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Papa Verine
02-19-2008, 05:35 PM
I called the CVS pharmacy where I fill my benzo scripts and asked the pharmacist when I can refill my prescription. She tell me February 25th. OK... but I look at my calendar and count the days since I originally filled it and the 25th is exactly day 31 of a 30-day supply.

Is it true that you can't refill a 30-day script until day 31??? This can't be so. They must give you a couple extra days in advance to refill something. What if there's a snowstorm coming or I'm going out of town for the week-end?

I know there are people here who can answer this one for me!

corlene
02-19-2008, 06:15 PM
I think it depends on the pharmacy/pharmacist Ive never had trouble filling my controlled scripts upwards of 5-7 days early. I see my doc's every 21-25 days and drop my scripts off accordingly. My PM doc fills all scripts in house. But I have certainly refilled my xanax maybe 7 days out. Most insurances wont pay until 3-5 days prior to when they meds are supposed to be up. I once was denied by a walgreens pharm to fill my opiates from my pcp and I just took it to CVS. I dont know if this information is of much help, but Ive also filled early when I went on a cruise for 14 days. They didnt ask for proof of trip or anything. Have a good night.

SpecialGuy69
02-19-2008, 06:21 PM
I think it depends on the pharmacy/pharmacist Ive never had trouble filling my controlled scripts upwards of 5-7 days early. I see my doc's every 21-25 days and drop my scripts off accordingly. My PM doc fills all scripts in house. But I have certainly refilled my xanax maybe 7 days out. Most insurances wont pay until 3-5 days prior to when they meds are supposed to be up. I once was denied by a walgreens pharm to fill my opiates from my pcp and I just took it to CVS. I dont know if this information is of much help, but Ive also filled early when I went on a cruise for 14 days. They didnt ask for proof of trip or anything. Have a good night.Shady as hell, but convienent! No doc could get away with that in VA!

corlene
02-19-2008, 06:26 PM
They're a cash only operation which is ideal since I wouldnt use my insurance and have them find out im double dippin'. Prices there are infact cheaper then walgreens/cvs. The last PM place like this I frequented was raided by the feds, and I just had to pickup and find another. They still are in business though, just new doctors. The only place I have ever seen meds distributed in an office besides samples have been these pain management clinics. There is no shortage of pain management clinics here in S. FL, new ones opening everyday it seems.

strikks
02-19-2008, 06:28 PM
I called the CVS pharmacy where I fill my benzo scripts and asked the pharmacist when I can refill my prescription. She tell me February 25th. OK... but I look at my calendar and count the days since I originally filled it and the 25th is exactly day 31 of a 30-day supply.

Is it true that you can't refill a 30-day script until day 31??? This can't be so. They must give you a couple extra days in advance to refill something. What if there's a snowstorm coming or I'm going out of town for the week-end?

I know there are people here who can answer this one for me!

i have never heard of such a thing are you sure your dates are right?? are you sure your doctors/pharmacist dates are right?? well all i know is i get mine 28days into a 30 day script sometimes 27 that is some bullshit!!!

Papa Verine
02-19-2008, 06:32 PM
They're a cash only operation which is ideal since I wouldnt use my insurance and have them find out im double dippin'. Prices there are infact cheaper then walgreens/cvs. The last PM place like this I frequented was raided by the feds, and I just had to pickup and find another. They still are in business though, just new doctors. The only place I have ever seen meds distributed in an office besides samples have been these pain management clinics. There is no shortage of pain management clinics here in S. FL, new ones opening everyday it seems.

I've been to one here, right outside of Chicago that does the same thing. If you have the cash, you can fill scripts for all the Hydro and Xanax you want in office. There's no record of it this way. they prefer to do the cash sale. A friend of mine who is an escort would go in there and give the doc a blowjob in the exam room for a big bottle of Norco 10/325's (Watson). So, yeah, they're a bit crooked there...

nova67
02-19-2008, 06:39 PM
Yeah its called a *Flag Fill* guys...its a new horror that the pharmacies have come up with to torture us, it is to catch folks with no insurance filling controlled scripts frequently...you know how insurance limits how often you can fill...well this is a database shared between all computer base pharmacies...yup thats right no more filling scripts at one and getting away with it at another...today is a sad day....:(

Papa Verine
02-19-2008, 06:39 PM
i have never heard of such a thing are you sure your dates are right?? are you sure your doctors/pharmacist dates are right?? well all i know is i get mine 28days into a 30 day script sometimes 27 that is some bullshit!!!

The only thing I can think of is that the pharmacist just looked at my fill date and added 30 days to it, and that's what she told me. I haven't actually tried yet but I'm going to try in the next couple days, about 4 days early, and see if the automated re-fill phone system will allow me to get it. If not, I'm going to get an actual person on the phone and say WTF???

I hate pharmacys. Every time I go to one I obsess the whole time about jumping over the counter and grabbing all the bags ready for pick-up. Of course the good stuff is kept in the safe but those bags are right there and they could have anything in them. It would be like opening Christmas presents when I was a kid!!! I bet 10% of them are opiates or benzos.

nova67
02-19-2008, 06:51 PM
I dont think you guys get it...If you have more than one controled substance filled at any pharmacy that is a chain and computer based you wont get the script filled until day 31! I called and complained because I have a trip planned and needed to fill early before I leave...they asked me "are you traveling within the continental U.S.?" I said yes, and they said, well you will have to have it filled there *my destination* because we no longer will fill early for any reason unless you have you doctors written aproval for EACH instance...oh yeah the sky IS falling folks! :mad:

Papa Verine
02-19-2008, 06:55 PM
I dont think you guys get it...If you have more than one controled substance filled at any pharmacy that is a chain and computer based you wont get the script filled until day 31! I called and complained because I have a trip planned and needed to fill early before I leave...they asked me "are you traveling within the continental U.S.?" I said yes, and they said, well you will have to have it filled there *my destination* because we no longer will fill early for any reason unless you have you doctors written aproval for EACH instance...oh yeah the sky IS falling folks! :mad:

so this is new? No wonder I never noticed before and I'm just asking about it now!

This pisses me off tremendously! Like they didn't have enough regulations at the pharmacy already???

Assholes...

jdub
02-19-2008, 06:55 PM
I hate pharmacys. Every time I go to one I obsess the whole time about jumping over the counter and grabbing all the bags ready for pick-up. Of course the good stuff is kept in the safe but those bags are right there and they could have anything in them. It would be like opening Christmas presents when I was a kid!!! I bet 10% of them are opiates or benzos.

You are telling me. Before I got on my subs, I would go to Walgreen's by my office and pick up my points. They always had at least a couple bottles of codeine cough syrup right on the shelf. Now for us opiophiles codeine cough syrup isn't a score. But around here, white boys from the burbs who watch too much BET will pay $200/pint.

That's like $600 dollars just sitting there!

Hookahed
02-19-2008, 07:01 PM
Papa, I use CVS for my Benzo script. 15 day supply and I can always refill on day 13. I think you will be fine on Feb 23rd. You can register online w/CVS, go to the pharmacy counter and enter the info and find out if a refill is valid. Just need the script # & store #. If it says "valid refill" you can order it or back out from there.

Hookahed
02-19-2008, 07:04 PM
Did your pharmacy tell you about "Flag Fill" Nova? If not what is the source of your information?

nova67
02-19-2008, 07:05 PM
Well when I called in to fill my meds I thought oh its only gonna be three days im in the clear...Apparently this bullshit went into action on friday....It was passed as part of a fucking pork belly and it is fucking up my world man... Ya know without insurance you had a little bit of an open door but of course they gotta slam it shut on all us *drug addicts* "no you dont need your meds before you go! You dont have a vehical when you get there and the nearest pharmacy is an hour from where your going, SORRY!" i doesnt effect those who need to pick up meds from being in the er... but if you have been prescribed more than one controlled substance in the last thirty days...you might as well give it up or beg doc for a fill slip cause them gates is shut! :mad: I called Walgreens,CVS,and a slew of other pharm's then I called my docs office...he said he had posted a flyer about it at his office two weeks ago, I havent been in there for three... Not all states have been affected yet *called doc back* but they must comply buy years end...this also affecting our docs too guys, if one doctor has a certain amount of "flag fillers" on his prescription record, he will get an automatic audit by the DEA....

Hookahed
02-19-2008, 07:08 PM
Does it apply to refills covered by insurance as well?

nova67
02-19-2008, 07:19 PM
since insurances already have their own *acceptable fill date* programs they can keep what they have or go with the new law...but most will make more money off of early fills so I dont think it will change...god I hate the goverment!

corlene
02-19-2008, 08:46 PM
Is this program your talking of Nova specific to your state or just different internal regulations in major pharmacy chains? I highly doubt they have put anything like this in place atleast here in FL. We dont even have any state prescription monitoring here. If this was the case the junkies at my PM clinic would be going nuts in the waiting room.

xxanxx
02-19-2008, 09:01 PM
Shady as hell, but convienent! No doc could get away with that in VA!


I went to a Pain Clinic here in KY that also owned a pharmacy(sort-of), on site. I mean every opiophiles dream pharmacy, 80% of their stock was CII!! Best of all, the owner/head doctor was best friends with my uncle so I was treated for free, by him. God, that place was insane. I've never seen so many junkies congregating, and I have been to many a methadone clinic and I've copped in Detroit, Lansing, Phoenix, Oakland, San Francisco, and Portland. Too bad I fucked it up.....


Shit, I realized I didn't address the original question, sorry Papa V. I think it's different in every state and it certainly varies from pharm to pharm.

Young Professor
02-19-2008, 09:13 PM
The reason she said the 25th or day 31 is because you have script that should last 30 FULL days....so if filled on the 1st (day one), it should last through the 30th, and refilled on the 1st (Day 31 or Day 1 of your new script). They don't care that you may need to take it early in the AM on day 1 and need it the night before.

As to why some people can get things filled early:

(1) It's almost exclusively up to the pharmacist. If you pay "cash" and don't have any insurance, or bill any insurance, it's 100% the pharmacist's call. I've actually need stuff refilled early due to a trip or whatever, and the insurance has denied it & I've told the pharmacist I'd just pay cash, and he fills it. Of course, most pharmacists are more strict with controlled than non controlled.

(2) As other posters have said, some insurance companies give you a 3-4 day window and authorize early re-fills, regardless of the drug.

(3) As to really early re-fills, pharmacists have "codes" they can enter into the computer to indicate a vacation, trip or whatever....The insurance company will then authorize the refill despite being very early. However, (a) it's up to the pharmacist to enter it and (b) the insurance companies only allow a couple of these per year.

Hope this helps.

