What pharmacy patients should know when seeking pain medications
Written by De’Bora White and Bob Dávila of The California State Board of Pharmacy
“I have been on Norco for 10 years, and the pharmacist never questioned the prescription before.”
“Lately, the pharmacy never has my pain medication in stock and won’t let me get my refill a few days early. I feel they are discriminating against pain patients.”
A growing number of consumers are filing complaints like these with the California State Board of Pharmacy about difficulty getting pain medication prescriptions filled. Many prescription pain drugs contain opioids or other controlled substances, which are strictly regulated by state and federal laws.
Pharmacists are often the last line of defense in the battle against prescription drug abuse. Pharmacists must weigh their professional calling to serve patients against their obligation to prevent controlled substances from getting into the wrong hands.
Unfortunately, this means a pharmacist sometimes may delay or decline to fill a prescription for a painkiller – such as an opioid medication – or other controlled substance if the pharmacist has doubts that the prescription is legitimate.
A pharmacist’s obligation
Under California law, a pharmacist has a duty (known as a “corresponding responsibility”) to ensure a prescription is for a legitimate medical purpose and is not intended for abuse. The law requires pharmacists to use their professional judgment in determining whether a prescription is suspicious. To make that determination, a pharmacist may:
- Contact your doctor or other prescriber to clarify or adjust a prescription.
- Discuss with your prescriber other medications you are taking or other health care practitioners you are seeing.
- Ask for documentation of your medical condition, diagnosis or treatment plan.
- Consult medical reference materials regarding the dosing, indication or appropriateness of the prescribed medication.
- Review your patient medication profile in a statewide database known as CURES that monitors controlled substances prescriptions issued to patients in California.
Tips to help get your prescription filled
The Board of Pharmacy cannot require a pharmacist who exercises professional judgment to fill a prescription. But there are some things you can do to make it easier to get your controlled substances prescriptions filled as quickly as possible:
- Talk to your pharmacist. Establish and maintain a relationship with the pharmacy that fills your prescriptions. This relationship enables a pharmacy to better understand your needs so that the pharmacist can order and have your medications in stock when you need them.
- Talk to your prescriber. Discuss your medication needs and contact your doctor or other prescriber if you have problems getting your prescription filled. Your pharmacist may also contact your prescriber. This relationship will make it easier for the pharmacist to validate your prescription.
The Board of Pharmacy is committed to protecting and promoting the health and safety of consumers through the highest quality of pharmacist care. If you have a concern about your experience with a pharmacy, you may file a complaint with the board online or in writing. For information, visit the board’s website at www.pharmacy.ca.gov.
This makes absolutely no sense. The Pharmacist don’t have the history or understanding of pain to make these decisions. These pharmacist are so afraid that they only will fill a pain medication if it fits into what their book tells them is the amount that should be taken which is ridiculously low. Also, it is funny how just a few years ago Norco wasn’t even considered a triplicate prescription. I fell like we, as individuals dealing with pain are not only being cut off cold turkey which is dangerous but, that we are living in a time of Proabition, concerning pain meds. I don’t think it is ethical to have someone who doesn’t have the education that my doctor does, deciding that they won’t fill what my Doctor deems necessary. This new culture is going to back fire as the illegal market will be glad to pick up new business and then you Will have no checks and balances. People with legitimate pain, are becoming desperate and that is a recipe for disaster. I don’t want my pharmacist policing my doctors decisions.
In response to your comment above. Part of the pharmacist’s responsibility to the public is to “police” the decisions of prescribers. Everyone is human and everyone makes mistakes and the pharmacist is the last line of defense against those mistakes. As a pharmacist I have caught countless over-sites that prescribers have made and that everyone appreciates. You also need to understand that if you do not have a relationship with your pharmacist and are using multiple pharmacies, the pharmacist does not have any information about you and you expect them to make a decision. That decision takes time and great effort and you need to appreciate that. My patients that I see that have chronic pain appreciate my input and having me their every month to talk to them and to help them make decisions. I have no problem dispensing opiate medications as long as I have a relationship with the patient and everything falls in line standard of practice. My duty is to protect the public and to protect my patients and if that means I have to go the extra mile and speak to providers and patients to achieve that, then so be it. But in my heart I am doing the right thing and I know that patients commend me for “policing” and appreciate what I have to offer.
Now to address your education comment. Pharmacists go thru as much didactic education as your physician and twice as much education as most physician assistants. So that argument unfortunately does not hold much weight.