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