Thursday, August 13, 2015

Favorite Question of the Week... Dude

The pharmacist is the last line of defense in protecting the patient from wrong medication, doctors that make mistakes, drug interactions, and the patient. Sometimes our biggest roadblock in providing that protection is the doctor (and in this case, the DDS).

Case in point: Man, age 35, sees dentist, has root canal, gets Rx, comes to our pharmacy. He smells like alcohol and is presenting an Rx for Vicodin. This is a red flag. Alcohol is a depressant in many ways, and one thing it depresses is RESPIRATION. Add Vicodin to that mix and you have a deadly combination. Don't take my word for it... ask Heath Ledger. Oh no, you can't, BECAUSE HE'S DEAD.

I call the dentist, explaining that the patient is drunk and wants to get Vicodin filled with an Rx obtained from their office. I figure the patient stopped at the bar between the dentist and the pharmacy and I'm expecting the dentist to cancel the prescription. "Yeah, we had trouble with him today with the drinking." I'm astounded. Apparently this guy GOES to the dentist drunk, gets work done, then heads off to the pharmacy with a script for Vicodin and NO ONE at the dental office questions this...

I tell the dentist I'm not going to fill the Rx and I tell him why. When Mr. Drunktooth comes back for his Vicodin, I politely tell him why I can't fill his prescription and that it could possibly be a serious situation to take it given his condition. I mean, seriously, the guy is having a hard time standing up and the dentist just wants me to hand over a bottle of Vicodin to him?

Mr. Drunktooth looks me in the eye... and his words still puzzle me to this day...  "Why are you being so liberal with me, dude?"

I'm still not sure what he meant by that. 


CM said...

He was probably at least somewhat libertarian and upset about "the nanny state," blaming "liberals" for passing laws designed to prevent people from harming themselves.

After all (from his perspective), what business is it of yours if he accidentally kills himself with the medication you have just handed him? What business is it of anybody's?

FWIW, I have no complaints about my current pharmacists (although I am not pleased by the fact that there have been fewer and fewer people working in the pharmacy over time while the number of people using that pharmacy has seemed, based on the number of bags of meds waiting to be picked up, to increase significantly), but I think I'd be very lucky to have you as a pharmacist. I'd like to think that quite a few of your patients understand how lucky they are and just don't realize that it would be nice to say something.

I really hope that if my alcoholic mother is ever prescribed Vicodin or a similar medication, her pharmacist recognizes and at least comments on the issue. Maybe the people who love Mr. Drunktooth are as unaware that they have a reason to be grateful to you as the people at the dentist's office appear to be, but because I love my mom, I'm glad for your attention to detail.

Carolyn said...

I used to work for a dentist - one of the few who knew the pharmacist was the expert! Right across from the office was a mom and pop pharmacy and he would regularly call over when he wanted input on dosing or alternatives and the pharmacist gave more than one heads up about drug seekers.