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Dr. Thomas Kline, MD, PhD: Medical Myths Revealed: Distributors and Filling prescriptions being denied
Posted on November 22, 2020 by Pharmaciststeve
How can every pharmacy in the Hollywood/Hallendale area not have Percocet 10/325 ?
Posted on November 21, 2020 by Pharmaciststeve
Hi
I’m from Arkansas. I came to visit my daughter & grandchildren October 28th not realizing I had a broken hip (right) I had fallen the day before I left for Florida & went to the ER X- Rays showed no break so i came to Florida. On November 14th I bent over & felt a pop in my (R) hip & down I went, luckily half on a bed. Went to ER (memorial in hollywood, Fl.) X- Ray showed no break, CT showed an irregularity which prompted an MRI after staying in the short term stay the results from that is a “non displaced superior fracture of the pelvic ramus with extensive marrow adema” can’t have surgery due to location of fracture.
I was able to be released & the doctor wrote a script for 12 Percocet 10/325 & told to see a local doctor within 3 days because that was all they were allowed to write my script for & I would need more pain medication so I made a appointment with a doctor got a script for 7 days here is my problem when I went to fill my script every pharmacy I went to said ” we don’t have any percocet, our shipment will be in the middle of next week”, 2 wal marts, neighborhood market, 2 CVS then finally Walgreens filled my 3 day supply however, I’m still looking for a pharmacy to fill my 7 day script! How can every pharmacy in the Hollywood/Hallendale area not have Percocet 10/325? They are not out right refusing to fill but they are supposedly out, come on! That’s the way they get around refusing to fill the script to not be reported.. So, I’m here in Florida with a broken hip a 7 day script & no pharmacy that will fill my script & in severe pain this does not sound right to me! I am so disappointed in the process or the lack thereof I have never felt so angry to have people lie right to my face when I’m in this kind of pain (the worse pain I’ve ever felt in my life)! What can be done about this, if anything? Your help is greatly appreciated, thank you..
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Could adequate pain management be the best way to prevent many suicides ?
Posted on November 21, 2020 by Pharmaciststeve
VA study uncovers critical link between pain intensity and suicide attempts
https://www.blogs.va.gov/VAntage/67708/va-study-uncovers-link-pain-intensity-suicide-attempts/
Many factors are associated with suicide risk. These factors range from PTSD, depression and anxiety disorder to financial and interpersonal concerns to access to opioids and other lethal means, like firearms. Even when we take these risk factors into consideration, moderate to severe pain intensity is associated with suicide risk.
Veterans are a particularly vulnerable group. The suicide rate among Veterans is 1.5 times that of the general population. Also, Veterans develop chronic pain conditions at higher rates and report greater pain severity than members of the general population.
VA’s Behavioral Health Autopsy Program: Executive Summary reports pain is the most common factor Veterans experience before they die by suicide. The VISN 2 Center of Excellence (CoE) for Suicide Prevention studied the link between reported pain intensity and suicide attempts. The results may uncover how effective pain treatment can be a critical suicide prevention tactic.
Managing pain in daily life
Veterans have several treatment options through VA to cope with pain and reduce pain intensity. Nonmedication interventions are considered first-line treatments. They include physical therapy, cognitive behavioral therapy for chronic pain and chiropractic care. Medication-based treatments include nonsteroidal anti-inflammatory medications and injections. Examples are cortisone for low back pain and botulinum toxin for migraines. Opioids may be used under close monitoring when they are taken appropriately and the benefits outweigh the risks.
Strategies
Strategies that improve psychological well-being can also help Veterans cope with pain in everyday life. Veterans can discuss the following tactics with care providers to see which may work best:
- Be honest about the pain you’re experiencing. An important step in managing chronic pain is accepting that it is part of your life. Accepting the presence of pain can help you move on and engage in enjoyable and everyday activities despite that pain.
- Pace your activities. Although you may not be able to do everything you did before the pain began, try to find ways to reintroduce some activities in a moderated way and create more balance in the activities you’re doing. For example, if you plan to go for a long walk in the morning, consider taking a break mid-day to give your body time to recover and to prevent a pain flare-up. Even if you start to feel better over time, avoid overdoing it to avoid a relapse or further injury.