Princess
02-19-2008, 09:15 PM
This *flag* thing isn't quite right.

I just called my friend, who is a Pharmacy Manager for a chain store here in Phoenix. He said that only HIS chain store is linked to other stores within their chain. They are in no way connected by computer to any other pharmacies. He said it is the pharmacists choice NOT to fill before 30 days, he never makes someone wait 31 days.

Target, for one, does not even link to other Target stores (at least in Phoenix). So if you fill in one Target and go to another to fill, you have to fill out all their paperwork again at the new location.

ALL Walgreens are linked to each other, but not to another store. He said Walgreens just bought out another chain in Las Vegas and they are in the process on linking those new stores to the Walgreens database but only Walgreens. Walgreens is linked nationwide to other Walgreens stores.

He has no idea what I'm talking about when asking about EVERYTHING being linked by computer. He's going to see if he can find information on other states when he goes into work tomorrow.

I know that with my Duragesic, being on the patient assistance, I can only fill at 30 days EXACTLY. If I were ever out of town and it was fill time, I'd be royally screwed since not too many pharmacies store 15 of the 100mcg/h Duragesic patches in the safe.

I'd take that script somewhere else. That's bullshit.

Papa Verine
02-19-2008, 09:21 PM
Well, to settle this debate about new reulations at the pharmacy, I can tell you all this...

In a couple days I'm going to call my pharmacy to get my prescription filled. If they give me any shit, I'm going to get very angry. If they want to continue to give me shit I'm going to...

Let's just say things are going to get ugly... I am absolutely opposed to any policy that says a person cannot fill a prescption 2 days prior to their "RUN-OUT date". I don't wait until Thursday morning to take out the garbage! I take it out on Wednesday. I don't wait until I'm completly out of milk to go buy another gallon! I get it when the old gallon gets low! I don't wait until I'm completely out of toilet paper to buy another package. I get it when I'm down to one roll per bathroom!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!

And I'LL BE FUCKED IF I'M GOING TO RUN OUT OF ANY PRESCRIPTION BEFORE I CAN RE-FILL THAT PRESCRIPTION!!! FUCK THIS!!! IT IS NOT THE WAY MOST PEOPLE PREPARE FOR THE FUTURE, AND IT IS NOT THE WAY I WISH TO PREPARE FOR THE FUTURE OF MY MENTAL HEALTH. I'M GOING TO RAISE ALL FUCKING HELL AT MY PHARMACY IF THEY PULL THIS BULL-SHIT ON ME AND YOU ALL CAN READ ABOUT ME IN THE NEWS!!!!!!!!!

IT'S TIME TO STAND UP FOR WHAT'S RIGHT FOLKS!

Wish me luck!

skank69
02-19-2008, 09:23 PM
i think that you should be able to call your doc and they should help you if there good and not all by the book assholes :cool:

Princess
02-19-2008, 09:25 PM
YEA! What PAPA said!!

I only tolerate my fent script fill every 30 days exactly because I have no choice. I get it free from Patient Assistance... so I have to wait. BUT it does screw up any plans I may have since I DO travel!

Not all pharmacists are assholes. Mine is pretty cool. But then again, he's kinda related. He lets me fill my shit early all the time, I just try to not go to the doctor too early.

skank69
02-19-2008, 09:40 PM
well the way the pharmacy's around here is they will not fill any narcodic script early with out the doctor saying so :(

Papa Verine
02-19-2008, 09:43 PM
Well, like I said, who waits until the last minute to do anything??? It's just not right. I don't care what they say, I just want to speak my mind and they can do whatever they want about it.

Just imagine waiting until you use the last square of toilet paper before you go to Wal-mart and pick up another roll. Nobody does that!

Princess
02-19-2008, 09:46 PM
Well, like I said, who waits until the last minute to do anything??? It's just not right. I don't care what they say, I just want to speak my mind and they can do whatever they want about it.
Just imagine waiting until you use the last square of toilet paper before you go to Wal-mart and pick up another roll. Nobody does that!

And ain't it funny that on almost all the scipts, it says "if you are taking this medication regularly, obtain refill before running out....." or however the fuck they write it??

eveline
02-19-2008, 09:53 PM
Hey Papa, don't worry. I don't think they're trying to give you a hard time. Most of the time the person who answers the phone is a pharmacy tech, not the pharmacist, and what he/she probably did is just look at "January 25" for when you got it filled, and told you Feb 25. It's 31 days because January has 31 days in it. ;)

What Young Professor said is spot on. Whether or not you have insurance, the pharmacist can put it through as cash if they want to. Most insurance companies will pay for a script when 90% of it is gone--so 3 days early for a 30-day script. If you have insurance and they're not paying yet (because it's more than 3 days early), the pharmacist usually won't let you get it--they won't even cash it out for you unless you have a believable story (I'm talking about controlled substances here). If you're going on vacation or lost your meds the pharmacist (or you) can call the insurance company and they'll usually put through at least one override (early fill) a year no problem (actually, I don't have much experience with this for controlled substances, so I'm not completely sure, but unless it's a C-II you've got a chance). If you don't have insurance they'll probably use 3 days as a rule of thumb. There's no pharmacist who will make you wait till you are literally out of pills--what, do they want you to come first thing in the morning if you have to take it in the AM? I've never heard of the "flag fill" thing and there aren't any Google results for it--maybe it's WA only?

Anyway, call back (on whatever day 27 would be) and just try to fill it. I'm almost completely sure it'll be fine, whether you have insurance or not.

Uncle Wiggly
02-19-2008, 10:15 PM
I dont think you guys get it...If you have more than one controled substance filled at any pharmacy that is a chain and computer based you wont get the script filled until day 31! I called and complained because I have a trip planned and needed to fill early before I leave...they asked me "are you traveling within the continental U.S.?" I said yes, and they said, well you will have to have it filled there *my destination* because we no longer will fill early for any reason unless you have you doctors written aproval for EACH instance...oh yeah the sky IS falling folks! :mad:

This only affects people with no prescription coverage?
Just want to make sure. I get my CII meds filled every 27 - 28 - no problems. But, I'm covered by health insurance. I get my scripts filled at the same pharmacy. They are privately owned but they have to hook up to my insurance company via the internet to get them authorized. I've never heard anything exactly like you're talking about. I know there's a monitoring program but it's not stopping people with 30 day prescriptions from getting them filled a few, up to four I think, days early. Legitimate PM clinic appointments are setup every 28 days not every 30. If what you're saying is true, people would be experiencing mild W/D every time they went to fill their prescriptions.


Young Prof hit the nail square on the head. I've had a CII script filled earlier than normal because of a death in my family. All the pharmacist had to do was put in an over-ride request to my insurance company.

Nova - This is something that probably would have been in the news and on this board for quite a while. There is a sticky about a prescription monitoring program but nothing to the extent you're writing about. This is the first I've heard of this and I try my best to keep up on these matters.

Roxi*stardust where are you?

Papa Verine
02-19-2008, 10:35 PM
Now look what I started...

Let's just wait and see what the good folks at my local CVS say on Thursday. If I'm not back here Thursday night to post, you all can assume CVS has adopted some new bull-shit policy and that I was arrested for disorderly conduct.

skank69
02-19-2008, 10:37 PM
Now look what I started...

Let's just wait and see what the good folks at my local CVS say on Thursday. If I'm not back here Thursday night to post, you all can assume CVS has adopted some new bull-shit policy and that I was arrested for disorderly conduct.
ha ha ha good luck man :D

xxanxx
02-19-2008, 10:41 PM
Well, like I said, who waits until the last minute to do anything??? It's just not right. I don't care what they say, I just want to speak my mind and they can do whatever they want about it.

Just imagine waiting until you use the last square of toilet paper before you go to Wal-mart and pick up another roll. Nobody does that!

Hey, I do that!! :D j/k:D

NV12
02-20-2008, 12:34 AM
Shady as hell, but convienent! No doc could get away with that in VA!

They do it where I live at the quick care even... and yes, they are shady...

Uncle Wiggly
02-20-2008, 01:22 AM
YO PTO - Nice new avatar. Feet are neat! :D

Princess
02-20-2008, 01:33 AM
YO PTO - Nice new avatar. Feet are neat! :D

Thanks UW! Not my feet, but I do own those shoes from my sales whore days. My feet are smaller and have a cute, fresh pedicure. I changed the avatar for all those boys with a foot fetish. ;)

pain-patient
02-20-2008, 10:02 AM
I had all my CS scripts filled on December 28, 2007, and then on Jan 2, 2008, my car was broken into and my briefcase with all meds stolen. I had to file a police report, but the doc re-wrote all scripts, cautioning me that insurance might not pay, and my pain meds alone are over $1,000/mon sans insurance, so I was WORRIED. When I got to pharmacy, pharmacist told me to wait while he checked on prices, and sure enough, with, as he put, the "right override" codes, he got BC/BS to pay!:) It helped me avoid a heart attack!

He said they only let you do this once a year, so be careful:).

M

LorTabitha
02-20-2008, 12:04 PM
If you have more than one controled substance filled at any pharmacy that is a chain and computer based you wont get the script filled until day 31!

Is this something that changed between Monday and today? (because I just got a refill 5 days early that I picked up Monday and I typically pick up at least 3 days early because I have to depend on a ride to the pharmacy)

Could it be something that is state-specific? :confused:

Princess
02-20-2008, 12:19 PM
Is this something that changed between Monday and today? (because I just got a refill 5 days early that I picked up Monday and I typically pick up at least 3 days early because I have to depend on a ride to the pharmacy)

Could it be something that is state-specific? :confused:

IF it is something new going down... we're safe here.
If you have any problems in the near future, let me know and I'll send you to my guy/pharmacy
:)

OxyContinuously
02-20-2008, 12:53 PM
First of all, it's great to be back.:D In case anyone was wondering, there was some drama, but that has long since been resolved, and is now in the past...Moving forward, let's see if I can help PapaV with his question...

Someone before me had mentioned "flag fill." As far as I am aware, at least from this New Yorker's point of view, I am un-aware of such a policy existing here. Just for reference, I am considered "Lower Hudson Valley" in the county of Westchester..

I, too, have a benzo script, it's given to me once-a-month by our company's shrink, and it's for xanax. Papa, I'm not sure if u mentioned, but I recall u having a Klonopin script right??

