Is This The "Norm" For CVS?

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gtrplayer
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Hello to all of my Pharmer family members here, and a happy 4th of July to you all. I know that I do not post as often as I used to, but every now and then, I experience something that I just have to share with you all. I am going to share with you what I witnessed on July 3rd, while picking up 3 prescriptions for my father, none of which were narcotic. Also, it should be noted that the area I live in is in North Central Indiana. Google "North Central Indiana Dr Receives Jail Time", and you will probably see what I believe started this new "policy".

When I approached the "Drop-Off" counter of the pharmacy, I was greeted with a sign that I found to be absolutely abhorrent, disgusting, and prejudicial towards chronic pain patients. As a pain patient myself (not through CVS, I will never take my business there), and as a new patient advocated/awareness writer, I feel that I should relay, verbatim, this sign that I was  greeted with. Remember, this is the first thing patients see when they get to the pharmacy.

"We do not accept any coupon vouchers or promotional cards for pain medication. We will not fill any pain medication in excess of quantity 60 tablets without the following: A) Diagnostic code from your doctor indicating the condition being treated with narcotics. B)A signed copy from your doctor outlining the dr/patient controlled substance agreement. C) A signed "Plan of Action" from your doctor indicating the length of time your are likely to continue to take narcotic pain medication. D)  Proof from your doctor showing your next scheduled appointment. E) At any time, at the pharmacists' discretion, we reserve the right to refuse to fill any pain medication for any reason. F) If pain medication is written to last 1 month, it should last one month. Do not come in a day early just because insurance will cover it. Your INSURANCE telling us theywill allow your pain medicine to be filled does not mean that we MUST fill your prescription. G) We will not order a 3 month supply, for any reason, for your pain medication. You MUST use mail-order services if you wish to have 3 months of your pain medication dispensed at one time, however, if during that three months you require additional pain medication, we can not fill any narcotic medication for you."

The meds that I picked up today were Klonipin, and Wellbutrin (300mg and 150mg, pops must be extremely depressed?)

Most of you regulars, and especially the few on here I have developed friendships with on this site, know that I have always been an extremely, almost fanatical, preacher of taking your medication responsibly. I know that not all, but 95% of us in chronic pain, take our medication exactly as prescribed, or even less. Rarely have I found a true chronic pain sufferer to be one who abuses their medicine. This is why I found this CVS sign so offensive as both a patient and advocate. Do we really need pharmacies to develop their own formula as to what constitutes "proper" care? Do the pharmacists have any idea of the amount of pain an individual is in? Of course not! Even as a chronic pain patient myself, I can not begin to imagine the pain some of you must be in. How, then, can a pharmacy justify taking this position? I know that they are trying to save their own behinds from some unscrupulous Dr's who, if the cash is there, will script for anything, but to case such a wide net seemed odd to me.

Personally, I go to a mom and pop pharmacy and NEVER have I had the slightest of a problem. These chain pharmacies are trying to rewrite how healthcare should be applied, and if they are successful, may end up causing a lot of suicides from miserable people in pain, or even cause death due to pain not being treated adequately in the form high blood pressure leading to heart attack. I know that the pharmacy has to be careful, but does this not offend anyone else.

Yes, there is a prescription drug problem  in the US. There always will be a prescription drug problem as long as narcotic pain medication is being prescribed. My advice for any of you using CVS as your pharmacy of choice is to look elsewhere. Do not be bullied by their self-imposed standards as to what is excessive treatment.

That being said, and this illustrates perfectly just how bad opiate abuse is here inNorth Central Indiana (read my older posts to find out where I am from, if you want to know), I could not help but laugh at a guy who brought a script in through the drive-thru. I overheard the pharmacist telling the young man, "Sir, I'm going to have to call your Dr to verify this prescription because there is no strength written on it." The young man replied, "What do you mean no strength? It says right on there Take 1-2 hydrocodones as needed for pain." Pharmacist: "Yes, it does, but it does not say what strength of hydrocodone and what strength of acetaminophen." Young man: "Awww, (expletive) just give me the GD thing and I'll take it back and get a new one." Pharmacist: "I'm sorry sir, I really need to hold on to it now that I have called the Dr. I have never heard of this Dr, where is he from" Young Man: "He's, He's, in that office suite you know, right over there on, ummm, just give me the script back." Pharmacist, "I can't. We will call you once we hear from the Dr."

Sad.

