Saturday, July 18, 2009

I Hate Liars

One of our regular customers called up looking for a refill on her Vicodin. Let me give you a little background on this woman. She's been getting a month's worth of Vicodin every single month for as long as I've worked at the store. It's the same deal with her husband, except he gets Vicodin ES every single month. She always comes to the counter with a big smile and very conversational. For the first few times you meet her, you think she's one of the nice customers. However, every once in a while she'd leave a little clue that she was completely full of shit.

This just happened to be one of those times. She was about 10 days too early to get her Vicodin refilled. I told her I couldn't fill it due to it being too early, and of course, she tells me that she's leaving for vacation early the next morning and would run out before getting back.

Those wonderful words start a long process of getting an early refill approved for her. I called the doctor's office. As always, they didn't care if she was asking to have a whole year's worth filled at one time. Next, I called the insurance company to see if they would approve the early fill. Well, they only sort of approved it. Her plan had some kind of plan limit where no matter what, she could only get a certain number of tablets within a certain number of days. Therefore, instead of getting her usual 90, she'd have to settle for 75 this time.

I informed her of the plan limit only to have her respond with, "can I pay cash for the other 15 tablets?"

If the stink of bullshit wasn't strong enough before, that question made it unbearable. I told her that she had more than enough tablets to get her through her vacation considering she still had 10 days left from her last fill, and now was getting another 25 days worth. I would not allow her to pay cash for the rest of it. Of course, she argued with me for a few minutes, but after realizing she wasn't going to get anywhere, she hung up the phone.

About an hour later, she showed up at the pharmacy to pick up her Vicodin. One of our techs waited on her. She was lively and conversational as always. I was busy behind the counter filling prescriptions, but I could hear every word she was saying. After she paid for the prescription, right before walking away from the counter, she mentioned that she was going away to the technician. The tech inquired, "Oh, that's nice. How long are you going?"

"Just for the weekend." Then she said bye and walked away.


Let's recap that. She had 10 days of Vicodin left before calling in this refill. Then upon filling a 25 day supply for her early, she bitched about not being able to get the other 5 days due to her insurance's plan limit. This gave her a 35 day supply of Vicodin.... SO SHE COULD GO AWAY FOR 2 FUCKING DAYS!!!

These are the kind of people that I wish would just die. Seriously, it would have made my day if she got hit by a bus and died in a fiery crash on her way home. I have no concern for people like that. I think they deserve whatever misfortune they get. To me, she's the scum of the earth.

Therefore, outside of hoping that she dies a painful death due to acetaminophen induced liver toxicity (which I'm sure won't happen because it's never the fucking lying Vicodin addicts that end up with liver problems), she can be sure that she will never get her Vicodin a day early ever again. She'll have to bring me a goddamn travel itinerary to pull off that one again.

Let this be cautionary advice for anyone on long term opioid pain medication...

Pharmacists understand that your pain may increase in such a way that you would want to take more tablets than directed by your physician. If you work with us and your doctor by telling us that your pain is not being well controlled, we can help improve your medication regimen in hopes of getting better pain control. We know that not everyone who takes opioids is a drug addict. Hell, we know that the vast majority aren't addicts.

However, if you lie to us in order to get your pain medication filled early, whether you have a legitimate reason or not, you will go to the very top of our shit list. Well, at least you'll go to the very top of mine. I can empathize with people who really have pain issues. I can even empathize with people who have developed an addiction. If you're upfront about it with me, I will help you. If you lie to me, I'll hope you fucking die.

I can tolerate a lot of things in retail pharmacy, but I can't stand liars.


Phathead said...

We have a running joke in our store regarding situations like this.

On Fridays we usually have at least a half dozen customers come in claiming they're 'going on vacation'.

What have since defined vacation as the following:

* Going to the local bar
* Going to Wal-Mart
* Moving from the living room to the bathroom
* Moving from the bathroom to the living room
* Answering the door for the pizza delivery man
* Getting high of your narcs so you think you went somewhere.

Bunch of conniving little shits

Anonymous said...

I always let them know that if I fill it early, I will not approve another refill until day X (adding up what they have left, what they are getting and subtracting 1 to 3 days depending on how much BS I smell

Anonymous said...

If a person asks for an early fill and I suspect abuse, I ask them to bring in their vial with them when picking up their rx so I can see that they have the right amount of pills remaining.

Frantic Pharmacist said...

I always like to ask, in a friendly, conversational way -- Oh, where are you going for your vacation? One of our frequent early-refillers told me she and her husband were going to Arizona. When I asked specifically where, she looked wide-eyed and couldn't come up with the name of the city.

RxKerBer said...

