Letters

November 7, 2005

Regarding your Instant Poll (posted on your Web site in October) about whether triptans should go over the counter, they shouldn't. Side effects or overdose reactions are far too severe. But insurance companies should make them more accessible to patients by eliminating preauthorization or quantity control to legitimate patients who have been counseled by a doctor/pharmacist. I personally know some patients who have stopped trying to fill legitimate Rxs for triptans because of all the red tape involved and the length of time to actually get the drug.

Regarding your Instant Poll (posted on your Web site in October) about whether triptans should go over the counter, they shouldn't. Side effects or overdose reactions are far too severe. But insurance companies should make them more accessible to patients by eliminating preauthorization or quantity control to legitimate patients who have been counseled by a doctor/pharmacist. I personally know some patients who have stopped trying to fill legitimate Rxs for triptans because of all the red tape involved and the length of time to actually get the drug.

Christina Harrell
Clinical pharmacist
Richmond
EMPTY-NEST@comcast.net

Not all heavy drug users are abusers

The higher possibility is that these patients have been unable to get a single physician to properly address their chronic pain and/or they have been "read the riot act" at the pharmacy counter by a holier-than-thou pharmacist about taking so many controlled substances.

In my opinion, too many chronic pain patients are mislabeled as drug seekers, when the bottom line is that they had to "work the system" to get the pain relief they deserve.

There are an estimated 20-50 million chronic pain patients. How many has the system failed to adequately treat and how many are being mislabeled as drug abusers? The system is abusing these patients; it is not the other way around.

Steven R. Ariens, P.D.
Pharmacist/Business consultant
ariens@insightbb.com

Pharmacists as intermediaries

After reading your June 20 Rx Care article concerning emergency contraception (EC), I felt compelled to write. I read with horror Dr. Espy's suggestion that EC be over the counter (OTC) and passed around to female friends "like aspirin." I honestly believe that Espy does not fully understand the far-reaching consequences of such an action.

Maybe Espy's patients are capable of making important health decisions for themselves and others without the aid of a learned intermediary. However, I don't think that holds true for the rest of the country. For those receiving EC, I feel it is extremely important that the patient be counseled appropriately by a healthcare professional.

Your article quoted Dr. Ogburn concerning the adverse event of nausea and vomiting. If this occurs, whom would a woman speak to if the product was purchased at a convenience store? I don't think she would get a good answer from the clerk, nor would she get a good answer from her friends.

Espy fails to realize that if EC becomes OTC, you will have women and young girls using EC as their primary form of birth control instead of more effective forms, e.g., condoms, oral contraceptives. This will, in my opinion, lead to an increase in sexually transmitted diseases.

Finally, Espy asks if the pharmacist's role is to dispense morality. I find this argument disingenuous and a bit arrogant. Given the opportunity, I know pharmacists would do the right thing and provide the appropriate medication with the appropriate counseling.

With that in mind, I think it's time for a third class of drugs. It's now time for pharmacists to step up and demand to be treated like the healthcare professionals we know we are. I have heard too many times from pharmacists that it's "not my job" or "I just want to fill prescriptions." Anyone can fill a prescription; pharmacists need to stop being that person in a white lab coat looking frazzled. It's now time for us to use the education we worked so hard for and prove our worth.

Matthew Carangelo, Pharm.D., R.Ph.
Long Valley Pharmacy
Long Valley, N.J.

Letters (including e-mail) should be as brief as possible and sent with the writer's name, address, and daytime phone number, and date of the issue you are referencing to: Editor, Drug Topics, Five Paragon Drive, Montvale, N.J. 07645-1742. E-mail address: drugtopics@advanstar.com
. Correspondence may be edited for length and clarity.