June 19, 2009 - 9:24pm
I know this topic has been covered on the boards before, but it came up for me again today when I was reading through the reports from the Arizona Medical Board. I personally trust my pain management doctor very much. She has never asked me to bring in any unused portion of my meds when they are changed, but I'm not sure if that's the office policy or not. The only medication I ever had a surplus of after being put on it then taken off of was methadone. Anyway, I've always been torn when I've seen this topic come up on the boards. If I pay for a prescription, what right does my doctor have to take it from me? On the other hand, my doctor has the right not to prescribe me something if I don't comply with her rules. I just don't know that I'd feel safe with ANYONE having my medication, including my doctor. I trust my hubby more than I trust my doctor and I still keep my medication safe. I'd be very afraid of leaving my medication at my doctor's office to be destroyed without actually seeing it done. I mean, another person on staff could see it and take it all, or take a few, or whatever. If my name is on a script like morphine, I feel it's my duty to care for it at all times. One thing I wouldn't have a problem with would be watching my doctor physically destroy my medication, but I've heard people on here say their doctor's don't have the time for that and in reality most doctors probably don't. However, I do think with controlled meds the time should be made, or at least some sort of assistant should watch it be done and a paper should be signed or something.
Anyway, after reading an action taken by the AZ Board of Medicine about a doctor who would take his patients' medications and give them new scripts I'd definitely insist upon seeing the meds destroyed myself. I'm pretty sure at my clinic they'd understand this, although they are always very busy. I think they'd understand my caution and probably appreciate it as they are always safeguarding their butts...why can't I safeguard mine?
Here is a link to the case: http://azmd.gov/GLSuiteWeb/Repository/0/0/4/0/f9f61370-dcf1-41a4-a7f2-5e66b758516f.pdf
June 19, 2009 - 10:02pm
#2
If a doctor told me to give
If a doctor told me to give him my un-used medicine, to destroy it, so I can give you something different. He had better be paying me for every single pill he takes from me, most strong pain meds are very expensive!!!!!!
But, if I did that I would be commiting a felony. Patient beware!
June 19, 2009 - 10:14pm
#3
I know in the pm contracts
I know in the pm contracts they can count your pills but I can't imagine them actually taking them from you. . . Out of all the people and stories I've heard of no one has ever said they doctor asked the patient to give them thier pills back. . . First of all, once you paid for them, thier yours. . . I also can't imagine a doctor actually having the time to ask for a patients medicine back and then sitting around and counting them. I'm sure the doc's have much better things to do. . .
I think it is more of a precautionary thing, covering themselves legally in all aspects. . .
If I was a Dr. I couldn't imagine asking a patient of mine to do that. . . Let'em be :)
June 19, 2009 - 10:20pm
#4
bigbrody- There have been
bigbrody- There have been TONS of doctors here that have had their licenses suspended or revoked here and put on MAPS (managed aftercare program- a program for doctors with substance abuse issues). I like to read through the reports here because #1 I actually found my cardiologist on the list one time, which I came to because I really questioned his abilities after a few appointments with him and #2 they are interesting. I'd say about 25% of the doctors are reprimanded for charges related to prescribing scheduled drugs and about 50% are for doctors with their own drug addictions. The other 25% or so are for various infractions.
allgood- I'm so with you on this subject. I don't feel like a doctor should require you to hand over your pills, but I can also see why they don't like you to have something like 90 leftover morphine if they switch you to 120 oxycodone. What are patients and doctors to do though? I feel like if I pay for something it's mine, but doctor's have to protect themselves. I guess a patient could always just finish up their first prescription and start the new one once their other medication is exhausted. This could be really crappy if you're in a lot of pain though. What would you do if your doctor asked you to hand in your extra pills to be destroyed before he wrote you for something stronger? What if you were in a lot of pain and he wouldn't write the new script until you complied? I mean, my doctor didn't make me turn in the remainder of my insulin when I was switched from Humulog to Novolog. The 2 of them used concurrently could easily kill me and I could OD on insulin. I guess insulin isn't something that's widely abused, but still it can be, so is there a difference? I'm so torn on this issue. I guess I'm just happy the issue has never come up between my doc and I.
June 19, 2009 - 10:20pm
#5
Illegal
That is illegal by federal law. A doctor, pharmacy, etc. cannot take back controlled substances from a patient. Several pharmacists have lost their licenses due to taking back deceased patients controlled drugs and narcotics.
June 19, 2009 - 10:22pm
#6
MAPS
Kelly, that is not only pathetic, it's shocking.
June 19, 2009 - 10:52pm
#7
NJRx242- That is really
NJRx242- That is really interesting. I know that you're a pharmacist so you just know that information, but by any chance can you point me to something that spells this out? There have been 2 different threads on this board that I've participated in on this topic ("what to do with extra pills" and "is this legal" threads). It seems that there are doctors out there requiring that their patients bring back pills to get new scripts. I know Dr. Lois said that she requires her patients to bring back meds to be counted and destroyed in the "what to do with extra pills" thread. However, she said that she doesn't care if her patients watch her flush them down the toilet, so is that different? Is it just pharmacists that can't accept filled prescriptions back, or is it doctors too?
