ladyfoxfyre >> step in please

This may be an ignorant question but I’ve asked around plenty of knowledgeable people I know and haven’t got an answer.

What’s the problem with being addicted to painkillers?

There must be something really horrible about it if so many people are required to suffer so much, just because a some people might get addicted when they shouldn’t be.

Does it interfere with the quality of your life? I haven’t noticed that people on oxy or percoset are unable to function (quite the opposite, if they are in chronic pain and unmedicated).

Is it expensive? Not so I’ve seen. They’re really really cheap at the pharmacy, they’re only expensive on the street because of the black market, which only exists because of the war on drugs, and I haven’t figured out what the purpose of that is yet.

Do they destroy your health?

Do they upset God and put the sanctity of your immortal soul in peril? (Yes, I’m reaching.)

Anyone? What’s so bad about a painkiller addiction?

This is completely incorrect. Pharmacists are professionals and they absolutely are liable for what they dispense, regardless of whether the doctor prescribed it. If the pharmacist’s professional opinion is that a prescription is the wrong dose, or will have bad drug interactions, or even if it’s just not the right medication for the patient, they will be liable if they fill it.

Pharmacists are not just drug dispensing machines. They have brains and are legally accountable for what they give out, and could suffer professional consequences for dispensing errors (e.g. loss of license to practice).

I’m sorry, but who are you and why do I need you to determine anything about me? If I’m not mugging you or conning you, why would you presume to interfere in my life? If you want to live my life, the least you could do is pay my mortgage.

So if a pharmacist can tell through their training and experience that a certain prescription will be harmful to the patient because of it’s dosage or interactions or any other reason, they should just go ahead and fill it? There is a reason that pharmacists are trained medical professionals. They are not the same as a Burger King counter worker filling out your order. They are absolutely liable for any mistakes in medication you get, even if it is a valid prescription. But this is not what happened here.

He took more of the addictive medication than his doctor wanted him to. The pharmacist caught him at it. They did their job. They are only following the doctors medical decision.

I have dealt with many OC addicts. For some reason they all seem to read from the same script. They seem to be pressed out of a mold somewhere. I’m not sure why that is. They tend to be a lot more dishonest about their addiction then any other addict I have met. They also tend to spend a lot of time trying to convince you that they are not an addict. Crackheads usually don’t bother.

Please show me the Maryland statute that assigns liability to pharmacists for filling a valid prescription that they have verified? I don’t believe that statute exists.

Liability doesn’t work that way. Where is the statute saying a doctor is liable for your healthcare? Or a mechanic for doing a bad brake job? Or your landscaper for leaving a rake in your lawn for you to step on? There are no statutes which assign job descriptions in the public sector. That doesn’t mean they are not accountable for doing their jobs.

If the pharmacists detects harmful drug interactions, yes, by all means they should call the doctor and inform them. But the fact is, a doctor’s authority trumps a pharmacist’s - that is why doctors can prescribe controlled substances and pharmacists cannot. So if the doctor says that yes, the medication is medically necessary and that in his medical opinion it is safe and appropriate, then yes the pharmacist has a duty and obligation to fill it.

Pharmacists’ liability is limited in most states. Again, please show me any state statute that assigns liability to a pharmacist who fills a script after practicing due diligence.

State law defines civil liability for certain medical professionals. Look at any state’s medical malpractice statute.

Well, there can be some problems there-like antibiotics. IIRC, taking them when one doesn’t need them and frequently so allows certain infections to become resistant to the drugs. And when those strains start spreading, we’re all in deep shit.

In that case, if you ARE abusing drugs, you could end up harming someone.

Not insulting you, Lib, I’m just sayin’, is all.

Because for those whose addiction arose from over-dependence on prescription meds, they are personally very invested in believing – and convincing themselves, not just you – that they are not addicts. Addicts shoot heroin up their veins in sleazy houses. They beg for money on the street. They shake and twitch and have bad teeth. They are not in control. They are losers. That’s not me! That could not possibly be me! They are not just trying to fool you, they are trying to fool themselves.

The same problems with being addicted to any drug: Adverse physical and mental consequences; obessive thinking and behavior about the drug; increased physical demand for the drug; and potental fatal overdose, among other things. There’s a ba-zillion articles on the web about drug addiction and about opioid addiction in particular.

Here’s a pretty balanced article on the problems with opioid prescription for chronic pain – both doctor’s reluctance to use opioids effectively and patient problems with dependence, tolerance, and addiction.

IMO, a person with chronic pain should be in the care of a chronic pain specialist, not just a general practitioner or an internist, precisely because of these types of issues.

It has nothing to do with statutes. It is common law and tort law. And it is still not what happened in this case. In this case they were following the doctor’s orders. The doctor prescribed a certain dosage. The OP took more than the doctor ordered dosage. He ran out. The pharmacist would not fill the prescription early and give the patient more medication than the doctor ordered. The exact opposite situation from what you are arguing. They were following the doctor’s instructions by not filling the prescription.