In any event, xanax and klonopin are both benzos (obviously) and they are both controlled substances in Schedule 4 ---> "CIV"

I know that there is a little "leeway" I guess would be the correct word, with drugs in CIV and even CIII to some extent. By that I mean that pharmacists in most larger pharmacies (chain stores, but surprisingly enough a lot of the "mom and pop" establishments) adhere to the policy that if a customer has a record at that establishment, has multiple recurring prescriptions and he/she comes every month, they give some room for incidentals. CIV drugs are usually no worry, and CIII's like vicodin, codeine, etc. are similar, but the doc must "sign off" on early refills. And for CIII's an early refill is no more than a couple days at best--even that gives some pharmacists the heebee-jeebees though, so it is really a crap shoot.

CIV's like xanax, klonopin, librium, valium, and even the schedule 4 stimulants like phentermine, and to a lesser extent fenfluramine, are liberally refilled usually. Let's say that for your example, Papa, they want to refill it on the 25th...Okay, that's what? five days away--not usually a problem.

Just to be complete, I'll say that CII's are a no-go. they don't care WHAT the reason is, you are on your own with these!! no exceptions anytime.

What I do personally is tell the pharmacist that I won't be able to make it in, due to whatever reason, and that if it is okay with him, could I pick up next month's in advance...and just so you know, PapaV, I have done this maybe a half-dozen times, a couple days here, three days there, and the longest "advance" I requested was a full week (7 days, not including the day I called). All of these requests were met cheerfully and I was on my way...

A couple notes though:

1) if a customer asks for these favors every month, then chances are you'll get rejected

2) by law, they do not have to give it to you, even one day early, regardless of the circumstances. they view it as your responsibility, so if anything happens, they can literally tell you tough luck. Personally I think that's rather harsh, but unfortunately it IS the law...(and we know how squeamish people can get over controlled substances, regardless of what "schedule" they are in)

3) it helps a lot if you are a consistent customer. insurance is cool, but cash is fine too.

4) problems occur if you are in a database, and the pharmacist observes that you have more than one script at more than one pharmacy. They start to think, "hmm what's up with this fellow?"

5) sometimes, depending on the applicable insurance co., the policy may be not to pay before a certain date. period. we know how insurance cos. can be sometimes.

6) remember that it is a "CIV" so you really shouldn't have to jump through hoops

7) be nice and act as if you could care less if you get it early or not...this way no one picks up on a sense of urgency, cause if they do, chances are you'll have to wait.

8) always ask permission. people like when you give them the authority and it makes them feel important. Pharmacist eat it up because this way they can play the role of your doctor, and most of them love doing that anyway.

hopefully this helped you out, but good luck anyway

peace

Oxy

ACDF2Pain
02-20-2008, 01:06 PM
Going on eight years of filling CII scripts I can't resist adding my two cents.

First - and this probably only makes sense to smokers - what's worse than not having any cigarettes? Having a cigarette and no way to light it.

So it's important to find and cherish a good pharmacist/pharmacy. Before using my current pharmacy - and not doing anything remotely improper - I went through some tough situations but those are stories for another thread.

I see my PM doc every 28 days and two of my scripts are 30-day supplies and one is a 28-day supply. I bring my scripts to the pharmacy right after my appointment and I've never had a problem. I've only asked for an early fill (about 4 days) once so I could travel 2500 miles to my son's college graduation. On the several occasions when the appointments were less than 28 days apart because of scheduling problems or holidays, I would bring the scripts to the pharmacist and tell him to call me when they were filled. He always tells me to wait and see if they would go through the insurance carrier and if they did, he would fill them. I think my carrier uses an 80 percent rule so if 24 days elapsed they went through. Fentanyl-based drugs are an exception - they are a flat minimum of 25 days.

So my thinking is that it's critical to have a good clean relationship with a pharmacy because - what's worse than not having your drugs? Having a script and no way to fill it.

OxyContinuously
02-20-2008, 01:11 PM
<snip>what's worse than not having any cigarettes?</snip>

good one!! and to answer that, as a smoker, I'm not sure there is anything worse!!

LorTabitha
02-20-2008, 01:16 PM
Is it true that you can't refill a 30-day script until day 31??? This can't be so. They must give you a couple extra days in advance to refill something. What if there's a snowstorm coming or I'm going out of town for the week-end?

Have you tried their call-in refill number? It's automated and will either tell you when to come pick up your goodies or that it's too soon to refill (and usually tells you when you can refill.) I don't think that using the automated system would flag you for anything if it's too early. Please keep us updated! :)

Papa Verine
02-20-2008, 01:23 PM
Have you tried their call-in refill number? It's automated and will either tell you when to come pick up your goodies or that it's too soon to refill (and usually tells you when you can refill.) I don't think that using the automated system would flag you for anything if it's too early. Please keep us updated! :)

I'm going to wait until tomorrow, then try the automated re-fill system. If it refuses to re-fill for me I'm going to wait another couple days and I'm going in there on the 23rd. If they give me any shit I'm going to raise Hell and move my prescriptions to another pharmacy. I'll keep you all informed and if I have to go in there and cause a disturbance I'll post a word for word because I can get pretty fuckin funny in these situations.

betmylife
02-20-2008, 07:11 PM
The only thing I can think of is that the pharmacist just looked at my fill date and added 30 days to it, and that's what she told me. I haven't actually tried yet but I'm going to try in the next couple days, about 4 days early, and see if the automated re-fill phone system will allow me to get it. If not, I'm going to get an actual person on the phone and say WTF???

I hate pharmacys. Every time I go to one I obsess the whole time about jumping over the counter and grabbing all the bags ready for pick-up. Of course the good stuff is kept in the safe but those bags are right there and they could have anything in them. It would be like opening Christmas presents when I was a kid!!! I bet 10% of them are opiates or benzos.


mmmmmm.....I do the same shit.....like ok, I can punch the grouchy old pharmacist out, grab a shitload of bags, a few giant bottles of hydrocodone, and get the hell out.....just in time to get arrested.

Suboxstitute
02-20-2008, 07:39 PM
I use a Walgreens, large chain of course - advantage & disadvantages. I have alway been able to (although rarely needed to until lately) fill my benzo script when about 80% of the script is used up (that is probably an insurance thing but also pharmacist discretion. So I had a script that was actually due to be filled on FRIDAY the 22nd this week and I really needed it. In all of 3.5 years I have never asked for an early fill. So I request it on Monday.

The doc, for some reason, refuses to authrorize it until this morning. I actually did run out yesterday, and after my benzo drought of last week (almost 6 days without, my own fault) I said NEVER again.

So I don't know WHAT it up! Something I'll have to take up with the doc/he is probably watching me more closely since for the first time I've run out early on the benzo script.

But I could always get 5-6 days early if I was traveling, or no reason at all.

No consistency.

nova67
02-20-2008, 08:14 PM
I use a Walgreens, large chain of course - advantage & disadvantages. I have alway been able to (although rarely needed to until lately) fill my benzo script when about 80% of the script is used up (that is probably an insurance thing but also pharmacist discretion. So I had a script that was actually due to be filled on FRIDAY the 22nd this week and I really needed it. In all of 3.5 years I have never asked for an early fill. So I request it on Monday.

The doc, for some reason, refuses to authrorize it until this morning. I actually did run out yesterday, and after my benzo drought of last week (almost 6 days without, my own fault) I said NEVER again.

So I don't know WHAT it up! Something I'll have to take up with the doc/he is probably watching me more closely since for the first time I've run out early on the benzo script.

But I could always get 5-6 days early if I was traveling, or no reason at all.

No consistency.

I did some digging that took me quite a while I might add and found these following items...
1.) the person will only be flagged if they fill more than one higher schedule prescription in a thirty day period schedule IV and higher.
2.) Not all pharmacies are in compliance yet... They have till 2010 to comply and link.
3.)Not all states are in complaince yet and must show evidence of compliance or working towards compliance by years end...they MUST be compliant by 2010
4.) This applies mostly to people without insurance...but insurance companies will have the discretion of adopting this system
5.) the bottom line, if you have to travel call your doctor and tell him you are traveling,or if you have other emergencies you doctor is your final word.
This really sucks and I know it will change the way we do things but we adapt and that is the good thing about us *users*...we will make it through and find every loop hole, Im giving my best wishes to those that it affects right now, this is gonna suck. This was put into the bottom of a federal bill in a pork belly project and since it was done so hidden and sneaky it has yet to catch wind of the press but it will soon...we are starting to complain, and you know there has got to be few reporters with a habit that is about to get fucked up so watch the headlines...

Young Professor
02-20-2008, 08:16 PM
Again, it's totally up to the pharmacist on whether to fill a script early. The pharmacist uses "codes" they enter with each script.....There is a code for vacations, emergencies, brand only, and all sorts of things.....Most can literally "force" a script through. At the end of the day, it comes down to the relationship you have with your pharmacy, which includes how long you've been taking something and your past behavior (lots of early refills for example).

However, most PM clinics now are moving to system where they write on the script "do not fill until xyz date." In these cases, it's against federal law for the pharmacy to fill early. Now....They could fill it, but if they get caught in a routine DEA audit, they'd lose their license. So, to give you a detailed example, you go to the PM clinic on Jan 1, and scripted Oxy for 30 days. The script is dated that day (Jan 1) and can be filled immediately. Then when you leave, you set up an appointment for Jan 25th. When you go back on the 25th, you get a new script (for Feb), but it says "Do not fill until Jan 31" under the premise that your first script lasted Jan 1-30. Then, your next appt is Feb 25th or so, and you get script that says "do not fill until Mar 1st (if in a leap year as this year is)". And, so goes the example. This forces patients on a 30 day schedule and keeps them from moving their appt up to get early refills. PM clinics will work with you, however, it you have a legitimate trip or something....But then they add the days back in for the next refill....so if you need it filled on day 28, the next month, it's day 32.

The only way you can get your dates changed is via your appointment and you convince your Doc the meds aren't lasting. In most cases, this has to be done IN PERSON and not via phone. As a general rule, early refills are one of the best indicators PM clinics use to "flag" patients. Avoid them at all cost if you can.

Hope this helps.

YP

Uncle Wiggly
02-20-2008, 08:26 PM
I did some digging that took me quite a while I might add and found these following items...
(http://findarticles.com/p/articles/mi_qa4440/is_200412/ai_n16066136)

Hi, could you please give out the source/sources of your information so we can read it for ourselves?
This is all I could find but it's nothing like what you're speaking of and it's a couple of years old.

PRESCRIPTION MONITOR MEASURE DIES IN SENATE (http://findarticles.com/p/articles/mi_qa4440/is_200412/ai_n16066136)

"The Senate failed to act on House-passed legislation, HR 3015, allowing federal and state police to conduct electronic monitoring of prescription medications. A report accompanying the bill cited estimated from the Office of National Drug Control Policy that 6.2 million persons abused prescription medications in 2002.