FeliksD- I know right? That's why I check out that website for the AZ Medical Board. My cardiologist almost killed a woman! Although I still see him because my heart conditions are more of a "watch it until the conditions become a problem" kind of thing. I don't want to go through all of the hassel right now of finding a new cardiologist because they are in short supply here. The one script I did get from him I had my PCP take over prescribing for now. What's even more crazy about this MAPS program is that doctors get 3 strikes before they're out! So they can continue to use substances and get caught up to 3 times before they lose their license!
June 19, 2009 - 11:36pm
#8
once a
pharmacy gave me mallis for es hydros and i walked out and noticed and i wasnt taking these my choice of what brand i will be getting, and they did have the coffins by abbott. the head pharm gave me a huge thing about me walking out of the store for seriously 2 minutes. ya like what am i gonna do in that time switch them or something dumb. i ended up getting the name brand but it was a big ordeal, think he actually called the dr on it and complained i was asking for name brand. end of the story i left with the abbotts. man those are expensive!! i paid 27 for 20 tabs of abbott vicodin es, and at another place i paid 25 even for 120 norco10 10/325 the watson brand, which is imo a way superior hydro med than the mallis. take care off subject but always have a story
June 20, 2009 - 1:32am
#9
Great topic Kelly.
One time I had this "usually very mean" pharmacist demand that I bring back into the store after I already paid for it & drove off out of the store w/ it of course, PROZAC; I know it is not a controlled drug but still. She, the pharmacist really tried to make me look like a "drug-addict" but again she did not succeed b/c all the pills were in my son's Rx bag. (She gave me a dirty look, called my son's Doc, &???) SHE PROBABLY SUSPECTED MORE CUSTOMERS THAN JUST ME! The reason that I had to even call back & question the Prozac is b/c I believe he, my son, did much better taking the tablets, not the capsules & THAT'S WHAT WAS TO BE IN THE RX BAG! However, I though that that was illegal for the pharmacist to have done.(?). So it only applies if the Rx is a controlled med, huh? Very interesting post here.
June 20, 2009 - 4:42am
#10
Wow, I was reading through
Wow, I was reading through more reports (I need a life, lol) and I found another one where a doctor here in AZ was stealing his patients' medications after they brought them in for disposal! After reading all of this, legal or not there's no way I'd bring my medications in to my doctor to be destroyed unless I got to watch. I'd politely remind them that I am responsible for my medications and I would feel more comfortable watching someone dispose of them. If they didn't agree, I'd find another doctor and question their hesistance. I cannot believe how many reports I have read tonight about doctors being addicted to opiates and still being allowed to practice medicince if they completely MAPS for a year. I have to ammend my previous estimates. I think 20% of the doctors are reprimanded for charges related to prescribing scheduled drugs and about 70% are for doctors with their own drug addictions. The other 10% or so are for various infractions. I honestly can't believe how many of these reports are related to either the doctor prescribing opiates incorrectly in some way or another or for the doctor abusing drugs themselves.
Here's the link to the 2nd report I read about a doctor stealing his patients' meds: http://azmd.gov/GLSuiteWeb/Repository/0/0/4/6/95a25927-7cb0-4429-8d44-5dcac8d19915.pdf
June 20, 2009 - 7:36am
#11
Listening to Prozac
I take generic Prozac, and a couple years ago I was always getting the tablets. For at least the past year I have only been given the capsules, which are less convienent than the tablets because I am trying to lower my dose, and that usually would require me breaking a tablet in half. This is cheaper than getting two seperate prescriptions for Fluoxetine, one for 10mg and one for 5mg, and paying two seperate copays. So apon my request my psychiatrist specified that I wanted tablets instead of capsules, which I have tried on to do on two seperate occassions. Both times my pharmacy has given me capsules because the price for tablets would be significantly higher than the generic copay for the capsules. I find this strange, especially since I had the same insurance a couple years ago.
June 20, 2009 - 10:21am
#12
I am stunned by these PMC contracts etc.
After reading countless posts on the subject of PMC contracts as well as threads like this and the other 2 that Kelly mentioned, I am sort of glad that I have cancer therapy related CP. My oncologist is in charge of my analgesic Rxs and no one else. He was the Dr. that diagnosed my cancer 29 months ago and I've stuck with him all the way. The man even treated me for free 1/2 that time while I stuggled to get affordable Health Ins. Back on subject Q. By this rather macabre joy I meant to emphasize the unreal, to me, conditions that the average CP must face in order to live a normal life.
I have never been asked to sign a contract, let alone been randomly urine tested. This whole idea of "giving back your pain meds" is mind boggling. As Kelly stated, her name is on those bottles, and as Allgood stated, some of these meds are very expensive too boot. I know that mine are, and I'd hate to see someone taken to the ER in a Fentanyl induced coma with my Rx box in their possession and a bunch of patches stuck all over themselves. That stuff is potent, as in micrograms p/hr potent, and it would be too easy for someone to accidentally OD on it if they didn't know what they were handling. I completely agree with Kelly that I feel responsible for my pain meds, even if it is a "worthless one" that ODs. This thread has enlightened me, thanks OP.
