I recently wrote about Cardinal Wholesaler “cutting off” the controls to one of its Medicine Shoppe Franchisees… https://www.pharmaciststeve.com/?p=3929
https://www.pharmaciststeve.com/?p=3982
I have been communicating with this RPH.. and the information that is being provided to me… makes this whole situation very bizarre …
It would seem that this whole situation unfolded because a pt was referred to this particular pharmacy because the pharmacy that this pt had been getting their 270 Oxycodone 30 mg for an extended period of time.. got a new – freshly minted RPH as PIC .. and this RPH refused to continue filling this Rx for the pt.. because of the dose.. that the pt had been taking for some time.
Apparently the sudden increase in Oxycodone purchases by this Medicine Shoppe got the attention of someone at Cardinal.. which got them questioning..
The Medicine Shoppe RPH sent to the pharmacy’s attorney a redacted information on this patient and the pharmacy’s protocol in how they handle ALL chronic pain pts meds.
Apparently the pharmacy’s attorney.. turned this information over to Cardinal and apparently all hell broke loose.. since Cardinal turned the information over to the DEA.
Also after all of this.. the pharmacy’s attorney decided to resign from the case… so now the RPH has to fight both an attorney who may have gotten in over his head and left the RPH high and dry and find a new attorney to take on the case and get up to speed… all the while.. this Medicine Shoppe cannot get any controls from Cardinal.. even though the Franchisee agreement MANDATES that the pharmacy purchase a minimum of 95% of all purchase from Cardinal.
I guess that the interaction of Cardinal with the DEA in that Florida incident with those CVS stores that sold multiple of times the doses of Oxycodone than the average store and the DEA blamed Cardinal for “not paying attention” and it ended up costing Cardinal millions and millions of dollars… settling it all..
I am starting to wonder if the government is really here to protect us.. or could care less if they do substantial harm to a certain segment of our population. My money is on those that abuse drugs will find some other substance to abuse.. while those that have a legit need for these meds.. will end up suffering in silence
Filed under: General Problems
Everyone has already the thoughts on the DEA.
But I also have to chime in that both Cardinal Health and the Medicine Shoppe franchise (not the independent stores and their owners) are pretty terrible companies.
There is entirely too much government control in Pharmacy Practice. The laws we have do not help those who need medication. Those who legitimately need the medication are usually punished by laws. The DEA will become more and more intrusive. It is NOT a good time to be a pharmacist.
I can honestly say that y’all are in a catch 22. You don’t have access to patient records, how can you know for sure if the prescription is valid or not? It is one thing if you see that patient several times per month, you’re on a first name basis, know their kids, know their health issues etc etc. You can make an educated, somewhat informed decision when presented with a narcotic prescription.
You make a very good point about the Florida problem. Why does the whole of the country have to pay for Florida’s former Free-For-All (non)policy?
The whole “War on Drugs” has been a colossal failure from the get go, and should be abandoned. The only casualties are people like me, who would love to not have to shove 32 pills down their gullets each day just to survive., and the pharmacists who have to wonder which prescription will be the one that lands them in jail.
Amy, I agree with you that there must be a better way to treat people without assuming they are druggies. The one problem that pharmacists face, when it comes to trying to determine if a person is just a drug seeker, is that we don’t have access to patient records. We cannot always assume the physician is writing the rx for a valid medical condition. We have one physician in my area that seems to write for anyone and everyone. The DEA got after him and the rx’s have slowed down, but not stopped. The rx drug problem clearly rests on the shoulder of physicians. Pharmacists are being singled out by the DEA, but pharmacists don’t know whether a rx is written for a valid medical condition or not. I had one physician that kept trying to give me a prescription for a ‘druggie’ and it took a lot of convincing before he finally decided not to give me the rx. First, my state has a prescription monitoring program. This physician should have had access to it. He was working the emergency room. I asked him about it and he said he did not have access to it. The ‘druggie’ had gotten rx’s filled 2 days before at a pharmacy 75 miles away from another doc. This doc did not know the patient! She had convinced him that she was in severe pain and he was bound and determined to give her a rx. It is this sort of thing that keeps the druggies in drugs….it is physicians that are too quick to write rx’s and don’t check to determine their rx fill history.