Twenty-one states currently operate some form of prescription drug monitoring programs. Each state program is unique, often varying by which state agency operates the program, the controlled substances that are covered, and how patient information is collected and monitored.
Related Results


Most prescription drug monitoring programs function as electronic monitoring systems through which pharmacies transmit prescription data for covered controlled substances to a designated state agency or a private contractor.

In addition to providing information about existing prescriptions for a patient to a health care provider, these programs provide real information to drug enforcement agencies to identify illegal activities.

The goal of the bill was to provide incentives to states without monitoring programs and to establish a uniform system for all states."

Princess
02-20-2008, 08:40 PM
Hi, could you please give out the source/sources of your information so we can read it for ourselves?



Yes, I agree.. LINKS Please!
Thanks!

nova67
02-20-2008, 08:45 PM
Ok...I will go back through my searchs and stuff and dig up the links...I agree this should be public info and it really sucks no one has gotten wind of it...give me a bit and i will be back to post

eveline
02-20-2008, 10:22 PM
Again, it's totally up to the pharmacist on whether to fill a script early. The pharmacist uses "codes" they enter with each script.....There is a code for vacations, emergencies, brand only, and all sorts of things.....Most can literally "force" a script through. At the end of the day, it comes down to the relationship you have with your pharmacy, which includes how long you've been taking something and your past behavior (lots of early refills for example).

That's not completely true.

"Brand only" is a DAW (dispense as written) code. There are like 7 or something: not specified (generic is OK), prescriber requests brand, patient requests brand, substitution not permitted by law... umm... pharmacist substituted because of stock (out of stock of generic)... that's all I can think of right now. DAW codes go to the insurance company and can be important (some insurance will only cover brand if the doctor writes "brand medically necessary" or "dispense as written"--some won't cover it even so). But they're standardized. "Not specified" is always DAW 0, etc.

Then for insurance, there are override codes that the pharmacist might know off the top of his/her head, but those are different for each insurance company, and MOST of the time an override will not go through without calling the insurance company. Sometimes they'll give the pharmacist a code to put in, sometimes they just OK it on their end and then the pharmacy processes it as normal and it'll magically go through.

The pharmacist can cash a script out (as if you didn't have ins.) and sell it to you if insurance isn't paying--that's at his/her discretion. But they can't force insurance to pay.

Young Professor
02-20-2008, 10:54 PM
With all due respect, you're giving a very specific obscure example. What I meant by "brand only" is when a Doc writes "medically necessary" on the script....Each insurance co. has a special code and when entered, the patient gets the regular generic co-pay. Conversely, if the patient or Doc just wants brand, the patient usually pays the difference between the generic co-pay and the brand price. Some insurance policies require pre-authorization and etc. ....some don't. Variation all over the place, depending on the quality of your policy.

But you missed the basic purpose of the post....It's almost ALWAYS the pharmacist's call on whether to allow an early re-fill. Legally speaking, a pharmacist can deny any script for any reason....Can't read it, suspicious customer, whatever. I've seen pharmacists punch all sorts of codes in until the script goes through. Obviously, some pharmacists and some chains are way more strict than others....That's the point. The OP was dealing with a super strict pharmacy/pharmacist. Regardless, most Docs are moving to a "don't fill until date" anyway, so it takes it completely out of the pharmacy's hands. Furthermore, the pharmacy monitoring system is designed to pick up multiple controlled scripts filled by the same person thereby giving the pharmacy/pharmacist even more power.

Just a an fyi tip......If a person attempt to fill a script and it gets "denied" by insurance and then you take it somewhere else, it will pop up for the next pharmacist trying to fill it (as just being denied). Additionally, if you get a script filled at pharmacy A for something controlled and get a new script from either the same or diff Doc (doesn't matter in this case), take it to pharmacy B and try to bill to the same insurance, the insurance will more than likely kick it back saying something similar was just filled thereby alerting the pharmacist at pharmacy B. And, for those paying "cash" to avoid all of the above, the pharmacy monitoring system is designed to catch these folks.

Moral of the story......Don't do anything stupid!

Chicago
02-20-2008, 11:04 PM
I saw this earlier but could not post up.
But i do this all the time, when you have no insurance like me then you can call like it says on the bottle 2 days early, alot of times like at costco, they be closed sunday, so if my shit falls on a sunday I get it on saturdays a day early.

Also when & if my bottles do run outta refills & they gotta call my Dr. & I have none they HAVE to get me atleadt 1 days worth till they get a hold of my Dr. b/c they see I been on these benzo's for 10yrs & no that I can go into a seizure if not having them so they will give me 1 day's worth till they get a hold of the doc.

To add I go threw 2 different pharmacia's b/c of companys, ONLY places that I no for a fact that all there computers are in tact w/there other locations is Walgreens & Osco.
Not even any costco or Wallmart & targets have the same system having my name in there. & that is where I shop, I no this b/c today was a refill day for me & called a few wallmarts & costco's b/c wanted to switch b/c of the brand names of the benzo's, they had to do a whole new sheet on me & the wallmart was only 15mins away from my orignal one.

HOPE THIS HELPED YOU OUT.

nova67
02-21-2008, 03:00 AM
Just a an fyi tip......If a person attempt to fill a script and it gets "denied" by insurance and then you take it somewhere else, it will pop up for the next pharmacist trying to fill it (as just being denied). Additionally, if you get a script filled at pharmacy A for something controlled and get a new script from either the same or diff Doc (doesn't matter in this case), take it to pharmacy B and try to bill to the same insurance, the insurance will more than likely kick it back saying something similar was just filled thereby alerting the pharmacist at pharmacy B. And, for those paying "cash" to avoid all of the above, the pharmacy monitoring system is designed to catch these folks.

Moral of the story......Don't do anything stupid!

Well I was on state medicaid during my last pregnancy *and i could fill anywhere and my insurance wouldn't call me on it...I mean, I would go and fill my mscontin at the insurance owned pharmacy90 day supply, then like then next day I broke my ribs and got a script for thirty roxi and filled them at walgreens no problem, then i went and did my follow up appointment with pcp and got some hydros, and took them back to said walgreens a filled those...not once did they check me on it...and when I told the gal down at the insurance owned pharm...she said....you get your morphine every month you shouldnt need all that...well apparently the insurance was looking at what it was prescribed for in order to fill it...I had the same situation with dose changes close together during titration...i would get mscontin 15's for four times a day...then a new scrip for five times a day...and so on and so forth...all within a months time and never had a problem filling them even at two different pharmacies...i mean that is pretty high sched...i dont know how it worked but it did...just lucky i guess, oh by the way I am compiling links into one and adding a link in acrobat form for the original text of the flag fill bill....keeping you updated on progress

eveline
02-21-2008, 10:24 AM
With all due respect, you're giving a very specific obscure example. What I meant by "brand only" is when a Doc writes "medically necessary" on the script....Each insurance co. has a special code and when entered, the patient gets the regular generic co-pay. Conversely, if the patient or Doc just wants brand, the patient usually pays the difference between the generic co-pay and the brand price. Some insurance policies require pre-authorization and etc. ....some don't. Variation all over the place, depending on the quality of your policy.

But you missed the basic purpose of the post....It's almost ALWAYS the pharmacist's call on whether to allow an early re-fill. Legally speaking, a pharmacist can deny any script for any reason....Can't read it, suspicious customer, whatever. I've seen pharmacists punch all sorts of codes in until the script goes through. Obviously, some pharmacists and some chains are way more strict than others....That's the point. The OP was dealing with a super strict pharmacy/pharmacist. Regardless, most Docs are moving to a "don't fill until date" anyway, so it takes it completely out of the pharmacy's hands. Furthermore, the pharmacy monitoring system is designed to pick up multiple controlled scripts filled by the same person thereby giving the pharmacy/pharmacist even more power.

Just a an fyi tip......If a person attempt to fill a script and it gets "denied" by insurance and then you take it somewhere else, it will pop up for the next pharmacist trying to fill it (as just being denied). Additionally, if you get a script filled at pharmacy A for something controlled and get a new script from either the same or diff Doc (doesn't matter in this case), take it to pharmacy B and try to bill to the same insurance, the insurance will more than likely kick it back saying something similar was just filled thereby alerting the pharmacist at pharmacy B. And, for those paying "cash" to avoid all of the above, the pharmacy monitoring system is designed to catch these folks.

Moral of the story......Don't do anything stupid!

I'm not trying to be an ass, since this isn't really related to the OP, but what I was saying isn't specific or obscure at all. When a doctor writes "brand medically necessary"/"dispense as written", it's not an override. Every script that is typed in (insurance or not) has a DAW code, which is usually 0 (generic substitution permitted). That's where you indicate "brand medically necessary" (DAW 1). (And in almost all cases, if insurance will even pay for brand there's a higher copay. For a particular insurance plan the copays might be the same if the dr specified brand, but that'd be a good plan. They're actually increasingly moving to requiring prior authorization for a brand med if there's a generic available, even if the doctor writes "brand medically necessary", because it's no skin off the dr's back to write that if the patient just says "I want the real ones, not generic". Prior authorization requires them to call the insurance company and explain exactly why it's medically necessary. And after prior auth it'll probably still be a higher copay.)

The override code blank is a completely separate thing. There are all sorts of rejections, not just "refill too soon". And like I said, usually for any override to go through, the pharmacy has to call and the insurance has to approve it. Believe me, I've dealt with a lot of customers angry at us (the pharmacy) for negligence on the part of their insurance company. If we could make insurance pay by sheer force of will, everyone would be happy.

I agree it's the pharmacist's call on whether to allow an early refill (even if insurance says yes the pharmacist can say no, and vice versa), but they can't make insurance pay. They will take the insurance off that script and process it as cash for you. That's what I said in my post.

Anyway, like I said, I seriously don't think the person at Papa V's pharmacy was being a hard-ass. I think they just absent-mindedly looked at Jan 25 and said Feb 25.

Oh, you're totally right about filling similar drugs at a different pharmacy with insurance. If it rejects as "refill too soon" and the pharmacist can't find that drug on your profile recently, they'll call the insurance company and the ins. will tell the pharmacist what you got filled, how many, what day, and at what pharmacy (and what prescriber, and what the instructions were). That's why doctor shoppers usually pay cash. Of course, paying cash makes you suspicious too, since they can't tell where else you've filled controlled substances. Just for the love of god say "I don't have insurance", not "Don't bill my insurance" or "I want to pay cash". If you have one on file they'll most likely try to bill it though, because patients are happier with lower out of pocket. Unless they're trying to hide something. (2 reasons to bill, then--I've talked about this before--I don't support pharmacists trying to police your controlled substance prescriptions since it has nothing to do with health care, but that's how things are right now.)