Q
June 20, 2009 - 12:47pm
#13
Tip!!
If you read the label on your bottle or the pharmacy paper it says that it is a federal law against giving or selling medication to anyone other than whom it is perscribed. If my Doctor asked me that I would contact the State Medical board and the DEA. Even if you signed a pain management contract and that was indicated on there I would still inquire with both agencies. I recently signed "my life away" with my regular dr. over getting Percocet 10mg. It was a really long legal thing and even said I could be charged with DUI if I was taking meds and driveing!?!. I live in the communist wealth of Virginia if that helps. so there is the best tip. Hope that helps....
June 20, 2009 - 1:19pm
#14
Wow! again
Unimatrix, did your PCP made you sign a contract or a waiver? There's a big difference between the two. A waiver is concerned with covering your Dr.s posterior while a contract is truly "signing your life away". Any state that has a DUI law (Driving Under the Influence) considers all drugs, even some OTCs like anti-histamines, as potential driving hazards. If your state only has a DWI law (Driving While Intoxicated), then only Alcohol is covered.
There's nothing Communist about wealth, wealth is totally a Capitalist concept. You are hereby sentenced to read Adam Smith's "Wealth of Nations" and the Marx-Engles' pamphlet "The Communist Manifesto". LOL I think you'll find the "Manifesto" the better, and shorter, read, though every self proclaimed believer in the Capitalist system should familiarize themselves with the basic cornerstone of that system . . . Adam Smith's book.
Q
June 20, 2009 - 1:59pm
#15
My PM Office...
will have me bring in my old meds. I will watch while they count them out, then watch as they flush them. Then I watched while she ( the NP ) shredded the label in a shredder. This happened when I switched from Hydrocodone to Morphine, and I just had a script filled. So I had to watch while they flushed 127 Hydrocodone.
My Mother had cancer, and was going to the same PM Office. She had a severe reaction to Oxycontin, so I had to bring them in, and do the same thing, BEFORE they would give her a script for something else.
Now, my son-in-law see's a different PM..same City, different Dr. His meds have been switched numerous times, and he has never been asked to bring the old ones back...even Fentanyl Patches and Morphine. My Dr. is way more strict than most. And you are right, I DO feel like I signed my life away.
Best,
Granny
June 20, 2009 - 2:18pm
#16
When I asked to be switched
When I asked to be switched from Oxycontin to a lower dose of oxycodone IR I had a surplus of like 10 40mg ER pills. It was nice to put away a few of those for the more difficult days to come but I thought about the liability these situations could create for doctors. For example, since both scripts had active instructions that overlapped for a few days, it would be possible for someone to follow both instructions and take too much. My doctor didn't tell me to bring them back but I could see if our relationship weren't what it is how he might have requested that, just to make sure I didn't essentially double my Oxycodone dose.
Maybe some PM programs have this policy in place to lessen the likelihood of something disasterous happening with overdose.
June 20, 2009 - 2:36pm
#17
1Rockingranny
When you brought your meds back to the doctor did they reimburse you for the portion that they took back? If not did you ask them to, or did they even offer? I know to some people this could be very finacially upsetting. Nothings free in this world, especially oxycontin. . .
I wonder what insurance companies think of doctors taking and destroying medicines that they paid for?
Thanx
June 20, 2009 - 4:02pm
#18
1rockingranny
Why didn't your mother's oncologist have control of her pain meds? That's the arrangement that I have with mine, and we are both satisfied with the results. I have early onset aggressive prostate cancer. At the time of my diagnosis 29 months ago (I was 52), I was given a 65% chance of being dead in 3 years, hormone therapy or no. I chose the therapy, which resulted in numerous very painful side effects, one of which is RA. The other side effects, combined with the rheumatoid arthritis, make my life physically miserable. Most every oncologist that is worthy of the title knows that quality of life is one of the, if not THE, most important factors in the length of a terminal patient's remaining lifespan.
By reducing my pain my Dr. has added years to my life. As far as I'm concerned, I'm gonna last till I'm 80 . . . so there, actuarians and statiticians! I sure hope that your mother wasn't allowed to suffer unneedfully. If I were you, I'd get rid of that Doc so fast, his/her head would spin till it flew off and good riddance! Good Luck......
Q
June 20, 2009 - 4:42pm
#19
No doctor has ever asked me to do that
and if they did I would say fork over the dough and you can have em....Just don't bring your meds unless you're specifically asked to.
Ray
June 20, 2009 - 4:44pm
#20
hmmm
I always thought that it was up to the patient to physically destroy ALL medications when no longer needed by way of flushing them. Or else taking them back to the pharmacy where they have a destroying protocol and program in place. When it comes to controlled meds there are a few extra steps, where they witness and sign off on the controlled meds. With the CII & CIII meds 2 pharmtechs or pharmacists all watch as one pharmer takes the pills and deposites them into the Med-Anihilator 3000™. With the C IV meds such as benzos etc, there is only 1 witness needed.
ohh ya. I got the inside scoop. lol. scoop of bull. I really do not have a clue.
