to blacklist a bunch of doctors, my doctor included. I called my doctor, he told me to take my script to the nearby Walgreens, so I did. The pharmacist there filled it like normal, though I did have to pay around 15 dollars more. That may not sound like much, but that's a lot of money for me. Not only had I been forced to go to a strange pharmacy, again, but now I had to pay more for the same fucking prescription? Ugh! I will say that the pharmacist at this particular Walgreens (I think he's the head pharmacist), is a nice guy who seems to have a good head on his shoulders and a sense of humor.

So I've been taking my scripts to this Walgreens every since. Shortly after I began going there, however, the DEA started forcing pharmacies to call and confirm any and all controlled prescriptions with the doctor who wrote them. Each and every time I fill my Methadone, they have to call my doctor, and do a buttload of extra paperwork. I can't imagine how irritating this is for my doctor, he must get over 50 calls a day. Luckily for his patients, he's always available, day or night, and if he doesn't answer his phone personally, he calls back quickly. If it where most other doctors, those prescriptions may not be filled for days. I can understand having the pharmacist call to confirm with brand new prescriptions for controlled substances, or when there is a big change in dosage, or if the person trying to fill it is obviously suspicious, but this is just plain ridiculous. It's an enormous waste of time, and only burdens doctors, patients with legitimate prescriptions, and the pharmacy staff who fill them.

Another annoyance, this one Walgreens doesn't always have enough to fill my prescription, so I sometimes have to go find another Walgreens that does. The other day, I went to fill my Methadone, but they didn't have enough, so I asked the tech "what about the Walgreens down the street?". She hesitated and said she didn't think they'd fill it there. I asked her why. She said "they're really picky". Picky. What the hell is there to be picky about!? I'm a decent person with a legitimate prescription from a doctor who specializes in pain management. I've been filling the same damn prescription at regular intervals for many years. They can look up my prescription record in seconds to confirm this. My doctor even writes the fricken diagnosis codes on the scripts for crying out loud! UGH! So, I ask the tech to call another Walgreens to make sure they have enough and will fill it, which she does, and tells me they can fill it. So I go over there and drop the script off. As I'm waiting in line, I happen to overhear a rather disturbing conversation. There's someone at the pharmacy drive-through window who has a question. Apparently, the pharmacy won't fill this person's controlled prescription. They've instituted a new "Good Faith Dispensing Policy". This "policy" is nothing but senseless trash, designed to allow pharmacy staff to deny anyone their medications for any reason. What all goes into the decision making process? They can't won't tell you. They don't even have to tell you why they're denying you your prescription. It's all arbitrary, based on the personal tastes and beliefs of the individual pharmacists. Maybe they don't like that shirt you wore in there. Maybe you're a Mexican. Maybe they don't think you look or act like you're in pain. Maybe they've never heard of the doctor who wrote the prescription. Maybe they just plain don't like your doctor. Maybe they don't believe in the existence of chronic illness. Maybe they think all opioid medications are evil and nobody should be able to use them. Maybe they saw you buying something they didn't like last time you where here. Maybe, maybe, maybe. The point is, there are no checks and balances, no appeals process. The pharmacist is judge, jury, and executioner. This pharmacist power grabbing has been getting worse and worse. They claim they are supposed to be part of your healthcare team too, but in no way should they be allowed to override the doctor's decisions. They don't have the medical training, nor all the information on each and every patient to be doing this. It's like if I gave them this equation: 16_ X ___ = ? And they firmly claim the answer to be 351 when they are clearly missing more than half the equation. It's ridiculous, it's dangerous, and just downright crazy. They call it "good faith", clearly the only "good faith" is in themselves to make all the decisions, not in the medical doctors or patients.

Anyway, I stood there and listened as the pharmacist told the person at the drive-through window that they weren't going to fill their prescription. When the person asked why, the pharmacist goes on to spout a bunch of baloney about how they check each controlled prescription against a list of criteria, (but he can't reveal what all is on this list of course), and this particular prescription didn't measure up. I could feel my blood boiling as I stood there and listened. While I couldn't see the person in the car well, I certainly never got any weird or suspicious vibes from them, they where most likely just someone like me with a painful medical condition just trying to get their usual medicine. Well, after that, I'm thinking they're going to tell me they won't fill my script either. But, lo and behold, they took it and filled it, and I was able to come pick it up later. While they didn't give me any trouble this time, I fear it's only a matter of time before this "good faith dispensing" policy causes me grief. I'm lucky, there are more pharmacies than you could shake a stick at around here, so if I am denied my pain medication at some point, it shouldn't be all that hard to find a pharmacy that will fill it. But not everyone lives amongst a buttload of pharmacies, what about them? I shudder to think.

I don't normally approve of lawsuits, but pharmacists who deny people in pain their medicine are certainly heading for a good suing, and that may be the only way to get through to these cruel morons. I only hope it happens sooner rather than later.