u/tonybaboon

Any good Pina Colada, preferably frozen, or other frozen alcoholic beverages close to downtown? It's hot out there 🥵

Have a difficult patient, walking red flag. Constantly asking about early fills, pharmacy hopping, "lost meds"... Since the new year they have lost their C2's 3 times: stolen bag, car B&E, and again Friday they were in her car that is now in another state (SO borrowed) Now they are calling complaining about withdrawals and how much pain they are in because they are without. Other pharmacist refused to fill, I have refused to fill. But it has got me wondering, and mildly stressed, at what point do you consider risk of abuse vs risk of going without treatment? Both from a patient care perspective and from a legal perspective.

​

I have left some things mildly ambiguous to maintain some anonymity but some extra details:

​

First time we just got confirmation from the doctor that they were aware and approved the early fills of all her meds stolen. Documented everything and moved on.

​

Second time we did the same thing, but also required the police report to be brought to us and allowed early fill of all medications documented on the report.

​

Third time patient said it was ONLY the controls taken, everything else was home. No report possible as they weren't truly stolen.

​

Doctor kind of terrible, approves early fills constantly, doesn't seem to even know what the patient is taking half the time and can't use their own record system well (difficulty confirming dose changes in the past). They are so notorious at it we reported them to our higher ups to continue monitoring them across multiple pharmacies.

​

Personally, I suspect they are abusing or selling and just trying to get early fills. But I do believe what they are saying COULD be true, they seem to be living out of the car off and on, rough part of town, etc. I just worry that I could face legal trouble or just feel bad denying a patient their meds

The pharmacy system has started recommending HepB for 18-59 year old patients and on most of them we can see they completed the series at birth. Are patients being recommended to do another series after hitting 18 even if they have previously completed a pediatric schedule? When I look at the CDC Adult Schedule it just says "compete a 2,3, 4" dose series as routine, nothing mentioned about catch up.

Best I can tell is they shouldn't need it if we can PROVE they had it as a child but if we can't prove them we can recommend it.