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PostPosted: Fri Sep 25, 2015 6:55 pm 
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Hey guys, I need to vent and get some input if anyone cares to share. I'm wondering if this pharmacist was trying to be extra careful or if her attitude/agenda was getting in the way of providing proper care. In other words, was she being a petty pauline or b? (can I use the "b" word on here? if no, moderators please let me know I will edit it out.)

Ok, here we go...

I receive my suboxone refills every 14 days on Fridays. So I get a 14 day supply each script. The week I need to fill my suboxone I will call my suboxone clinic to let the doctor know I need it filled and the receptionist will ask me, "when will you be out" and I always say Friday even though I am technically out on Saturday. In other words, the last day of my 14th day lands on Friday, and that is not technically my "out" day. It is my "last day" of medication. My "out" day is Saturday.

The reason why I do this is because I had a bad experience once because I got lazy and waited till my actual "out" day to fill the script (even the the doc had called it in the day before I told the pharmacy to wait to fill it till Saturday). Turns out I was unable to fill my prescription till later in the day. The reason I was unable to fill it was that since I had a dosage change I needed a prior-authorization but with Medicaid being closed on Saturday's it was unable to be processed. I would have thought that the pharmacist (it was coincidentally the same one I am talking about) could have filled the script without running it through insurance and just given me 2-day supply but that's besides the point. I had to call the nurse-on-call to see if something could be done and my doctor was finally contacted while he was on a biking trip poor guy and he was nice enough to call it in under the same dosage as before (so no prior-auth was needed). By the time I got my medication on that day it was 4pm and I was already feeling withdrawal since I am on 4mg a day. On 4mg depending on how well the med is absorbed and my metabolism I can sometimes wake up and even be in slight withdrawal! Sometimes it can be bad to the point that I can't eat till I take the medication. So, lesson learned. No more waiting to fill my med till I am out "out". I managed to save up an extra days' dose since then so I don't have to worry about. I'm sure that my doc would even want me to have a days dose saved up for emergency cases anyways.

Ok, so here's the story. The last script I filled before the one from today I was only able to receive 3-days' worth of medication because the pharmacy (CVS) only had that many left and had to order more. So I went in on Friday and picked up the 3 days worth of meds. I didn't even have to pay for it since he said he hadn't run it through insurance and to come in Monday to pick up the rest and pay. (This is why I wonder why when I needed the prior-auth and couldn't do it on a Saturday (explained in the above paragraph) why the pharmacist didn't just give me 2-days worth without processing it through insurance. She could have made me wait to pick up the rest on Monday and pay then. But she is not a regular pharmacist there).

So I actually didn't come to pick up the rest till Tuesday because I didn't really need to since I have that extra days' dosage which is what got me through Monday. So, today my doctor calls in the prescription as usual. I get a phone call on my home phone number which was weird since my registered number with CVS is my cell-phone number and that is the only number they have ever called me on. I am currently living with my parents for a few more weeks and they also use the same pharmacy so maybe she figured what the hell. But makes me wonder what kind of message she would have left for my parents to hear as well ("we can't fill your medication early, please come tomorrow when it is due"). I've been using this CVS for 5 years and I've been exclusively getting all my medications from there for the last 2.5 years. It's kind of disconcerting when the pharmacists and techs all know your name hah, except for the rotating "fill-in" ones like this pharmacist (who I had an issue with) I'm talking about. I think I'm pulling it too far with the theoretical voicemail hah.

Anyways, I answer the phone and it's the same pharamacist from the Saturday Medicaid prior-authorization deal (described in the second paragraph or so). She tells me she can't fill the medication till Saturday (tomorrow, today is Friday). I say that yes she should be able to fill it today since I filled it exactly the Friday before. Again, I get a 14 day supply, so if I filled it 2 weeks before that Friday, then I would have used up that particular prescription on Thursday. She said I understand but since you picked up the remainder of you prescription on Tuesday you don't need to pick up the script till tomorrow. Of course, I could have picked it up tomorrow but then I would use up my "extra days dose" and have to work to restore that day's dose again (by cutting out a half a mg for a few days till I get my 4mg saved).