- Explore mindfulness. Increasing awareness of the present moment can help relieve emotional and mental tension that can intensify physical pain. Meditation and other mindfulness practices help you become more comfortable in feeling the way you feel without judgement, helping to prevent pain from taking over your thoughts and acting on autopilot.
To learn more about pain management treatment provided by VA, explore VA’s pain management webpage for Veterans.
People with higher pain intensity had lower survival rates than those who had mild pain or no pain at all.
Study findings
A CoE study looked at Veterans’ average pain intensity scores in the year after they began receiving pain specialty services to determine whether pain intensity was associated with suicide attempts. Based on data from 2012–2014, moderate and severe pain over the course of a year increased the risk of a suicide attempt, even after considering other factors like a Veteran’s history of suicide attempts.
As the graph to the right shows, those with higher pain intensity had lower survival rates than those who had mild pain or no pain at all. This close correlation between pain intensity and suicide risk and death rates suggests that reducing pain, or the perception of that pain, can help prevent Veteran suicide.
Advice for Veterans’ family members and friends
Family members and friends are often the first to realize that a Veteran may be at risk for suicide. Warning signs include changes in mood or behaviors, outward comments about suicidal thoughts or increased interest in lethal means, such as firearms and opioids. If you see these signs in a Veteran in your life:
- Start the conversation. Topics of pain and suicide can be challenging to talk about. Still, don’t be afraid to begin the conversation with the Veteran you’re concerned about. Starting the conversation can help the Veteran realize the need to address pain. It also reassures the Veteran that you’re willing to help.
- #BeThere for the Veteran and engage in healthy activities. Invite your friend or loved one to a movie or dinner or for a walk around the neighborhood. Getting a Veteran out of the house can remind them of activities they can enjoy, despite their pain. Research suggests changing a Veteran’s mindset and engaging them in activities can improve overall wellness.
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Could the Amazon Pharmacy prevent pts who have a valid medical necessity for controlled substances from getting their meds ? – UPDATED
Posted on November 21, 2020 by Pharmaciststeve
For numerous years the DEA has “forced/persuaded” the pharmacy wholesalers to RATION controlled substances that a community pharmacy can purchase. That rationing is based on a PERCENT of all the Rx meds that a particular pharmacy purchases… I have seen rates of 15%-20% being thrown out as the limit of controls that a pharmacy can purchase.
Several of the statements/press releases that has been put out by Amazon over the past 1-2 weeks… have had some vague statements as to what they are intending to do. One of their statements was to push the issue that they believe that they can sell pts medications for less than their insurance copay.
They also said that they would inventory “common prescribed medications”… since controlled substances are typically 15%-20% of all prescriptions – will they be considered “commonly prescribed medications ” Just think of all the potential headaches of dealing with the DEA that they would avoid if they don’t dispense controlled meds ?
Just like pain clinics wants to only do ESI’s on pts so that they are not dealing with controlled substances.
If people start having their non-controlled meds filled at the Amazon mail order pharmacy, that means that the local community pharmacist will be purchasing fewer non-controlled Rx meds and most likely the DEA will reduce their ability to purchase the amount of controlled substances as they have in the past.
Could this produce a larger “out of stock” issue by local pharmacies for controlled substances and/or if the local pharmacies are even able to retain enough overall Rx business to remain profitable enough to remain in business.
The vast majority of controlled substances are prescribed to pts who are dealing with subjective diseases (Pain, Anxiety, Depression, Mental Health & ADD/ADHD). The total number of pts that could be affected could be a HUGE NUMBER.
As fewer and fewer controlled meds being distributed by pharma wholesalers, will this just encourage the DEA to cut pharma production quotas on controlled meds even that much more ?
Could this end up causing a whole lot of collateral damage to those pts with a valid medical need for controlled substances that NO ONE WILL CARE ABOUT ?
UPDATE
We do not deliver Schedule II controlled medications, which includes most opioids. Learn more at amazon.com/pharmacy.