I'm not familiar with prescription monitoring programs personally, but it sounds like the data is mostly used by the government and maybe disclosed to doctors. It's definitely possible that eventually it'll work in a similar way for cash patients as insurance does now (in terms of alerting pharmacists to what else you're getting), but I don't think it's at that point yet. Of course, each state has a different program (or no program). Roxi might know more on this, and can back me up on the other stuff.

Papa Verine
02-21-2008, 04:54 PM
I called today to refill my script and it went through without a problem. (4 days early)

You see there... I got my panties all in a bunch for nothin'. I'm kind of disappointed because I was looking forward to raising Hell in there.

Princess
02-21-2008, 05:17 PM
I called today to refill my script and it went through without a problem. (4 days early)

You see there... I got my panties all in a bunch for nothin'. I'm kind of disappointed because I was looking forward to raising Hell in there.

Whew! Thank goodness! I was awaiting your call to bail you out!

Glad that's over. ;)

SpecialGuy69
02-21-2008, 09:49 PM
nova- I'm pretty sure the "flag" thing is something that happened to YOU specifically at that pharmacy, probably because of early refills. 99.9999% sure the pharmacist didn't want a to piss you off, so he/she just said "oh this is a flag fill- new law says i cant fill it inside of 30 days" but what he/she MEANT was "you are flagged. I don't want to fill your script early because i'm a douche."

corlene
02-21-2008, 09:53 PM
I was thinking the same thing. I looked at pharmacy laws for various states and it seems from those states that I did look up its at the pharmacists discretion.

Uncle Wiggly
02-21-2008, 10:01 PM
nova- I'm pretty sure the "flag" thing is something that happened to YOU specifically at that pharmacy, probably because of early refills. 99.9999% sure the pharmacist didn't want a to piss you off, so he/she just said "oh this is a flag fill- new law says i cant fill it inside of 30 days" but what he/she MEANT was "you are flagged. I don't want to fill your script early because i'm a douche."

I've been on all the search engines every chance I've had since I first read this Flag Fill thing. The only scrap of information I found was what I pasted in my post asking Nova to post her links. I don't get it.

Young Professor
02-21-2008, 11:15 PM
I'm willing to bet there was a different pharmacist there today (than when you called). Especially since you indicated it was a CVS....They run em through there like cattle. I have found that the substitute pharmacists usually don't give a shit and fill stuff that the PIC or staff pharmacist might stop. It's also plausible that a tech pulled it up on the computer, did most of the filling and the pharmacist signed off on it in a hurry.

My point for bringing this up is to be CAREFUL. I've had many friends who are on various controlled meds and got in the habit of filling a couple days early....Over the course of many months to a year, they were a week or two ahead and then all of a sudden one day, BAM.....Too early and had WDs until refill day.

I've also had friends who were in the same situation as above and then all of a sudden at the next appointment, the Doc writes "do not fill until XYZ date" and they were screwed." New office policies at the request of the DEA.

Good luck going forward.

Princess
02-21-2008, 11:44 PM
So Papa V's panties got bunched for nothing! ? !

Papa, whatcha wearing panties for anyway??


nova- I'm pretty sure the "flag" thing is something that happened to YOU specifically at that pharmacy, probably because of early refills. 99.9999% sure the pharmacist didn't want a to piss you off, so he/she just said "oh this is a flag fill- new law says i cant fill it inside of 30 days" but what he/she MEANT was "you are flagged. I don't want to fill your script early because i'm a douche."

nova67
02-22-2008, 06:37 AM
nova- I'm pretty sure the "flag" thing is something that happened to YOU specifically at that pharmacy, probably because of early refills. 99.9999% sure the pharmacist didn't want a to piss you off, so he/she just said "oh this is a flag fill- new law says i cant fill it inside of 30 days" but what he/she MEANT was "you are flagged. I don't want to fill your script early because i'm a douche."

Ok to clear some things up....I have only filled early 10 times in five years...and when I filled my titration scripts I ALWAYS brought my others in to my doc as proof that i was taking them right *or as far as he knew*...I used the term "flag fill" because it was the terminology one of the senators supporting the bill used that is why I put it in quotations for emphasis and to single it out...Like i said this was buried in a pork belly in an entirely unrelated to drugs bill, I am pretty sure the original bill was for infrastructure improvement because they talk alot about funding for bridges and roads and stuff in the preceding parts...sorry haven't had a chance to work on it, my step dad has ruined my mom's life. she is in hell, and i've been trying to keep her calm...she has CRPS and if she stresses she doesn't function she has been a CP patient since 1997...as am I and the stress from her has done a number on me today to..plus had to get my spine injections today...I really don't mean to seem like i'm flaming or mad or anything...im really not, just tired and hurting and stressed, i'm sorry I haven't got the info to you yet but i'm working on it...just getting side tracked. Papa i'm glad you got it cleared up...yeah! So far from what I have seen is the bill so far affects only a handfull of states, and even in those some have yet to put it into action...like I said it is *just* starting...It only looks like washington state so far and a few other *northern* states due to high volume canadian imports,and very lax web pharmacy laws...you can still get em sent to your door here. I will be back..after I handle the crisis *like I always do* sorry if it seemed like I was mad. :o

Uncle Wiggly
02-22-2008, 06:45 AM
Hi Nova, I live in a northern state and there is nothing remotely like what you're talking about going on. I've searched every Pork Barrel deal that's tried to pass as well as pharmaceutical, monitoring, uninsured, flag, fill, controlled substance et al and the only thing I found was what's pasted in my post where I asked you for links. I also spoke with my pharmacist yesterday and he said there's nothing like that happening. He also told me that pharmacists and Doctors are almost always the first to know about anything remotely fringing upon a national monitoring system for insured or non insured patients. What I can't figure out is why nothing can be found on this and why only one person would be privy to this information when all the rest of us can't find one single thing regarding it.

BTW - What senators support or wrote this bill and what's the bill's number? They all have an identifying number whether they're passed or die on the floor. Please tell me where to start and I'll do the searching for you.

"4.) This applies mostly to people without insurance...but insurance companies will have the discretion of adopting this system"
I've never heard of a prescription, or any other, federal law that gives individual companies the option as to whether to obey it or not.

Help roxi*stardust. You're expert opinion is needed.

Chicago
02-22-2008, 07:08 AM
Just by talking to you...I bet you got them duke a hazzard panties huh, or Incrediable Hulk?

I no you not a race car guy or smurff ARE YOU?:rolleyes::D



I called today to refill my script and it went through without a problem. (4 days early)




You see there... I got my panties all in a bunch for nothin'. I'm kind of disappointed because I was looking forward to raising Hell in there.

SpecialGuy69
02-22-2008, 07:12 AM
pork belly= a commodity used to make bacon
pork barrel= political term used to describe tacking on extra SPENDING for one's home state

Uncle Wiggly
02-22-2008, 07:58 AM
NOVA67:
"1.) the person will only be flagged if they fill more than one higher schedule prescription in a thirty day period schedule IV and higher."

Almost all CP patients are prescribed one long term med and one short acting med for BT pain. Many are prescribed a benzodiazepine as well. That would mean practically all CP patients will be flagged as well as their doctors?? I personally get three higher schedule prescriptions a month and know many other CP patients prescribed this same combination.
This is all very confusing.

Chicago
02-22-2008, 09:16 AM
WHAT ABOUT ADDICTION MEDICINE SPECIALIST Dr.

B/c mine all he rx's is shed III or lower, like vic's & benzo's are a regular but ms & oxy are done all the time w/depresents & well he is a addiction med specal Dr. so all rx is AREAL DRUGS,
SO IS HE FLAGGED B/C 10 YRS OF HIM I HAVE WENT THREW A FEW PHARMS SWITCHING ALOT?



NOVA67:
"1.) the person will only be flagged if they fill more than one higher schedule prescription in a thirty day period schedule IV and higher."

Almost all CP patients are prescribed one long term med and one short acting med for BT pain. Many are prescribed a benzodiazepine as well. That would mean practically all CP patients will be flagged as well as their doctors?? I personally get three higher schedule prescriptions a month and know many other CP patients prescribed this same combination.
This is all very confusing.

Princess
02-22-2008, 09:32 AM
Hey UW~ As far as the CP meds go... I agree about how we're scripted. I get 15 of the 100mcg Duragesic patches, 120 Perc 10's, 90 1mg xanax, 30 Celexa, 200 Fiorinal and sometimes 120 MSIR 30's on top of the rest... I've never had a problem. Same meds for almost 5 years. However, I don't refill early (except maybe a day or so), have never done the midnight pharmacy run or anything like that.

I just got home from Walgreens. I asked the Pharmacist if I was "flagged" for anything and he said "Huh?"

This is all very strange indeed.


NOVA67:
"1.) the person will only be flagged if they fill more than one higher schedule prescription in a thirty day period schedule IV and higher."

Almost all CP patients are prescribed one long term med and one short acting med for BT pain. Many are prescribed a benzodiazepine as well. That would mean practically all CP patients will be flagged as well as their doctors?? I personally get three higher schedule prescriptions a month and know many other CP patients prescribed this same combination.
This is all very confusing.

Young Professor
02-22-2008, 10:21 AM
PTO- Sounds like you're in perfect shape....LT patient, LT meds, one pharmacy, no early refills, and if so, just by a few days, which can always be explained.

As a general rule, opiophiles can get paranoid....combination of the meds and the thought of not having them. DO NOT GO TO YOUR PHARMACY AND ASK A BUNCH OF QUESTIONS.....It's a major tip off that something could be up. Pain Docs and pharmacists look for things out of the ordinary. If they get suspicious, either they'll start digging (and may or may not find something) or watch you very carefully from there on out. A lot of pharmacists are cool and won't hassle you, but some unfortunately, are anal as hell. Those are ones you have to worry about.

Not to beat a dead horse, but those who fill early are on borrowed time. I highly suggest that early refillers get on track because the day is coming where you go into the Doc and walk out with a script that says "do not fill until xyz".......As everyone knows, there is more and more publicity / regulations. The DEA is working HARD to get all the PM clinics to use the same routine procedures: Triplicate Rx pads, raised seals on the script, do not fill dates, no phone call refills, random UAs, and firm appointments.

Good luck to all.....All this regulation is a bitch. They just don't understand the life of a patient.

Princess
02-22-2008, 10:49 AM
YP~ I should have added, the pharmacist is a personal friend. I was in his wedding ( ;) )...that is the ONLY reason I can ask crazy questions. I agree, no one should ask fishy questions to a pharmacist...unless you *know* 'em. Otherwise, asking suspicious questions to a pharmacist might make you a "flag filler". Ha.

