Drug Topics Voices, September 2014


Letters, e-mails, posts, and tweets from the readers of Drug Topics magazine.

Hydrocodone headache

Re: “DEA tightens restrictions on hydrocodone combination products” [Mark Lowery, August 22, 2014]:

Reclassification may decrease the prescribing of hydrocodone, but it will increase the ‘street price’ and may actually increase the danger aspect of obtaining the drug illegally.

This will cause people who suffer from chronic pain the undue hardship of extra trips to the physician. And it could decrease the physician/pharmacist’s ability to adequately treat patients who legitimately need hydrocodone. It may also impact the patient from a pricing perspective.

I am afraid this is another case of government thinking that it can legislate morality and punish the many because of the few. As usual, politicians make decisions without the facts or consulting with those whom it impacts.

posted at drugtopics.com

Sez who?

“‘Although there is much more that must be done to curb prescription drug abuse, I am confident that rescheduling hydrocodone will undoubtedly begin saving hundreds of thousands of lives immediately,’ Senator Joe Manchin (D-West Va.) said.”

Uh, just where did that calculation come from? At last check, deaths from hydrocodone abuse weren’t nearly that high (even when you add in the collateral damage of innocents killed in under-the-influence auto accidents or robberies).

The “victory” in the war on prescription drug abuse has only returned us to happier days when heroin ruled the opiate-abuse scene.

Don’t get me wrong, I’m all for aggressive scheduling of hydrocodone products, but I think C-III was quite adequate and we’ll all be cursing our lot come October 6.

posted at drugtopics.com

Politics over patients

The DEA has never much listened to “comments or suggestions” from the public or scientists. It does what it wants to do because it is bigger than others and has power over all medical disciplines - very similar to some bullies I have met.

Decisions like the recent rescheduling of opioids will only affect those who are truly in pain. Their increased suffering does not seem to be a concern. Now that this is done, look for an increase in oxycodone prescriptions, along with an increase in the demand and availability of heroin.

Trying to stop drug abuse on the supply side is like squeezing a balloon. If one side is reduced, then another side is increased. In this case, politics, strong-arm tactics, and medicine don’t mix very well.

posted at drugtopics.com


Think about it

Re: Jim Plagakis’ column “Farewell to the druggist culture,” [JP at Large, August]:

Before opening my own pharmacy, in the years between running home infusion pharmacies and hospital pharmacies, I worked for Walgreens, Longs (CVS), Rite-Aid, and others. I spent a lot of time in the aisles with customers, teaching them about probiotics, vitamins, minerals, proper OTC use, etc., and I was constantly being
reported and chastised by the GED-educated (if that) store manager to get back behind the case and fill prescriptions so as to cut down the wait time.

These days, I take no insurance. Cash only. I take time with patients. We have a conversation. (How else are you going to find out what someone needs?) I’m not “everyone’s pharmacist.” I don’t try to be.

There are people who need to go to Wal-Mart, Target, RiteAid, or CVS and get the lowest-priced Rx and the lowest priced can of cat food or bag of Cheetos. I don’t want them as customers.

These days, I choose how much time I spend with a client/patient. I charge a premium fee for consults. And my
patients pay it gladly. Those other patients, the ones who aren’t my clients - we’re both happy with the arrangement.

If you graduated from pharmacy school and you are working at a mill (as I assume most of you are), you need to step back and evaluate where you are and what you are doing. The years go by fast. You don’t want to be on the other end of your career, wishing you had listened to Jim or me or others like us.

posted at drugtopics.com

JP nailed it

The scenario Jim described is precisely what happened to me in my brief attempt to work for “XYZ” National Chain Pharmacy.

I was told implicitly that I spent too much time counseling patients about their medications and health concerns, not promoting their crap repackaged vitamins, and should instead: 1) answer the phone; 2) receive the Rx from the patient; 3) input data for the Rx; 4) fill the Rx; 5) verify the accuracy of the 6) resolve insurance questions or rejects; 7) dispense to the patient; and 8) ring up the prescription - all while attending to the drive-through, and within 20 seconds.

These metrics were designed by non-pharmacists. They were electronically monitored, and customer “surveys” rating timeliness were also used. Support staff hours were based on the number of prescriptions filled, which resulted in the pharmacist running the department for several hours of each 14-hour day.

The national retail pharmacy environment currently supports only a profit-driven practice, which I now see as the “dark side.” For years I have grieved the loss of the neighborhood druggist, but am encouraged by your suggestion that it might be possible to create a similar opportunity to practice the profession I love.

posted at drugtopics.com

Pharms didn’t think that one up

When you say “Pharmacists have decided that running the prescription mill at breakneck speed is more important than to triage for the patient in need,” that is a stereotypical statement. Yes, as a retail pharmacist, I know this happens; however, it is not by our choice.

Your pay and ability to keep your job are affected by the number of prescriptions you fill. Corporate has decided this for us. I know that filling prescriptions at breakneck speed is not the way to practice pharmacy. However, companies also know that this is the way to increase revenue and maintain their status in the business world.

I believe it is much more accurate to say, “Pharmacists have been forced to run the prescription mill at breakneck speed while not being able to eat or use the restroom because they don’t get breaks, which also causes a lack of time to triage every patient feeling neglected by a physician at their recent office visit.”

posted at drugtopics.com


Correction: In the August cover story [“Collaboration in transitional care”], the name of Medicap Pharmacy was misspelled. Drug Topics regrets the error.



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