Pharmacist Almost Wouldn’t Fill My Medications?!?!

Hi friendo, maybe I could provide some insight; I've been working in pharmacies for about 4 years (not a pharmacist though).

Depending on a multitude of factors, pharmacists can be very nit-picky about controlled substances, especially ones that seem to contradict each other/have opposite effects. In fact, Ambien and Adderall are a pretty good example. Most pharmacists would get red flag vibes with that combination, because things considered to be "uppers" and "downers" being filled together is often a ruse in this business, unfortunately. People will do this to sell the pills, which if caught can put the pharmacist's license on the line, so they've been trained to keep a very watchful eye for high doses of controls or "strange" combinations like yours. By law they are allowed to not fill any prescription that they believe is fraudulent, dangerous combination, or suspicion of abuse or misuse.

However.

In my opinion, that pharmacist handled the situation INCREDIBLY poorly. Had you seen this pharmacitlst before, if you're a regular there? If not, they may have been a floater pharmacist, i.e. a person who works there if the manager or regular staff pharmacist isn't able to come in. At least in my experience, floaters tend to be EXTRA stingy and paranoid about controls. Not entirely sure why, but most likely because they don't really know the patient well.

If he felt uncomfortable filling the script, the very first thing he should have done is contact your doctor to ask about the combination for clarification. The doctor would have told him it's for narcolepsy treatment and that would most likely be good enough for the pharmacist. The second thing he should have done is look on a database that shows when, where, and what people have filled in the past as far as controlled substances go. If there's a pattern of you getting it only once a month, generally from the same place, and by the same prescriber, then that would be an indicator for legitimate use.

As far as what to do? I suggest this:

1. Call the pharmacy and see if you're able to speak to the pharmacy manager (I hope that guy wasn't the manager!) or a regular staff pharmacist if they're available. Ask whether that person who denied your drugs a floater or a regular staff pharmacist. If they're a floater, the manager will most likely be fine with filling your medication, especially if you've filled that combo before. You can also request having them put a note in your profile saying "X and Y okay to fill together, Dx Narcolepsy" or something of that nature, to indicate to any other pharmacist at Walmart that this drug combo is perfectly fine to fill and that they don't need to worry about their licenses.

2. Switching pharmacies, especially if the guy you talked to was in fact the manager. This can mean simply switching locations, or different chains altogether. The shitty part about chain switches though is that your insurance may not want to pay for things from some chains, and at a chain you've never filled before will ABSOLUTELY have to contact your doctor for clarification, especially if you're only filling controls. In my state (WA), you cannot transfer any new controlled substances; you either have to have the paper copy and physically bring it to the new pharmacy, or you have to have your doctor send an entirely new electronic script to the new pharmacy. I don't know what your state's laws are, so that's another consideration for a chain switch.

Your best bet if #1 fails is to try switching locations for now and see if that works. If not, mail order or another chain will be the next step.

I'm so sorry for the way they treated you. I've had to educate the pharmacists I work with about my weird drug combos and how they're used in my idiopathic hypersomnia before they filled them. I get it from their perspective, but the ones who handle it so poorly like this one did really piss me off. There were so many things he could have done differently and he chose the worst route. Good luck 💓

I had a pharmacist call a police officer on me when my doctor up my adderall up to 90mg day for my narcolepsy. It was taking forever and they kept saying it was because of insurance verification. Two officers walk in, I think nothing of it because I'm a retired (disability from an injury) police officer. They go to the pharmacist and then walk over to me asking where I got the forged prescription from. I was like, excuse me?? Thankfully I carry my retirement shield and I asked the officer if they pharmacist called the doctor's office to verify the prescription. I know they have to do this first for questionable prescriptions because my wife is a physician and also because of my past experience as an LEO.. The officers turned around and asked the pharmacist if he had called the doctor. Being that my wife is a physician, i know this doctor and was texting him to call the pharmacy ASAP. The pharmacy said that he had not because it was an obvious forgery. Anyway, the pharmacist calls the doctor's office before the doctor calls the pharmacy and they verify the prescription. I was so pissed off. I filed a complaint. I have no idea if anything was done or not. Anyway, I say all this to say, I can relate. There's so much ignorance out there, even with healthcare professionals, about narcolepsy. Like they have no ability to understand that one of the main symptoms of narcolepsy is insomnia.