Papa Verine
02-22-2008, 11:10 AM
So Papa V's panties got bunched for nothing! ? !

Papa, whatcha wearing panties for anyway??

It's just a funny little figure of speech. Between me and my friends, if someone's getting upset about something we'll tell them "Don't get your panties in a bunch"

I don't really wear them, but for those of you guys who do... whatever floats your boat! You're still OK in my book.

Uncle Wiggly
02-22-2008, 11:17 AM
Hey YP You seem like an intelligent person and I generally think your posts are pretty spot-on. But a lot of things you mention in your last post go on at some PM clinics but certainly not all. I've been going to the same pharmacy for 22 years. I ask my pharmacist all kinds of questions. In fact if any one, opi or not, has a question regarding their meds they should ask their pharmacist. That's one of the things these folks went to school for. I'm talking reasonable questions such as dosing or adverse reaction kind of stuff. I don't think it would be cool to ask your pharmacist, "Do you know how to smoke Fentanyl?" That would not be smart.

Most PM clinic appointments are setup every 28 days. That gives me, the patient, a couple of days to get the scripts filled. Good medical sense dictates not waiting until your out of meds before getting them refilled. Consequently if the script is dated for the day you're in the clinic there won't be any problems.

As hard as the DEA may be working toward uniformity, the individual state is still the source of most medical regulation - at least for the near future. I've had one UA in over 10(I think) years at my current PM clinic. I did have to sign a contract that I would not obtain narcotics from any other source with the exception of the emergency room. I have to go to the ER every so often due to kidney stones and I get a lot of IV narcotics while I'm there. I just don't ask for any take-homes. My PM doc knows all about it because I bring the discharge report to him. No problem. There is also a clause that I only get my prescriptions filled at one pharmacy. Since I've gone to the same pharmacy for the past 22 years, with the exception of a couple of 24 hour stores from the kids getting sick as night, that isn't an issue.

As far as phone-ins go - my clinic won't/can't phone in CIIs or any other narcotic but anything else is at their discretion. In other words if you are trusted you can get a call-in on something like a benzo. But if you're not in their good graces you're out of luck in that area.
As-far-as firm appointments go, I've gone in a day early now and then but that's about it. I really believe a lot of these rules have to do with the integrity of the clinic. If it's a by-the-book organization, things run pretty smooth. I've heard some folks in here talking about random med checks and having to bring their unfinished meds into the clinic when they have their monthly follow-up appointment. Nothing like that has ever happened to me. I'm not saying it doesn't happen but I think it's more the individual MD than the rule. If doctors are that paranoid they are probably in the wrong specialty. Mine sure don't act that way.

Princess
02-22-2008, 12:37 PM
Uncle Wigg~

Everything you said is exactly my situation over here. Everything.

Doctor/patient, kidney stones, pain contract, same pharmacy, ER...everything! We must be the same person....

What sucks for me, is being on the Patient Assistance Program, I have to pick up my patches every 30 days. Exactly 30 days. Can't get it early...can't get it late. Its crazy because that shit has to be ordered. So, I have to take the script in 10 days before I need it and pick it up every 30 days on the dot. Talk about fear. Shit, I stress every month when I use my last patch.

I've never had a pill/patch count, UA, nothing. It sounds like our doctor's offices work the same way too. Interesting!

Papa~ I knew what you meant...I was just having fun with you. The best way to keep your panties from bunching is just not wearing any. ;)

Uncle Wiggly
02-22-2008, 01:12 PM
Uncle Wigg~

Everything you said is exactly my situation over here. Everything.

Doctor/patient, kidney stones, pain contract, same pharmacy, ER...everything! We must be the same person....

What sucks for me, is being on the Patient Assistance Program, I have to pick up my patches every 30 days. Exactly 30 days. Can't get it early...can't get it late. Its crazy because that shit has to be ordered. So, I have to take the script in 10 days before I need it and pick it up every 30 days on the dot. Talk about fear. Shit, I stress every month when I use my last patch.

I've never had a pill/patch count, UA, nothing. It sounds like our doctor's offices work the same way too. Interesting!

Papa~ I knew what you meant...I was just having fun with you. The best way to keep your panties from bunching is just not wearing any. ;)

I think a lot of it boils down to playing by the rules. I also think some PM clinics operate more on the edge of things. There are three docs, two Nurse Practitioners, three RNs, a physical therapy facility etc... where I go. It's all straight-up. Plus they don't even let you in there unless your problem is in black-and-white - Documented beyond a doubt. No one gets in there claiming they have a back-ache unless they can prove it via diagnostics.

I've got pretty good health and prescription coverage through my wife so I have a four day window as far as picking my scripts early. My prescription provider has a web site that I can access and I can find out how much X amount of X med will cost me out of pocket. It doesn't matter though because I always get them every 28 days. I still pay a good amount for Duragesic. I guess that would be a toss-up in my book. The only offset we have is being able to bank X amount of money per year in a pre-tax account. We get a debit card to pay for what insurance doesn't cover, up to what ever we choose to have deducted of course.

LorTabitha
02-22-2008, 01:15 PM
I don't really wear them, but for those of you guys who do... whatever floats your boat! You're still OK in my book.

Papa goes commando???? :D

nova67
02-22-2008, 05:36 PM
Papa goes commando???? :D

Lmao LT....ok here we go link number one...this is a pretty good representative of when scripts can be filled under the new rules...its from the state of Massachusetts, this stuff is spread all over so bear with me here... http://www.massmedboard.org/physician/prescription_filling.shtm

Two quotes from www.pharmalot.com (http://www.pharmalot.com)...
"So far, more than 540 pharmaceutical bills and resolutions are under consideration in at least 41 states plus Washington, DC, and more than 100 have been filed for 2008 legislative sessions while the rest are carried over from last year. The proposals cover a wide range of state-sponsored approaches, from creation of subsidies or discount programs, to promoting safer pharmaceuticals and regulating the management, marketing and distribution of prescription products, according to the NCSL (http://www.ncsl.org/programs/health/drugbill08.htm#Summary). The following examples are cited by the organization as widespread or “hot” topics this year…"

"Additionally, several more states seek to establish electronic prescription drug databases to monitor the misuse, abuse and diversion of prescription drugs and controlled substances. In August Alaska became the final state to change laws and regulations to allow for e-prescribing;"

quote from www.ncsl.org (http://www.ncsl.org) ...
At least six states in 2008 are proposing "comprehensive" health expansions that include pharmaceutical policies as a visible component. Some measures have been approved by Task Forces or Commissions but not yet seen action in legislatures;

On this ncsl.org it has a table if you scroll down it will show you what bills have been enacted last year that take affect this year...or still needed to be decided on in upcoming legislature sessions...here is an excerpt from that table on the electronic monitoring...it shows roughly what states it is pertanant to.

Electronically transmitted prescription drug orders; electronic prescribing practices; category includes electronic monitoring
E
CA, GA, HI, IL, ME, MN, NH, NY, OH, PA, SC, TN, VT, WA

Box one shows you what the bill is about...box two is the section it falls under and box three are the states currently affected...as you can see my state, Washington, is up there.

Regulation of pharmaceutical benefit managers
PBM
DE, GA, IL, IA, KS, MD, MI, MN, MS, NH, NY, SC, VT, WA, WV

Study or task force on Rx
Study
AK, NY, OK, PA

Another quote from www.addictionsearch.com (http://www.addictionsearch.com)
Most states have developed strict prescription monitoring programs, which can help prevent and detect the diversion and abuse of pharmaceutical controlled substances. Recent bills have made funds available to develop and enhance the strict enforcement of drug regulation in each state.

PLEASE go here...it is linked directly to the DEA website...it also includes a link to the bill....the link to the bill looks like this...it is an older version and is pretty long, they have recently added items to include psuedoephedrin as well...
State Monitoring of Prescription Drugs and Other Substances - August 2007 (http://www.natlalliance.org/pdfs/August%202007.pdf)(As of February 2007, this update includes summaries of bills related to electronic tracking systems for retail sales of ephedrine and pseudoephedrine products)

The link just above is what im speaking of...it only covers a few states so far...and some have kicked it back, denied it, and embraced it...if you look at my state, it is already in appropriations....look for your state and see what it says...but the common thread is "A real time searchable electronic database that can be searched with a patient identifier, to stop the diversion and miss use of higher controlled substances"
now that I have given you some info I hope you will all see that this is not some "pipe dream" of mine...it's REAL and deadly serious....what I was trying to do was compile the info so it was easier to read and understand...all together ya know, but with these links you must dig and read and read and read....here you go...now go raise hell about it!

the part pertaining to "flagging" frequent fillers is in the federal bill which these state bills derive from....will have the link to it soon...the bill is about 500pgs long so must dig it out and attach

SpecialGuy69
02-22-2008, 06:21 PM
Nova- I think we would agree that there is no current 50 state law requiring that CII scripts not be filled prior to 30 days, right?

So, the "flagged fill" is something that your pharmacy has developed and implemented, not the government (as far as I can tell)- at least so far.

If it were easy to implement, we would already have a nationwide prescription monitoring system. Luckily for us, privacy advocates like Sicily would shit bricks, and the pharmacies themselves would oppose it to the bitter end. Why? Because they are competing (rival drug dealers, you could say) for the same market share (YOU, the prescription filler). There is NO WAY Walgreens is going to give Rite-Aid your personal info, along with what scripts you fill, without a fight. Beyond the obvious privacy concerns, there are also valid business concerns- companies don't like being forced to share market data with their competition.

Rite Aid, CVS, Walgreens, Eckerd, and the rest of them form a powerful lobby on Capitol Hill, and right now Congress owes them, big time, because they let the "combat methamphetamine act" pass without a lot of shit. Putting pseudophederine and ephederine products behind the counter, getting ID, and the record keeping associated with it cost them big money- in addition to lost sales, some estimates of the cost of implementation of the combat methamphetamine act are as high as $15,000 per STORE! And that doesnt include all the people who say "fuck it I dont need my actifed that bad".

So, when the pharmacy lobby asks congress for a favor, they will probably get it.

There is a LOT working against a national prescription monitoring system. Like I already said- if it were no big deal, it would be a reality already.

nova67
02-22-2008, 06:59 PM
Nova- I think we would agree that there is no current 50 state law requiring that CII scripts not be filled prior to 30 days, right?

So, the "flagged fill" is something that your pharmacy has developed and implemented, not the government (as far as I can tell)- at least so far.
.

