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Old 11 July 2014, 08:14 PM
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Plurabelle Plurabelle is offline
 
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Blow Your Top General access to pharmaceuticals

Sort of inspired by the Hobby Lobby thread, plus somewhat from experience, plus somewhat from curiosity.

A) Faith - My feeling is that it should be forbidden for any pharmacist to refuse any legitimate script from a doctor except in case of lack of stock (which should be rectified by a fast order or referral to another pharmacy) or potential interaction (which should be dealt with by an immediate call to the doctor). If you have problems with certain drugs, don't be a pharmacist. I love most animals, but have an irrational terror of snakes, so I never sought any general animal care profession.

Eta: I think this is sort of a cheap argument, but if you were a staunch communist, worked at a bank, and refused to disburse sums on an unequal basis, you'd get fired. How is Communism less of a belief system than any other?

B) - fraud - Every state I've lived in recently has very secure rx forms (black light symbols, etc); yes, script pads can get stolen, but that should be dealt with by punishing the thief, not legitimate patients.

I used to have a hell of a time filling my Ritalin RX when I lived in a certain Manhattan neighborhood. My psychiatrist and I knew the requirements well - a dx code and description had to be included - but every month I routinely went to 3-4 pharmacies before one would fill it for me. They'd say my RX wasn't completed properly, I'd press until they finally admitted they wouldn't stock the drug because of liability and thieves. How are they even a pharmacy, then? I swear I went to every pharmacy on the LES - wasn't much of a problem uptown, but those were also years later so it may have been time, not place.

C) Privacy. With all the HIPPA precautions pharmacies take, they still require a scan of my ID and a signed statement every time I get a controlled substance. How is this consistent?

I do understand the reasoning etc but I don't get why the federal government gets to track whether I'm on an anti anxiety drug vs an anti depressant. (Yes, intellectually I get one is more addictive than the other but we can buy alcohol and tobacco with cash).

And now allergy medicine requires ID - I know WHY, but I wonder why it's permitted. Sacrifice of rights for the greater good? Any studies ever prove ID and qty limits on Claritin have reduced meth usage?

I'm shocked people figuratively lose control of their bowels over their right to own an assault rifle but happily let their ID be scanned to buy Sudafed. Medical privacy here is a well-revered farce.

Can you tell I'm a little jaded after recent surgery and the recent SCOTUS rulings? Hope this made sense, if it didn't, please tell me. I'm pretty much off the painkillers now.

Last edited by Plurabelle; 11 July 2014 at 08:37 PM. Reason: My English degree is ashamed of my tense usage.
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Old 11 July 2014, 08:21 PM
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This article is an interesting read on the meth topic: http://www.motherjones.com/politics/...g-pharma-lobby
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Old 11 July 2014, 08:23 PM
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With regard to the pharmacist refusing to dispense medication based on religious beliefs, personally I feel they lose the right to be called a pharmacist and should be drummed out of the profession. Go get a job teaching Sunday school or something, not dealing with the general public many of whom do not share your world view.
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Old 11 July 2014, 09:52 PM
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I absolutely hate having to buy cold medicine because I feel like I'm being treated like a potential criminal* because my nose is running/stuffy and the stuff that is on the shelf doesn't work.

I've recently been having a hard time getting non-controlled prescriptions filled. I found out that I have to get a prior authorization every month to get my Imitrex filled. Who the heck would abuse Imitrex? When I have a migraine, it makes me feel worse before I feel better, so I sure wouldn't want to take it if I didn't have to. Also, when I'm getting it filled, I usually need it right then because I am not allowed to have a sufficient amount every month.

*TBH I would love to try to cook meth just to see if I could do it, but I would rather not have the end product. There are the safety issues, too. Also, I need the sudafed for my runny nose.

Last edited by mela681; 11 July 2014 at 09:57 PM.
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Old 12 July 2014, 02:13 PM
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Quote:
Originally Posted by mela681 View Post
I've recently been having a hard time getting non-controlled prescriptions filled. I found out that I have to get a prior authorization every month to get my Imitrex filled. Who the heck would abuse Imitrex? When I have a migraine, it makes me feel worse before I feel better, so I sure wouldn't want to take it if I didn't have to. Also, when I'm getting it filled, I usually need it right then because I am not allowed to have a sufficient amount every month.
A prior authorization has nothing to do with abuse potential; it's an insurance issue. Your insurance company limits the amount that they pay for because of cost. Migraine meds are a particular bugaboo with insurance companies, since there is usually no consistency with how often a person might need them, thereby creating a situation wherein a patient might overbuy the pills (and the insurance company spends more than they need to.) So usually the insurance companies either require a prior authorization before they cover the med at all, or they limit how many pills you get in a 30 day period.