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I have been using that Walgreens, for the past 4 months, pharmacist would not fill my prescription, because my dose was doubled
Posted on November 20, 2020 by Pharmaciststeve
Hello Steven
I was very impressed with the article that I just read . I am having that problem with a Walgreens store located in Indialantic Florida 32903 Highway A1A and Paradise Boulevard. I have been using that Walgreens store where I have been filling my chronic pain medicine hydromorphone (4 mg) for the past 4 months and before that I was with them for years The pharmacist would not fill my prescription based on the fact that it was increased from 4 mg to 8 mg 3 times a day 90 tablets. I had to wait 4 days until I found another Pharmacy to fill my prescription and therefore was without my pain medication. The reason other pharmacies did not want to fill it is because on record I am a patient using Walgreens pharmacy. and I should not be using different pharmacies. I just went to the doctor and have the same prescription that’s why I hope you might be able to help me. It is due to be filled on the 27th of this month.
I have already contacted the corporate office and filed a complaint approximately 2 weeks ago I still have yet to hear back. Any suggestion on how I am supposed to get my new prescription filled? Unfortunately I cannot go back to the pharmacy Care Plus Pharmacy in Sebastian Florida. This is where I finally got my script filled from last month. The reason being they called me about a week after they filled it and said they did not realize I was in Brevard County and their Pharmacy is located in Indian River County even though the pharmacy it’s about 20 miles from my house
I would highly appreciate your help in resolving this matter so I can have my medication that I so much need. I am also disabled and have at least five other major illnesse. For one a brain aneurysm so as you can probably imagine the stress of the situation is not good at all for my health
Thank you so much for taking the time to read my email
Here is my response to this pt:Here is a revised Pharmacy practice act that went into effect Dec 2015 and basically Pharmacists are not suppose to start looking for a reason to refuse to fill a prescription https://floridaspharmacy.gov/latest-news/validate-pain-medication-prescriptions/
In filling these prescriptions, the Board does not expect pharmacists to take any specific action beyond exercising sound professional judgment. Pharmacists should not fear disciplinary action from the Board or other regulatory or enforcement agencies for dispensing controlled substances for a legitimate medical purpose in the usual course of professional practice. Every patient’s situation is unique and prescriptions for controlled substances shall be reviewed with each patient’s unique situation in mind. Pharmacists shall attempt to work with the patient and the prescriber to assist in determining the validity of the prescription.
unfortunately, I’m not aware of any action the FL Board of Pharmacy (BOP) against any pharmacist that has denied care … as you have experienced here is a link to file a complaint with the BOP https://mqa-flhealthcomplaint.doh.state.fl.us/
The DEA has claimed that a pt traveling a long distance to get a controlled Rx filled is a RED FLAG.. . because that is what substance abusers/addicts/diverters do… I heard one story years ago a chain pharmacist refused to fill a controlled Rx for a pt that lived in a different zip code that the pharmacy … but… the pt only lived about 1/2 mile from the store but there was a zip code boundary line between the pt’s home and the chain pharmacy.
My suggestion is to find yourself a independent pharmacy where you will be dealing with the pharmacist/owner here is link to find one by zip code https://ncpa.org/pharmacy-locator
go talk to the pharmacist/owner and talk about moving all your Rxs to them… talk to them about syncing up all your meds so that they are all filled on the same day each month.. everyone saves time and trouble.
I wouldn’t hold your breath on getting a response from Walgreen corporate… we have a serious and growing pharmacist surplus and if they were unhappy with how a pharmacist was treating their pts.. they would get rid of them… just yesterday I posted a article on how the surplus is so bad that for every 3 new pharmacists grads… ONE may be able to find a job — and do not count on it being FULL TIME. IMO, Walgreen’s lack of response SPEAKS VOLUMES about how much they care about chronic pain pts getting their medically necessary medications and/or being thrown into cold turkey withdrawal.
Finding a independent pharmacy may be the quickest route to help you deal with your health issues. every other entity that you can complain to will drag their feet and you will be lucky to hear from them within 12 months.
One final point is that one of the basics of the practice of medicine is the starting, changing, stopping a pt’s therapy – that Walgreen pharmacist basically changed your therapy – refused to follow physician owners… you might find some relief by filing a complaint with the FL medical licensing board… for the Pharmacist practicing medicine without a license.
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Every chain pharmacy is understaffed, techs are underpaid. Pharmacists are overwhelmed
Posted on November 19, 2020 by Pharmaciststeve
As a retail pharmacist for 18 yrs with a massive company. I would highly recommend that anyone who can, transfer their prescriptions to a local independent pharmacy
The brick and mortar chains are cheating customers and employees, while earning a windfall of cash for the executives only.