If it were a fabrication of the pharmacy then why do I have black and white PROOF, that the states are starting to implement the electronic monitoring of patients in my last post? This is the approved and enacted Arizona provision of the law alone and verbatim it says "The program shall: (1) include a computerized central database tracking system to track the prescribing, dispensing and consumption of Schedule II,III and IV controlled substances that are dispensed by a medical practitioner or by a pharmacy that holds a valid license or permit issued pursuant to Title 32," The staus of the law in Arizona is adopted, signed and enacted. The above quote can be found in my previous post...it is the last one where I say the link looks like this...it is the blue clickable title to this item...it list all the sates it affects at the present time...the status of it being implemented in that state...and EXACTLY what the states own definition of the new law will be...The pharmacy didn't "make" this up...its cold hard fact...yes all the fifty states haven't implemented it yet...but it is only a matter of time...as I have said before, the states have till 2010 to find a fit. not saying you aren't right...the fat cats always find a way to make a buck. but I am NOT imagining things, and the pharmacy didn't pawn me off...im very good friends with my pharmacist and I really dont think he would do that to me anyway.
editing....made a mistake and forgot to add the link i was speaking of that I found on the DEA website...sorry here ya go
http://www.natlalliance.org/prescription_drug.asp

Uncle Wiggly
02-22-2008, 07:05 PM
I did some digging that took me quite a while I might add and found these following items...
1.) the person will only be flagged if they fill more than one higher schedule prescription in a thirty day period schedule IV and higher.
2.) Not all pharmacies are in compliance yet... They have till 2010 to comply and link.
3.)Not all states are in complaince yet and must show evidence of compliance or working towards compliance by years end...they MUST be compliant by 2010
4.) This applies mostly to people without insurance...but insurance companies will have the discretion of adopting this system
5.) the bottom line, if you have to travel call your doctor and tell him you are traveling,or if you have other emergencies you doctor is your final word.
This really sucks and I know it will change the way we do things but we adapt and that is the good thing about us *users*...we will make it through and find every loop hole, Im giving my best wishes to those that it affects right now, this is gonna suck. This was put into the bottom of a federal bill in a pork belly project and since it was done so hidden and sneaky it has yet to catch wind of the press but it will soon...we are starting to complain, and you know there has got to be few reporters with a habit that is about to get fucked up so watch the headlines...




Nova, All these links you just gave out have ABSOLUTELY NOTHING to do with this set of so-called laws or what ever you want to call them you've been ranting about. All you have done is put up a bunch of links that say NOTHING and do NOTHING to verify what you've been talking about as far as a National Prescription Monitoring system goes. Oh and your link to addictionsearch.com had nothing to do with any of the above STUFF that you've been rambling on about for all this time. A portion of this State-by-State - NOT NATIONAL grouping of bills and other what-ever died on the floor. WE could dig from now until the cows come home and all we would end up with is NOTHING. There's no black-and-white proof. It's just dribble. The state monitoring of prescription drugs link ARE ALL SEPARATE BILLS WITH SEPARATE ID NUMBERS. READ IT FOR CRYING OUT LOUD. GIVE US A BREAK
I'm finished with this GARBAGE !!!!

Hookahed
02-22-2008, 07:21 PM
I'm 99.9% sure my CVS will fill my 15 day benzo script tomrrow on day 13 as they have for years. Glad this was a false alarm. Knew all that real stuff about PMP's. Geez Nova....

nova67
02-22-2008, 08:13 PM
Look...I know you are sick and fed up with me....Im sick and fed up with it myself, im missing important things and putting things that dont matter...believe me I was trying to sort it out. But you guys kept asking what I was talking about...and to post links and such. So instead of organizing my thoughts and items I had gathered i basically threw up all the notes and items of news clips on the subject i had gathered....I FINALLY found out the name of the damn thing...it is an extension...that was pushed through...of NASPER which stands for National All Schedules Prescription Electronic Reporting Act of 2005....Im sorry for this whole mess, and UW I was trying to get something on here as fast as I could about it because you kept asking for it, I was trying to do it for you in particular...I know how you always look into these things and was just trying to give you... something...to help you search. What the bill does is give NASPER more power...essentially forcing states to take the grant...thereby having to comply with the grants rules..which require state to state comunication and national databases that can be searched and used to end abuse of the high schedule drugs. I have included info on NASPER the site I got the info from and You can google it for more info. I was just trying to help. I wont be back for a while my mom tried to commit suicide and I have a flight in three hours...thanx for reading this.
http://www.deadiversion.usdoj.gov/faq/rx_monitor.htm
13. What is NASPER?

On August 11, 2005, President Bush signed into law the National All Schedules Prescription Electronic Reporting Act of 2005 (NASPER). The act creates a grant program for states to create prescription drug monitoring databases and enhance existing ones, similar to the Harold Rogers Prescription Monitoring grant program. NASPER authorizes $60 million for the program through fiscal 2010. While the Harold Rogers grant program is placed within the Department of Justice, the NASPER program is placed within the Department of Health and Human Services (HHS).
The NASPER grant program is authorized for $60 million over five years, with $15 million allocated for 2006 and 2007, and $10 million for 2008, 2009, and 2010. However, HHS did not receive an appropriation in its FY2006 or FY2007 budget for this program. Funding for NASPER in FY2008 has not yet been determined.
14. What are the differences between the Harold Rogers Prescription Drug Monitoring grant program and NASPER?
The Harold Rogers grant program, housed in the Department of Justice, allows states to establish their own requirements with regard to Schedules monitored, information sharing, and accessibility/availability to the program data. Harold Rogers encourages the sharing of information and prescription data among states. Harold Rogers encourages the submission of data for prescriptions in Schedules II, III, IV & V. Eligibility for Harold Rogers grant funds has a very simple requirement: States applying for grants must have in place an enabling statute or regulation "that requires submission of controlled substance prescription data to a centralized database administered by an authorized state agency."
The National All Schedules Prescription Electronic Reporting Act of 2005 (NASPER), housed within the Department of Health and Human Services (HHS), requires states to meet requirements in order to receive grant funding. NASPER requires states to collect data for prescriptions in Schedules II, III, and IV. Additionally, NASPER requires states to be capable of sharing information and prescription data among states.

Uncle Wiggly
02-22-2008, 08:31 PM
First off, I'm sorry about your mom but...No matter how many ways you look at this it is still a STATE-BY-STATE monitoring program. I just finished reading it. There is no Federal Mandate to link all pharmacies via computer. There is no filling deadline. It's mainly aimed at diversion. No ones refills are going to be affected - period. This kind of talk gets people nervous about their scripts. It's a republican(read partisan) bill that's only affected those few doctors who wanted to participate. It's not an across the board Federal law. it happened in 2005 - not 02/15/08. IT'S OLD NEWS. It has absolutely nothing to do with anything. There have been no changes in prescription laws due to it. It's up to the state. This is from your own post.

However, HHS did not receive an appropriation in its FY2006 or FY2007 budget for this program. Funding for NASPER in FY2008 has not yet been determined.

There's no funding being given to it because it's so limited in its scope.This year,2008, hasn't even been determined. This is a dead subject and I wish a mod would close this thread - PLEASE.

Uncle Wiggly
02-22-2008, 09:51 PM
I apologize for the double post but for any of you who may be worried about NASPER. I did a little more research on it and found out exactly why it's so lame. This is the first line of the letter our wise lawmakers sent out to each state's Governor about NASPER. It's no wonder this bill has never received funding. Please folks, don't worry about your prescriptions.

The NASPER Act does not mandate that states implement a monitoring program, rather, it gives each state the option to create such a program and the funding to do so. I strongly believe that this is a much needed program in ____, and I intend to urge ______ legislators pass a bill that takes advantage of this new law. I hope that you will join me in this effort

Chicago
02-22-2008, 10:00 PM
I NO IN CHICAGO, SCHD II can only be filled by a rx being brought in.
You can't have refills on them, thats why my Dr. wrote me some Ms Contins w/2 scripts one time when detoxing b/c he said you can not call in sched II only bring in the rx.

BUT THIS IS CHICAGO & COOK COUNTY.

Young Professor
02-22-2008, 10:13 PM
Hey YP You seem like an intelligent person and I generally think your posts are pretty spot-on. But a lot of things you mention in your last post go on at some PM clinics but certainly not all. I've been going to the same pharmacy for 22 years. I ask my pharmacist all kinds of questions. In fact if any one, opi or not, has a question regarding their meds they should ask their pharmacist. That's one of the things these folks went to school for. I'm talking reasonable questions such as dosing or adverse reaction kind of stuff. I don't think it would be cool to ask your pharmacist, "Do you know how to smoke Fentanyl?" That would not be smart.

Most PM clinic appointments are setup every 28 days. That gives me, the patient, a couple of days to get the scripts filled. Good medical sense dictates not waiting until your out of meds before getting them refilled. Consequently if the script is dated for the day you're in the clinic there won't be any problems.

As hard as the DEA may be working toward uniformity, the individual state is still the source of most medical regulation - at least for the near future. I've had one UA in over 10(I think) years at my current PM clinic. I did have to sign a contract that I would not obtain narcotics from any other source with the exception of the emergency room. I have to go to the ER every so often due to kidney stones and I get a lot of IV narcotics while I'm there. I just don't ask for any take-homes. My PM doc knows all about it because I bring the discharge report to him. No problem. There is also a clause that I only get my prescriptions filled at one pharmacy. Since I've gone to the same pharmacy for the past 22 years, with the exception of a couple of 24 hour stores from the kids getting sick as night, that isn't an issue.

As far as phone-ins go - my clinic won't/can't phone in CIIs or any other narcotic but anything else is at their discretion. In other words if you are trusted you can get a call-in on something like a benzo. But if you're not in their good graces you're out of luck in that area.
As-far-as firm appointments go, I've gone in a day early now and then but that's about it. I really believe a lot of these rules have to do with the integrity of the clinic. If it's a by-the-book organization, things run pretty smooth. I've heard some folks in here talking about random med checks and having to bring their unfinished meds into the clinic when they have their monthly follow-up appointment. Nothing like that has ever happened to me. I'm not saying it doesn't happen but I think it's more the individual MD than the rule. If doctors are that paranoid they are probably in the wrong specialty. Mine sure don't act that way.



Hey Wig- You're right, not all PM clinics follow exactly the same procedures, but it's amazing how many you outline also apply to my clinic. I think what's happening is:

(1) The oversight and publicity of the field has become such that the "partner(s)" of each clinic all attend the same seminars, legal briefings & etc. where "consultants" outline standard operating procedures and general practices....Thus, they get implemented once the Docs return home...Or the vast majority anyway.

