new policy on opiates prescription

[Mark N]

I just found out the CVS is now only going to fill opiates the last day of the prescription. In other words there will be no way to get a refill until I run out. This used to be two days prior so that with my lost days or days I couldn't get out there was a little bit of leeway with my meds. It was a big problem during my illness as c-diff was kicking my butt and I couldn't get out of the house some days. It is just another case of people that abuse the system making it harder on those of us that follow the rules. How much longer before they tell us we don't really need opiates to deal with our pain levels? Has anyone else seen this change with their pharmacy?

[tortoisegirl]

I've never heard of being able to fill it even 2 days early. Maybe you can try to accumulate two extra days of meds so you have some of your own leeway? Some extra meds are something very good to have as you never know what could happen to delay getting meds. Or do you have someone who can go pick up your meds for you? There are also still some pharmacies out there who will deliver, especially to seniors or disabled folks.

With regular meds with refills, since you can refill early each time and they then calculate the next refill time based on that, someone can really accumulate extra meds over time. Since Schedule II meds have a new script, that won't happen though.

In my area they are already telling patients they can't prescribe high dose opiates long term for chronic pain, even patients who have been on them for years and are doing well and nothing else works for them. Plus many pain doctors don't even prescribe opiates around here. Best wishes.

[Lil E]

You think thats bad?

In California we have Prop.46 on the Nov. ballot. Its sponsored by lawyers to make it easier to sue doctors, hospitals and to get rid of the cap on the amount they can sue for. They're trying to hide it behind a case where two kids were killed by someone on prescription medications. Attached to it is a part that is going to make it harder to get meds if we can get them at all. They want every doctor to check up on every patient every time they get a script for opiates using a data base that won't even be operational until 2016! Doctors insurance rates are going to go thru the roof, you will have to go see them every month and some doctors will not prescribe opiates at all.

Go to Noon46.com for complete information.

[Kathi49]

Mark, since you and I both live in the same state, I find that rather odd about CVS. I just refilled my pain med last week and I usually do so about 1-2 days early. They never mentioned a new policy. So, it makes me wonder. Are you sure it is not your insurance company? I read where you recently switched, that's why I ask. I did have that happen to me once...too early to refill that is. But the rejection so to say came from my insurance company and not from CVS. But that wasn't for a pain med. I believe it was for Nexium and that was years ago. It hasn't happened since. Anyway, I know it is difficult for you to get out. Could your wife pick it up for you? I know my husband can pick mine up. And when my Mom was living us prior to her death from cancer, I was able to pick up her pain meds. CVS also offers delivery but I don't know what the rules are, if any, for pain meds. Anyway, best of luck to you but I would look closely at your insurance policy.

[Kathi49]

Hey All, I just had a call from CVS. It was really about my Nexium prescription and no biggie. But I did ask the gal about what Mark had mentioned...not using any names of course. She told me that since Hydrocodone (I take Norco) has just been reclassified, that every patient will have to see their doctor each month to get a new script. There will not be any refills at all. So, Lil E had a good point. I am not sure if this is just CVS or not. I've read something similar in regards to Walgreens. So, yay, more fun we all get to run to the doctor each month. I don't like it any more than the next person but will just have to go with the flow. But I think CVS should let the patients know before they do run out.

[Mark N]

Cathy I asked the pharmacist specifically if this was an insurance issue or a change in the law; she replied no it is a change in CVS policy. This is just another way our difficult lives are made more difficult by people that don't live with the pain we live with.

[Mark N]

lilE, I hope prop 46 gets voted down as CPers don't need our lives complicated any more than they already are due to our pain.

[Kathi49]

Thanks for clearing that up Mark. But this is what is so strange. When I asked her about my own Norco, and before she went into the October bit, she said, "No, if for instance you have a 30 day supply, you can call a refill in on the 28th day." But then she said, "Oh, but starting in October...."

It is all so strange. Oh well, I see my GP towards the end of October anyway. I'll see what he has to say. Thanks again though.

[Earth Mother 2 Angels]

((((((Mark)))))) ~

CVS is changing their image to "CVS Health." Their first advertised move is to stop selling cigarettes. Looks like they will still sell beer and wine, as well as candy. So, perhaps this policy change pertains to their new image.

Some thoughts ~

1. Call your prescribing physician ~ ask whether s/he is aware of this policy change, and whether it applies to all pharmacies. Ask whether s/he expects you to visit her/his office monthly to obtain a prescription, or if there is some other way around that requirement.

2. Call other pharmacies ~ ask them their policy regarding filling your meds. If they aren't following CVS' new policy, then switch to another pharmacy for your prescription.

3. Post to or PM Pharmacist Steve ~ ask him if he's familiar with this change. (I'm hoping he sees your thread here and responds, but if not, PM him.)