I have heard of the spouse who has recently become a widow bringin in all the meds to the pharmacy because they dont know what to do with these controlled and often VERY STRONG meds, and the summer student pharmtech takes them and say's "we'll dispose of them". The thing is, this person I read about looked around to make sure nobody was watching and pocketed some OC80's or some type of strong narcotic! And disposed of the other drugs...
June 20, 2009 - 5:16pm
#21
This is a really scary topic,
This is a really scary topic, and I really wish I could see something concrete concerning it. One thing that does seem pretty concrete is the poster that said to look at the side of the labels where it says that you cannot sell or give away your meds to anyone else. Like I said, I've never had to give back any meds, but this topic distresses me because who knows if it could hapen in the future or not. I'd be most worried about the case where I told a doctor that they were mine because I paid for them and that I was responsible for them and then the doctor said that it was his/her choice not to write another script then. It's kind of like you could have it held over your head that you weren't complying with their demands, and really they have every right not to write you another script if they don't want to. Then again we all have the right to see another doctor if we want, but that's sometimes easier said than done.
June 20, 2009 - 5:36pm
#22
I've tried to bring
I've tried to bring medications to the pharmacy for disposal in the course of my job and they said they don't dispose/destroy medications. It could have just been that pharmacy but I'm not sure they have a protocol on that...
June 20, 2009 - 6:14pm
#23
just out of curiosity
Where the meds controlled at all? Or was it just a basic RX.?
This thread, really has me thinking. Your Doctor has you in a sort of catch 22 here, you should just tell him/her that you flushed them and can bring the bottle in because you didnt want to break any laws by giving your medication to ANYBODY it was NOT prescribed, which means, YOU and only you. So that is illegal.
I wonder about this....Dr Lois, any Pharmacist's in the house?
Whats your take on this. "Medication not to be shared. It is strictly meant for only who it was prescribed" or whatever type of terminology.
June 20, 2009 - 7:47pm
#24
acey, we have an excellent . . .
Pharmacist on the board, his tag is NJRx242. His reply on this thread is #5, I'll let you scroll up and read it for yourself so that he doesn't try to get me for copyright infringement. BIG LOL Rx is one of the good guys!
I know what you mean though Kelly, this is a scary topic and it would be nice to be armed with as much paper and concrete info as possible. The poster that replied about the warning on the insert thing has provided us with the best defense so far. I hope some more stuff pops up.
Q
June 20, 2009 - 8:17pm
#25
Kelly, VERY good thread and
Kelly, VERY good thread and you have 100% made me think twice about all this!!! I read the legal on Dr. Bast. Wow. I tried to use the same address but put my state's initials in. It did not work and then tried google. Could not find anything. Take care, htmom
June 21, 2009 - 1:21am
#26
HTmom- I found the website
HTmom- I found the website for your state, but messaged you privately with it since I'm not sure that you want others to know where you live. =)
June 21, 2009 - 1:36am
#27
acey
if your question was to me then No, it was not controlled.
Actually I had three 100mg/ml Haldol vials to get rid of. It was an unusual situation...we ended up mixing them with coffee grounds and putting them in the dumpster...
June 22, 2009 - 8:14am
#28
I posted the standard pain contract of most clinics in Virginia,
it states that if caught driving , while taking narcotic medications that you can be charged with a DUID, this is so that its plainly stated that the patient accepts responsibility for their action, that they have been advised of potential consequences of their actions, thus releasing the Dr. of any responsibility, or court appearances.
anyone taking their medication approiately has no issue with this portion of the contract, I do have to somehow think that one day I may blow out a tire an be involved in a accident, an somehow be charged, just to have to hope a judge will be willing to understanding
Im no Dr., just a hillbilly
June 25, 2009 - 6:57am
#29
This happened to me twice, by
This happened to me twice, by the same PM group. The first time, they were going to do a discogram on me. They gave me a script for these lollipops that would help immediately with pain. The Script was for 6 pops. They took all of the pops from me prior to the procedure, and I needed only TWO during the procedure. I asked what they were going to do with the rest, and they said "we will hold for unfortunate people who don't have the medication or don't have insurance". So although I felt "these are mine, I paid for them etc..." I felt bad when they said "unfortunate people". Also, I needed my prescription for pain meds that day and was afraid if I put up too much of a fight, they wouldn't give me my script. Second time was when they were switching me to an ER type med. They first tried a morphine based ER, which made me sick. When I said I needed it switched, they asked to see my bottle. I remembered that the pops still had my personal information sticker on it from the pharmacist, so I told them "i'm not giving you the bottle" and they said that was fine and held out their hand. I asked what they were going to do with them and they said "we will flush them". Since then, everyone I've told this story to has said "never, ever give your pain meds to anyone" First, we paid for them. Paid for every pill. Second, once they are given to us, they are our responsbility. But everyone here knows that if you give the doctor a hard time, they will give a hard time back writing scripts for pain meds.