Now, if you cannot get your insurance company to agree to pay for as many pills as you really need in a month, you should have the option to pay for some out of pocket. Obviously this is not ideal, but again, it's almost certainly a cost issue, not an issue of you not being allowed to have it.

*Note: I am a pharmacy technician and this post is based off of my experience. Your actual situation may include nuances that I am not aware of.
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Old 12 July 2014, 02:40 PM
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Thanks for posting that article, Chloe. Very informative.

I hate meth with the flaming hatred of a thousand suns. It creates so many problems that require Solomon-like solutions. My contacts in law enforcement believe that making pseudoephedrine prescription again would go a long way toward decreasing the problem. I'm in favor of trying anything that might work, at this point. Also, making it prescription might make people feel more like patients and less like crime suspects when they go to buy it, as well as making it easier to control.

I have to admit, though, that I am speaking as someone who has never had the need to buy it. I understand that those who frequently need it would feel differently.
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Old 12 July 2014, 02:41 PM
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I have personally never experienced that here - I guess I'm lucky. I have even called twice in one month and got the refill. But I'm on Axert. With Topamax I don't need anything hardcore. Maybe that's because it's 5 pills and the instructions say I can use 2 per migraine if necessary.
My doctor does a bit of policing - I have Ativan for insomnia and whenever I come in for a refill she checks the date she last gave it to me to make sure I'm not addicted.
I buy meds with psuedoephedrine all the time and if meth was a big issue here I would support it going to prescription.
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Old 12 July 2014, 05:25 PM
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Originally Posted by mela681 View Post
I absolutely hate having to buy cold medicine because I feel like I'm being treated like a potential criminal* because my nose is running/stuffy and the stuff that is on the shelf doesn't work.
I found out in this city there are pharmacies that don't stock pseudoephedrine at all. I was downtown and needed something for my cold so I asked for it. I was told that they don't stock it. Not because they don't believe it, or wouldn't give it, but because when they did have it, their pharmacy was subjected to break ins and armed robberies for it.
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Old 12 July 2014, 08:47 PM
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It's not uncommon for pharmacies to stock "uncommon" medications, or even very expensive ones. I had trouble getting prescriptions filled for anti-malaria drugs, vaccines, and at least one rather expensive medication because pharmacies don't stock it. There's always a risk that they buy it and keep it on the shelf until it expires, and that money is tied up in stock that could otherwise be moving and selling. This is true even for a dispensary pharmacy which only provides medications, as opposed to the full-service "drug store" which also sells health and beauty products, foodstuffs, etc.
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Old 13 July 2014, 03:24 AM
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Originally Posted by wanderwoman View Post
Also, making it prescription might make people feel more like patients and less like crime suspects when they go to buy it, as well as making it easier to control.
If I have to get in to see a doctor to get Sudafed, I will never be able to buy it. Seriously? You want people to have to wait in a doctor's office (usually for hours, because, you know, they have to fit you in--it takes months to get appointments), for the sniffles?

Let them treat me like a criminal. Sudafed is something I want to have on hand, not something I need yet another barrier to get. No. Just NO.
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Old 13 July 2014, 03:34 AM
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Originally Posted by Avril View Post
You want people to have to wait in a doctor's office (usually for hours, because, you know, they have to fit you in--it takes months to get appointments), for the sniffles?
That's assuming you can even afford 1) the loss of money while you're stuck waiting at the doctor's office and 2) the cost of the doctor's visit itself. The price of a box of decongestant pills just got bumped from $7 to $70+. I agree with you completely - having to show ID is vastly better than virtually cutting off access to a useful, legal substance.
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Old 13 July 2014, 05:43 AM
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Unfortunately, in some places, the id requirement alone cuts off access a lot of times. We don't have a pharmacist open on Sundays or after five, so if I get sick Saturday evening, too bad for me.