IANAL, so I don’t know if such a statue exists, or how I could find it if it did. But my understanding is that there isn’t a statue out there describing exactly every circumstance under which a health care professional is liable. If a patient feels the pharmacist made an error, they take can sue them and see if the court/jury agrees that the pharmacist made a mistake.

Anyways, that’s irrelevant in the case of the OP. You stated “How can a pharmacist unilaterally negate the doctor’s medical decisions? That is bullshit. The doctor prescribed it, now do your job and fill it.” The doctor’s medical decision was that the prescription refills are to be made after set periods of time. The patient is trying to fill the prescription early, contrary to what the valid prescription states.

I’m no professional, but anecdotally, the problem is that such an addiction does not stay static - the addict typically requires more and more of the drug to avoid the pain, as you get habituated. While at normal doses the drug does not necessarily have bad side-effects, the more of the drug you take, the worse the unwanted side effects get, until your health is ruined - and the more drugs you take, the more addicted you get, meaning the more pain and suffering you have to go through to get un-addicted.

How can such a cycle not be harmful?

That being said, an addiction which is medically controlled need not inevitably go that route - but “medically controlled” pretty well means taking as much drug as your medical professional dictates, not as much as you want.

You have only the addic’ts side of this- seen through an opiate haze. The veracityis thus highly doubtful as addicts will say anything for a fix- and they often beleive it too.

Listen to him, he’s a doctor.

You begin to need more and more as the drug effects you less and less. It takes over your life as you invesnt way to get more- lie, cheat steal. You can then overdose and the effects of overdosing are (Wiki)"*Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold and/or clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse cardiac arrest and/or death.
*

And of course there is acetaminophen in most compounds- an overdoes of this will lead to liver damage and liver failure. ODing on acetaminophen is inevitable if you just take more and more pills.

Ther are many cases of Hydrocodone addiction leading to deafness- 60 failry recent cases in LA alone (link requires sub)
http://pt.wkhealth.com/pt/re/addi/abstract.00008514-200109000-00019.htm;jsessionid=Gx7b3nn82QCyKvRnzG1wNT1r3hnxRVNSqbndycLnhqLzb4Q1Fyys!-1444185405!-949856144!8091!-1

Dudes on Hydrocodone do not act all that bad - but it is difference for addicts. Just lke drinkers don’t act badly unless they are drunk but alcholics have problems.

Hydrocone has numerous side effects and they get worse when taken over a long time or taken to excess:

"*The most frequently reported adverse reactions include: lightheadedness, dizziness, sedation, nausea and vomiting. These effects seem to be more prominent in ambulatory than in nonambulatory patients and some of these adverse reactions may be alleviated if the patient lies down.

Other adverse reactions include:

Central Nervous System: Drowsiness, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, psychic dependence, mood changes.

Gastrointestinal System: Prolonged administration of VICODIN® Tablets may produce constipation.

Genitourinary System: Ureteral spasm, spasm of vesical sphincters and urinary retention have been reported with opiates.

Respiratory Depression: Hydrocodone bitartrate may produce dose-related respiratory depression by acting directly on the brain stem respiratory center. (see OVERDOSAGE).

Special Senses: Cases of hearing impairment or permanent loss have been reported predominantly in patients with chronic overdose.

Dermatological: Skin rash, pruritus…

“Drug seeking” behavior is very common in addicts and drug abusers. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). “Doctor shopping” to obtain additional prescriptions is common among drug abusers and people suffering from untreated addiction.*…"

So yes, it interfers with your quality of life (it ruins it) and it destroys your health.

Edit: I may be incorrect - yes. I am. Never mind.

A pharmacist also told the same lie to me, and I’m not any kind of addict.

People that have built up a high tolerance aren’t going to ‘overdose’ per se (they COULD, but its going to take a massive amount to do it, more than the level they need to get high due to the higher tolerance), but they will experience some bad side effects, like the deafness you mentioned (this is what happened to Rush Limbaugh).

And any addict worth his salt knows how get the acetaminophen out of the hydrocodone - it ain’t rocket science.

Well, sorry I didn’t really notice this for a while but I guess it’s about time to step in and say my bit.
Frankly, I don’t retract any of the accusations I made. From the situation you were presenting, I gave you my personal experience from several years in the pharmacy. The behavior you were describing is typical of a person who has a history of seeking controlled medications at many pharmacies. I’m sorry if you felt slighted by the way the staff treated you, you weren’t at my store or I would have told you point blank that your medication was too soon. Again, I don’t have all the relevant information except what you choose to share with us, and from my experience on the other side of the counter I’m willing to bet there’s a whole lot more there. Like I said, in your previous thread you declared that you “receive a prescription for the same pain medication from the same pain management clinic every month” and I am willing to bet that the issue was not with your dental vicodin as much as it was with your previous month’s supply of Lortab. The math just doesn’t add up, even if you’d received it 3 weeks earlier, that would leave only 1 week left to finish out 28 days, which is normal. Two weeks to wait means you had just gotten the other script 2 weeks ago.

