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Valid Addiction Med Prescriptions Refused By Pharmacies
#1
I am not quite sure how widespread this issue is but I do know that it is a major issue in my state and the states surrounding me. Basically, pharmacies are refusing to fill prescriptions for the addiction drug Buprenorphine for whatever reason they so desire it seems. I have read posts at another forum I am a member of and have heard from about 1,000 people about this.

In my state, the treatment centers accepting insurance are all full and the cash only facilities charge between $380 and up to $800 monthly just for treatment. People can cross the state lines and get the same exact treatment for $220-$250 per month and anyone would opt for the lower cost if everything was the same or even better. Pharmacies have taken to turning away legit prescriptions for the medication with the following excuses:

1) We are not accepting new patients for that medication.
2) We cannot fill it for you because you live in a state different from where it was prescribed and the pharmacy is located.
3) We cannot fill it because it was written in another state, take it to the state it was written in to be filled 
4) We don't carry the medication and will not order it.
----And here's the real kicker, these are the GREEDY ones----
5) Although we accept your insurance and it does cover your medication, we are not running your prescription through your insurance because we will lose too much money if we do that.

Some people travel to 25-50 different pharmacies to find one pharmacy that will fill it. Even if you have a pharmacy already filling it and switch doctors that is in a different state, they will not fill for you, regardless of how long you have been a customer there. It is horrendous that people can't get an addiction treatment medication filled.

I'm not quite sure what they expect addicts trying to be treated for addiction to do in this situation but a lot of them just give up and go back to their old ways. People that have been on the medication for periods of time experience out of this world withdrawal symptoms and it seems these pharmacies don't really care. The battle of addiction is extremely hard anyway without all of this too.

I am just wondering, have any of you had this problem? If so, how long did it take to get your prescription filled and how many pharmacies did you visit? 
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#2
Your post got me a bit curious as I was on Suboxone soon after it first became available. This was in 2003. The pharmacy I went to had to special order it because they had never heard of it before. After the 1st special order they started stocking it.

Anyways, I have been off of it and all opiates since June of 2006. The physician who prescribed it is a specialist in addiction and became a personal friend who I speak with frequently. We are of differing opinions as he prescribes the stuff and I keep telling him that it doesn't "treat" anything it just prolongs opiate dependency. For some people (like me) it allowed me to get other parts of my life in order and finally stop all opiates but I am one of the lucky ones. Probably less than 5% actually have this outcome.

The doc has told me stories about his increasing frequency of contact with the DEA and Law Enforcement over the diversion of Suboxone. I guess it is pretty popular for people to sell it and/or trade it for other drugs nowadays.

I spoke with him earlier today about your pharmacy situation because it just didn't sound right. He told me that pharmacies can refuse to fill pretty much any prescription for any reason...Person has abuse history, in the state database, possible interactions with other medications, they don't want to order/carry it, don't like the way you look, etc. Basically there are not very many protections for a patient to get a pharmacy to fill ANY prescription.

His advise was to have your physician call your pharmacy and make arrangements to have the prescription filled. He said this is not guarantee but a call from a physician holds some weight.

He also said that if you are in the SE US you may not have much luck as that is the epicenter of the opiate epidemic and there is a lot of eyes on pharmacies from the DEA to local LEO. Nobody wants to stick there neck out right now.

Not much help but I don't think you are alone in this.
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#3
(08-22-2017, 07:42 PM)ghostofjack Wrote: Your post got me a bit curious as I was on Suboxone soon after it first became available. This was in 2003. The pharmacy I went to had to special order it because they had never heard of it before. After the 1st special order they started stocking it.

Anyways, I have been off of it and all opiates since June of 2006. The physician who prescribed it is a specialist in addiction and became a personal friend who I speak with frequently. We are of differing opinions as he prescribes the stuff and I keep telling him that it doesn't "treat" anything it just prolongs opiate dependency. For some people (like me) it allowed me to get other parts of my life in order and finally stop all opiates but I am one of the lucky ones. Probably less than 5% actually have this outcome.

The doc has told me stories about his increasing frequency of contact with the DEA and Law Enforcement over the diversion of Suboxone. I guess it is pretty popular for people to sell it and/or trade it for other drugs nowadays.

I spoke with him earlier today about your pharmacy situation because it just didn't sound right. He told me that pharmacies can refuse to fill pretty much any prescription for any reason...Person has abuse history, in the state database, possible interactions with other medications, they don't want to order/carry it, don't like the way you look, etc. Basically there are not very many protections for a patient to get a pharmacy to fill ANY prescription.

His advise was to have your physician call your pharmacy and make arrangements to have the prescription filled. He said this is not guarantee but a call from a physician holds some weight.

He also said that if you are in the SE US you may not have much luck as that is the epicenter of the opiate epidemic and there is a lot of eyes on pharmacies from the DEA to local LEO. Nobody wants to stick there neck out right now.