Despite all of that, do you think that CVS has overstepped their boundaries by declaring that you can only get 60 tablets of anything considered "narcotic" (not a controlled substance- solely anything "narcotic") Also, if you are from out of Indiana, please tell me if you have the same signs up at your local CVS. I want to know if this is a local thing, or a nationwide thing.

Thanks all, and I have another little article I want to get up before Sunday night concerning Dr.'s and whether they care more about you, or their pocketbooks. I do not believe all Dr's are money hungry, but I do believe some of them push their ideas as the new "standard". If you want, I will upload that article, which was written in February of this year (2014)

Regards,

Josh

PS: It's the 4th of July. Utilize common sense and don't be "that person" that gets taken to the ER because you thought the fuse was longer!!!

quincy
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Lost reply: hi gtrplyr, I just wrote a three paragraph reply to your post but it didn't make it too the board, darn it. Here it is in short form . . . you certainly got some very rude treatment there at you IN. CVS! As for your question about if this is a nationwide CVS policy, it is not happening here in NM. I regularly, two years now, pick up a script for # 150 600 mcg Fentora and #240 30 mg Oxycodone IRs. These are both high strength pain meds to keep my cancer pain at bay. The Pharmacist does require that the Dr. Writes down the reason I need these class IIs but he sure doesn't require a copy of a patient/Dr. Agreement. Isn't that against the patient/Dr. Privacy code? The Wallgreen's here were limiting their Class II script fills to #120 for a couple of weeks last fall but that ran into so many snags they had to drop it. Here's an example of a snag that was in our newspaper: A patient who was regularly Rxed #180 5/325 Percocets was given an Rx for #120 30 mg Oxycodone IRs so as to comply with the rule. The patient was alarmed at the increase in dosage amount and alerted his Dr, ( a PRN wrote the Rx) and when the Dr. dopesx
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I just got this weird looking white xanax 2mg bar. It does not look like the normal white ones. It looks exactly like the one in this picture: http://www.pharmer.org/images/domestic/alprazolam-xanax-2 Kind of worried that it might be fake and I don't know what's really in them. Can someone confirm if this is fake or real xanax?

Submitted by ddmmats on April 2, 2007 - 9:02pm

Generic Name: Alprazolam
Strength: 2 mg
Manufacturer: Pfizer
Trade Name: Xanax
Type: Antianxiety
Class: RX, CIV
Comment: Image courtesy of ddmmats. Imprint Xanax2

(edited to insert image - admin)

Learned of the policy he raised one heck of a stink

quincy
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It's still mixed up

Anyway, the Dr. Raised a heck of a stink and got Wallgreen's attempt to practice medicine in our paper and the practice was dropped. The squeaky wheel gets the grease.
I hope that this reply makes it through this time . . . Quincy

gtrplayer
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Hey Quincy, Good to Hear from You:)

Hey Quincy,

  Here in my town (I do not want to give the name of the town away, even though I have in the past, because there is a huge lawsuit that, just yesterday, ended for one of five doctors that were operating a pill-mill here in my hometown, as well as one of the little towns neighboring us. I was shocked, to say the least, when I read their sign. Today, being the fourth of July, I can not go back to take a picture, but I am going to do so tomorrow.

You asked the question regarding patient/dr confidentiality (a.k.a. HIPPA), and you and I are on the exact same train of thought. Personally, I have never done business with CVS, and never will. I have always gone to a family run, mom-and-pop type pharmacy my entire life, and always will. However, my hometown's largest employer is the Chrysler Corporation, followed by GMC Shareholders (Formerly Delco, more formerly GMC), and the insurance plans that are offered through Chrysler and GMC Shareholders, both, require that any medications that are going to be used long-term, like thryoid, blood pressure, heart, and anti-depressants, be filled through CVS Caremark. If persons who are insured through said employers opt for a different pharmacy, other than CVS, the cost goes through the roof.