Back in the 90’s, the pendulum swung toward giving narcotics quite freely to anyone that might be in pain. The idea was that no one need suffer needlessly. Today, the pendulum is swinging in the other direction. The DEA is trying to curtail narcotic use in the US. Where is our Health and Human Services department on this matter? People like you are having a difficult time getting narcotic prescriptions. My guess is that no one wants to go against the DEA. The question is whether, or how long it will take, before enough people complain to Congress and the DEA is put in their place and no longer can make ‘judgments’ about how many narcotics a pharmacy can stock. Just because things got out of hand in Florida is no reason to choke off the supply to all pharmacies in the US. The problem in Florida squarely rests on the shoulder of the DEA because they were negligent in overseeing the physicians. The problem was not with the pharmacies handing drugs out the back door. The pharmacies had valid rx’s. How in the world do pharmacists know if a rx written by a physician is for a valid ailment or not? We don’t! That is why the problem of drugs being dispensed to drug seekers is caused by physicians…not pharmacists…not drug wholesalers. The DEA is going at the problem backwards. They are shutting off the supply at the wholesaler. Why? Because it is the easiest thing to do. Just look at the pitiful number of physicians they arrested last year. Makes you wonder what they were doing.
Amy Rapp, it is people like you that concerns me. With the DEA getting ever more aggressive, I am afraid that people that really need pain meds are going to have a tough, if not impossible, time getting those drugs. And, as Anonymous talks about prohibition, I am wondering if the DEA is creating more abusers with their ‘prohibition’ tactics. I think this country needs to try something new when it comes to this ‘war on drugs’. As an experiment, the DEA should be eliminated and no more prosecution of drug users or sellers. We could then see if things got worse or better. The government failed to stop the use of alcohol, so why do they think they can succeed at stopping the use of illegal drugs?
The prohibition analogy is spot on! My children range in age from 4 to 12. I can assure you that when they get up today and I decide to put the kaibosh on green Kool-Aid, they will employ every trick in the book to drink green Kool-Aid. I may be oversimplifying it here a bit, but come on….we have seen this before. Does anyone doubt that Al Capone and his ilk could have made the millions that he did if Prohibition were not in place? Does employment with the DEA require that you must have NO knowledge of US history?
OSU Med Center has also made it difficult for physicians to prescribe CII drugs. My nephrologist can now only sign for prescriptions on days he is in clinic seeing patients. He does that one morning per week. All other days he cannot sign prescriptions for CII drugs. In June, I called on a Monday, my prescription was due to run out on Friday. No problem, except that staff forgot to print out the script and he left on vacation, not to return until the following Tuesday. I find all this out on Thursday, the day before I run out. No other doctor can write that script for me…..the nurse said “you can go to the ER if the pain gets too much”. Pain? That I can work through, it is the sudden onset of horrific withdrawal I feared! Thankfully, the previous month my urologist had written me a 14 day supply for the same med (knowing that I was already on this) when he discharged me from another inpatient stay. (post stone surgery my ureter collapsed a few hours after the stent was removed…..they replaced the stent). I didn’t realize it until I got home, I had only wanted 5 or 10 Vicodin to help with breakthrough pain. The Vicodin was called in and I never got around to shredding my Oxy script. I took that to my pharmacist, explained the situation, they verified with all parties involved what the situation was thus agreeing to fill the script and I avoided 6 very sick days. Now, if you look me up on Ohio’s prescription drug monitoring program, that is going to look suspicious. I look guilty.
Yesterday I picked up my big prescription. In 4 hours I am having oral surgery to repair an oral-antral fistula. This is the second one I am having done. The surgeon knows I am on Oxycodone and will write me a prescription for Vicodin for breakthrough pain. Bells and whistles will be going off at all sorts of government offices.
