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Limits on Opioids

dilaurodilauro ConnecticutPosts: 12,771

Today, I got to see first hand how some of the bigger name pharmacies are handling the limits of opioids given in a prescription.   Some of these was outlined in the CDC guidelines from last year.   It really boiled down to Acute vs Chronic pain patients.

I went to refill my Oxycodone IR 5mg 150/ct.   No problem, I received the entire amount.   However, right before me in a line was a gentleman perhaps a few years younger than me.  He was filling a script for an opioid ( I did not know which one), but the pharmacy technician they could fill only 1 week supply instead of the full amount.   The man questioned this and spoke with the pharmacist.   He said he had a fall and his doctor prescribed him 30 days of XYZ 3 times a day.   The discussion went around for a while and the bottom line, was that script was for an acute problem, and the company guidelines now say 7 days maximum limit.   The man was fine, because he said IF he needs more than one week, he is sure his doctor will write another script, but this time for a smaller amount,

Now my script is written such that I can take up to 5 pills a day for moderate to severe pain.  No where is there any indication that the script was written for a chronic pain patient.   However, since I've been dealing with this same pharmacy for over 10 years, the all know me and iit was always the same prescribing doctor.    I dont know if that made a big difference, but the pharmacist told me Yes.    She told me that for customers that are new or they dont know, many times, they need to call the doctor to understand the condition and the prescription.

I dont know if this is the way things are going to happen in 2018, but it does seem in this section of CT (outside of Danbury) at least one pharmacy chain has already started this new procedure.

Ron DiLauro Veritas-Health Forums Manager
I am not a medical professional. I comment on personal experiences 
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13

Comments

  • I ran into a situation this month getting my 5 mg oxycodone filled at my drugstore where I get alll of my meds filled. They know me, but new year, new month and new headache from major insurance company. Was told they would fill a 7 day supply, or I needed a prior authorization from my doctor to get full rx. Between my busy doctor and insurance’s new rule, and a weekend end in between, I went 5 days without my pain meds! 

    It’s my understanding that this is the new norm now. And they only let the pharmacies get so many pills at at time so they run out! What about the people that really have to have these meds to live a half way decent existence and still suffer with pain? 

    I hate drug addict junkies that mess it up for good people like us, that have an MRI and years of medical records proving our legitimate need for opioids! 

  • What is SOOOO backwards about how the government is reacting to this issue is law abiding citizens who are legit pain management patients are going to start using the black market to get questionable drugs.  The need for care does not go away for chronic pain patients.  But the government and health insurance is treating everyone as addicts. 

    I'm going to predict that by the end of this "War", people who would have never considered smoking pot will be doing it to get relief. 

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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  • Glad you aren't having problems getting your meds Ron.  I know my Pm group sends a copy of the contract you sign to the pharmacy that you designate that you choose to use so they are well aware of what my issues are.  I just changed store locations and the pharmacist there has been great.  I call a few days before I am to bring my script in and she makes sure she has the meds and then puts them in the safe with my name on them.  She says that usually they can have a drug the very next day after ordering but once in a while they will get notice from corporate that they have received their allotment which they can still override showing proof they need the meds which might take an additional day.  So far things are going much better for me. Thanks Ron for starting this new topic.

    Cindy

  • With my insurance, they only allow a 1 week supply at a time while they work on your prior authorization for the full amount your doctor is planning on giving you. The downside is that my insurance will only allow 2, 1 week supplies in a 45 day period. I filled the 2nd one week supply this past Thursday. They were still working on my PA at my pain management doctor's office. So I have to go back AGAIN this coming Thursday and get my full prescription amount and hopefully, the PA has finally been accepted by my insurance. They were only missing one thing so it should be good to go. My pain management doctor said a lot of insurance companies are going this route. They also reduced the daily amount of Percocet I can take. So I guess we will see.

  • Hi greg_mooneyhan
    Gee what a nightmare to go through and I fail to see how it fix"s anything. So do you have to pay the full amount every seven days? My husband went to five different pharmacy's the other day due to the fact I cannot drive etc. He got told " no she does not fill her meds here and we save them for our regulars. How do those who don't have anyone to go for them handle that? I was even thinking about those who live in areas where they have to drive a long distance to fill them what a hardship. 
    Anyways sorry you are dealing with that it is a shame what is currently going on in this country.
    Best wishes Sherri

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  • I have encountered the same problem early one with getting my medications filled, it all stopped when I started using the same pharmacy every month and as Ron said when they get to know you it becomes a non issue.  The other thing I have noticed on my prescriptions from my PM doc, they put a numerical code on the actual pain medication’s script, i think it is 689.3 or something similar to that.   I asked what that code meant and it is for chronic pain patients so the pharmacy knows.  