(2) Because most large scale PM clinics get visited by the DEA on a regular basis, the need for # 1 above is even higher, and of course, the DEA has their own list of recommendations, which Docs invariably implement in order to be good citizens.

(3) Fundamentally speaking, the larger clinics are naturally more "at risk" due to their larger patient base, and thus, become more policy driven than a mom and pop type operation. For example, my clinic used to do phone re-fills for CIII all the time, and now signs are up that say "no phone re-fills."

I've heard of the same pill counting system at my clinic and I'm guessing it's reserved for the most at risk patients. That would really suck!

I've been tested three times in 6 years, and I'm wondering if it's truly random or semi-random. I do know for a fact that all "new" patients get tested at the first appointment....I'm assuming the Doc wants to CYA right out of the block. It also establishes who is there for "need" and who is there for other reasons. I know there are exceptions to everything, and I'm sure good honest people get caught in the big fishing net at times. Personally, the whole thing sucks and I feel like a F..ing child at times. Oh well.

I enjoy your posts as well. You're a great resource to the group.

YP

Young Professor
02-22-2008, 10:19 PM
Hey Chicago- If you don't mind me asking, what's going on with the whole Detox thing? Is that your undertaking? Someone elses? Also, did the Doc give you some guidelines on Detoxing or just script you a bunch of pills?

Uncle Wiggly
02-22-2008, 10:45 PM
Hey YP. Spot on once again. I'm not 100% but it would make sense. I'm always seeing posters up about seminars regarding new AMA standards and legal issues. I'm pretty sure many of these seminars are sponsored by the same legal/medical organizations. That being the case, if most PM clinics are adopting certain procedural protocols and aren't being hassled by the feds then other would follow to keep in the clear.

I'm in a unique situation because my PM doc knows me from years ago. I actually took my first UA in 10 years(all the time I've been there) maybe two months ago. He was really polite. He asked me if I minded and I thought it was funny because I'd always wondered why I never had one. Just to be clear, I still provided all the necessary diagnostic reports to get in the door. But I was fortunate because they called my hospital and requested all the files instead of me having to chase them down. They mainly are looking for street drugs but not all PM clinics test for the same substances. I also agree with you about the med counts. I've never had to do it but I know some one from my clinic that has to because he's had too many, "The dog ate my pills." etc...

I think between common protocol, strict guidelines on who gets in the door and solid self-policing we may start seeing many common standards between PM clinics. That is as long as the fucking DEA doesn't get an even bigger hard-on for CP patients. :D

HMMM...
02-22-2008, 10:49 PM
I go to this pharmacy that I love to death. Even tho there are long waits sometimes its sure damn worth it.
Cheapest place by far. 60 2mg Xanax= $5. Also when filling expensive meds like brand 80 ocs your allowed to take out as many as you can afford.
Never any questions. Nice people too. Just wish it was kept more of a secret.

nova67
02-22-2008, 11:36 PM
Hey UW...I just want to apologize for being so combative and argumentative with you...I have dropped the subject for us to both keep our peace and sanity. I'm sorry If i have caused you any stress or anxiety. As a contributing member over on paincare. org we often get really political and im sorry if I dragged that bullshit attitude over here....can I please extend a peace offering?
And as far as pain clinics go you are spot on...most require contracts,UA's and sometimes pill counts, depending on how scared the doc is and the suspiciousness of the patient. I'm pretty lucky in the fact, that my doc has a very good rap with the DEA and local authorities...to the point that he does not issue any of these tactics, unless you have a vague diagnosis, early fills: more than once a month,or history of abuse.
The big thing here in Washington state are the contracts...you find them everywhere, even at pcp's now here if you have to treat a pain condition longer than three months. They are trying to make a paper trail to follow doctor shoppers...and specifically where I live the hospitals are all owned by the same mega corporation, so you can't jump around the ER's. And they have these damn propaganda commercials, telling folks to fear the evil guys just waiting to bust into your house and snatch your unused meds... so "don't be sorry, throw them out!" what absolute nonsense. I haven't had problems with my doc's once I get in...its getting them to treat me...im only 24...and its like I gotta haul around my medical records and MRI cd's in order to get treated...jeesh :)

Princess
02-23-2008, 12:02 AM
I really hate stuff like this. I got all freaked out when I first started reading this thread...then the links get posted, UW checks it out and its all cleared up.

Now I read something about *Arizona*. I'm not even going to go back and read it...I AM in Arizona...and as I previously posted, my Pharmacist is a good, personal friend and well, he has no clue about all this *linked info* and such. We don't have any linking or "flag fill" programs in place here. Some *chain* stores here are linked to each other and some chain stores aren't. No statewide system is in place.

I'm not worried, as I do not doctor shop or refill early...and I hope no one else gets worried.

UW~ Thanks for all your digging.

YP~ Thanks for all your input.

Chicago~ Things as you mentioned in Chicago are the same in Arizona.

Uncle Wiggly
02-23-2008, 12:25 AM
Hi Nova, I wasn't really angry with you. But I was very interested in what you had to say. Then I got confused, and even more confused. When you finally mentioned the nasper deal it jogged my memory. I recall when it first happened. Had you said that from the beginning I could have let you know that it was so limp it couldn't stand up if it was starched. In fact one of the Big-Three TV networks did a piece on it in their "wasting the taxpayer's dollars" segment. So it was the inaccuracies that bothered me. I'm much too old to get angry at people in cyber land. You've done nothing to personally attack me. No worries. :drinkit:

BTW - Nova, I used to visit the CP forums a lot but there was way too much ranting and rumor mongering going on. I came over here to escape that kind of thing. It's nice and relaxed here - for the most part,,,
I think once you've caught on to our mellow mood you'll love this place as much as I do. :D

nova67
02-23-2008, 02:55 AM
Thanx UW...They do rant and rave like lunatics over there that IS why I came here too...Got tired of the politics, but since im a volunteer there I kinda have an obligation and can't really get out of it for a while. It is really so much more laid back...and like I said in my i be new here post...ive been lurking here for about four years...so yeah, it is much more relaxed and lighter hearted here...i'll get the hang of it...and after this whole mess im glad I haven't upset ya, because you say some pretty funny shit sometimes...and you are a damn quick wit. Thanx for not giving me the axe...* i would have ran away with it!* :D

Young Professor
02-24-2008, 12:05 AM
PTO- You are correct in that you don't have anything to worry about b/c you do things the right way. I enjoy your posts, btw.

The ONLY thing I worry about is some major diverter/addict infiltrating my PM clinic and then the Feds either (1) shut them down, or (2) scare them such that they make major Rx changes. I probably won't win any popularity votes by saying this, but it wouldn't hurt my feelings if my PM clinic tested me (and others) every appt. A quick blood draw of every patient at every appointment would weed out a lot of crap and leave those with legitimate pain to not be hassled. UAs are a hassle and time consuming, but a quick blood draw would be easy and prudent. I know there would be issues of cost & etc., but what better way to find out who's on the up and up? And, I'm not talking about a super rigorous system, but rather rid those who (1) Don't have any meds in their system or (2) Have all sorts of stuff in their system that isn't related to pain control...i.e. coke, H, meth & etc. Hey, if you want to do those things, fine, but please don't screw up my PM Doc as I need him to live.

Personally, I think many drugs should be legalized as the "war on drugs" isn't working and it's time for a new approach. The cost(s) could be re-distributed towards prevention and rehabilitation. I don't think the Gov't should be telling people what they can and can't put in their bodies. I mean we allow people to a choice via Roe vs Wade, but you can't smoke a joint (I NEVER have btw due to health issues related to smoke)? If someone can take whatever drug and still function, hold down a job, & etc., what's the issue? If they couldn't, then the system would weed them out and they'd be forced into rehabilitation. My Kroger grocery store is next to an ABC store, and judging by the people I see stumble in and out of that place, I don't believe for a second that alcohol is any better.

Additionally, by taxing drugs and taking the criminal element out of it, you would eliminate the flea bag corner dealers not to mention lots of other collateral damage. Not sure if anyone saw this or not, but it will be interesting to see what kind of debate (if any) it stirs up.

Source: www.digg.com

http://blogpublic.lib.msu.edu/index.php?blog=5&title=american-college-of-physicians-recommend&more=1&c=1&tb=1&pb=1

http://stopthedrugwar.org/chronicle/524/american_college_physicians_medical_marijuana_poli cy_statement

Sorry if I offend anyone for being on my high horse tonight, but I'm in one of those moods.

YP

nova67
02-24-2008, 03:26 PM
I agree YP...I mean it would also open up markets for countries that survive off of a drug product economy, look at Afghanistan...They're whole economy is based off of opium growing, If they had more open markets for the product in legitimate uses it would provide them better chances to grow infrastructure and the country in general without having to go to the taliban to support them...A very interesting point made by an person who does NOT support opium but understands WHY they grow it is this woman...Sarah Chayes, a reporter who went to the country after 9-11, but stayed and lived there afterward...she says in her interveiw with Bill Moyers she says
Afghans need credit, just as much as we do. They can't get it. And so, they borrow money. They need to marry off their sons, for example. It's gonna cost 'em $5,000 or $10,000. They have to pay a bride price. They have to have a feast for the entire village. They have to-- you know, where are they gonna get that money? So they turn to the opium trafficker, who lends them money. And he demands repayment in opium.
I mean we are spending money every day, to prosecute someone who puts something into themselves out of thier OWN choice! These funds could be used to help those who WANT help just like YP said...and to help the rest of the country in the process. Oh and for those who are intrigued by that interview, here is the link to the article, which has a link to the video of it. http://www.pbs.org/moyers/journal/02222008/profile2.html

Hookahed
02-26-2008, 04:07 PM
My CVS filled my 15 day Ativan script on day 13 yesterday along with a scrpt for Vicoden so this flag fill does not apply in WV (yet). Had me worried.

Papa Verine
02-26-2008, 04:23 PM
Since I started this whole mess, I'm very happy to see everyone has reconciled and that nobody's having any legal problems at their pharmacy.

Let's all drop it and go back to loving each other!!!

nova67
02-26-2008, 04:58 PM
Since I started this whole mess, I'm very happy to see everyone has reconciled and that nobody's having any legal problems at their pharmacy.

Let's all drop it and go back to loving each other!!!

Hey papa,

lets get this clear YOU in no way started this...I..did, and to all of those who were frightened...worried..or caused any form of anxiety over the whole mess, I would like to extend a public apology, for my lack of research and investigation, before I even posted. Without the criticism and other posts to put me in check, I wouldn't have realized my mistake...and scared even more folks. As it is, I got my own early refill done, without so much as a question, not more than two days after my original post. So lets get back to things as usual...happy things that help and make people feel good :D