I talked to a practitioner a few days ago, this practitioner had a high intensity, intractable chronic pain pt who had been filling a opiate Rx at a local grocery store pharmacy for some time. All of a sudden, the pt was informed by a Pharmacist at the pharmacy that he “was not comfortable” to continuing filling the pt’s C-2 and this was just a few days before the pt was get a new C-2 filled. In fact, the practitioner had already electronically sent the C-2 Rx to the pharmacy.
The pt had been taking 135 MME/day for some time. I have often stated that one of the basics of the practice of medicine, the starting, changing, stopping a pt’s therapy. In reality, “I’m not comfortable” is not a valid clinical reason for stopping a pt’s therapy and it would suggest that this Pharmacist is totally indifferent to intentionally throwing this pt into a cold turkey withdrawal and within days of Christmas.
I don’t know if this pt was intending to travel to be with family or the pt was planning on having family at their house for Christmas?
IMO, this Pharmacist should be taken before the state pharmacy board for unprofessional conduct and lack of empathy for the cold turkey withdrawal and torturous level of pain the Pharmacist’s action was intentionally causing for this patient.
I wonder what a State Board Pharmacy actions would take – if any- against a Pharmacist, if a pt would file a formal complaint?
I went out to www.perplexity.ai and asked the following question:
what could be the consequences to a pharmacist that intentionally cut a legit chronic pain patient off their pain meds and intentionally throws the patient into cold turkey withdrawal. Could the pharmacist be charged with practicing medicine without a license
If a pharmacist intentionally cuts a legitimate chronic pain patient off their pain medications, leading to cold turkey withdrawal, the consequences can be severe and multifaceted. Here are some potential outcomes:
## Professional and Legal Consequences
– The pharmacist could face disciplinary action from their professional licensing board, including the suspension or revocation of their license. This is because such actions would violate the standards of professional practice and potentially harm the patient[1][6][8].
## Criminal Charges
– While the pharmacist would not be charged with practicing medicine without a license, as pharmacists are licensed to dispense medications, they could face other charges. For example, they might be charged with negligence, reckless endangerment, or other crimes related to the harm caused to the patient[5].
## Civil Liability
– The pharmacist and the pharmacy could be held liable in a civil lawsuit for any harm or suffering caused to the patient. This could include damages for physical and emotional distress, medical expenses, and other related costs[5].
## Health Consequences to the Patient
– Abruptly stopping opioid pain medications can lead to serious withdrawal symptoms, uncontrolled pain, psychological distress, and even thoughts of suicide. Patients may also seek other sources of opioids, including illicit substances, which can further exacerbate the situation[1][4][6].
## Ethical and Regulatory Violations
– Such actions would violate FDA guidelines and other regulatory standards that emphasize the importance of gradual tapering of opioid doses to avoid serious harm to patients. This could result in regulatory penalties and further disciplinary action[1][6].
In summary, while the pharmacist would not be charged with practicing medicine without a license, they could face severe professional, legal, and civil consequences for their actions. The primary issue would be the violation of professional standards and the potential harm caused to the patient.
Citations:
[1] https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes
[2] https://www.davidrankinlaw.com/former-pharmacist-arrested-for-practicing-health-care-without-a-license/
[3] https://www.govinfo.gov/content/pkg/FR-2018-04-30/html/2018-09020.htm
[4] https://www.nbcnews.com/health/health-news/cdcs-new-opioid-guidelines-little-late-chronic-pain-patients-rcna74248
[5] https://www.criminaldefenselawyer.com/resources/practicing-medicine-without-a-license.htm
[6] https://www.npr.org/sections/health-shots/2019/10/10/768914092/dont-force-patients-off-opioids-abruptly-new-guidelines-say-warning-of-severe-ri
[7] https://www.mbc.ca.gov/Download/Publications/pain-guidelines.pdf
[8] https://en.wikipedia.org/wiki/Practicing_without_a_license
Filed under: General Problems
Two years ago something similar happened. After filling prescriptions for years the pharmacy one day said if the amount prescribed wasn’t dropped to an amount they arbitrarily stated within 30 days they would no longer fill prescriptions. Even though my dr called and spoke with them . And to add insult to injury my dr called around and not 1 other pharmacy in my whole county will fill my prescriptions. I did call the state pharmacy board after messaging some with you . Thank you. But they said that they would call me back and have never returned my call.. for now I have to drive over a hour each way to revive a prescription. For the moment I’m am on borrowed time . The new pharmacy has now cut it number of Medicare excepted plans down to like 7 and if you don’t have one of those then your out .have to pay cash . Also had a completely different prescription that was covered told they wouldn’t cover it because they didn’t get paid enough so because I have to agree to get all my meds at said pharmacy because of the pain medication contract. I now have to pay out of pocket for something that’s covered. It’s like being held for ransom. They know you can’t get your meds anywhere else they also know if you speak up against the wrong that they’re doing they will tell you that they are not going to continue filling your medication. . It’s a very sad and stressful situation in which to live in.never knowing from day to day if this is the day they just drop you . 15 1/2 years in . Almost afraid to post this because of the fear this whole dynamic is perpetuating.
What you are bumping up against is that pharmacies are rationed how many/much of controlled meds they can purchase and it is based on a percentage of non-controlled Rx meds they purchase from the wholesaler. I have heard of Insurance/PBM companies reimbursing pharmacy as much as $100 less than the pharmacy has to pay to purchase it from a drug wholesaler.
Having lived through this nightmare myself I personally feel that any pharmacist or physician that cold cuts a patient for any reason at all should have criminal charges filed against them. It is a hell there are no words for.
Excellent as always. Does having a PharmD place a pharmacist in a different class as they ARE doctors and in some states CAN practice and rx badic cold/strep throat type meds?
Technically, those PharmDs are classified as “mid-levels” like ARNP, PA, NP. One thing that I know those of us who have a BSPharm that are discriminated against is the American Diabetic Association, I could never be granted “diabetic educator credentials ” because only PharmDs are eligible. Anyone who questions where I stand with a BSPharm.. I just tell them there were 80-85 declared Freshman Pharmacy Majors in my class and only 13-15 made graduation. This is while if you were not in college you would be in “rice patties” in Vietnam. I cannot imagine that someone could say that a pharmacist with decades of clinical experience cannot match up with a PharmD with an extra year – which is nothing more than doing rotations in different practice settings of 4 weeks each in the last year.
How about when a medical group decides not to do anymore refills for a long stand chronic pain patient ⁉️ Should they be able to do that same thing ⁉️ I tried like Hell to get help and there were NONE‼️.No one helped me,‼️.Why don’t you write about all of the patients that have been forced to go through withdrawals cuz the providers are a bunch of chickens They were being blamed so they turn on their patients ‼️. Like we just didn’t matter ‼️ Only a select few are ever helped! What’s that about ⁉️
I know you don’t like me but that shouldn’t matter when it comes to helping!? But wrong again ‼️
I don’t know where you got the idea I don’t like you.. I just checked and the first time you made a comment on my blog – of 12 years – was on 2024/11/22 at 2:42 pm
Did you ever ask me to publish your story? I can’t publish what is not shared with me.
Sorry if I’m misinterpreting but I don’t believe Liana was saying YOU don’t like her. I think she was referring to the drs who cut her off. She switched the voice of her statement., l do Think she was asking why she was cut off, and then adding “I know you don’t like me” as a potential reason her drs cut her prescription.