Over the years, Mrs. Norco has managed to get herself up to taking 20mg of Ambien at bedtime and 5mg in the afternoon (for a nap). Now before you start yelling at me... I know, I know, I know how dangerous this is and I've tried, desperately, to explain that to her doctors, her husband, and of course... to her, to no avail.
You see, Mrs. Norco is one of those patients that listens to you but has an excuse FOR EVERYTHING. I think every third sentence that comes out of her mouth is "Yeah, but..." It doesn't matter what you try to tell her, she won't listen.
It takes a few months, but once her current doctor gets tired of the "Yeah, but" stuff, they drop her and she's on to the next one. The current doctor, unaware of the future problem she's going to be to him, wrote yet another script for Ambien, #60, two at bedtime. When I called the office and tried to explain the situation with Mrs. Norco, the staff's response was, "Yes, we're aware of the situation." Ok, I tried.
Then 21 days later (after she had exhausted a #60 "one month" supply), the doctor calls in an "emergency supply" of 20 tablets. I tried to talk to the doctor, again, only to be told by a staff member, "The doctor is aware of the situation."
I refused to fill it until day 28 which was the next Friday. Mrs. Norco said ok and left. Flynn the tech tells me the NEXT day (my day off) she was back in to ask the other pharmacist if he would fill it. He said no, we would have to wait until day 28 as Crazy RxMan said. She tried to coerce him by giving all the usual excuses we've heard before. He wouldn't do it. He's as tired of her as I am.
Friday rolls around. Here's Mrs. Norco. As Flynn prepares the Ambien, I told her I didn't appreciate her coming in the day after I told her when we would fill her prescription trying to get the other pharmacist to fill it. She denied trying to do that, saying she "forgot" when I said we would fill it. Horse manure.
As nice as I could, I told her she needed help, and not from her current doctor. I told her that at these high doses of Ambien there's dangerous side effects, and I reminded her that I've been telling her that for two or more years. I told her if she won't get help for herself she should do it for her kids. It was like an abbreviated "Intervention" episode.
Then the tears started along with all the excuses. Every excuse you can imagine was now being spit out at once. And then the "Why are you being so mean to me?" and "Why are we discussing this here?" (Where are we supposed to discuss it? McDonalds?)
This is the sad part about pharmacy. For all our efforts to help people, sometimes there's just nothing that can be done. You do your best to help, you counsel your head off. You warn doctors and patients. You beg and plead. You refuse to fill and take the complaints from The Authorities. And still, the patient makes the wrong choice.
I don't know what's going to happen with Mrs. Norco, but I have a feeling that one of these nights she's going to take too many Ambien, go on a late night taco run, and end up killing someone.
Another story about Mrs. Norco: LINK