4. Search for a pharmacy, which delivers to your door.

One last observation ~ my son is a Medicaid patient, and he takes 3 anti-seizure meds. We are not allowed to refill these meds earlier than 2 days before the end of the month. Our CVS knows us after 37 years, and they give us "tide overs." But, that may change in the future. Who knows? We would like to have an excess supply on hand, in case we have a natural disaster, and we can't get to CVS or anywhere to refill his meds. Without his meds, the risk of seizure, likely a fatal seizure, is enormous. But we can't have a back up supply of his meds.

I hope you're able to work this out in the most beneficial way for your well being.

Love & Light,

Rose

[tic chick]

hey everyone!

as kathi49 said, drugs are being reclassified.

i did a little research and came up with this article: Only registered and activated users can see links., Click Here To Register...

this statement is prolly the most important to this discussion:

In an attempt to decrease the utilization of hydrocodone combination products (such as generics of Vicodin, Norco or Lortab) the DEA recently announced that as of October 6, 2014 all such products will become Schedule II controlled substances (they are currently Schedule III). To be fair – this decision was made because they are convinced now that hydrocodone combinations are addictive enough for this classification. They’re probably right. This means prescriptions for these products can NOT have refills and will be tracked more stringently. This means they will probably now be stored in a safe or locked drawer in the pharmacy.

schedule 2 drugs generally have a greater chance of being abused than schedule 3 drugs, so there are more restrictions on getting them. doctors have to account for all the prescriptions they write for these drugs and pharmacies have to fill out monthly (i think that's the time frame), reports on how many schedule 2 prescription drugs they fill. they have to account for every pill they order and every pill that goes in a prescription and the numbers better match up. there is also a different way of ordering schedule 2 drugs that is more difficult and is done separately from ordering other drugs. unfortunately, the people who are abusing these drugs are making it harder for people who legitimately need these drugs to get them.

this is pharmacist steve's website: Only registered and activated users can see links., Click Here To Register... if you click on the link you will see about 3 articles on the left hand side about the deaths from opiates in the usa.

cvs is not the only pharmacy that is affected by this change, all pharmacies are. so i don't think you're going to find differences between pharmacies and their rules on schedule 2 drugs, since the rules in use on schedule 2 drugs have remained consistent over the years.

this is the current schedule of drugs:

Schedule I

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Schedule I drugs are the most dangerous drugs of all the drug schedules with potentially severe psychological or physical dependence. Some examples of Schedule I drugs are:
heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

Schedule II

Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, less abuse potential than Schedule I drugs, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are:
cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

Schedule III

Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are:
Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

Schedule IV

Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are:
Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien

Schedule V

Schedule V drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are:
cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin (Only registered and activated users can see links., Click Here To Register...)

so some of the drugs in schedule 3 now will be moved up to schedule 2 classification and the rules for refilling them will change.

i hope this helps.

jeannie

[Pharmacist.steve]

Some of the Pharmacist in Charge (PIC) are making up all sorts of policies in their individual stores... I saw a note from a PIC in a 24 hr CVS store in another state where the edict was that the store was to fill no controls between 8 PM and 8 AM. Keep in mind that this store was the closest 24 hr store to a very large teaching hospital with a very busy emergency room. It appears that the chains have little concern about these PIC establishing their own little fiefdom when it comes to controlled meds and establish draconian policies in their stores.

[Pharmacist.steve]

The only opiate that can now be called in is Tylenol with Cod.. Tylenol No.3 (30 mg Codeine) should be abt equal to Hydrocodone/APAP 5/325 and Tylenol No.4 (60mg Codeine) should be abt equal to Hydrocodoone/APAP 10/325

[Mark N]

Earth Mother, like anything in life I will work around this it just doesn't give me any leeway. It just seems the DEA, pharmacies, insurance, or doctors are making it tougher for us CPers. I haven't increased my opiate does in 11 years yet any time I am off by a day or two it seems I am seen as a seeker of meds. I can deal with this latest change but I am concerned about what is next for us.

[Kathi49]

Thanks Steve, Sorry it has taken so long to reply. But your info. on the Tylenol is good to know as I do take Norco 5/325 (one to two a day as prescribed). I just read also and forgive me if I don't have the exact wording (bad headache right now), that the doctor per his discretion, can write scripts for let's say 3 months hypothetically. Can you provide more information on that? Also, we all know that a lot of this is DEA driven. But does the ACA play into this as well? Other than digitized medical records.

[Pharmacist.steve]

The regulations state that a doctor can give a pt three -30 days Rxs... with current date but marked when they can be filled. I see more and more Federal/State Gov agencies trying to get their bureaucratic tentacles into regulating this area. Suggest you read this Only registered and activated users can see links., Click Here To Register... .. I am a very active blogger now Only registered and activated users can see links., Click Here To Register... and post a couple of things a day about what is going on...