ETA: I don't know if I made that clear, but because of the ID requirement, a lot of places that are open later and/or Sundays don't carry it anymore. Also, I would mind the ID part a lot less if it seemed like training for salesfolk included "Don't treat the customer like she's probably a drug addict." /ETA

Anecdotally, I once knew a dude who wanted to try making meth, and he said that he had the recipe, and he didn't need any cold meds, just a lot of matches and some cleaner or something else industrial like that, I forgot what, but nothing you needed ID for. (As far as I know, he never did make any; the people who were present all refused to be a part of any attempts.) He talked about having to scrape the ends off all the matches for it.
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Old 13 July 2014, 11:46 AM
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No, Avril, I do not "want people to have to wait in a doctor's office for the sniffles." I assure you that, because you seem to be against putting pseudoephedrine on prescription, I am not going to accuse you of wanting the myriad of problems cause by meth, either. The problem is a lot more complex than that.
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Old 13 July 2014, 12:05 PM
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Quote:
Originally Posted by imjustasteph View Post
Anecdotally, I once knew a dude who wanted to try making meth, and he said that he had the recipe, and he didn't need any cold meds, just a lot of matches and some cleaner or something else industrial like that, I forgot what, but nothing you needed ID for. (As far as I know, he never did make any; the people who were present all refused to be a part of any attempts.) He talked about having to scrape the ends off all the matches for it.
There are other ways to make it, but the main precursor chemicals are all restricted by law. So making it without pseudoephedrine still requires getting access to chemicals illegally.
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Old 13 July 2014, 01:43 PM
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Yes, this is not "evil people want me to suffer with a cold" vs. "evil people don't care about the meth epidemic." It's about finding a way to balance the needs of sufferers and the needs of law enforcement/ social health. The question is where the balance lies.
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Old 13 July 2014, 02:39 PM
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Quote:
Originally Posted by wanderwoman View Post
No, Avril, I do not "want people to have to wait in a doctor's office for the sniffles." I assure you that, because you seem to be against putting pseudoephedrine on prescription, I am not going to accuse you of wanting the myriad of problems cause by meth, either. The problem is a lot more complex than that.
How to you propose a prescription program to work? I don't understand how it would work without added time, cost, and hassle. And you didn't say the prescription would solve the problems with meth; you said it would help people feel like they weren't being treated as criminals.

I would prefer the way pseudephedrine is handled being sort of police-state-like, at least where I buy it. I think the limits are low enough that I have to buy it routinely whether or not I need it, which is annoying, because if I do get sick I'll run out too fast, and I think that the limitations on who gets to buy it (based on the ID issue) are somewhat problematic. But that system is still much better than prescription laws.

But I do mind being treated like a criminal, in a host of other ways, which is why I avoid flying as much as possible, for example. I guess the Sudafed system and the "war on drugs" feels a lot less degrading than many of the other things going on in America's "war on terror."
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Old 13 July 2014, 02:48 PM
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The benefit of a prescription program would be added accountability and oversight. Presumably that would make it harder to get enough of the product to make meth, and also easier to track people who manage to get the product for that purpose. The drawbacks, of course, would be the added time, cost, and hassle you have referred to. I'm not mentioning it because I think it's some sort of magical solution with no drawbacks, but rather because the manufacture of meth is a serious problem and we are making little headway in addressing it with current methods.

I'll turn this back on you: how do you propose to decrease the use of the product for methamphetamine production? If you have a better solution, I'm all ears.
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Old 13 July 2014, 02:53 PM
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I don't think you explained it.

If you don't want people waiting in the doctor's office for the sniffles, how will they get the prescriptions? Will it be per cold? Or what?

We are definitely making headway with the current system, so I don't see a need for further restriction that, like many such systems, unequally burdens the poor. At least the strip-search for flying tends to cause a lesser burden on the lower socioeconomic classes. I don't want to make a law that basically says that only the middle class and up get to have cold medicine.
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Old 13 July 2014, 03:02 PM
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Did you read the article Chloe posted? I suggest you do that.

I don't really want to discuss this further with someone who dismisses the other side of the issue so readily. I don't see the point of addressing the inconvenience of (g) you not having the cold medicine that you prefer when you won't even acknowledge the extent of the problem that currently exists.
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Old 13 July 2014, 03:02 PM
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Quote:
Originally Posted by Avril View Post
I don't think you explained it.



We are definitely making headway with the current system, so I don't see a need for further restriction that, like many such systems, unequally burdens the poor.
Per snope's instruction I trimmed this for the points I'm addressing:
Did you read the article linked above? I was reading most posts after that point as references to the article. If the article is correct we are definitely not making headway with the current system. In fact, it is getting worse. I don't know what the answer is, and I don't take the medication in question. We do need an answer to the problem, though. Trust me I know about fees and services unfairly hitting the lower middle class and the poor. However, the meth epidemic is also hitting that portion of the population harder too.

Drat, spanked by Wanderwoman. I wonder if she needed a script for that?
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