And you know what gets me? I have been on this dose since 2008. I am sure I have become somewhat tolerant, as it does not work as well as before. But I am afraid to ask for an increased dose. My doctor tried to get me set with an intrathecal Dilaudid pump last year, but the spine center stated they no longer do those because patients built up a tolerance too quickly. The doctor there must have said 5 or 6 times that they do not write narcotic prescriptions until I finally said “I know, and I have not asked for one, but since I am here, I would like to see if there is any further degeneration in the lumbar-sacral vertebrates due to osteoarthritis and to see what the RA has done in regards to my c-spine. I just want information, or better yet, answers”. Until that point, I had been treated rather rudely. I later learned he had printed out my prescription drug database file, and assumed I was a drug seeker.
There has to be a solution other than treating everyone who comes in contact with narcotics as a criminal.
Well the reason for Cardinal’s paranoia is coming into focus. As for drug abusers finding other substances to abuse, yes they will. Addicts are very determined people and they will do what they can to get their drugs. Then the rest of us are left to be treated like criminals, jumping through hoop after hoop meant to deter the criminals, but only actually really hurting the real patient. I live in Central Ohio, just a few short hours from the Hillbilly Heroin capital of the Word. I have two medical syndromes that can cause horrendous pain: Loin Pain Hematuria Syndrome….after 30 surgeries, my kidneys are a mess, they work but it feel like I’m passing stones every day, I recently walked around for 6 weeks with an 8mm stone lodged in my ureter because I couldn’t differentiate that pain from my daily issues. And I also have Rheumatoid Arthritis. Treatment with Biologics (Enbrel, Orencia) do wonders, until my IGG levels bottom out and a sinus infection will put me in the ICU in septic shock….(sigh) So, I had to stop those. I get 360 Oxycodone 5mg IR tablets per month to treat the pain I live in. Due to my kidneys, I’m not supposed to take NSAIDs. So I take a lot of prednisone, have gained 70 pounds and my teeth have become so brittle….I am 42 years old and having what teeth I have left pulled so I can get dentures. I am not a healthy person. My pharmacist at Walgreens and the couple of techs who have been there since my medical odyssey began in 2005 know me and my health. When I come in to get things they know if I’ve been inpatient and take the time to talk to me. When the latest new CII procedures came out, and they had to document “why” I was on that amount of meds, a new pharmacist was there and I was listing out my many medical conditions that would require my prescription, she asked if I felt I would be better off with a long acting drug (suggested OcyContin ) so I wouldn’t have to take 12 pills a day. Well, 90% of my stomach has been removed, due to that, oral ER drugs just don’t seem to work well for me. I have a serious malabsorption issue. The only really effective ER drug for me would be something like Duragesic…..and I never want to go back on that stuff. But after reading your posts about this, reading about the DEA coming down on Walgreens, I almost feel guilty…..like I’m going to get them in trouble or something. I certainly don’t want to be dropped.
I pick up my big prescription today, along with my daughter’s ADHD meds and some Sudafed. I wonder if I’ll make it back to the parking lot before DEA agent rappel off the roof take my cane and tackle me?
Prohibition Revisited! Drug controls, like many other corrupt activities by our government, has become way over-the-top! I wonder if drug addiction, alcoholism, and drug related violent crime is as bad in countries with less aggressive drug laws than the U.S. I know, unfortunately, first hand, how horrible it is to suffer severe endless chronic pain because it is “unfashionable” in this country to prescribe or dispense pain medication even to those who so desperately need it for its approved use without being scrutinized and risking your health provider livelihood. My heart goes out to those who suffer needlessly as a result. Was there a higher percentage of alcoholics in our population during Prohibition, or now? I’ll bet if you checked, you may be surprised…DURING! More alcohol related violence, too! US government is intellectually handicapped!
It sounds like a ‘tangled’ mess. Now, can the pharmacist sue his lawyer?