I was pretty sure that, given the attention my town has received from various media outlets solely because of the heinous practices by five doctors, three nurse practitioners, and even regular nurses, was to blame for this sign. I did not think there was any way that this could be a nationwide policy, but I also admit that when it comes to CVS, I know very little about them and their business practices. Currently, I am going through a lot of literature online, concerning the legitimacy of this sign. I believe that, even though a pharmacy does have the right to refuse to dispense medication if they believe it will harm the patient, or believe that the amount of pills dispensed poses a threat to the community (ie: they believe the amount written was done so solely for the purpose of diverting said medication), to put that sign up at the drop off window (not even the consultation area!) was a slap in the face to chronic pain patients. My personal feeling towards that sign was "how dare you tell me, or my mother, or my father, what the acceptable amount of pain medication is for their condition." Once this legal problem is resolved, however, I think things will go back to how they were before. I will PM you some of the details so you can read up on it. It is very, very interesting reading. If you google the Dr Name + affidavit, you will see where a lady went in to get her script for Adderall, Xanax, and Lortab after failing her drug test three times in a row by failing to have the prescribed medication in her system. She was a dealer, and the doctor was the pusher. These doctors are the ones that need punished, not the chronic pain population.

quincy
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I agree . . .

These pill mill type of Drs. are the ones to blame as well as the customer that was abusing/diverting her drugs. We have a lot of that going on down here, they tried limiting the amount dispensed but that turned into a huge can of worms as the medical community here is both liberal socially and also quite vociferous.The local medicos wrote a joint letter condemning this practice and Wallgreen's soon put an end to it. I so agree with you where you wrote "How dare you (CVS) tell me what amount of meds I should be taking.". I see that the part of my post that got lost included my ER story, well here it is in short. Last week I had to go to the ER due to complications with my cancer meds and it being a late Friday afternoon. I was hallucinating, mentally confused and wicked dizzy so my oncologist recommended that my wife take me to the local hospital ER in case I has a mild ischemia or stroke. We are blessed with a fine ER here and they gave me an MRI, a CT scan, full blood work up, a galvanic bath for the stroke which was inconclusive due to a severe nervous twitch, and I can't remember what all else. Then they checked me into the Hospital for a couple of nights  of observation. The diagnosis was also rather inconclusive,the lead Dr. said that it was multi factoral; a reaction to the Fentora along with lack of exercise.My serum level on the Fentora was just right but that stuff has a tendency to make you confused and since I am so fatigued from my cancer treatment I think that it stays in my system longer than normal. Its three walks a day from here on out, a short mile each walk, and I'm already feeling the benefits.

im looking forward to reading your pm and will be answering soon. I have to say that that was my first experience with an ER, the quality and professionalism of the care was outstanding. They let my wife stay with me both nights on a sleeper chair that folds out flat and, oh yes, my main point, though they provided me with my regular meds they couldn't do that with my Class IIs. Instead they let my wife bring me me regular dosages from home. I don't know if that is a regular practice but it sure made my life easier. Best of luck . . . Quincy

 

gtrplayer
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Sounds like you had a fun weekend...

Dang, Quincy, if we ever meet up in person, I can think of things a tad more fun than spending it in the ERLaughing

I know you are a tough guy, so I won't pander you with the "I'm so sorry you had to go through that" type of stuff, even though I think it x*#&s that, in this day and age, we still can not limit side effects of medications any better than where we are right now in the medical community.

One thing that I had to laugh about was the hospital denying your CII meds, but allowing your wife to bring your doses in for you from home. I say laugh in the sense where, it's just so GD absurd to think that, here you are in a hospital, the place to go when you need help, and they let their personal feelings/prejudices towards CII medication dedicate the type of care you will receive. It's almost as if the Dr was saying, "I have no problems with you taking it, but I'm not going to be the one responsible for giving it to you." When did doctors develop this type of thinking? I know several doctors, and have a friendly relationship with them outside of medicine/treatment (they are not my doctors), and I hear the same thing from them time and time again. "I can't have the DEA breathing down my neck, and appropriately care for my patients. For every narcotic prescription I write, I feel like I am answering to three different people, be it insurance, the patient, adjustors, or even the government asking me if there is not some alternative therapy we can try first."

I am not a political person. I never have been, and hope to never be. However; I am a common sense person. When politics starts running the life of everyboday (to keep it topical, I am going to stay on the DEA train of thought), and politicians decide what is acceptable amounts of opiate medication, we, collectively, need to stand up and tell them that enough is enough. My personal feeling, and my God how I hope that I do not end up regretting this after some blow-hard DEA agent reads it and wants to make my life a living nightmare, is that the DEA has lost their war on drugs. What do  you do when you can't take out the heavy hitters in the "underground" drug trafficking system supplying the world with the drugs like [filtered word], ecstasy, lousiana, and other substances? You go after the easy targets: the Dr and the patient.

