Misc [Rx Drug Addicts] Do you think your pharmacist can tell?

[tryptakid]

Suboxone patients really get fucked at all points on the medical spectrum - come for visits 1x/week - get handed a cup in front of the waiting room - go into a visit with a prescriber who may or may not give you the meds you need if they want to give you a hard time - not be believed when your utox shows a false positive - be sent to the pharmacy where you are definitely looked at as one of "those" patients - not have your time viewed as as the same level of importance as others - plus because of the weekly fills, you're paying 4x/copay a month.

Also, having naloxone or suboxone on your prescription history can lead to getting denied for life insurance sometimes.

I used to go to the pharmacies with patients who were having a hard time getting their meds filled and definitely saw how much nicer they were when I showed my work ID and said I was a clinician. Suddenly they were much more helpful.

Having been a heroin addict myself, I also have been on the receiving end of that suspicion, though some of it was definitely deserved at times. When I worked in pharmacy, it made me see the other side - the people that just wouldn't understand no, the people who threatened violence on us, the people who looked at us like we were not doing something because we didn't feel like it or didn't want to.

Part of what sucks is the health care system here causes patients, especially drug users, to experience ongoing traumatic interactions, and it also puts clinical staff in a position to deal with the worst of drug users at the same time. For as many shitty pharmacy folks I've seen over the years, I've seen just as many shitty patients trying to game the system or berate their way into getting what they want. The system isn't set up for success and the people who end up paying the price are the patient and the front-line staff (many who are making minimum wage and have no real power to do anything). The frustration that these interactions causes build up on both sides, and people take it out on one another over and over again.

 

[Gridlink]

I get a bunch of controlled medications every month. I wait to call on filling scripts until it's been 30 days, don't go in til I get the text saying my scripts are filled, and try to look presentable. The pharmacist and techs always chat with me a bit, ask if I have any questions, and I am good to go. If they think I am abusing anything they've never made it known, but personally I think they're just too busy to really care if anyone is.

Probably most pharmacists and techs are like that, given that they are pretty overworked and in understaffed workplaces that expect them to maximize the number of people served despite ever-changing regulations and insurance policies. It seems like the assholes who 1. suspect someone of abuse and 2. actually try to do something about it like refuse to fill the script or contact the provider are pretty rare.

 

[tryptakid]

I get a bunch of controlled medications every month. I wait to call on filling scripts until it's been 30 days, don't go in til I get the text saying my scripts are filled, and try to look presentable. The pharmacist and techs always chat with me a bit, ask if I have any questions, and I am good to go. If they think I am abusing anything they've never made it known, but personally I think they're just too busy to really care if anyone is.

Probably most pharmacists and techs are like that, given that they are pretty overworked and in understaffed workplaces that expect them to maximize the number of people served despite ever-changing regulations and insurance policies. It seems like the assholes who 1. suspect someone of abuse and 2. actually try to do something about it like refuse to fill the script or contact the provider are pretty rare.

Likewise - these days I'm rx'd either desoxyn or dexedrine (I go back and forth between the two, but never at the same time), gabapentin, and I get a prn for dayvigo which is technically a schedule 4 though it's not really abusable. I've also had plenty of benzos over the years and a few times getting ambien when travelling. The main funny thing that has happened was when a tech was reading my profile and kept saying "methylphenidate" instead of "methamphetamine" when I was filling desoxyn. When I corrected her she gave me this look of horror and was like "Ummmm that's not a prescription" but when I clarified that it was and then the pharmacist came over and confirmed what I was saying, she just looked super confused.

At this point I'm in my 40s, have a career, and I do my best to be pleasant and understanding whenever hiccups occur. I don't fill things early and I don't make a big deal if there's some kind of issue like a prior auth or when one of my meds requires the pharmacist to ask me extra questions. There are definitely points in my life when I didn't have the luxury or stability to deal with issues that came up in the same way, but in general I try my best to treat people with decency and respect and that hasn't steered me wrong yet.

