Can my Psych find out if I handed in my script to a pharmacy and collected it?

[Rybee]

So basically, I've had a bit of a nightmare with my anxiety lately. Not seeing my Psychiatrist (I go privately in London so use private prescriptions) for another 3 weeks and to cut a long story short; I wanted to change from Lorazepam (Ativan) to Diazepam (Valium) for pro re nata use, because I just didn't feel the Lorazepam (Ativan) was working for me, to which he happily accepted and agreed that I would be better off with such change. He's been prescribing me Benzodiazepines's for about a year now. I don't abuse them, or take them daily, perhaps 2x10mg per week to help with what I call breakthrough anxiety. (I'm taking Dosulepin (Dothiepin) to help bring my overall anxiety down, with great results). I see him every 4 weeks and he keeps a close eye on what he prescribes me, how much I take, how I respond to it etc...

After a quick phone call, he agreed to post me a script for Diazepam (Valium) and said he wrote it out and would put it in the post on Monday, to be here for Tuesday, Wednesday at the latest... It's now Saturday and it's still not here which is frustrating because I really need it for the weekend...

So the script STILL isn't here and I really do need it. I have a very bad relationship with my GP, which stemmed from requesting a copy of my medical records from my doctor's surgery last year in order to give to my Psychiatrist so he could have a thorough read of my history and evaluate it before treating me. At this point I noticed that it had *SPBU* (Suspected Problem Drug User) , and *ICDS* (Identified Controlled Drug Seeker) markers on the top of my notes which also say *NO DIAZEPAM* on the homepage of the computer screen that I can see whenever I go to see a doc there... To which I was pretty upset more than anything, I've never been confronted about either of these issues, and was completely unaware of it until then. So going to my GP is an absolutely no-no.

Me and my Psychiatrist have very good mutual trust and confidence in one another, which has been key to my rehabilitation from my mental illness problems over the last year since he's started treating me.

It was sent by post from his London clinic to my house. So I'm now stuck in the position of not needing to tell him that I never received it, and struggling with bad anxiety for the next 3 weeks until I see him face to face, and probably resorting to using Oxycodone (Roxicodone) in small doses to help alleviate my anxiety (legitimately prescribed by my pain management consultant last week).. because I don't want him to think that I did in fact receive it, get it filled and walk away with a load of Diazepam (Valium), and then be asking for another script. When he first put me on Diazepam (Valium) he gave me a prescription of 5mg (q.d.s.) so 112x5mg tablets so we could be talking about a large quantity. If it was just 14x10mg tablets or 28x5mg tablets I'd just tell him. But on the phone, he never told me what quantity of what dose he was prescribing me... it could be 14x5mg/28x5mg/56x5mg/112x5mg or 14x10mg/28x10mg/56x10mg... It could be another large dose, who knows...

So do I just be honest and call him saying I didn't receive it and test our trust, potentially causing trouble, by making him think that I've pulled a fast one. My issue of not telling him is that when it comes to seeing him in 3 weeks and me saying, oh can I have some more, he could turn round and say, well no, I posted you a script for 112x5mg tablets just a few weeks ago... Then if I say I never got it at that point, it looks VERY suspicious.

So that's the moral problem I'm in, I don't want to ruin the mutual trust we have for one another... He's literally my rock. I owe him so, so much and I can't ruin that trust.

So do I:

A) Be honest, call him saying I've still not received it, can he post me another one. And if the previously posted one turns up I'll bring it with me to our next session and give it him back - so he knows that I didn't get it filled and was being honest. To which I think that looks suspicious in the fact that I may have already got my prescription filled and am asking for another one. Making it uncomfortable for him, and damaging our trust a little.

B) Try not to ruin our mutual trust and confidence and use some Oxycodone (Roxicodone) to help with anxiety for the next 3 weeks (which I find very good to relieve my anxiety), and then ask him for another script for Diazepam (Valium) when I'm in his clinic... but face the possibility of him saying he prescribed me 112x5mg tablets a few weeks ago. To which I think that looks very suspicious - why didn't I tell him before?

This brings me on to my second question (for ENGLAND users ONLY)

Would he be able to find out if I got the missing prescription filled, or not in my case? If he can check some kind of system that says I didn't get any prescription for Diazepam (Valium) filled, then he knows I never received it, filled the prescription and walked away with a packet(s) of Diazepam (Valium)?

I really need the Diazepam (Valium), but I don't want to make him think I'm pulling a fast one on him to potentially get 228x5mg Diazepam (Valium) tablets filled in two separate prescriptions? I don't want to make him feel suspicious and not trust me, but I really do need that medication.