June 26, 2009 - 2:34am
#30
sami- that is EXACTLY the
sami- that is EXACTLY the situation I fear! I mean, what were you supposed to do? Say no to giving back the Morphine ER and not be given anything else? You obviously couldn't even take the Morphine ER until it ran out and you could start a new medication because they made you sick. That really stinks that you had to do that. Morphine isn't cheap either. As for the suckers, that response would have upset me more than anything. I mean, I know they said they'd give them to the unfortunate people who don't have insurance, but I would have felt like they should ask me before giving them to someone else. On top of that, they are giving YOUR medication to another patient. With the way the DEA is I wouldn't be surprised if a patient OD'd on one of your suckers and it was discovered that the patient was given your medication and you somehow got in trouble. What right do they have to give something YOU paid for to someone else? I'm not trying to be mean, because I actually would prefer to have my leftover meds go to someone who could use them, but I just don't feel it's safe for anyone involved, so it shouldn't be done.
June 26, 2009 - 3:54pm
#31
Especially since my
Especially since my insurance pays between $23.47 & $25.17 ($2815.93 & $3019.81 for 120) each for the 800 mcg. suckers. That is for the generic, and that is what the ins. has negotiated price wise. I'm sure the cash price is different, and I know that the times I got brand for these it was $46.80 & $53.84 ($5615.88 & $6460.86 for 120)each ins. price. I would not be handing them over, that's for sure! The MD's and drug manufacture should be helping with the unfortunate without insurance NOT the other patients. Although, if I could help a seriously needy patient with no ins. pain relief or other needed medication with my $0 & $5 copays without losing any of my meds or getting caught for fraud, I'd do it in a heart beat!
Just for fun, here is an example of price changes at different pharms from 1/08-present date, all for the same medication & quantity:
Vons (Safeway): $5615.88 brand $5630.36 generic (4 months later same chain diff. store funny huh, generic was more??)
Walgreens: $2815.93 generic
Medical Arts Pharm: $2815.93 generic
Gen RX Drug Store: $5615.88 brand
Hope Plaza Pharm: $6460.86 brand $2815.93 & $3019.81 generic (went up in price from 1/09 - 5/09 dropped back down 6/09) My current Pharm.
As you can tell, the ins. has a neg. price for generics since they didn't really change between pharms but brand jumped around alot!!
I don't care because my out of pocket is next to nothing, but for those of you who pay cash, there can be a huge difference!
My ins. co sends me perscription history statements. Year to date, we are at $35,166.23 for my medication alone with 6 months to go.
I Thank God for our insurance daily!
I'm sorry if I shared too much, I just thought some of you might find it interesting.
June 26, 2009 - 5:04pm
#32
doctors
doctors.........abusing drugs 
who would have thought lol. even if you took your perscription to the doctor to get a new one which i have no idea why you would because all you have to say is my medication is old can i get some more and if your not someone who abuses or if they call you in for a pill count and you always have yours there shouldnt be a problem you can simply flush your old ones down the toliet. i like this website im a new member and i could really talk on here all day everyone i beleave trys to give there best opinion which is cool keep up the help
edit/g
June 26, 2009 - 6:12pm
#33
Sami, a little bit more about those suckers . . .
The active ingredient in those things is Fentanyl, the most potent narcotic out there. It's potential for addiction is off the charts, right along with the price. A Mom was right on the money with her post on the cost of Fentanyl and I join her every day with a "Thank God for health insurance" myself. I'm Rxed the 75 mcg p/h patch and it has significantly reduced my pain level but there's no way I could afford it w/out HI.
Unfortunately, I'm not a believer in the "basic goodness" of human nature and I'll have to admit that I sincerely doubt that those lollipops are going where the nice people say they're going. Before I got HI, I certainly wasn't given any of those and I've got terminal cancer with Zero income. Also, I believe that that practice could be illegal . . . I know it is for an opened bottle of pills. What say, Rx or FeliksD?
Q
June 26, 2009 - 8:00pm
#34
A mom- I'm in the same boat
A mom- I'm in the same boat with insurace paying out a boat-load on my behalf. One thing you may want to check your policy for that I was shocked to read once is that a lot of health insurance policies have maximum lifetime benefits! When I was working I had the health insurance paid for by my employer. I was lucky that they covered my pre-existing conditions because I had never had a lapse in health insurance coverage for even a day since I was first born. Anyway, I was reading through the fine print and it actually had a 1 million dollar maximum lifetime benefit! I was shocked. For most people that would be a ridiculously high amount to reach, but for me it wouldn't take long. Every year 50-100k is spent on my healthcare (100k has only happened in the years when I went into comas and ended up in the hospital long-term in ICU, etc. but it happens). Anyway, it could take as little as 10-15 years for me to reach a 1 milliion dollar lifetime benefit. Then what would I do? I no longer have private health insurance, so I don't have to worry about it, but if I were still working or was able to get health insurance through my husband's work I might be in trouble. I don't think it's fair that an insurance company could or would impose a maximum lifetime benefit for health insurance. I think this practice should be illegal, and at the very least it should be made more clear and obvious to the person with the health insurance. I always read the fine print, so I was lucky to see it, but it really was just a little tiny paragraph in a very long health insurance policy. I'm not trying to scare you, and I'm not sure if your health insurance policy has a limit like that, but it's definitely good to know something like that if it is there. Hopefully it's not.