I can't believe that she would be so nit picking about when I picked up the rest of my dosage! That is completely crazy. That means she had her eyes pealed on the dates obviously since by that point there would have been so many dates related to that certain prescription... the day I picked up the 3 days worth, the Monday they filled the rest, and the Tuesday I picked it up. Then she has the ovaries to ask me how many I have left! I said NONE. Of course I'd have none left, unless I take my dose in the evening. So I don't even know why she asked me how many I had left. Unless she thought I hadn't been able to take any today, which would have meant I would have run out early. Weird. And her tone of voice is so condescending, just like last time that one Saturday. I told her that she should fill it since the doctor called it in today, but she said she wouldn't since it was "corporate rules".

I KNOW the CVS corporate policy because I've filled suboxone there early before! As well as Adderall! I have filled both on the 30th day of a 30 day supply, and even with the suboxone I have filled it on the 29th day (which would make it 2 days early). So it was totally her discretion. What makes me upset too is that I've used this pharmacy consistently and exclusively since summer of '13, so over 2 years. In addittion , I just checked the online CVS prescription history and I've been on the 14-day refill schedule (they changed it from 30 to 14 day because I'm tapering and they need to adjust dosage) for 2 months, and CONSISTENTLY been filling it on Fridays. So it's not like I was filling it a day early every week. So she asks me if I want her to call the doctor and I said yes. I call my doc 20 minutes later cause I'm mad and I need to explain the situation to them and the receptionist said don't worry about it the pharmacy is filling it. So that pharmacist never even bothered to call me back to let me know they would fill it that day... so much for courtesy.

This just makes me frustrated and upset... I guess I'm overreacting a bit but what if it had been like 5pm and they couldn't get ahold of my doc? I'd be OK but it would make me annoyed since I'd have to restart the whole saving and extra day's dosage thing again.

It also upsets me because this pharmacist thinks it's OK for me to pick up my medication on the day I need it. And CVS is able to fill if at least 2 days early anyways, so her personal disrection to me is just being mean.. I mean what kind of pharmacist has that kind of time to deal with this?? What if it was a blood pressure med? Some poeple take those in the morning and if they waited to get their refill till the day they actually need the prescription then they would risk possibly not taking it in the morning if their car didn't start up or not taking it at the same time if they take it right upon waking... For me, I take my dose right when I wake up and I don't like breaking the routine especially if I wake up feeling slightly icky. Yet this pharmacist felt she had to make me wait till the day I needed the script like some freaking methadone clinic. The whole convenience of suboxone is that you don't have to go to a clnic daily to take your med... If it was a schedule 2 drug I might understand her hesitancy, but only with some kind of cause, like it the patient was picking it up early for months at a time.

I think this is cruel personally and I think she has some vendetta that has to do with how people who have substance abuse problems are frowned upon. The fact is, I wouldn't have been so upset about it if she had some probable cause to be weary... like if I were filling it a day early for months on end... then I would build up a small but noticeable quanitity and that wouldn't be cool. But that wasn't the case. What upsets me also was how she blamed it on "corporate policy" when in fact I KNOW, and I KNOW SHE KNOWS, that corporate policy is fine with 2 (or even 3 days on schedule 3 I think) pick up.

When I was fresh on suboxone I also thought addicts were untrustworthy people, and because I hated myself I especially hated my fellow addicts. However, the biggest change I've seen in myseelf in this recovery compared to a few years ago when I first recovered is that I trust addicts again. Addicts as in recovered addicts. And even ones who are using, depending on how they're doing, I KNOW they can be good people. And how do I know? You want to know???

Because I can trust myself! The only way I was able to start trusting other addicts again was by learning to trust the most important addict of all, ME! I have a feeling this pharmacist has some issues and is projecting them on "addicts".

