PHARMACIST STEVE

Hi Steve,

I came across your website and noticed you had your email listed. A pharmacist refused to fill a controlled substance for me after speaking with my physician from a nationally renowned clinic in the US. I was not provided a concrete reason, other than pharmacists have the right to not dispense. However, it is a legal script from a legal institution. I’m covered under ADA since I have PTSD and I was accused (loosely) of putting their business at risk due to addiction concerns. I’m not an addict, but my report has a lot of medications because it takes a lot of trial and error for mental health patients to find the correct medications. Anyway, it seemed like her personal opinion. I then contacted the Costco manager and they said I don’t have a right to her last name to file a formal complaint against her license. My husband called and corrected them and received her name. Any insight you have into this would be appreciated, such as is this an ADA violation? Can a pharmacist defend not filling a legal script? There are no other medication interactions.

Thank you,

Pharmacists have a few very valid clinical reasons for postponing the filling of a Rx. Level one Drug to Drug interaction, drug -disease contraindication, dose potentially lethal. . until the prescriber was contacted and my concerns were validated and the prescriber confirmed that is what he/she wanted or the med was changed..   If the prescriber told me to dispense as written… I would document the conversation and have a conversation with the pt of my concerns and ask if they wanted me to fill it.. If they wanted me to fill it, I would advise them of what side effects that they should be on the look out for.  If the Rx was forged or altered… I tried my best to get the person a free ride downtown..  and when that happened I typically would get a 12-18 month respite of anyone trying to pass a forged Rx on me.

Somewhere along the line, Pharmacists seem to have forgotten that refusing the filling a Rx is permissible for ANY VALID CLINICAL REASON.  Personal opinions, biases or phobias are not clinical reasons.

One of the basics of the practice of medicine is starting, changing, stopping a pt’s therapy..  IMO, a Pharmacist refusing to fill a Rx without some valid clinical reason… is in a pretty fuzzy area, no trying to resolve or adjudicate any clinical or therapeutic concerns with the prescriber… is shirking their professional responsibilities.

In reality, all addictions typically have a substantial underlying mental health issues… most all undiagnosed and untreated… and the addict is mostly self medicating to silence the demons in their head and/or monkeys on their back that they did not know they were there and their drug(s) of choice silenced them… and they end up going down a pretty rough path.  So, from what you said, it would appear that Costco does not want to fill prescriptions for people dealing with mental health issues ?

At one time, I was Pharmacist in charge of the 2nd largest out pt mental health company in the country, in house pharmacy.  I may have a better understanding of mental health issues than the average pharmacist.

IMO, you were profiled and discriminated against because of your necessary medication, and was probably a violation of ADA and Civil Rights Act… but… getting any bureaucratic entity that should enforce those laws… won’t do so on a single incident. Will claim they don’t have the resources to pursue your issue.

My suggestion is to take your Rx business to a local independent pharmacy, where you will be dealing with the Pharmacist/owner.  I had my own independent pharmacy for 20 yrs and rubbed elbow with these pharmacist at state & national association meetings.. The mindset is 180 degrees from your typical  employee chain pharmacist…  They are there to take care of all pts, not pass judgement on pts.  Here is a link to find some independent pharmacy by zip code & radius https://ncpa.org/pharmacy-locator

I am sorry that I can’t give you a path to take to get a resolution, You can file a complaint with the state pharmacy board.  If you go down that path, file a complaint against the Pharmacist and there is a PIC (Pharmacist in charge) that is legally responsible to the board of pharmacy for the legal operation of the Rx dept as well as Costco…that has a pharmacy permit with the board of pharmacy, but you will probably only get back a statement that “we can’t force a pharmacist to fill a Rx”… which is true.. but .. if they wanted they could call the Pharmacist before a board meeting to explain their professional decision making process, but I doubt if they will…

Filed under: General Problems