Every store is understaffed, techs are underpaid. Pharmacists are overwhelmed.
Demand better healthcare!
Pharmacist Job Outlook: It’s Worse than You Thought studentloanplanner.com/pharmacist-job At a minimum, it seems as if a net 10,000 pharmacists will be entering the labor force yearly with nowhere to go
CVS: The pharmacy was 1,200 scripts behind and eight days behind in prescription refills
I have read statements from numerous statements from numerous chain pharmacists that typically pharmacist’s shift is from opening to close – normally some 12-13 hr shifts and when they leave at the end of their shift..there is still a few hundred UNFILLED Rxs left in the computer que that was not filled by the end of the day.
I have read from pt statements that when they come to pick up their Rxs after calling in a refill a few days before and it is still not ready and when they do finally get their refill.. the date on the Rx label can be a few days before they tried to pick up their Rx and it was not filled. Not to justify a such lag time … it could be done so that if a prescriber has to be contacted regarding a refill with no authorized refills left … that process can be initiated and/or if the pharmacy computer system auto replenishes inventory… that would help assure that the needed medication can be in stock… when the Rx finally gets to be filled.
Historically, there has always been what is called a PIC ( Pharmacist in Charge) who is responsible to the state’s board of pharmacy for the legal operation of the Rx dept that they are listed as PIC. Back when these designations were developed into a pharmacy practice act, the vast majority of pharmacies were independent pharmacy… so the PIC was typically the pharmacy owner.
Some states have changed this designation from PIC to “responsible pharmacist”… and since chain pharmacies dominate the market place… the pharmacist that is responsible to the state’s board of pharmacy for the legal operation of the Rx dept … is now responsible for everything and IN CHARGE OF NOTHING… just the way the corporate management of chain pharmacies likes it.
When a pt patronizes a independent pharmacy… typically they are dealing with the Pharmacist/owner and often the tech staff has been there for years… because the Rx dept is well staffed and the staff is well paid. We had our own independent pharmacy for 20 yrs and when we sold out to a chain… my primary tech had been with us at least 12 yrs and they said that they would keep her hourly rate and benefits and was told that she was going to be the HIGHEST PAID TECH in the entire chain pharmacy and this chain was in the top 5 in the USA as far as the number of stores that they had.
It is YOUR HEALTH…. It is YOUR LIFE…. It is YOUR CHOICE …. chose wisely !!!
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Amazon opens online pharmacy, shaking up another industry- should healthcare remain locally ?
Posted on November 17, 2020 by Pharmaciststeve
I have always had a concern about mail order pharmacies.. first of all… all medications have temp storage requirement typically in the mid-50’s to mid-70’s. These storage requirements have to be met by the pharma, wholesaler & the pharmacy. But, when a pharmacy hands off a packaging of Rx meds to a delivery service… NO ONE has a obligation to maintain those storage requirement. Normally, if a pharma, wholesaler, pharmacy allows Rx meds to be outside of the required temp range for > 24 hrs the product is consider adulterated and NO LONGER SALEABLE.
From this article and others that I have read, Amazon appears to be “pushing ” paying cash for Rxs. If this Amazon pharmacy has a contract with your health insurance and you pay cash… it won’t applied to your deductible and highly possible if you submit your cash receipts to your insurance company they will not reimburse you and apply to your deductible because Amazon pharmacy has a contract to bill the insurance for the pt.
Encouraging pts to PAY CASH the Amazon pharmacy will not have to deal with the BS from insurance companies in getting a Rx claim thru the system and with a charge card .. Amazon will get their money in – at most – a couple of days instead of having to wait 2-3 weeks for the insurance company to pay and then reconcile their payment against what was billed and won’t get docked with those unpredictable DIR fees.
If this Amazon pharmacy functions like most mail order pharmacies, filled Rxs may not reach the pt for up to TWO WEEKS and what does their statement mean that they “will offer commonly prescribed medications“… Does that mean NO CONTROLLED MEDS ? The DEA states that it is RED FLAG for a pt to pay cash for a controlled substance if they have insurance.