Today I refused a refil that was 11 days early. 29 days out of 40 day supply. Pt was OK with the pick up date of the 28th (2 days early). Husband comes in about an hour later with a stack of receipts. He says Blue Cross ALWAYS lets them get the refil on the 31st day. I say too bad (politely). He says we haven't had a problem before and if I am going to change policy that I need to let pts know. Still too bad. She should have 10 days left. I say if wife is using more than md has written for, she needs to get rx to reflect correct usage. Mind you, this is still well under APAP limit. He says he will not comment on that. Oh well. Tough shit. What really gets me is they are my nicest customers. And good customers. He says it is a shame he will have to find another pharmacy. Oh well. I will not back down. I looked up her refil history and she has filled 200 days worth of med in 150 days since she gets it early every time. So, he's pissed cause we finally caught on.

As far as going on vacation...see my post

pharmer said...

I have a lady come to refill oxy every month early, her reasons: her mother die, her bother die, her family member die, and the same peole would die again the following month..

Anonymous said...

You need a new job. Wishing death on anyone is wrong.

Anonymous said...

I am 29 years old and a sufferer of chronic pain. Reading your pissy posts, I have realized maybe I am seen by my pharmacist as one of those "junkies" you speak of because I take Vicodin as well. You cannot always look at someone and tell whether they are legitamitely in need of the med or not. What? Anyone who needs a narcotic is a junkie unless they are hobbling around with a cane? Give me a break. I know there are some quacks out there, but most doctors require proof of a long term injury, such as an xray. I was in pain for Years before I finally sought pain relief and Still I encounter assholes( aka-my drug addicted mother in law) who says I am making "excuses." Don't be so bitter man- Vicodin is not that great to turn someone into a "junkie." Some of us are legitamitely in a shitton of pain.

Pharmacy Mike said...

Perhaps your chronic pain is affecting your reading comprehension. In my post, I stated that the vast majority of people who take pain meds do so for legitimate reasons. I have problems with the fuckers that lie to me and give me bullshit stories trying to get their stuff early every single month.

And you'd be surprised how many Vicodin junkies there are out there. If you don't work in a pharmacy, then quite honestly, you have no business telling me about this stuff. Do you think that all the pharmacist bloggers who write about people lying to them trying to get their Vicodin early are all delusional? Believe me... It happens all the time.

In fact, we just caught a doctor shopper today.

Anonymous said...

Boy oh Boy, what a world we live in. Me being a severe chronic pain suffer can understand all of the posts. The pharmisist is correct in saying do not take more than perscribed but I can also understand when you take 3 ibuprophens and your pain med @ double dose, roll ons etc & it it doesn't work, whats up. You tell your doctor your pain level and one of two things happen. You need to learn to live with it or they will want perscribe say, a morphine patch. Which scares you more. I also have a disabled son who is 9 and I have to do everything for him, lift, change, feed, med, bath etc, doc says you can't do that any more. Ya ok. I know it causes more discomfort but what can I do. The problem is not the pharmasist, it is us and our society that we live in. Pain is not accepeted and not tolerated unless you as an indivual experience the daily fight against this evil. Pain, pills, imbarresment and the fear of addiction or addiction itself. In general Im effected in both hips, L4-L5, right knee & right elbow, what a curse and yes I have a fifteen day supply and on the 10th day they sometimes will fill it and sometimes not. I have been on pain meds for 9-years now and try to take the lowest said narcotic level drugs vicodin, I have had oxy and I stop taking it in fear of the addiction road and also how people view me. If I can not get my Vics I take my oxy till its refilled. I think all the time I wish water would make your pain stop. Thats all I want is for it to stop and for the majority it won't. Pain drugs only mask the cause and symptoms. In conclusion do not be mad or abuse your pharmasist. Try to continue to seek releaf. Cry like a bitch to your doctor or find a better one. I heard of a person who had to seek out fifteen docs till they finaly releaved the patient of their distructive pain. Hot whirl pool baths, stretching etc. I do it all but still suffer so please do not bitch back at me Im on your side. I think of applying for disability but I keep fighting every day. Please don't make up b.s. address it or shut up and suffer. Best is to keep pushing you doc, if I had all day I could tell you some good ones, like docs receiving 6-hours of pain management courses, oh boy. Or sometimes understanding you and you think someone is finally understanding you and then next visit its like your a crying baby. Hang in and as far as wishing death upon someone I think some people might wish they were dead so they would not have to suffer any more. I do agree not to wish someone be dead even if they are a liar. I think all that stress of being a pharmasist is getting to you. I hope you don't posion someone. Use all those thoughts to maby reach out and help but I think that patient won't except the fact that she is abuseing her meds, then I guess you just have to live with it, just as pain suffers live with it. Can't we all learn to just get along?