Did you read this before you posted it?
And I feel for the OP because I recently injured my back and I can’t stand, sit, walk, lie down, crawl or fart without taking The Lord’s name in vain.
I live in the U.S. and I get my meds (Vicodin) from Walgreens. If my doc orders a refill at Walgreens can I walk into a CVS pharmacy to have it refilled? Could CVS look up my Walgreens scripts? Are their databases linked?
Hope you feel better, kambuckta.
No, their databases aren’t linked. Generally, each chain or supermarket has it’s own database. With larger companies, the database will usually be centrally shared with all of it’s stores and in real-time or semi-real time, while with smaller companies, they might not be. CVS’s database may also be linked to CVS Caremark’s mail-order pharmacies, though I work for a competitor and couldn’t say for sure.
Per Federal law, you can transfer your controlled substance prescription one time between pharmacy chains (due to the separate databases), while you can transfer as many times as allowed from one Walgreens to the next, save for where your state’s laws are more strict, per each unique RX#. So if your doctor wrote for a 120 tablet supply of Norco 5/325 with 5 refills (the maximum number of refills allowable for a schedule 3 or 4 controlled substance), and you get it filled at Walgreen’s the first time, if you wanted the subsequent fill at CVS, all fills (2-6) after the transfer would be locked to CVS–unless the doctor issues a new prescription, which could be taken to any pharmacy legally permitted to dispense a controlled substance to an outpatient. In order to transfer, you would need to provide, at bare minimum, your name, your date of birth, the name of the drug, and the location where you last had your Norco/Vicodin filled, and the pharmacist would then call (where allowed by state law) and get the information necessary from the pharmacist on duty at the previous location.
In some states, however, there is another database involved–that of the state prescription monitoring program. This database is (currently) not real time in most states (if any), but generally it is required that all pharmacies which dispense scheduled medications must report the drug, quantity, day supply the quantity is expected to last, date dispensed, prescriber name, identity of the specific pharmacy dispensing, and (sometimes) whether it was paid for by cash, private insurer, medicaid, or medicare. Any healthcare provider who is allowed access to this database can look up a patient and see their controlled substance history. In my state, all pharmacists are required to sign up for access, and are required to access it if certain conditions are met before dispensing a controlled substance. We are allowed to access it more frequently if we feel it necessary, but we cannot access it for a patient whom we are not actively determining if we can/will fill a prescription (basically, I can’t look up random people, or former patients who haven’t currently presented me with a prescription to be filled). We can’t use this database to directly transfer a prescription, but we can to see if someone is doctor shopping, over-utilizing a medication (based on day supply submitted), is on other potentially interacting controlled medications, etc.
I went through this shit a couple of weeks ago. I had to go to the ER because it was on a weekend.
I got my scripts with no problem but when I asked them for that shot (whatever it is) that goes directly into my back for immediate relief, she told me they don’t do that in the ER.
WTF?! You’re a freaking ER for fer cry’n out loud! You take bullets out of people!
But hell, in retrospect, I feel kind of bad for bitch’n about it (in my head) now that I’ve read about kambuckta’s ordeal.
In response to the high-level question of why isn’t there some master linked database that tracks our health / prescription history so that all doctors and pharmacies could instantly access our data?
Welllllll…who’s going to build it? Who’s going to pay for it? Who’s going to manage it? Who gets to access the data?
In the US we have seen what happens when the Federal Gov’t tries to do something “universal” (for every action there is an equal and opposite reaction, ya?) And there is a deep skepticism of insurance companies knowing too much about our personal health history, as it just gives them excuses to deny claims, charge absurd amounts, etc.
So, I wouldn’t hold my breath waiting for a master linked database, as useful as it sounds on a day-to-day level for patients and doctors and pharmacies.
Addicts are crafty. A lot of addicts have that one prescription that they got a long time ago and never refilled. Some of them even have that years old prescription with 1 pill left sitting in their medicine cabinets.
Because, see, an addict wouldn’t have that old bottle with just one pill in it, right. So anyone that looks into my medicine cabinet knows I’m not an addict.
There is a whole huge section of the addicted brain devoted to perpetuating deceptions such as this.
Of course, it’s easy to keep up that ruse when you have a steady supply of drugs from other sources. Those other sources are often something other than prescriptions in their own name…black market drugs or even scrip’s in someone elses name. So a prescription registry proves nothing to the clinic. Zero. Zip. Nothing.
And I’ve got to say that the OP kind of sounds like every drug addict that’s ever tried to cop pills from an ER or clinic. “Hey, I understand that you get a lot of addicts in here trying to get drugs, I get that, I really do.” But I’m not an addict so you can break those rules for me, right. Sure you can, c’mon. I’m in pain here.
Don’t get me wrong - I’m not saying that the OP is an addict, I actually believe his story. ( Although his use of the term “benzo’s” nags at me a bit, most people who really NEVER take pills ever wouldn’t use that word.)