While it seems I am having a dialogue with Quincy only, I say this to every single member here that has ever taken the time to post a thoughtful, meaningful opinion about the opiate crackdown nationwide. It is time that we, as patients, stand up for not only our rights, but for the rights of the doctors whose lives are being ruined because they are faced with the dillema, on a daily basis, of doing what is right for the patient from a medical standpoint, or doing what is easiest and offers the least amount of recourse from a legal standpoint. We need to do this in a civilized, and respecful way, to let the government know that what they are doing to pain patients is an injustice to everyone afflicted with chronic pain. I, for one, am more than willing to head-up an organization whose purpose is to work with the DEA, and inform the DEA why, as pain patients, we sometimes have to take medications at a rate that would kill someone who does not suffer from chronic pain. As pain patients, we become opiate tolerant. This does not mean that we are doing anything wrong, it simply means that our brain has reached it's point where the dose we have been on no longer works. This is what happens with chronic pain.

When we start hearing rumors of illegitimate doctors, we should pass that information on to the DEA. When we notice people limping into the doctor's office, only to freaking skip out of the doctors office after receiving their prescription, we need to inform the DEA. As pain patients, I feel we need to work with the DEA so they can actually go after the people they are looking for, and not stop every old lady with a bottle of Percocet (unless she is dealing).

I am going to state here, on the message boards, what happened with the Dr that was arrested and subsequently sent to jail on July 3rd, 2014. This Dr was one of the "bad ones". He would drug test his patients, which, we all know is for two purposes: 1. To make sure you are not taking something you are not prescribed, and 2. To make sure the drugs that you were prescribed are being used only by you. That being said, one of the plaintiffs in this case admitted that she failed her drug test three times, but all three times she still received prescriptions for Adderall, Xanax, and something else. At this point, the plaintiff, in my opinion, has now gone from a plaintiff to a co-defendant. However; in the real world, things don't work out that way. This lady had the gall to try to sue the Dr, alleging malpractice. Was he guilty of malpractice? I am neither a lawyer, nor a doctor. I do know that he threw all common sense out the window, and let greed get the better of him. Doctors like the one I am mentioning are the ones that need to be dealt with my the DEA. However, I believe the patient also needs to be dealt with by the DEA. The plaintiff, however, testified against the Dr after the police raided his office and shut down the practice.

In the affidavits, which are available for download online through our local newspaper for free, there are so many things that, while reading, I found myself saying, "are you kidding me? This is a joke". People would show up by the van full to be seen by this doctor (who was not a chronic pain doctor, and had absolutely zero training in chronic pain management, yet operated as the "XYZ pain management center". These patients would show up, pay cash to be "seen" by the Dr, urinate in a cup to give the allusion of a drug test, and then pay the doctors per prescription. No insurance companies were billed for anything. There was never mention of any attempts to incorporate injections, epidurals, rhizotimies, or even ordering MRI's for patients. Again, these are the doctors, and patients, that I feel we, as legitimate sufferers, have an obligation to report. Will one single instance of you or I calling the cops do any good? Probably not. However, after the fifth or sixth time calling, the authorities usually begin to take notice.

All of the above was in reference to just one of the 5 "bad" doctors that this place employed. I know I am being long-winded, but I have wanted to make this type of post for a good couple of months now, but never really had the ambition to do so.  Now that I have started, I feel we also need to talk about defending doctors whose patients overdose, and die, because they failed to follow the agreement they made with their doctor. I am so sick of seeing families crying on the news because "Little Johnny" was just such a great kid, fun, loving, never had a problem he couldn't talk about, and now he's gone, and it's all the doctor's fault.

No, it isn't. A compassionate doctor will prescribe the amount of medication needed to treat a condition. Did any of these family members of "Johnny's" ever go to a doctor's appointment and witness what he told the doctor about his pain? Did the family even know why he was going to the doctor in the first place? Probably not. All of us have seen people who are drug seekers. Many times, drug seekers actually dohave a legitimate need for pain medication, but they are incapable of being responsible, and taking the medicine as prescribed. I know about now, if anyone reads this far, someone is going to say, "Well, Johnny was an addict and the Dr should have known that." To which I counter with, "Why?" Why should the doctor know Johnny is a drug addict if he has herniated discs and was in a car accident? Do you want all doctors to approach everyone, including yourself, with such apprehension that he/she assumes that you are embellishing the amount of pain you are in?