Not much help but I don't think you are alone in this.

Well, I must say, thank you VERY much for inquiring with someone about this for me. No, Suboxone and Subutex really is not designed to get you totally off of everything quickly. It takes a very long time. The Buprenorphine is intended mainly as a maintenance therapy so you can function and live somewhat normal without being involved in illegal activity. It has strengthened my relationships, I am now productive and can actually enjoy my life without seeking drugs and I don't crave or want drugs, so it has worked well for me. In addition to controlling that, the added benefit is that it helps to control my chronic pain and takes the edge off to where it is tolerable. For me, I may never have to worry about coming off of Subutex because I am a chronic pain patient. For those that want to be clean, I've heard the best method for coming off of it is to taper extremely slowly, as little as possible (1-2mg or even less) at a time. My doctor told me when he brings people off the medication, he starts bringing them off 2mg at a time at first and then reduces that to 1mg at a time and then goes to every other day and every two-three days until they are completely off and experience minimal withdrawal symptoms and to me that seems like a very good plan that may in fact work well. 

I have done a lot of research regarding the topic and apparently it does violate at least our civil rights under the ADA. Technically, the only way a pharmacist is supposed to refuse a prescription medication is if it would cause harm to the patient, like an allergy, adverse reaction with another medication or the prescribed dose is above the recommended or maximum dosage, although some doctors can prescribe above that threshold. While as of right now with the DEA breathing down the necks of doctors and pharmacists, they ultimately have a hard decision to make. As of right now, it seems pharmacies can refuse prescriptions for whatever reason they deem necessary and nothing is truly being done. I don't know if it is because not enough people have complained or if this issue has not been brought forward. The whole thing with the Subutex prescriptions for addiction, it states right on the prescription it is for addiction so it is very plain and clear it is not being prescribed for pain management. 

I have filed a few complaints myself. I filed one recently with the pharmacy I got my medication filled at for 6 months and when I switched doctors (ONE SWITCH IN A YEARS TIME) because I was no longer able to afford $600 per month out of pocket when the same treatment about 60 miles away costs a third of that at $220.00 a month! Talk about a huge difference. But that wasn't the reason, the reason was because "they had problems with other doctors from the state my doctor practices in". I filed a complaint with corporate and today I received a phone call from the pharmacy manager telling me that policies had changed and filled prescriptions from another state was on a case by case basis. Basically, meaning, if you've switched doctors 20 times or there have been issues with your doctor or clinic doing illegal things with their prescription pads, they aren't going to fill it but if you are a straight laced person that doesn't switch doctors often and there have been no complaints associated with your doctor or clinic, they will likely fill it. I was basically told over the phone my next prescription would be filled at the pharmacy I have used for months. Had it not been for the corporate complaint, this would have never happened.

I do agree with you, sometimes having your doctor or clinic call the pharmacy for you is beneficial. [b]Having the doctor first contact the pharmacy and attempt to resolve things that way is a very good start and if that fails, it may be time to dig deeper especially if finding another pharmacy isn't going to happen in a timely fashion. It does seem that anyone stuck in my position needs to find the corporate contact information for the pharmacy and contact the if their doctor cannot make headway. Not everyone may experience the same results I did but it is a start. There is also the option of contacting the ADA, Medical Licensing Board and Board of Pharmacy regarding the situation and sometimes writing officials like senators and governors for your state does help too. Right now, a petition is being written about this and will hopefully be released pretty soon because it is affecting a lot of people out there.[/b]
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#4
Just wanted to chime in that people underestimate the power that pharmacist's have. In many ways, greater power than even the DEA or physician's have. They are legally protected if they refuse to dispense any medication they deem unfit to dispense. It's crazy. I am not saying that they are not highly schooled and knowledgeable professionals. They certainly are. But they were endowed with too much power and the buprenorphine situation is a good example. RM
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#5
I belong to one of those SE states,in the whole state the drs have dropped about 75% of the pain PTS.and only a select few have the special license to presc. Subs.,Subs on the street go for same or more than oxy's and so on.The DEA has forced retirement on so many drs.,and have the rest so scared your lucky to even get a couple days of Percs. after major surgery.and now the crack down on Subs,nowander why there are so many O.D's from people with nowhere to turn but to the big (H),cheaper,stronger,and almost on every corner from the friendly Cartels.this is why it is so important to help each other,just don't help other prying (EYES),by saying to much on open lines.this is what P.M is for.save our valuable vendors. PeaceBeWithYouAll..
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#6
Subutex is very different than Suboxone. Suboxone contains naloxone, which will keep opioid receptor sites from being activated by any other drugs than the buprenorphine in the Suboxone dose. Subutex does not contain naloxone, and thus is shown to have a much higher risk for dependency, and does not stop a person from combining it with other opiates. If you take other opiates while on Suboxone, the naloxone will prevent you from getting high and will actually make you very sick.