BL'ers please help me. We're incredibly open about my issues in life and he knows about my previous opiate addiction and abuse. I NEVER abuse benzo's because:
1) I don't really like it, they just send me to sleep
2) I really need to to treat my anxiety so I can't crank my tolerance up for fun.

So he may suspect that I'm pulling the wool over his eyes as such...


In future I think I'm going to ask him to fax it directly to a pharmacy so it can't get lost/missing in the post.


Please help! Rybee xxx

 

[Felonious Monk]

Tell him. Not being honest will bite you in the end. Plus, you've done nothing wrong, the Rx is lost in the mail at this point and you need another. If it's lost then it's gone, if it comes next week then you bring it in next appointment and it's clear you were telling the truth.

I wouldn't worry about whatever was written in your file, your psych clearly doesn't care and is treating you how he feels is appropriate.

And can you get a new GP so you can have active relationships with all your doctors?

 

[lurching]

B) Try not to ruin our mutual trust and confidence and use some Oxycodone (Roxicodone) to help with anxiety for the next 3 weeks (which I find very good to relieve my anxiety), and then ask him for another script for Diazepam (Valium) when I'm in his clinic...

What is your psychiatrist going to say when he hears that you've been self-medicating with Oxy for 3 weeks? I can't imagine that being good for mutual trust and confidence. As attractive as a three week opiate binge may seem...

I would simply make another call to your doctor and to the pharmacy, see if they know anything.
Doc probably just forgot to put the script in the mail.

 

[spudgun]

At this point I noticed that it had *SPBU* (Suspected Problem Drug User) , and *ICDS* (Identified Controlled Drug Seeker) markers on the top of my notes which also say *NO DIAZEPAM* on the homepage of the computer screen that I can see whenever I go to see a doc there...

Do you know what happened with your GP that led to them putting this on your record?

 

[j.t]

Yes, all prescriptions filed get logged. If he wanted to check to see if you had it filled would take a couple of minutes. (Well, take his secutary a couple of minutes.)

Sounds like you're trying to scoop more drugs and are asking if you can get away with it.

 

[Rybee]

Just had Saturday's post come through with a few things but no script

Tell him. Not being honest will bite you in the end. Plus, you've done nothing wrong, the Rx is lost in the mail at this point and you
need another. If it's lost then it's gone, if it comes next week then you bring it in next appointment and it's clear you were telling the truth.

I wouldn't worry about whatever was written in your file, your psych clearly doesn't care and is treating you how he feels is appropriate.

And can you get a new GP so you can have active relationships with all your doctors?

1) Yeah I thought it would come round to bite me in the end. I've always been honest and open with all kinds of drug abuse. Fentanyl, Morphine, Tramadol, Codeine, Cocaine, Alcohol... He knows everything that I've done that I regret, I'd trust him with my life... we've spoke about benzo abuse before and I was honest and just said it doesn't appeal to me. I usually take 10/15mg of Diazepam if my anxiety is bad, If I took 30-40mg I'd just fall asleep. I personally don't get much gain out of 'abusing them' perhaps that's because my anxiety is much more under control and I don't feel the need to take them everyday. The closest I get to abusing them is taking them for granted, as an easy way out sometimes, when meditation/CBT techniques aren't practical at that particular time. He knows I don't abuse benzos.


2) Yeah I think you're right. For all I know he's given it to his secretary and said to post it, she's said sure no problem, he's told me job done, and she's not actually got round to doing it...

3) Again, if he did issue me with another script and the first one turned up later I'd just give it back to him so he knows I'm being truthful.

4) The thing that's on my file is completely explainable, I told him of it, and I also asked my GP Surgery to remove it, to which they agreed, but never did... As you say, that message saying *NO DIAZEPAM* has been there for ages and I've since been prescribed Diazepam/Lorazepam/Clonazepam/Alprazolam by my Psych so it's really not an issue. I can move to a different GP Surgery but the next one's quite far away so would be a pain. There's 1 doctor there who happens to know my Psychiatrist on a social level, family friends, so he's always good for me.

Thanks for the reassuring help... I was just panicking earlier. Knowing that I don't have any Diazepam/Lorazepam makes me even more anxious, just because I know I that if I did need some, I don't have any! It's not the end of the world, by I'm aware that my anxiety and anxious thoughts are irrational in themselves. It just turns into an irrational circle of anxiousness. That's when I try CBT techniques to rationalise with myself that it's really no big problem!

What is your psychiatrist going to say when he hears that you've been self-medicating with Oxy for 3 weeks? I can't imagine that being good for mutual trust and confidence. As attractive as a three week opiate binge may seem...
I would simply make another call to your doctor and to the pharmacy, see if they know anything.
Doc probably just forgot to put the script in the mail.