On another note, I can't believe how much the Fentanyl suckers are! That's just crazy. It also emphasizes my point about this practice of doctors taking unused portions of medications back prior to writing a new script. I'm sure your insurance company would be none to thrilled with having to pay that kind of money for a patient that wasn't insured by them. Plus as has already been mentioned, it's a HUGE liability issue for everyone involved.
June 27, 2009 - 12:52am
#35
Yeah, I have a $1 million cap
Yeah, I have a $1 million cap through my hubbys med ins., but not perscription ins. So we're good for now. My cervical surgery was +$125,000 alone so I know what you're saying. This is also why I have my remicade infusions at home instead of at the hosp. or infusion center. If I order it from my script. ins. and have it delivered to my house, it doesn't count towards my cap, but if I have it done at the hosp, they bill through my med ins. and then it does! That ones a biggie, +$9,000 a month just for the remicade powder, none of the saline, depo medrol, heprin, tubing, etc. Now, all my IV poles, tubing, tegaderm, gauze, needles, etc. are covered under my script ins. when I order my remicade through them too. Only the nurse is billed through my med ins.. I am disabled and do have medicare as a secondary ins. if I was ever to reach the cap so for now, I'm good. Also, medicare now covers remicade infusions for those with RA, AS, PSA & Chron's. So at least I know I'd still be able to get my staple med, good old biologics, wish they could have develpoed them earlier. Maybe I wouldn't be quite in the shape I'm in now.
P.S. Q- I just saw your PM, I will get back to you prob on Mon. I have to leave the house at 4:30 AM tomorrow (baby girl has 6 softball games in 2 days 2 hrs. away) and that will kill me for the weekend. I'm sure you know how that is!!LOL or is it COL (crying out loud)cause I maybe by the end of the weekend!
PPS Too funny, cause I'm a Kelli too, just spell it different. Keep meaning to tell you that but then forget, I thought it was kinda funny.
June 27, 2009 - 5:27pm
#36
Yep, A Mom . . . I know how that is!
Whew, what a weekend you must be having!! I'm rooting for your baby girl's team . . . Go Kids, GO! Medical costs are unbelievable, I had no idea until it happened to me. Then I thought that my simple IM hormone injection was expensive at $7,000 every 4 months and here your one Rx for Remicade powder is $9,000 a month . . . astounding. I'm glad that I've also got medicare along with my BCBS Health Insurance. Now I've got to see if there's a cap on it, too.
I am so glad that I found this site . . . I googled "Oxycodone shortage" on 04/07/09 and Pharmer.org was at the top of the list. After I got the much needed and accurate info on that subject I read Topics and replies for at least 5 hours. The obvious compassion and intelligence that I saw here drew me in and I joined up. Every cloud (the Oxycodone shortage, in this case) has a silver lining, this cloud has a gold one!
Q
PS: We never had kids 'cause we're too selfish but I was a long term soccer Uncle and all the rest of that stuff for our most excellent nephews. We've had a big part in their lives and my Sister and Brother In Truth got to have bunches of time off. The boys are 31 and 33 this August, one of them lives 20 minutes away and helps us out all the time. What can I say? I'm a lucky guy and a Grand Uncle to boot!!!
June 28, 2009 - 10:01pm
#37
As far as avoiding giving back your meds to your doctor..
To everyone:
I think the easiest way to avoid giving back your unused pills without raising suspicion with your doctor is this:
When they ask you to bring in your old meds and they will give you new ones you agree and do it. However, when get there and they ask you to give them up, you just say, "I will dispose of them in front of you but I will not give them over to you, it's the law."
I don't think the doctor can argue with that, then you both just go to the toilet or incinerator or whatever and you dispose of them with him watching, Problem solved.
Greg
June 28, 2009 - 10:12pm
#38
xTrigeminalNeur...
Not unless the doctor pays me back for every single destroyed pill. Not everyon's rich. (no offense ment to you)
June 28, 2009 - 10:31pm
#39
I have heard of people
I have heard of people putting pills in the sharps box. I would flush them or put them in kitty litter and add little water. But I can see some addict busting apart the sharps box. Some facilities have rules against recapping needles but some people will recap anyway. I know they have the ones that flip and cover the needle. My point is they are risky their life to get pills out of the sharp box if they are not capped. They might see it safer if all needles are capped. I hoped this made sense. I'm very tired. Take care, htmom
June 29, 2009 - 1:51am
#40
allgood:
allgood:
Yep, I agree with you totally, and a lot of times people spend a lot of hard earned cash to get their meds. Most of these pain docs don't seem to care either way. Maybe there could be an agreement made like some sort of law put into place.