 

[Gridlink]

Likewise - these days I'm rx'd either desoxyn or dexedrine (I go back and forth between the two, but never at the same time), gabapentin, and I get a prn for dayvigo which is technically a schedule 4 though it's not really abusable. I've also had plenty of benzos over the years and a few times getting ambien when travelling. The main funny thing that has happened was when a tech was reading my profile and kept saying "methylphenidate" instead of "methamphetamine" when I was filling desoxyn. When I corrected her she gave me this look of horror and was like "Ummmm that's not a prescription" but when I clarified that it was and then the pharmacist came over and confirmed what I was saying, she just looked super confused.

At this point I'm in my 40s, have a career, and I do my best to be pleasant and understanding whenever hiccups occur. I don't fill things early and I don't make a big deal if there's some kind of issue like a prior auth or when one of my meds requires the pharmacist to ask me extra questions. There are definitely points in my life when I didn't have the luxury or stability to deal with issues that came up in the same way, but in general I try my best to treat people with decency and respect and that hasn't steered me wrong yet.

That is how I behave toward pharmacists too. And prior authorization can be a hassle but every time I have had it come up, I just remind myself that it isn't the pharmacist, it's insurance policies they have no control over.

The methamphetamine story is great, too.

 

[tryptakid]

That is how I behave toward pharmacists too. And prior authorization can be a hassle but every time I have had it come up, I just remind myself that it isn't the pharmacist, it's insurance policies they have no control over.

The methamphetamine story is great, too.

The pharmacist actually asked me about it - why i had switched to it. I told her that it's less stimulating than even dexedrine when it comes to peripheral stimulation. She was like "that makes sense since it's more focused on dopamine and less on norepinephrine". It was kind of a nice moment to connect over the mutual appreciation of pharmacology - something I'm sure she rarely gets to do with any regularity.

With prior auths I usually just make sure to follow-up with the prescriber as soon as possible and I've found it helpful to review the formulary to pinpoint what's needed. When I started taking dayvigo, it was the first sleep med that worked for me without any major side effects. I'd been on quviviq, zolpidem, triazolam, sonata, and lunesta at various points in the past decade. My forumlary changed a month or two after I first started taking dayvigo and they took dayvigo off of the formulary and recommended some of the other orexin inhibitors (which I'd found less helpful with more next-day grogginess) - dayvigo really hit the sweet spot for me.

The insurance company wanted evidence of 5 prior trials with sleep medications, which I was able to pull from pharmacy records. I sent it all over to my doctor including the rejection reason, and they got the appeal submitted within a day or two. The kicker was, I still had to pay out of pocket that month because I was out of meds and it took 2 weeks for the appeal to process. My psychiatrist wouldn't have had records for some of the other sleep meds I'd tried since they were from my former PCP. If I hadn't been as on top of it, I'm sure the PA would have stood and I would have just gone to another medication that didn't work as well. It's shitty how convoluted the system can be, and I do feel for people who are less comfortable navigating it.

 

[notsmokeymcpot42088]

REPLY TO - sorry somehow my shit showed up in the quote?
Yeah, judging by how that grizzly old bitch looks, she was probably lit on a cocktail herself. I don't abuse my gabapentin, I never misuse it because I need it desperately, and my doctor has greenlighted me to use as much as I need. Even if I wanted to "abuse" it, it would just be a waste of gabapentin because it doesn't fucking DO anything other than act as a preventative measure for my horrible headaches. It isn't up to HER to hold my legally refillable prescription. Fuck that bitch. I reported her to the company and to the NC Pharmacy Board. Why? "Just because."
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I will say this, good chance you are right. I will say fairly confidently that nurses, pharm techs abuse drugs at a higher percentage than average citizens. Access + Temptation and all....

I also remember being in a room full of nurses when my mom said "Don't you drink when you take those the effects multiply" and the whole room cackled and broke out into stories. Off duty nurses but still.
. Had a friends mom that was a nurse and would steal the liquid morphine and replace it with sugar water. (Was eventually caught but how many surgeries...)

Personally I find the whole industry corrupt with greed and power.

The ma and pa pharmacy I go to now is very good though, like go out of there way far as possible; hypothetically beyond the law in extreme cases. Humans are humans, most of them suck and a small amount of power will quickly show you they true colors. Gotta find the good ones