Oh, and I would use a mom and pop but this CVS really is good other than this "whitch". She doesn't usually work there, maybe that's why she's upset, because she has to do rounds. Ugh, I wouldn't want to be a pharmacist anyways but I guess some people like it. The pharmacists there never give me faces and I feel they respect me which is important for me considering how much I use that CVS. They are clsoe to me, have an automated system, can order meds in no time, their hours of operation are great... all these reasons keep me there. Otherwise I would go to a mom and pop but I don't want to out of convenience. Oh, and just cause it's mom and pop doesn't mean it's good either... this one mom and pop place had the pharmacist count my 56 strips right in front of me!! Made me kinda feel like she was a dealer... lol. Counting out the cash in front of me (not that I would know this too.... the only thing i've bought was weed and the weed dealers never counted the cash). Oh and this same pharamcy wouldn't take my Reckit Benkiser discount coupon ($50 off, I had a different insurance at the time). The insuracne I had was still public but was super expensive, this was pre-obamacare when the people with pre-existing conditions couldn't get private insurance at all so I had to get it through the state which was still expensive as hell. When I asked her why she couldn't take the coupon she said it was because "the state already thinks you're getting enough assistance". !!!!! crazy!!! And I know she could have taken it because it said people on state insurance were OK, and CVS had accepted it before. Well, the head pharmacist called me later in the day and told me sorry, they could accept it.

So anyways, later today I think the head pharamacist will be there and I will pick up my prescription and tell him about my experience. The head pharmacist is awesome, no-nonesense, trouble-free guy. He always answers your questions and everything. I'm just tired of this condescentsion.

I'll have to share the story of how one of the docs at my clinic should NOT BE IN ADDICTION medicine... for another time. Anyways, do you all think this doc was being petty or mean??

Thanks!


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PostPosted: Fri Sep 25, 2015 8:31 pm 
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There is a lot of craziness out there regarding buprenorphine-- which has motivated me, over the years, to write my blog and start this forum. I took a break from writing for the past six months, mainly because the anger was getting to me. The attitudes our there are not 'reasonable', and not fair. But I've come to realize that there is only so much that we can do to set things right... and in some cases we need to just accept the world as it is.

In reality, there are pharmacists and doctors who don't understand addiction-- and don't understand buprenorphine. I hear from doctors all the time, who think that buprenorphine is 'just like heroin'. They are idiots, and I used to get upset by their attitudes. But I've come to realize that there will ALWAYS be idiots out there, and all we can do is to try to figure out ways to keep them from getting in the way.

I notice that many patients THINK they need 16 mg of bupe per day in order to avoid withdrawal... but except for rare cases, people can get by on less medication. If a person takes 8 mg each day, that person can easily save a few doses for emergency use. I cannot recommend that patients 'stash' extra meds--- but I don't think it is a good idea to be at the mercy of a misguided pharmacist at the end of every month!

Realize that 25% of each dose gets absorbed-- an amount that can be increased by paying a bit of attention to the dosing process. If you increase the absorption, you can take less-- and keep an extra dose or two for those situations when you run across unreasonable pharmacists.


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PostPosted: Fri Sep 25, 2015 10:39 pm 
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Dhalia, I'm sorry that you're going through such a rough time with that particular pharmacist! She sound like a bitch! (Yes you can use the b-word as long as you're not personally attacking another member of the forum.)

Btw, I like to throw that dead cat phrase around every now and then to catch people a little off-guard. I happen to like cats and don't want people swinging dead ones around, but it is a startling image! I actually heard this phrase from the movie "Three Men and a Little Lady". The mother of the bride was chagrined that their wedding officiant was missing and quipped, "You can't swing a dead cat around without hitting a vicar!"

Thanks for appreciating my attempts at humor. :)

Amy

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PostPosted: Mon Sep 28, 2015 5:27 pm 
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Hey Dhalia,

I don't think u were overeating at all, sounds like that pharmacist definitely had u stereotyped imo. Especially when she didn't even bother to let u know that ur doctors office said u were good to go. Ppl like that pisses me off so bad! I'd have totally lost my cool on her. But u showed her that u weren't going to just give up and take whatever she was dishing out. Good for u and if I were u I'd complain on her to her higher ups.

At the end of the day though, we will be putting up with some type of stigma for a long time. I hope that we can change that stigma and make it better over time.

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