A federal law that works like this: If a doctor requests to have medication returned in order to get new meds than there should be a federally backed/funded rebate that could be given to the patient at the time of disposal for a rebate/credit for whatever the value that they paid for the pills based on the actual amount disposed of. Maybe even the insurance company's could get this credit as well if the patient did not pay cash and the insurance picked up the bill for the meds that were disposed of.
I can definitely see the point to want to get the meds back to avoid someone from having too much meds or to avoid the extra meds from getting out on the street. But I don't see how the patient should have to pay for this, maybe the DEA should use some of that money they are wasting on their ineffective war on drugs to pay for these meds. I also think with the under-treatment of chronic pain that the patient should be able to save those for a rainy day, but all too often they end up in some illegal deal, once again the few bad eggs ruin it for the whole bunch.
Ahh yes, but only in a perfect world right? For now it seems we are still going to be forced by some doctors to bring in old meds to get new meds and whoever paid for them is going to be out that money and have to foot the bill for the new script.
Any thoughts?
Greg
June 29, 2009 - 4:26am
#41
I have come to the conclusion
I have come to the conclusion that the practice of having to give back your meds to your doctor to get a new script for controlled medications is ridiculous, even if you get to watch them destroy them. Medications are VERY expensive. I understand that doctors don't want their patients to overdose, but there needs to be some level of trust and doctors need to not be prosecuted if a patient does OD in a situation like this. I mentioned it as an example before, when I was switched from Humalog insulin to Novolog insulin I didn't have to give back the remaining Humalog insulin I had. If I took the 2 concurrently I could easily go into hypoglycemia and die. However, my doctor trusts me not to do that. I would hope that my doctor would trust me not to overdose. If by some chance I did overdose on insulin, for example, say I did keep taking the Humalog insulin while taking the Novolog insulin I doubt a medical malpractice lawsuit would make it very far in the courts. I mean, the jury would rule that as a diabetic, I knew better. I should have known not to take 2 fast-acting insulins at once. So why is it that a doctor who treats pain patients has to worry about getting sued if a patient overdoses by taking 2 medications at the same time just because they are controlled substances. Any good pain doctor will have a contract that the patient signs that clearly spells out the dangers of taking opioids. Therefore, as a pain patient, one should know that it is dangerous to take more than what is prescribed of your controlled meds. So why then are doctors blamed in this instance? It's frustrating as a patient and I'm sure for the doctors too.
The mistrust that doctors have about pain patients is exactly why I am so against people not taking their meds exactly as prescribed or people taking meds that were previously prescribed to them but aren't anymore. For example, the patients that take a leftover oxycontin because they ran out of Fentanyl patches (but just took off the patch so it was still in their system at high blood plasma levels) then ends up in the hospital from an OD are the ones that ruin it for the rest of us. That's what makes doctors take back our old medications, because they don't feel like they can trust us to think rationally and not take medications that aren't prescribed to us anymore. Anyone who takes an extra pill without their doctor ok-ing it before hand (if it's not written in a way on your script that allows you to do so or your doctor doesn't know you take less when you have less pain and vice versa) puts us all at risk as well. While most of us can handle an extra pill, some can't. Plus, some things like Methadone can be extremely dangerous if you take just 1 extra pill. We all need to be responsible with our meds, and hopefully as responsible pain patients, we can change the way doctors think about us.
I know what I say about not taking old meds kind of goes against me thinking doctors shouldn't take our leftover medications, but I have my reasons. My pain management treatment is always changing. Sometimes I go up in doses, sometimes I go down. As we all know, pain medications aren't cheap. The reason I want to keep my old meds (outside of the simple fact that once I buy them they are MINE and I worry about someone else having my meds in their posession) is that I may need them again in the future. For me, this isn't an unlikely occurrance.
I just wish there were more clear guidelines for doctors and patients to follow in situations like this. If there were a clear policy, even if it went against my personal opinion on what should happen with the meds, I'd be happy to follow it (of course only if it were a safe policy, but I assume it would be). I guess even if my doctor had a clear policy in my pain contract on that sort of thing and I signed the contract I'd be happy to follow it (again if it were a safe policy) since I would have agreed to it up front.
June 29, 2009 - 7:40pm
#42
Give my pills to you doc, heck NO!
Greg,
That idea of a refund or compensation would be the ideal, if you were given no choice and had to give them up. The problem is who would foot the bill. Some meds are individually packaged, but even still with the fact, there is no way to guarantee the meds were in a controlled environment the entire time they were with the previous patient. That would prevent another patient less fortunate from being able to recoup the cost of the "returned" meds, and the meds could have been tampered with. Clearly, anything that was not packaged individually would impossible to recoup their cost by transferring to any other person.
I think I agree most with "I bought them (no insurance) they are mine. And, when something goes wrong and you need that med for a rainy day it will be there (perhaps if you lost your doctor or insurance)."