You seem to be misunderstanding the whole point of my posts, which is exactly what happened in the other thread too. Which seems to be what nyctea scandiaca is doing also, with all her expertise in the, what, looking up pharmacy laws business? Got me trumped there, sweetheart. I’ll just take your word that you know what responsibilities the pharmacy has, better than say, people who actually work there. You think I won’t give ANYBODY pain meds, that I take one look at them and say “You obviously don’t need these, off with you.”
This isn’t even remotely the case.

I’ll walk you through a daily interaction with a narcotic junkie, just so you can follow along:
Guy walks up to the counter. Hands me a prescription for Percocet, the directions say “Take one tablet up to three times daily as needed, quantity #90”. Using the simple math skills I’m sure we all have, we can calculate this to be a supply that will last our guy 30 days, if he is taking the maximum he has been prescribed by the doctor. I look at his profile, and I see that he’s had this same medication, same strength, same quantity, same directions, filled only 18 days prior. Quick math boys and girls…this leaves him with 12 days of medication that he should still have. I say, “I’m sorry, your medication is too soon to be filled, you should have about 12 days left, so if you’d like to return in 9 days, I’ll be happy to fill it for you.”

Scenario 1) He says, “Oh, I’m sorry, you’re right, I didn’t realize that I had that much left, the doctor usually just writes me a new script every time I go in. Nine days you say? What is that, next Thursday? Sure, I’ll bring it back then. See ya.”
This is a guy who is not likely to be abusing his Percocet. I don’t have a single problem with these people, they are in legitimate need of the medications they are getting.

Scenario 2) He says, “Yeah, well I’ll just pay cash for them then.” When I explain to him that we must abide by tougher restrictions for dispensing controlled substances, he then says, “Oh, well see what had happened was I maybe forgot that I had taken my pills already one day, and took too many, but then I had left them open on the kitchen counter and they accidentally got knocked over by the cat into the sink, so I only saved about 5 of them, so I took them all that day and now I’m completely out.” Uh-huh.
Look people, I am not the reason you’re having difficulty getting your precious hydrocodone early. These medications fall into schedule 3 for a reason: HIGHER PROBABILITY TO BE ABUSED. Look it up. I’m not just making this up. I’m not the reason you are having such a hard time getting your meds. It’s the junkies who never take a break from trying to work the system, and in the end it’s the legitimate patients who suffer for it.

You think that the pharmacy should just “shut up and do their job and fill the damn prescription”? If this was the case, and the pharmacy was just an extention of the doctor’s prescribing power, they’d be in the same building. There’s a reason we double check these things, often doctor’s don’t have the time or energy to be researching which of their patients just got the same prescription written 2 weeks ago, lucky for them we have that information at our fingertips. I’ve never EVER had a doctor berate me for informing them one of their patients was too early.
Not once. They always thank us for looking out and keeping THEIR licenses safe. Besides that, pharmacists have to go through their own grueling process of school and have to pass their own state boards to get a license. They’re not just going to fill anything that comes their way that they feel is unsuitable.

These junkies aren’t usually writing scripts themselves, they’re getting them from legitimate doctors, so before you jump down my throat about having the audacity to contradict a doctor’s orders let me give you the number to the Pinellas County Sheriff’s Department’s task force on prescription medication crackdowns. I’m sure they’d be delighted to hear that you think they should let go all the doctors they’ve arrested for writing narcotic scripts to patients they’ve never seen. Physician’s medical discretion, indeed. Give me a fucking break.

Maybe I don’t have any reason to believe that he is an addict. Maybe he is really just prone to bad luck. But I’ll be damned if I’ve never heard about someone opening their bottle of blood pressure medication right over the toilet, but you’d better believe the Oxycontin fell in there.

I have nothing against chronic pain sufferers. I resent the fact that you have a desire for me to suffer from chronic pain because maybe then, I’ll believe your sad story. As I have said repeatedly, and as will probably be ignored yet again, I have nothing against people who are on pain medication. I have a very big something against people who abuse it, openly, and then lie to me about it, and then try to use me as a tool to feed their addiction.

So don’t direct your ire at me for calling you out on a situation that I and many others have seen ad nauseum. Be upset at all the phony pain management clinics, the hospital junkies, the doctor shoppers, the pharmacy shoppers that pull this scam so much nobody believes it anymore. I’m sorry you have shitty insurance coverage, but that’s not what the issue was here. They would have called the insurance company and found out exactly when and where and how many for what days supply you’d received three weeks ago.

That’s all for now.