I'll bet you didn't know...

Imitrex now has an otic formulation! This prescriber thinks so, anyway.

Just put it in your ear on the side of the head with the migraine for quick relief! Or maybe you stick a tablet in each ear to drown out the noise that's causing the migraine?

Here I am...

...Trying to keep up on Monday morning!

IT'S FOR ADELINE!

I answer the phone. 

"Is this a Pharmacist?" an elderly lady asks. 

Yes. 

"Yeah you fill a prescription for my neighbor. She needs a refill."

Ok. What's her name?

"Adeline. Are you a temporary pharmacist? The regular people know her."

Last name?

"Uh, I can't remember, but you would know her. She gets all her stuff there."

I'll try and figure it out. What's the medication?

"Uh, I don't know. But you should know. She gets all her meds there. It's for Adeline."

I've been working here since 2008. I don't recall a patient named Adeline. Maybe you're calling the wrong pharmacy?"

"No. She gets all her stuff there," she says, then raises her voice as if that's going to help. "IT'S FOR ADELINE."

There's another Goofmart Pharmacy down the road. They do a lot of meds for care homes. Maybe if you call them they will recognize the name. That number is...

<Click> she hangs up on me. 

Dear Chronic Pain Patient

No one likes to be judged or categorized. You don't like to be thought of as a narcotic addict. We know that. Your pharmacist doesn't want to be thought of as a mean and despicable agent bent on keeping you in pain. Consider the following:

There's rules regarding the dispensing of controlled substances. A pharmacist protects his or her license by following those rules. An example of that would be the expiration date of a prescription for Percocet. It is good for 90 days from the date of issue. After that, it is expired. No good pharmacist would honor a prescription like that after 90 days.

We also have a mandate to protect the public, and sometimes that mandate is protecting the public from itself. For example, we would not fill a new prescription for Percocet a couple of weeks after the patient filled a 30 day supply of the same medication without good reason. There are no absolutes, however. Medications do get lost, stolen, left behind, accidentally destroyed, etc. In these cases the pharmacist uses his or her personal judgment to assess each situation individually. No good pharmacist wants anyone to suffer. This is an absolute.

The problem, dear reader, is that there is very distinct difference between a true chronic pain patient and addicts that will literally say and do anything for more narcotics. Most every pharmacist everywhere is inundated with addicts that lie and draw suspicion on a daily basis. A narcotic addict will literally say or do anything to get more narcs. And unfortunately, I see it on a weekly basis. Because of this constant bombardment from the addicts, your friendly neighborhood pharmacist is markedly distrustful and cautious with every new prescription for a controlled substance. 

Those that say all pharmacists are on a "judgmental ego trip" and that it is standard procedure to deny pain meds in "every chain pharmacy in America" are vastly misinformed. This simply isn't happening. It is the responsibility of the pharmacist to make sure every prescription is valid, appropriate, safe, and correct. Asking questions about a controlled substance is NORMAL. We're extra cautious BECAUSE of the addicts. That's NOT punishing the legitimate chronic pain patients, it's the result of years of dealing with those who take advantage of the system. It's unfortunate that a few people get categorized in the latter group, but not unexpected because of the opiate epidemic we deal with as a nation.

Instead of decrying the pharmacist who is just doing his or her job, we should applaud their efforts in trying to do the right thing. 

Confused?

Me too.

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