While it is tragic when someone dies from an overdose, we can not continually hold the Dr responsible if the Dr followed the guidelines, and the patient met the criteria, to be on opiate therapy. In some cases, the doctor very well may be the party to blame. However, more times than not, I believe that a Dr chooses the best course of therapy for his/her patients, weighs the risks and benefits, and makes an educated decision as to how to best approach managing a patient's pain.

I apologize for this abrupt ending, but I'm sure you are tired of reading this, if anybody made it this far. For those who did, I still have some things I need to say, but lack the time and energy to do so today. Later on, Saturday evening, I will most likely update this. My main point that I am trying to make is that we all have a role to play if we want to receive better health care. While it may not be the popular thing to do- contest to a family that their son who died of an overdose is the one responsible for his own death because he abused the medication, it is something that must be done to protect the good Dr's out there. By "good", I do not mean the ones who carelessly script opiates for everyone and their brother. I am speaking only of the doctors who were once able to run a practice the way they best saw fit, without the DEA breathing down their neck every time they wrote a prescription.

quincy
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Good Dr.

My wife had such a Dr. He was trained in oriental pain relief techniques as well as the usual Western ones. C, my wife, is under a lot of stress dealing with a husband who has long term cancer. Added to that stress in CDD, Degenrative Disc disease, Foraminal Stenosis, Osteo Arthritis, and a couple of others. These are all made worse by the stress. Her doctor thought her a likely candidate for opiate therapy after trying acupuncture and epidurals, along with cortico steroid injections. The opiates worked in their usual way, numbing some of the pain but increasing tolerance. Here's my point, this pain Dr. had several older ,55-75, patients with the same problems and he had them on opiate treatment which was the most successful of the aforementioned ones.
Can you see anything wrong with his approach so far? I forgot to mention that there was a contract and random p-tests as well. Well, the DEA thought so and sort of pushed him towards handing in his right to Rx opiates. Here's a fine Dr. treating " little old ladies" with care and compassion and the govt. made it impossible to do so. So, yes, I do understand your point. Fortunately, he was able to refer C to another pain Dr. Who is now giving her adequate care. For anyone reading this that thinks C is addicted all I can tell you is what I told one of her surgeons, " There is a big difference between addiction and physical dependence, we are seeing you so that you can take a stab at fixing the thing that is causing her pain and hence her dependence." What a world!

goat
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Nice to see you back on guys

 Great posts btw.   CVS will not fill my drs scripts.  
  On my scripts under the DEA number is a High Prescribing Permit #  that the county gives out.
I was dropped by the pharmacy I used for over 12 years in January.  The reason was that she was dispensing too much meds in the pharmacists words.   I was referred to this dr the year before by the same pharmacist.  
  When I showed him pics of her high prescribing permit he claimed it as fake and something she had printed up.
So I have been "lucky" to have walmart take over my scripts...it took about 5 months to convince them I am not a druggie and they suddenly have been filling my scripts on a somewhat regular basis.   my back issues go back 30 years now and I am in my 40s/ with a beard that's nearly waist level.  So you know I am judged by appearance Wink

quincy
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YeahGoat, that'll do it every time, the bigoted "book by its cover" types out there. I'm glad to hear that your Rx problems are somewhat over with, must be a relief, huh? I don't know how CVS sets up it managerial policy because the one hear is run very well . . . no problems with getting my Fentora like I always had with Osco , Walgreen's and a couple of Mom 'n Pops I tried wouldn't even touch it. Oh well, things are going good for me for now so no complaints. The two night stay in the hospital got rid of my hallucinations and they have me convinced that a walk three times a day will keep the insanity at bay . . . Quincy

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I know exactly what city and

I know exactly what city and the doctors (if they can even be called that) you are referring to.  I live in Indy so obviously it has been on the news a lot here.  I was in CVS to pick up some allergy medicine and I did not see any of the signs that you described and I inquired about it to the pharmacist and he said it's not a company wide policy currently and is most likely a result of the high incidence of abuse in your region as well as the unscrupulous doctors in the area.

quincy
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Sounds right,PMB . . .

As I wrote gtrplyr earlier, these signs usually do go up in hot spots. I just wish that they weren't so darn rude about it. We CP sufferers have enough to deal with on the negative side . . . being thought of as malingerers and crybabies comes to mind . . . without the pharmacies which are making a ton of money off our pain adding to the whole nastiness of having a sometimes hard to define problem. At least with cancer, like I have, they are polite to you when you show up for your monthly Class II meds . . . Quincy