I had surgery two weeks ago for a damaged nerve in my elbow (cubital tunnel syndrome). They gave me a prescription for 15 pills of Hydrocodone-Acetominophen to be taken every 4 hours. I asked the doctor for one refill for another 15 pills. After the 1 refill was used, I switched to OTC NSAID's and have been doing reasonably well. Of course, when filling prescriptions I got the normal fact sheets and warnings that come with most drugs now.

And today I get a letter from Express Scripts, the Rx insurance provider for my health plan telling me about how I need to take my opiod pain killer exactly as prescribed, and that it might not resolve all my pain, and that I might become dependent. On the other side are warnings about overdoses, effects of mixing with alcohol, and phone numbers for Suicide prevention, Substance Abuse, and Alcoholic Anonymous hotlines.

All this, for 30 pills taken over 5 days, as prescribed, under the instructions of the surgeon.

I called Express Scripts to explain in detail how displeased I am to get this letter implying that 5 days of painkillers after surgery might make me a suicidal alcoholic drug addict, and that they have NO BUSINESS inquiring or advising me about my health or medications in place of my Doctor. Furthermore, I expect never to see any other such letter again, and they are to simply fill the prescriptions that are prescribed, process the insurance payment, and do NOTHING ELSE.

Just unimaginable the nerve.

Getting wound up about nothing is another sign of opioid addiction.

So is paranoia.

quote:

..that they have NO BUSINESS inquiring or advising me about my health or medications...

Actually, competent, responsible pharmacists do have an ethical responsibility to do just that. I also doubt you got singled out for what is obviously a form letter.

Opioid addiction is a real thing. Study the rise, history and role of drugs like Oxycontin and you'll see that medically prescribed opiates played a significant role in the rate of addiction.

Or you could just take a chill pill...

quote:

Or you could just take a chill pill

Be careful that you don't get addicted to these.

THe astute pharm probably noticed you were taking benzos for sleep. I remeber you mentioning that. FYI opiates and benzos in the rithe right amout depress respiration and can cause death. If you so desire you can travel south of the border and get pretty much anything.

THese days good companies send flyers like you received.

Uh, yeah.

The pharmacist is at the pharmacy that filled the Rx near where I live. The actual pharmacist gave me the standard drug info sheet, with appropriate warnings and explanations of risk. My doctor told me about dosage and frequency, and considered my other active prescription for a very low dose benzodiazepine for sleep. I followed the instructions, no issues.

Express Scripts is the insurance processing company, not the pharmacist, not the doctor. That's the point. Their medical or pharmaceutical advice has zero to do with anything because they are not privy to any of the details, just processing the Rx claim.

I've had other Rx insurance processors do really stupid things. Like suggest I stop taking a drug that is not on their formulary in favor of one that is. Except I tried that one before and it was horrendously bad, while the one I was taking was effective and well-tolerated. Making that kind of suggestion based on nothing but $$ without any knowledge of the patient history, and the specific reasons a Dr. prescribed that specific drug is tantamount to malpractice.

Sure opioid addition is real. But one Rx for 2 days at a low dose with one refill does not lead to addiction. Yeah, it's a form letter, and a really really stupid one at that.

Lefty -- you are upset because a non-medical entity, not a doctor, not a pharmacist, took it upon themselves to get involved with what you need, what your doctor ordered, and what your pharmacist supplied. I agree with you 100%.

I had a sort of similar experience, but actually much more aggravating.

I got hit by Guillain Barré Syndrome and had quite a bit of nerve pain, Lyrica was prescribed. I used it for a while, it did not do the job, so my doctor told me to discontinue it and we would try Gabapentin. The doc sent the new prescription to the pharmacy that I had been using.

I went to the pharmacy after work to pick it up. The pharmacist, an immigrant who was sure that she was the smartest person in the store, refused to fill the doctor's prescription. She stated that the new prescribed medication, Gabapentin, was too similar to the previous drug, Lyrica, and she would not allow me to take both.

I carefully explained that under doctor's orders we were discontinuing Lyrica and switching to Gabapentin, but this asinine individual dug her heels in and refused to fill the prescription. When I held my phone to take a photo of her, showing her name badge, she told me that I was "making her feel uncomfortable."

I did not say a word, I just left and went to a different pharmacy, where I hesitated because the pharmacist there was a member of the same nationality / ethnic group as the idiot woman at the first place. He saw my hesitation and asked how he could help me. I told him what had happened; he was incredulous and told me that the pharmacist needed to follow the doctor's orders. He took all the information and asked me to wait a few minutes.

After contacting the original pharmacy, he had them transfer the prescription, he filled it, and gave me his personal cell phone number, telling me to call him if I ever encountered anything like this again and needed his help.

My employer had Express Scrips and they were horrible, I eventually just refused to use them.

Then they switched us to CVS Caremark which made Express Scrips look like the gold standard of competency and service.

Sounds to me exactly the way an addict reacts. Total self centered and defensiveness when in fact someone is trying to care.

Lawyers

Liability

Insurance policy requirements

quote:

Originally posted by Haveme1or2:
Sounds to me exactly the way an addict reacts. Total self centered and defensiveness when in fact someone is trying to care.

Oh, stick a sock in it.