Dear Steve,
I suffer from chronic lower back pain. My pain resulted from a combination of bad genetics (spondylolisthesis) that was exacerbated by a head-on collision in 2009. I take hydrocodone (Norco) four times a day.
As an environmental consultant, my job requires that I travel — often for several days at a time and even on weekends.
Because of my travel schedule, I can often be out of town on the date that I am up for a new prescription. I changed to a nationwide pharmacy (CVS) to minimize this risk. In the past, I could get a prescription for hydrocodone filled 2 or 3 days in advance, which greatly helped me in making sure I could stay on track and manage my pain while traveling.
But today, I ran into a problem. I have a prescription that was written by my doctor to be dispensed today (12/2/2014). However, I did not fill my last prescription (written for dispense on November 4th) until November 6th because I was traveling and could not fill it sooner.
Now, CVS is telling me that I cannot fill the new one as it is too early to fill right now.
My question is if the actual prescription date for dispense is today (12/2), is it legal for them to deny filling it until 12/4? Without the medication, I will be in a world of hurt and will certainly have trouble performing my job.
Andy in Alabama
Dear Andy,
It seems like I get an email like yours several times a week. In my opinion, way too many pharmacists when it comes to filling controlled medications have become bean counters.
They look at today’s date minus last day filled and if it doesn’t compute to 28-30 days, they are going to say no even if the doctor says it is okay. It is as if someone is going to do some harm to themselves if it is filled a couple of days early — unlike when they get a full month’s supply on hand and decide to do something harmful to themselves.
Most of these pharmacists have a great deal of “book smarts” but little or no clinical experience with subjective diseases (pain, mental health, anxiety, depression, ADD/ADHD). All they know is what they have read in a book or they were taught by someone at college in an “ivory tower” who has more book smarts than clinical experience.
They seem to have forgotten that all of us are individuals and our bodies respond as such, and that there are no black and white answers to individual medical care — especially subjective diseases.
If I was in your place, I would have my attorney send CVS’s legal department a letter stating that if their pharmacists continue to not follow doctor’s orders and cause you to lose business, force you to take days off, or even lose your job because you are not able to get your meds on a timely basis — causing incapacitating pain, withdrawal, hypertensive crisis, stroke, death, etc. — that you will hold both the pharmacist and the corporation responsible.
I would also include in the letter that you are going to file complaints with the Alabama Medical Licensing Board and Board of Pharmacy that the pharmacist is practicing medicine without a license, as well as file a civil rights violation/discrimination complaint under the Americans with Disability Act, for not following best practices and standard of care.
Too bad you can’t file a complaint for the pharmacist being a general PUTZ !
I would also file complaints with your insurance company and/or your human resource office for denial of care and patient abuse.
Steve Ariens is a retired pharmacist and patient advocate who has a blog called Pharmacist Steve. Steve’s wife is a chronic pain patient.
If you have a question for Steve, send it to AskthePharmacist@nationalpainreport.com.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media.