Subutex alone is no different than taking methadone as far as risk for abuse. Suboxone will keep you from taking other opiates and also make it nearly impossible to feel euphoric from the buprenorphine it contains. Modern addiction psychiatry has shown to favor Suboxone for treatment of opioid dependence for these reasons. It should not be difficult to both A) get a Suboxone prescription and B) have any big-box pharmacy fill it, especially in big cities.

Also, the taper schedule off of Suboxone depends a lot of the will power of the patient. That being said, if you are convinced on taking anything long-term, please take Suboxone, not Subutex. That closes the door on the chance of a person taking any other opiates or getting high, yet still relieves withdrawal symptoms.

Please find a support group, such as Narcotics Anonymous. I guarantee you that no matter where you are, you are not alone and you can find other people that may even have tips and pointers on where to fill maintenance meds. Good luck and godspeed.
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#7
(01-16-2018, 10:55 PM)kobe24 Wrote: Subutex is very different than Suboxone. Suboxone contains naloxone, which will keep opioid receptor sites from being activated by any other drugs than the buprenorphine in the Suboxone dose. Subutex does not contain naloxone, and thus is shown to have a much higher risk for dependency, and does not stop a person from combining it with other opiates. If you take other opiates while on Suboxone, the naloxone will prevent you from getting high and will actually make you very sick.

Subutex alone is no different than taking methadone as far as risk for abuse. Suboxone will keep you from taking other opiates and also make it nearly impossible to feel euphoric from the buprenorphine it contains. Modern addiction psychiatry has shown to favor Suboxone for treatment of opioid dependence for these reasons. It should not be difficult to both A) get a Suboxone prescription and B) have any big-box pharmacy fill it, especially in big cities.

Also, the taper schedule off of Suboxone depends a lot of the will power of the patient. That being said, if you are convinced on taking anything long-term, please take Suboxone, not Subutex. That closes the door on the chance of a person taking any other opiates or getting high, yet still relieves withdrawal symptoms.

Please find a support group, such as Narcotics Anonymous. I guarantee you that no matter where you are, you are not alone and you can find other people that may even have tips and pointers on where to fill maintenance meds. Good luck and godspeed.

I tend to disagree about the Suboxone vs Subutex. Personally, I feel Subutex is the safer drug.

Naloxone can make you sick if you use other drugs with it but plain Buprenorphine can as well. I know I cannot get high on other opiates taking just my Buprenorphine without the Naloxone. 

I am DEATHLY allergic to Suboxone (due to the Naloxone in it) and also Bunavail and Zubsolv. So, I cannot take any Naloxone containing products whatsoever. I nearly died three times from it. It seems the more it's prescribed, the more people they are finding are in fact are allergic to Naloxone! 

I have also read some studies from Australia (I do believe it was Australia) that has proven if Suboxone sits for a period of time it can be extremely hazardous to your health. I will attempt to find the study and post a link to it here so others can read that study as well. 

Many doctors are now starting to agree that your body can build up a tolerance to Naloxone just the same as it can any other drug and if it would need to be administered for an overdose, it may not even work. I've had several doctors and PA's agree as well. This is one reason why doctors in areas around my state try not to prescribe Suboxone, that and the cost.

Suboxone costs almost twice as much as Subutex also, so if you do not have insurance or you cannot find a pharmacy that will accept your insurance, you're stuck paying double for a medication that could potentially cause more problems than do good.

I do perfectly fine on my Subutex. My doctor has my dosage situated perfect so that cravings are minimal and I have no desire to go use opiates. I will likely be taking Subutex for the rest of my life because I am a chronic pain patient and surgery won't fix me.
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#8
Thanks for ur post WV

 If you get tired, learn to rest, not to quit.
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#9
Is the Subutex additionally sort of managing the chronic pain?  That's some progress on that issue!  Thanks for information WV.
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#10
(03-08-2018, 01:25 PM)BlackSocks Wrote: Is the Subutex additionally sort of managing the chronic pain?  That's some progress on that issue!  Thanks for information WV.

Honestly, YES, the Subutex does very well with the pain too. Many countries already treat chronic pain with Buprenorphine and some states in the US are treating pain with it also. You're welcome.

I do have some very valuable print resources on Buprenorphine including wallet cards that go in your wallet if you take Buprenorphine cards that lets doctors know you take it in case you're in an accident or need to go to the hospital for any reason for people on Subutex/Suboxone. I'd be more than happy to mail the information packets to anyone interested (if that's okay with site staff here).

I did find some pharmacies in the WV, PA and MD area that will fill Subutex prescriptions regardless of what state they are written in or where you're from as long as you have valid photo ID and they can verify the prescription by calling or faxing your doctor if anyone needs that information as well. I'll share it here just let me know.
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