  • Hello Sherri, no I don't have to pay the full amount. My insurance covered both 7 day supplies I was required to get so it wasn't a big deal. The big deal is having to go to my pain management doctor each week the past 3 weeks. My car can't make it to my appointments so I use the taxi service my insurance provides. After going back and fourth with my insurance for 2 weeks, they approved the full supply of my meds and it's good for 6 months so until August, all I have to do is go to my PM doctor to get my refill. So that's a huge weight lifted. And I get what you're saying about using the same pharmacy. I had been using Walgreens for the past year and a half until we had a big snow storm and used a Martins solely based on the fact that it's closer to where I live. And even if you do use the same pharmacy every month, insurance companies could care less. If it pops up on their computer systems that you now need a prior authorization, it won't matter if you use Walgreens or John and Dave's Hometown pharmacy. I'm just glad I don't have to worry about the hassle for 6 months. Thanks for the kind words 

  • And Sherri, as far as saving them for "regulars" that logic is so flawed it's silly. It's the same logic as when you apply for a job and they say you need 48 months of work experience in that field. How are you supposed to gain any experience if the bar is set so high. I'm sorry your husband had to go through all that trouble. And again, it's not ideal to drive around to find a pharmacy who can/will fill them but sometimes you have to, especially in situations like this.

  • jbowerjbower wisconsin Posts: 142

    This all just makes me sick. Since when is it any of the pharmacies business on why you are taking what is being prescribed to you by your doctor? Isn't that the reason why we fill out the Hipaa rights paperwork with our doctor? If I am being prescribed something by my doctor then there is a good reason as to why I am taking this medication.  Especially with how sprict the opioid "epidemic" has become. Doctors are not prescribing opioids just because anymore.

    CVS pharmacy came out with the same rules this year that they will only allow 7 days worth at a time to be filled if it's an opioid. I don't get mine filled there but I used to shop there. I now refuse to support their business any longer because of that though.

    So all of us pain sufferers are being scrutinized because some idiots want to get high off of heroin or any other type of drug then die because of an overdose. They should be happy these morons are killing themselves off because of a drug overdose. They are doing society a favor. Sorry if I sound harsh here, it just ticks me off about all of us that are being put through the ringer because of stupidity.

    Watch there come a day when they try to band it all together. Then they should band guns as well because people die every day from those also. Or you want to get even more nuts band vehicles and fast food or just about any other thing out there that are killing people off every day.

    It all is a joke. I use Walgreens and they have only made a few changes. Now instead of dropping off my pain med script and waiting in store till it is done, they say to give them 8 hours or so. They have to fill out all this extra paperwork now. Then a few months ago I stopped to pick up my pain meds and they asked if I wanted some other drug that in case I were to overdose you take this right away and it will save your life. I looked at my pharmacist and said if I really needed that then I shouldn't be taking these meds in the first place.

    The last one was they needed to call my doctor to find out the reason why I am on one specific medication. Keep in mind I have been on said med for years. When I asked why they said it was because some doctor are prescribing said med to offset the sleepiness pain meds cause. Even though I was on the said med way before I started taking opioids. It is none of their business why I am on that medication. Look at my history and you should be able to clearly see I was on it way before opioids.

    Unbelievable. 

    Taking it one day at a time, that is all we really can do while living with chronic pain.

  • I'm not sure if it was CVS who initially started the 7 day limit for new patients but I'm willing to get it was there doing. Two of the biggest pharmaceutical chains out there have started implementing these outlandish rules and laws. The reason they are doing them is basically because they have to. Walgreens was fined $80 million for improper dispensing of opioids. They were filling altered prescriptions or filling for unscrupulous doctors or patients. And go figure, it was in Florida. CVS had to pay a $22 million fine for something similar. That's why they are taking these steps to cover their asses. I understand that most pharmacists today must be PharmD's now but you will never convince me that they should be able to override my doctors orders. They are some of the most judgemental people on the planet. If you had to deal with what they do on a daily basis, you'd probably be jaded too. But it still gives them no right to play doctor. They refuse legitimate prescriptions based on a hunch that said patient "might" be abusing it. The fact is most patients are under medicated because of federal regulations so there are some days where their current regimen isn't sufficient enough. It's only going to get worse, believe me when I say this. As far as CVS goes, I dislike the group they have working there so much, I wouldn't go in there to ask for directions. 

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