I posted about S's experience with the stigma against people who take narcotics on a regular basis when he went to the emergency room.
Today, we ran into it again at the pharmacy. The pharmacists refused to fill his valid prescription, written by a reputable doctor, on the grounds that he is taking too much. My question is "Since when did pharmacists become doctors or DEA agents?"
This is a common problem when on a long term narcotic prescription. Many of the people interviewed for Arthur Rosenfeld's book The Truth about Chronic Pain: Patients and Professionals on How to Face It, Understand It, Overcome It complain about their pharmacists refusing to fill narcotic prescriptions.
In S's case, he was prescribed a higher dose of his breakthrough medication because we were going on vacation. His doctor tried to estimate how much more he would need, but the estimation was off and S needed to take more than was prescribed. Before he left, his doctor told him, "come back when you run out, I will refill it."
S went back to the doctor when we returned and explained what happened. The doctor had no problem with this and wrote another prescription to make up the difference. He knows that S is in constant pain, and any additional activity is excruciating. He also knows that S does not abuse his prescription. If he is not in pain, he doesn't take them. This was the first time that he ever asked for an additional prescription. It was not a problem.
We knew the insurance company would not pay for the second prescription and that is fine. If you take any medication outside of the prescribed amount, the insurance company will not pay for the additional prescription. We told the pharmacist what had happened, she called the doctor's office to verify and filled the prescription.
Today's script was his regular monthly dose. Because we live in a rural area, the pharmacies do not typically stock this medication. We almost always call around to find out who has it in stock. Our regular pharmacy is part of a chain and the local store did not have enough. We called the next closest store in the same chain and they did have it in stock. However, the pharmacist refused to fill it --without even seeing the prescription or talking to the prescribing doctor. I ended up driving an hour to get the prescription filled at a different chain pharmacy.
Correct me if I'm wrong, but I feel it is not the pharmacists job to determine whether or not an individual needs a medication. I can see refusing to fill it if there was a drug interaction or if S was allergic to it. But, simply because the pharmacist felt he was taking too much, I don't think that's right.
It is the doctor's job to determine the medication needs of his or her patient. S's doctor understood the circumstances, knew it was not going to be an ongoing problem and wrote the script. If he felt there was something underhanded or not quite right, he would have refused to write the script.
Needless to say, the pharmacy in question has lost our business. I am willing to drive an hour for our prescriptions if it solves the problem. S has fought long and hard to get the correct pain management. He is going to live with this pain for the rest of his life. He will become tolerant to the dosage he is on and it will need to be increased. These are the facts of chronic pain and narcotic use. I refuse to work with a pharmacy that does not understand or accept these facts.