Wednesday, March 21, 2018

Let's Compare!

This comparison is based on my personal observations over the years. It compares legitimate chronic pain patients with narc addicts. Let's compare:

Legitimate Chronic Pain Patient

* Brings in prescriptions ahead of time
* Ok to wait until "do not fill until" date comes and shows up hours after opening on that date
* Friendly, never in a hurry, willing to wait until the prescriptions are filled
* Never mentions anything about needing a specific color or manufacturer of the medication
* Lives in the neighborhood of the pharmacy
* If waiting for the prescription does so patiently in the waiting room or comes back hours later
* Picks up all medications (pain or non pain) at the same time
* Bathes on a daily basis
* Talks about new treatment options and wanting to get off the medication
* Takes the medication as prescribed and never runs out before the next due date
* Rarely (if ever) claims to be "shorted" on the medication
* Packs his or her medication first when going out of town
* Never loses his or her medication
* Locks up his or her medication to keep it from getting stolen or misused by others

Narc Addict

* Argues about when the next fill will go through insurance
* Wants to pay cash if insurance doesn't pay
* If not paid by Medicaid, somehow comes up with hundreds of dollars to pay for it
* Asks for specific colors or manufacturers of the medication
* Asks if the medication can be dispensed in the original container
* If there is a "do not fill until" date on the prescription, shows up on that day right at opening
* Asks where the water fountain is located or takes a tablet at the register before leaving
* Frequently goes "out of town" and coerces his or her physician into authorizing an early refill
* Sometimes seen in town when supposedly supposed to be "out of town"
* Travels miles across town to a specific physician and pharmacy
* Stands in front of the pharmacy or the register staring at the pharmacist no matter how long they've been told it will take to fill
* When multiple prescriptions come in, only wants the pain medications; says he or she will pick up the others later. Sometimes they're never picked up
* Has the appearance and odor of not bathing every day
* Often angry, ready to argue about the dates to fill prescriptions
* Often takes the medication more than prescribed, runs out, and wants to fill early 
* Often says "The doctor told me to take more"
* Routinely states "You shorted me last time"
* Talks about when the next refill will go through, never about getting off the medication
* Sometimes says the medication was lost, left on a bus, taxi, motel room, or was stolen at a party

Do you agree with my comparison?

What would you add to each list? 


Anonymous said...

I think you covered it pretty well.

Denise said...

Chronic pain:
1-is worried about politicians "do something!" attitude. Junkies go to the street, chronic pain commits suicide.

su tia said...

Legitimate pain patients are pharmacy loyal, using only one pharmacy. Users use multiple pharmacies (and docs) that you find out about when you sign on to the controlled substance database.

Tom Bridgeland said...

Night nurse here. Narcos wake up every Q4 or Q6 for their PRN meds. If they do happen to sleep through they get mad at you for not waking them up 'on time'. They often appear to be 20-30 years older than their chronological age.

Legits take one at midnight to get some sleep and don't bother you the rest of the night.

Narcos tend to take a lot of odd prescribed meds, and a lot of 'allergies'. Amazing how many are allergic to ibuprofen.

Elderly chronic pain sufferers tend to tell you 'no' if you ask about pain, but then admit their game knee or shoulder does hurt quite a bit, but they are used to it. Tylenol often works as a good sleeping pill for this type, taking the edge off enough to let them sleep.

Silja said...

Why does the color of the pill matter to an addict?

Crazy RxMan said...

Some addicts are under the incorrect impression that certain colors or manufacturers are more potent than others.

Anonymous said...

@9:20 - I agree with you that legit pain patients are doctor loyal but I think the way the C2 law is written, it forces a lot of people to not be pharmacy loyal. Since I can't get refills and can only fill my script when I have one or two pills left, I end up having to take a paper script to wherever I happen to be that day. Work has me all over the state and I often leave before my local pharmacy opens and return after it closes. I go to the pharmacy nearest my work that day on my lunch break. "Nearest my work" may change based on the day. In my case the C2 was adderall. Unfortunately, a lot of chronic pain patients probably are unable to work and don't have the same issue as me.

Anonymous said...

The chronic pain patients take the pills to keep being able to function, the addicts take them so they dont have to function,......

GregOhYeah said...

Also some percentage sell their medication. I think another review should be ppl addicted vs selling. I wish it didn't happen.

Kate said...

As a chronic pain patient, I have some comments:

(1) I can’t bring in scripts early. I see my pain doc every 28 days and get a 28 day supply script, on the day I’m due. Even if I got a post dated script, I’d personally avoiding dropping it off early, as if it somehow got lost, I’d have no recourse. My pain clinic has strict rules - no early fills, replacement scripts, etc. I’m happy to wait as long as they need to fill it though.

(2) Due to needing same day fills, occasionally my pharmacy is out of one of my meds, and I need to use another one. I used to call a week ahead to request my med, dose, and quantity be available on my fill date. However, that takes up time on both ends, and still doesn’t guarantee my med will be in stock. Sometimes they’d get another patient in before me (as its not like they would label it being for me and deny someone else’s earlier script).

Plus, supplies of opioids are literally being limited by the DEA so pharmacies can’t always order what they need. Thankfully I’ve been lucky lately and they’ve had my pain meds in stock. Needing to use another pharmacy is an extra inconvenience as my pain contract requires I notify their office.

I will never accept a partial fill, as if the pharmacy can’t provide the remainder of a Schedule II med in a certain period of time (72 hours? I think it varies by state), the remainder of the script gets voided. And there are no guarantees my doctor will rewrite the script for the remaining quantity.

(3) If my insurance doesn’t cover a pain med (usually as it needs a prior auth), I need to pay cash to get it that day. I can’t wait the typical 2-7 days for the PA to go through, as I’d have withdrawal and uncontrolled pain.

Although I’ve saved up an emergency supply (actually a no-no as this means not taking them prescribed, ie. less), if I wait for PA approval, I’ll not be able to fill my next script until 28 days after that fill, depleting my stash, which is very difficult to build up.

I even keep track of PA expiration dates and ask my pain clinic to submit PA requests ahead of time. However, lately I still have issues where my prescription won’t go through, as the insurance will say a new PA is required, despite the PA not being expired. My guess is they keep changing the approval criteria, thereby cancelling any prior approval.

One of my two pain meds (long & short acting) even requires two separate PAs, one for the med and one for the daily dosage being over their allowable max. I feel sorry for my pain doc’s office as they probably did about 10 PAs for me last year between 3 PAs being required for 2 pain meds at least every 6 months.