Narcoleptic and a pharmacist here. I see their side of the picture being that it usually makes no sense to be on stimulants and hypnotics like that, however that doesn't excuse them for being rude. There's a database they should've checked and so long as it was same doc/not filled early, the 'floater pharmacist' should have filled it. Which it sounds like they did.... This time. The way to get around it is to have your doctor call the pharmacy WEEKS BEFORE YOU NEED A REFILL to tell them that, despite it being a weird combination, it is in fact correct. You could ask the doctor's office yourself to do this, but I think it might be better if you call the pharmacy on Monday when the regular pharmacist is there and ask them to do it. That way the pharmacist is aware that you are being proactive, aware that the drugs are legit, and knows how to document so everyone else is aware. If you have the doctors office call directly, the message may get lost in translation and not be put on your chart.

I know it's a huge pita to have a pharmacist deny your LEGITIMATE refills, that your LEGITIMATE doctor prescribes for you EVERY SINGLE MONTH, but do try to give them some patience. Those are two highly abused drugs and their license is on the line if they aren't trying to screen for diversion. I'm not saying they handled it correctly (sounds like they were rude) but do try to not take it personally. Were only give the smallest of a snapshot of your clinical history, it's a terrible spot to be in.

This is why I’m always embarrassed to fill my prescription. I even had one pharmacies that explain REALLY LOUDLY why the adderall was taking longer (they were waiting for a physical copy from my doc) and my skin was crawling as she repeated the name adderall lord enough for everyone in the room to hear. Finally I couldn’t take it anymore and I politely asked her to lower her voice, but I nearly died of embarrassment. It’s not the same thing, but it’s always something getting these prescriptions filled!

Was the pharmacist you spoke with the pharmacist you usually fill with at that location? If you've filled there before, they should have your medical conditions on your profile already. You might check on that.

Also, if your doctor isn't putting ICD-10 diagnosis codes on your scripts you might request that they do so, so the pharmacist doesn't even need to ask you, they just look up the code and it will tell them what the script is for.

The only other thing I can think is it's due to the narcotics crackdown the DEA has been pushing on doctors and pharmacists in recent months. It's made things difficult for a lot of folks with chronic conditions that need regular controlled substance scripts, and everyone's being more cautious with who they dispense these things to and why.

Walmart seems to be so bold with this kind of crap. I was taking Modafinil and Adderall. I switched insurance, same company with different coverage, and for whatever reason the insurance company needed a prior authorization for the Modafinil. My general practitioner has been filling my meds, so I wouldn’t have to pay the specialist rates. Well, the insurance would only take the authorization from the sleep specialist. After it clears, it gets sent Walmart’s way for filling. Walmart calls him and tells him I’ve essentially been doctor shopping, because I had a stimulant (Adderall) filled by my GP. They could have asked me???

If I were you, I’d ask for a manager, and have them spell out in plain English what the problem is.

I have been narcoleptic for 30 years. Even in those days I had a local pharmacist, mail order wasn't a thing yet. Tell me that only an addict would need the quantity of Dexadrines I was having dispensed. (5 pills a day + ambien). His refusal forced me shop pharmacies, only to find not many places wanted to dispense control drugs to a new client. There a codes that can be added to Scripts to allow the qty to be explained. I know it's a huge hassel, but he is doing his due diligence.

Yeah, I used to get all kinds of shxt trying to get syringes for my dog's diabetes shots. Syringes don't require a script in California so even if I AM a druggie, they are supposed to give them to me so I don't spread disease via used needles so don't give me a rash of shxt and make it hard, just give me the damned needles. I even asked my vet to write me a script for the needles so it looked more legit but he refused cuz they don't need a script. A lot of people working at these pharmacies do not know what the hell they are doing.

At another place I go, I always get two packs of bronkaid whenever I am there. I like to keep well stocked in case of any supply chain interruptions, especially with how weird things have been lately, so I've been getting extra at every visit but am still way below the legal threshold which their internet system tracks anyway. So 5 times in a row, I get 2 packs, but the next time the guy says, "Oh no, we are only allowed to give out one pack." I know it's bologna though, I probably just looked too shady that day having both black pants and black jeans and needing a hair cut. THe next time I go after getting a fresh hair cut (just in time before the next lockdown!), the same guy will probably cough up 2 packs like I ask. It helps to look well put together to get your stuff from the pharmacy, sad but true. Any time I look too scruffy, I can only get one pack. One of these days maybe they will figure out if I was a stim addict, my butt would be a lot skinnier LOL!

can you get the prescription sent to another pharmacy?

That sucks! I’m sorry. Stimulants have such a stigma! I don’t even like telling people I take stims. I feel like everyone thinks I’m a drug addict or something, and I take modafinil... you couldn’t get high off it if you tried!