Filling a schedule II (C-II) or narcotic prescription at a retail pharmacy can be a daunting task nowadays. It doesn’t matter what kind of medicine – Narcotic pain relievers, Adderall, Vyvanse for the kids or Patches of any type.
Paying the price
Legitimate patients are paying the price of a society that has gone wide with the abuse and misuse of opioid narcotic pain relievers. This problem has prompted government agencies to respond adequately.
Unfortunately, the response has been punitive for Pharmacies. For instance, the CDC spend money to educate Prescribers regarding the epidemic while DEA takes a punitive approach to the drugstores which are at the front line of this epidemic that needs education. Consequently, Pharmacists are turning down schedule II prescriptions that don’t look familiar to them.Furthermore, regulatory enforcement among Pharmacies vary. Independent Pharmacies gets shut down, while Chain Drugstores receive fines. All my years working for chain drugstores, I have never seen or heard of DEA agents visiting chain pharmacies or closing any. (Update: DEA just started visiting chain drugstores – Someone must have read this blog!).
Alright, for legitimate users out there (that is assuming you don’t have a fake prescription), here are ten ways to increase the chance of having a Retail Pharmacy fill your schedule II or narcotic prescription and avoid the “We don’t have this in stock” talking point.
1. Electronic Prescriptions
Have your doctor electronically send the order over to your pharmacy. According to the DEA, “a practitioner will be able to issue electronic controlled substance prescriptions only when the electronic prescription or EHR application the practitioner is using complies with DEA’s requirements.”
Pharmacies are very likely to accept these orders because they have met standards set by the DEA. Moreover, these prescriptions will contain information the pharmacist will need to conclude that the prescription was for a legitimate medical purpose.
Another way to increase the chance of filling your prescription by a pharmacy is:
2. Medical use of the narcotic prescription
Increase the chance of having your prescription filled by having the prescriber write the medical use of the narcotic prescription.
It is the duty of the Pharmacist to determine that the prescription is for a legitimate medical purpose. So, gone are the days when you can tell the Pharmacist to “just give me the damn medicine. Who are you to challenge what the doctor wrote?” The only thing you will be getting back is your prescription paper.
3. Drop it off upon leaving the doctor’s office
Always take your prescription to the pharmacy upon leaving the doctor’s office even if filling it is too soon. Tell the pharmacist you know it is too early, but you just want to drop it off.
Some drugstores don’t hold controlled substance prescriptions for patients. But it can serve as an incentive for them to order it for you if they don’t have it in stock.
4. Cut off the friendliness
Yes. Cut it off. Skip the “where are you from?” questions or trying to be overly friendly. We know that if you are in pain, the last thing you want to do is be friendly. You can smile. But cut off the chatter especially if you are not a regular customer.
Too much chatter means you are high on something or trying to hide something or divert attention.
5. Stop calling around
Please, stop calling different pharmacies to see who has your controlled substance prescription is stock. There are many reasons why they should not tell you their stock level. High on this list is Robbery. Usually, a robber will call to make sure you have a drug in stock before striking.
Another reason is that it cuts out the “We don’t have it in stock” excuse to deny filling your prescription for one reason or another. It is easier to tell you we don’t have it in stock and have you move on to another pharmacy than have you shout at us if we say we suspect your prescription is fake, not for a legitimate medical use or that we have to call the doctor for verification.
Only a rookie pharmacist will tell you their controlled substance stock level until they learn otherwise.
6. Do not alter anything
If the doctor made a mistake with the date, name or something else, take it back or let the pharmacist deal with it. But I recommend you take the prescription back to the doctor’s office because the pharmacist is going to send you back anyway.
If you alter anything, you are not only going to get in trouble with the pharmacy but also with the doctor and the law. You cannot modify a schedule II prescription writing by a prescriber.
7. Stay away from the weekends
Do not wait till Friday, Saturday or Sunday before filling your narcotic prescription. Except, of course, you are coming from the emergency room or urgent care clinic. By this time, the stock is only enough to fill emergency prescriptions. You will be getting “we don’t have the full amount in stock” rejection. And that is true. No pharmacy has total quantities on weekends.
8. 2-day rule
You must wait two days until you run out of your prescription drug before filling the next narcotic prescription. Pharmacies check the state’s prescription drug monitoring database before they fill scheduled drugs. If it is too early, you might start falling in the “is he/she abusing this medication?” category.
What if I am going out of town? You may ask. Well then, get a doctor’s note to authorize an early fill. The reason requires documentation. The pharmacy has nothing to do with this. Regulatory authorities like the DEA and state board inspectors need such documentation. Filling prescriptions too soon are the number one reason a retail pharmacy gets shut down.
9. Stop offering to pay cash
You may not want it on the insurance because you don’t want your insurance or job to know you are taking narcotics and so on. But, paying cash is a sure way of telling the pharmacist and regulatory authorities you are up to no good.
The same goes for all those discount drug cards. It is a major red flag even if you just left the emergency room or urgent care clinic.
10. Tell the truth
Pharmacies abhor lies. Nothing irritates the pharmacist more than someone trying to be smart. If you are filling the prescription too soon because you doubled up on the dose or you gave some to your friend or spouse, let the pharmacist know the truth.
You are more likely to get an override than coming up with a lie such as “they fell in the sink” or “my dog ate them.”
There you have it. Those are ten things to do or avoid if you want to improve the chance of a pharmacy filling your legitimate controlled substance prescription. Put more effort into having your prescriber use electronic prescription delivery methods. It will save you and the prescriber a lot of headaches.
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