Yeah I know, that's a fair point. I ran out of Lorazepam around Xmas time and I didn't want to pester him around Xmas so I just ended up drinking codeine linctus as that's all I had to take the edge off, since I don't drink. I saw him in January and it's he first time I've seen him mad at me. He said that I'd let him down by thinking that he wasn't there fore me when I needed it and would've been happy to just take some time out for a quick email. I just knew he was away on holiday over the xmas period so I didn't want to nag him when he was taking time off with his family.

As I said above, he may well have handed it to his secretary who said she'll post it, and then told me 'its in the post' but not actually having had posted himself.

Do you know what happened with your GP that led to them putting this on your record?

I do indeed.

It was about 3 years ago when a doctor at my GP Surgery prescribed me 28x5mg diazepam tablets, didn't really explain what they were but just told me take one if I felt anxious, or couldn't sleep. Didn't explain that they were addictive and I should use them with caution, just said take on if you feel anxious. So naturally I did that... I took about 20mg per day, which I guess for someone who'd never take them before was a fair amount. A week later I went back, saw a different GP and said 'hi I'd like another packet of these please' (honestly had no clue what they were, to me it was just a pill that made you relax) and she went bezerk.

Started telling me I was abusing them, I shouldn't take more than 10mg in 1 day, they're addictive blah blah blah. Then she said I was addicted to them and was 'actively seeking class C drugs'... I just sat there like... What on earth are you on about woman!? It was blown totally out of proportion and she said she wasn't going to give me any, but refer me for CBT, and would have to talk to the partners of the GP surgery about how to handle this 'drug addiction.'

I just walked out like I thought I'd been on some kind of prank show... I couldn't believe it. I had no idea what they were, no idea they were addictive, no idea I wasn't supposed to take more than 2 in a day... It was just blown so out of proportion. After I was referred to my Psych he asked for a copy of my medical records and he sat me down and had a talk about this incident and I just explained to him that I had no idea what they were and certainly wasn't addicted to anything. He wrote them a letter asking them to remove it, which they said they would, but never have done. Just a power-hungry doctor who'd had a bad day I guess. Very irrational.

Yes, all prescriptions filed get logged. If he wanted to check to see if you had it filled would take a couple of minutes. (Well, take his secutary a couple of minutes.)

Sounds like you're trying to scoop more drugs and are asking if you can get away with it.

Excellent that's fine. So I can get his secretary to check that it's not been filled before issuing another script if that's the case.

As for your last point, that's not true. I could very easily buy Diazepam off of the street, or online. I told my Psych that's what I used to do with the opiates... he knows I could just go and get them very easily. But I'd rather they came from him because he's able to monitor my condition and help me. Paying £360 per hour to see him, ignore his advice and then go and buy my own drugs?

If that was the case, I'd rather not see him, keep the £360 and go and buy £300 worth of Xanax or Valium and get a nice pair of trainers too...

 

[parttime crackhead]

I don't want to ruin the trust between me and my psychiatrist.

Should I:
A) Tell him the truth
or
B) Lie to him

Think about it.

 

[Rybee]

I don't want to ruin the trust between me and my psychiatrist.

Should I:
A) Tell him the truth
or
B) Lie to him

Think about it.

I know, I know... Not just Psychiatrists, but all doctors must constantly have people saying they lost their prescription for X, Y & Z - can they have another one, then go and fill both prescriptions.

I just don't want him to ever think that I'm trying to pull the wool over his eyes and abuse trust. He must hear patients all the time claiming they lost their 100 pills of Xanax on the way home... I'm just not the type of person to confront someone, I'd just rather count my losses and not put him in an awkward position.

But if it's true as j.t that he or his secretary can check if a prescription has been filled (which it obviously hasn't) then I'd be absolutely happy to say 'still haven't received it, please feel free to confirm that it hasn't been filled before sending a new one.'

I dunno... I just don't want to put him in an awkward position.


All chances are, the secretary's just not posted it yet.


I'm just anxious & panicking! Sorry BL!


Thanks for the replies though, you've settled my nerves somewhat!

 

[BecomingJulie]

Ring your psychiatrist and be honest.

The absolute worst case is if it has been delivered to the wrong address, someone else has got hold of it and cashed it, and there's an anonymous overdose patient in some A+E department with pills in a box with your name on it. That's not going to look good, but it's one of a very few situations where keeping quiet really isn't the best course of action.

If someone else has got your script but hasn't cashed it yet, then it's still in your interest to ask for a replacement ASAP. Or if they tried and were refused because the pharmacist got suspicious that they weren't you, the pharmacist would have rung your psychiatrist.

The most likely thing is it's missing somewhere and never going to get cashed. There will be no record anywhere of the drugs ever being dispensed. That puts you in the clear; but it also gets you a benzo cluck and lets your psychiatrist know you can live without them.