Amazon opens online pharmacy, shaking up another industry
https://www.foxbusiness.com/retail/amazon-opens-online-pharmacy-shaking-up-another-industry
The company opened an online pharmacy Tuesday, giving Amazon shoppers the chance to buy their medication and order refills on their phones and have it delivered to their doorsteps in a couple of days, just like a book or toilet paper.
The move propels Amazon into a new business, potentially shaking up the pharmacy industry as it has done to everything from book sellers to toy stores and grocers. Big chains like CVS and Walgreens rely on their pharmacies to bring them a steady flow of shoppers who stop by frequently to pick up their medications.
Amazon said it will offer commonly prescribed medications starting Tuesday, including creams, pills, as well as medications that need to stay cold, like insulin.
Shoppers have to set up a profile on Amazon’s website and have doctors send prescriptions to the Seattle-based e-commerce giant.
ONLINE SHOPPING SURGE COULD LEAD TO HOLIDAY DELIVERY DELAYSMost insurance is accepted, Amazon said. But Prime members who don’t have insurance can also buy generic or brand name drugs from Amazon for a discount.Amazon has eyed the health care industry for some time. Two years ago, it spent $750 million to buy online pharmacy PillPack, which organizes medication in packets by what time and day they need to be taken. Amazon said that PillPack will continue, focusing on shipping medication to people with chronic conditions.
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Apparently the COVID-19 didn’t get the memo about it being gone in a few weeks – this dated 04/2020
Posted on November 17, 2020 by Pharmaciststeve
And something that not many doctors are talking about lately is one of those that apparently is a symptom caused by some vaccines. And it is that although within the study impotence is not taken into account as a determining factor within vaccines, the trend seems to indicate the opposite. That is why at UK Meds they take this problem very seriously and try to deal with it by offering the most effective product against this problem, being one of the best sellers in the United Kingdom.
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Stand and Fight Podcast – Darleen H. Palmer forced reduce dosages and SUICIDE
Posted on November 16, 2020 by Pharmaciststeve
Click on the link below to listen to a 32 minute pod cast that details how a ultra fast metabolizer intractable chronic pain pt was forced to decrease his dose OVER 75% and he ended up committing suicide… evening behind a young wife with FOUR KIDS.
In this episode Darleen shares the story of her husband Adam. He caught a rare disease from a tick called Rocky mountain spotted fever which left him dependent on pain meds to function. The problem became dealing with the insurance companies and his struggle to find common ground with them. In the end her husband took his own life. Now she is her to tell his story and to help other families in need. She is now a single mother of 4. Sometimes we don’t think about the 1% who live with an insane amount of pain on a daily basis. They need medication just to function. Myself being a recovering addict i always fight for everyone to be drug free but this conversation helped me with the other patients who actually need it. A voice clip of the husband’s suicide goodbye message is on this podcast so if you are vulnerable or feel you might be triggered please don’t listen or listen with a friend.
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Trial by Fire-CRPS documentary
Posted on November 14, 2020 by Pharmaciststeve
https://youtu.be/5WZCh3TeTa0
RSD/CRPS is a condition that needs much attention. Charles saw this dire need and wanted to contribute to get that need filled. Charles has talked to many, heard scores of stories and researched the condition; with this knowledge, his heart was moved to get involved and become an advocate for the condition through the love of his mother and the heartfelt for the countless others suffering. This moving piece takes us on a journey that will impact the perspective of how we view healthcare and the caregivers of those suffering daily. We walk with Charles as he helps his mother through her own treatment and life changes. We will also meet others fighting to stay alive from this deadly disease. We will fight to help this project move the health care system to figure out ways to help those who need the funding or the health care coverage to get the needed treatment to allow them to live. We will expose what at times seems like Guinea pig-type of treatments that at times can do more harm than good. This is a story that needs to be told and this documentary will open the eyes of many around the world that never knew of this condition and bring hope to those with CRPS. For more info on Charles and his work visit. To work or book Charles visit http://charlesmattocks.com PLEASE SUBSCRIBE TO THE CHANNEL AS WE ARE LOOKING AT DOING ANOTHER FILM BASED ON CRPS AND RARE DISEASE, GET THE LATEST UPDATES. All rights and music belong to our company.
https://www.youtube.com/watch?v=5WZCh3TeTa0
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