^And this, folks, is why my patients are used to hearing me say, “You know, that would be a GREAT question for your pharmacist!”
I <3 pharmacists.
Thank you!
This thread is the first I’ve heard of it. Very weird, since I’m subscribed to all of Medline and Medline for Nurses email lists. Huh. Guess I can stop begging the doctors to prescribe Norco instead of Vicodin now?
I agree that this is more about protecting innocents rather than addicts. I can’t tell you how many medicine cabinets I’ve gone through and thrown out multi-symptom OTC cold and sinus and sleep remedies. If you have a headache, take a headache pill. If you have a runny nose, take a runny nose pill. If you have a cough, take a spoonful of honey, for goodness sakes. It’s soooo easy to OD on APAP without noticing. Vicodin for chronic pain, multi-symptom cold relief for a cold, sinus pill for the sinus congestion and then a couple of extra strength Tylenol (“But that isn’t acetaminophen, right? It’s Tylenol!”) for your headache and a Tylenol PM (“But that isn’t Tylenol, right? It’s Tylenol PM!”) to sleep…who needs a liver, anyway? :smack:
I ate mine with some fava beans and a nice Chianti.
Thanks for the info about iburprufn and hydrocodone. Odd they don’t have one with codeine.
Regards,
Shodan
JayRx1981, is that something that can be/would be compounded? Ibuprofen with codeine?
You are most welcome, and thank you right back.
My patients might get tired of me saying it, but anytime I sell something with acetaminophen, I make sure to emphasize watching the label of other products to ensure that situation doesn’t occur (or at least, to slightly lessen the chance it will happen). Acetaminophen induced liver failure can be quite nasty and painful.
Within reasonable bounds, almost anything can be compounded. I suspect a compounding pharmacy can acquire USP-grade Ibuprofen and Codeine phosphate powders and could formulate a capsule or oral-suspension if necessary, but Codeine phosphate powder is Schedule II, IIRC, which would make the whole preparation schedule II (no phone-in, no refills) and is arguably more likely to produce nausea and vomiting vs the synthetic agents like hydrocodone, so I’d probably argue for a trial of Vicoprofen before resorting to compounded ibuprofen and codeine, myself.
Step 1: Fly to Canada (replace Canada with any other nation with lax prescription laws)
Step 2: See a doctor and have him/her write a scrip.
Step 3: Take the scrip to a pharmacy and have it filled.
Step 4: Fly home
Step 5: Repeat Steps 1-4 as often as necessary
Like ordering drugs from Canada and having them mailed to you, you risk having the drugs seized by customs without much in the way of recourse since it is technically illegal to import medication from other countries into the US without previous clearance (probably from both the FDA and DEA in the case of scheduled medications). This article from WebMD explains more expansively.
Most people can’t just fly to Canada every time they need their prescriptions filled. It costs money and time to do this. I suppose you could drive to Canada if you lived in Detroit or Bellingham, Washington, but what if you lived in St. Louis? In effect, you’d be adding at least a few hundred dollars to the cost of a bottle of pills. And, as JayRx1981 pointed out, it’s illegal.
was told by Dr. Robert Fazio at a continuing ed course at the Texas Dental Assn. meeting last May. He has a pretty good rep but don’t remember where he said the info came from.
You can bring back prescriptions with you into the US as long as they are prescribed to you. You can also mail them back; however, those might be caught in customs.
Who said anything about mailing ( at least I didn’t in my first posting). People who live near the border with Canada ( <6 hours)routinely travel to Canada to have scrips refilled. As long as you have a valid prescription, you don’t have any problems if you declare your meds at the border.
I was the first to mention mailing, and did so intentionally, since that is one of the two ways people get medications from Canada. While many individuals do so and no action is taken against them, the practice currently remains illegal. This is likewise true of actually crossing the border yourself, obtaining a medication (OTC or prescription), and re-entering the US. Generally speaking, the FDA doesn’t go after individuals who import, but the action itself is still illegal and can result in loss of the medications if US Customs decides to not allow entry.
See the FDA Travelers Alert.
Further, since this thread has revolved around narcotic pain relievers, the DEA has published guidance on the import of controlled substance for “personal medical use” in accordance with 21 CFR 1301.26 and limits the amount you can bring in to a total of 50 dose units combined for all controlled substances and that (quoting from Federal Register, Vol 68 No 176, second page, left hand column), “the allowance was not meant to encourage United States residents to travel abroad to obtain their controlled substances for use in this country.”