But the issue with the clinics is that some addicts are REALLY REALLY good at imitating people that aren’t addicted to anything - it’s a role they work on all day every day.
So - while I sympathize with the OP I really don’t blame the clinic one bit.
Some addicts are so crafty, I hear they intentionally don’t get addicted to anything, ever. Those are the ones you really have to watch.
Their databases aren’t linked, but California does have a prescription monitoring database they can look at.
As for transferring prescriptions between pharmacies, they will do that over the phone. In most states you can’t transfer prescriptions for schedule II drugs like Vicodin though.
ETA: I see this was already answered. Oops.
Minor tangent/derail, but the US can get seriously crazy about painkillers. Maybe France is too “rub some dirt on it, you wimp” or something, but an expat friend of mine got some minor dental work done recently and the doc scrip’d her for a week or so worth of Vicos for the pain. WTF ?
I mean, OK, it’s Florida, it’s *supposed *to be bonkers. Still, we were both kinda shocked. Maybe the guy has a deal with the local NA chapter or methadone dispensary, I’unno.
[QUOTE=kambuckta]
But what about the rest of us in pain?
[/QUOTE]
Luckily there’s an over-the-counter, general purpose painkiller available anywhere on the planet. It’s called “alcohol”. Doubles as an antidepressant, too.
Side effects include all-too-fleeting euphoria, nausea, vomiting, headaches, fatigue, depression, liver damage, diarrhoea, halitosis, memory loss, lifelong addiction, beating the shit out of your kids and regaining consciousness in a wide variety of embarrassing and/or traumatic situations.
Are you kidding? Are you suggesting that addicts are the only people to use the word ‘benzos’?
:dubious:
Another thing that obviously differs between here and the US. In Aus, you can only get one script for any sort of painkiller, and the most commonly prescribed is Panadeine Forte. It’s 500mg of paracetemol, and 30mg codeine. Twenty tabs per pack.
Doctors do not issue repeat prescriptions (unless in exceptional circumstances) so one pack of tabs (when used for acute pain, at the recommended dose) will last you roughly 4 days (if you’re super-lucky!). After that, you need to attend your GP again to get another prescription. No doc worth his salt is going to keep handing out scripts every few days without demanding an investigation, right?
Of course, Doctor-Shopping has been a common practice for those who need their fix of whatever floats their boat. My step-sister developed a raging pethidine addiction after a serious car accident, and was able to attend GP after GP getting scripts from ALL of them. Whilst her physical injuries healed within 3 yrs, her peth habit took another FIVE to overcome!
So that is why I question how come pharmacy data-bases aren’t linked! It’s just common sense, that for every Dr issued prescription, a record is kept that alerts the pharmacist that Joe Bloggs has already filled 28 scripts this week for a narcotic-type drug (for example), or that Jane Bloggs has now filled 30 scripts for Valium (or another benzo, sleeping tablet or anti-anxiety med). One would hope that it wouldn’t need to get to that number before red flags were being raised.
Anyways, thanks to all who shared my pain in the last week. I’m better now, insofar as I’m not screaming or wincing too hard when I move. My back is permanently dodgy though, so it’s just a case now of waiting for the ‘next’ time I do something silly like yawn, or bend over, or go to sit on the dunny! 
I do. Granted, most of what you said is probably true, but we’re never going to have a 100% guaranteed way of predicting who is and who isn’t an addict, given the overlapping nature of the brain systems involved in pain, addiction (or, using more recent terminology since addiction has been so terribly misunderstood/mischaracterized in both professional and popular media, substance use disorder), emotion, reward, etc. And since leaving someone in pain on a maybe is, well, IMO, barbaric and stupid, the clinic could have allowed for a very short course of narcotic medication (and non-narcotic adjuvent therapy) at doses capable of rendering an increase in functionality long enough to get to his GP, which would probably, but not absolutely, have been a drop in the bucket for a patient actively in the throws of a substance use disorder.
I, a registered/licensed pharmacist in the state of Ohio, also regularly refer to the benzodiazepine class (inclusive of the non-benzodiazepine z-drugs, in most cases) of agents as benzos. Do you suspect me of illicit behavior as well?
Not sure what I was supposed to read? The thread? Yes. I read it. And I read the OP’s response that pretty much sums up what is a problem for socialized medicine. Notice that I do not say that the US system is perfect, nor am I championing it. I just object to the idea that health care is free. It is not, under any system, the difference is just the way it is paid for.
Like all computer databases, there are some privacy and Big Brother concerns here.
Suppose somebody hacks the linked database (or is simply a pharmacist with a chip on their shoulder) and publishes the names of everyone who’s purchased this or that embarassing meds ? HIV meds ? Infertility treatments, Viagra scripts, birth control (if you’re a teenager)… the list of things you want to remain firmly between you, your GP and the pharmacist is endless.