Kelly,
The "Drug War" like it or not is the reason us legitimate pain patients have to go through all of this BS. I don't see it any different than Prohibition. More laws and guidelines aren't always the answer.
Right before I started taking Methadone, my doctor asked me if I would want to go to a pain management doctor. I am glad he gave me the choice, because I stayed with him. He is also my Neurologist and had been treating me for migraines for over a year before I had my car accident, and still is. I guess he had developed a lot of trust in me. I am glad I didn't go to a PM, because my doctor trust me enough that I don't have pill counts, UA's, or anything like that. It really helps me, because it is so time consuming to get to him considering I don't have a car and have to find a ride. I guess I got lucky with my doctors and that I lived through my car accident.
Take it easy all,
allgood
July 7, 2009 - 12:15am
#43
Here is some more information on the subject
Here's is some more information on the subject
http://www.pharmer.org/forum/discussion-prescription-and-otc-meds/legal
June 29, 2009 - 7:07pm
#44
thanks quahog
I was wondering where that topic was
June 29, 2009 - 7:18pm
#45
I can see the other side
Because of those folks who scam docs into giving them meds they don't need, to get high, and there are some people who are getting meds to sell, and a couple of other similar situations, I believe some people, having the former meds in addition to getting the new pain med, could have problems with themselves... Yes, docs should trust us, but with the excuses they get, I can understand why docs want some people to turn in meds. Just playing devil's advocate.
Some people don't have the dicsipline it would take, to not use both meds. Having a stash is fine for a rainy day, IMO. People who are getting their dose adjusted (still), and are not getting adequate pain relief may be tempted to use both, to relieve pain, without their doc's knowledge, or approval.
Docs have heard it all. Not everone would go home and flush, or otherwise destroy their meds.
June 29, 2009 - 8:17pm
#46
It would make sense to me if
It would make sense to me if doctor's offices had it in their policy that certain discontinued medications must be disposed of by the patient in the presense of the doctor or representative (ie nurse). I think that covers everyone involved.
The only remaining issue is the cost. As I see it, the doctor is doing you a favor by changing your Rx in the middle of the month. If you only have a certain amount of money to spend on meds for the month then you would have to wait until you normally would have refilled the medication and continue with the original drug until that time. Its either that or take a loss on the meds and return them. Tough deal but if you are really in need I'd imagine you could find a way to get it taken care of. For cash paying patients who would have to wait until they get paid to normally get their refill you may just get a partial fill (like a 10 day supply to get you by until you get paid and were planning to refill the Rx in the first place)
I've been fortunate enough to not have to return meds when I was switched. It saved a lot of headache and gave me a couple back up pills in case the doctor was out of town or I couldn't make an appointment.
June 29, 2009 - 8:52pm
#47
I have never
over the span of 11 years ever been subject to a pill count or a urine test.
June 29, 2009 - 9:30pm
#48
So so illegal
Doctors have no right to ever request any Controlled drugs from a patient that was filled at a pharmacy. Period. A pharmacy can't even take any controlled drugs back, even for disposal, because there is no trail to follow, meaning the pharmacy can keep them, use them, or put them back into stock, all of which are illegal as well. Any doctor who says otherwise is breaking the law. These are federal, DEA laws, and they supercede any state laws otherwise. Think about it logically: any unlogged narcotics given to the doctor are extremely vulnerable to diversion and misuse, regardless of how upright the doctor and staff may seem. I know plenty of nurses in hospitals and doctors offices who are on hardcore narcotics, while they are around narcotics or prescription blanks. A pharmacist in the area was arrested for taking back patients narcotics after they passed away, and then selling them on the street. Doctors dispensing controlled drugs straight from the office are a different story, and the laws differ. But, if a doctor requests you turn in meds that you filled at a pharmacy, they are in the wrong and you should tell them so.
June 29, 2009 - 9:35pm
#49
Goat
Me too. Not the 11 years, but the pill count or the UA. I would think that if my doctor did a pill count, he might as well be saying to my face that I am a liar. The UA thing though, I wouldn't be able to say anything about, because that was included in the narcotic contract I signed, not pill counts though. haha
Have a pain free night/day,
allgood
July 2, 2009 - 1:45pm
#50
No pill count at all
This morning, my new PM doctor confiscated a bottle of 15mg MSIR (filled 5/1/09,) along with all of my remaining morphine CR (also prescribed 5/1/09.) There were still 110 out of 120 pills in the bottle of MSIR, and even some left in the bottle of morphine CR. He also took my percocet, which I rarely use, but felt compelled to bring with me to my appointment. I was taking LESS than prescribed, and this imbecile still found it necessary to take matters into his own hands, and dispose of my pills.
All the while looking me in the face like and rambling about Michael Jackson, and how"so many people are dying" from abusing these meds.
I was paying attention to his pretty little nurse batting her eyelashes at me, and didn't realize that I was out a bunch of money (co-pay,) and the fact that my insurance won't even cover one of the scripts because it's too early for a refill.
I am infuriated.
they have been several doctors around here that have had their license taken for substance abuse.