So, yes, if you legally, under Canadian standards, acquire a prescription, and declare it properly, you aren’t generally going to be stopped by US Customs, unless you appear to be violating the aforementioned DEA rule by going over the quantity allowed or doing this fairly frequently (thus potentially violating diversion rules), or the FDA decides to crack down on individuals importing drugs. This of course, doesn’t get into whether your state or local jurisdiction allow you to do these things.
Thanks again. I usually get Vicodin for night time use, and Tylenol-3 for during the day, because hydrocodone makes me too spacy to work. And this is just for acute episodes that last a week or less, so I don’t need refills.
What I would like is Vicoprofen for night and an ibuprofen-codeine compound for during the day. Again, I don’t want to be labelled a drug seeker because I ask for specifics. Whether or not I do probably depends on the doctor - some doctors seem to hand out Vicodin like candy, and some treat you like you are starring in Trainspotting.
Regards,
Shodan
Although there currently seems to be a burgeoning trend of compounding pharmacies here, I’m unaware of any time or place in the USA when “chemist” was used in the same way as in the British Isles. However, I do have it on excellent authority that, just about this time last century, “Pharmaceutical Chemist” was the title of at least one kind of pharmacy degree.
I wasn’t aware of this; I’m not a professional in the field, just a layman with a general interest in drug policy.
Do all states have retrievable records? I ask because in California I’ve never had to swipe my license when purchasing my Schedule II medication every month, whereas when buying Sudafed I do have to swipe it. (FTR the prescription med is not an opiate, so that might be a factor). As far as I can tell, the pharmacy staff knows me by sight, but employ no other means of verifying my identity. This leads me think the tracking and record-keeping here might not be as user friendly as the system used for methamphetamine precursors.
I’m not saying I didn’t have to show my license the first time I had this prescription filled at any given pharmacy, but I’ve never had to do so more than once.
People in a lot of pain don’t always pick up their own pain meds. The person they’re prescribed to is tracked, but not always the person who picks them up. It’s a loophole big enough to drive a black market through.
I was referring to British usage.
Why should I care if you are inconvenienced?
It’s truly more than “inconvenienced”. It’s actual pain. Excruciating physical pain that people have to put up with needlessly because we’ve made it so hard to get appropriate pain medication.
Know what happens when someone spills their pills, or has them stolen, or is elderly and confused and can’t count the days, or for whatever reason runs out of pills on a Thursday and the pharmacy doesn’t get the refill authorization fax by Friday and the doctor’s office is closed for the weekend until Monday? Even with a nurse advocating for them and trying to sort it out, they suffer. They suffer for 5 or more days with no pain treatment because there’s just nothing I can do to make that refill happen for them faster. I hate it. I hate it more because they are in pain and there’s nothing I can do for them, more than I hate it because they (and I) are “inconvenienced.” It’s barbaric.
And worse, it doesn’t seem to do jack shit about the addicts, anyway. Our addiction levels and overdose rates haven’t gone down any since we started controlling pain medications so strictly. In fact, they’ve risen. The addicts can get more pain meds before the nurse can, for $5 a pill on the street corner. So what’s the fucking point?
[QUOTE=http://www.cdc.gov/homeandrecreationalsafety/rxbrief/]
Although many types of prescription drugs are abused, there is currently a growing, deadly epidemic of prescription painkiller abuse. Nearly three out of four prescription drug overdoses are caused by prescription painkillers—also called opioid pain relievers. The unprecedented rise in overdose deaths in the US parallels a 300% increase since 1999 in the sale of these strong painkillers.4 These drugs were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined.4
The misuse and abuse of prescription painkillers was responsible for more than 475,000 emergency department visits in 2009, a number that nearly doubled in just five years.6
More than 12 million people reported using prescription painkillers nonmedically in 2010, that is, using them without a prescription or for the feeling they cause.7
<snip>
Where the drugs come from
Pie chart showing that people who abuse prescription painkillers get their drugs from a variety of sources: 55% obtained free from a friend or relative, 17.3% were prescribed by one doctor, 11.4$ were bought from a friend or relative, 4.8% were taken from a friend or relative without asking, 4.4% were obtained from a drug dealer or stranger, and 7.1% accounted for other sources.Almost all prescription drugs involved in overdoses come from prescriptions originally; very few come from pharmacy theft. However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions. More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else.7
[/QUOTE]