Don't Lie to Your Pharmacist

Never, ever lie to your pharmacist. Especially your pharmacist works in a slow pharmacy. That is a very bad idea if you are a drug addict.

A patient brought me a prescription for Lortab 7.5/500 #60 today. She asked how much it would be. I asked her if she had insurance - she said no. I asked her again to make sure: “You don’t have any insurance?” She said she did not. I told her the prescription would be ready in 20 minutes and that it would be $19.49.

I immediately called ABC/Pharmacy across the street and asked if she has insurance on file. Sure enough, she has Mercy Care. I billed the claim and was informed by the lovely online DUR system that she received #120 Vicodin ES on 12/13/07. I called Mercy Care and found out the prescription for #120 was filled at Walgreens. When I called Walgreens, the pharmacist working knew this patient well. She also had received #60 Vicodin 5/500mg on 12/19/07 from another doctor at his store. She picked up #15 Norco 5/325 at my store (no insurance) on 12/6/07.
That means in 15 days she had taken 195 tablets (most of it ES) and was trying to get 60 more.

Her poor liver.

Maximum daily acetaminophen usage should not exceed 4000mg to prevent hepatotoxicity. From these 195 tablets alone, she was taking the equivalent of 8325mg of actaminophen a day. And who knows what other pharmacies she was going to and paying cash for hydrocodone products.

Ouch.

When I confronted her about the “no insurance” lie, she feigned innocence and demanded the prescription back. I had already written that she had filled #120 on 12/13/07 on the face of the prescription. So I gave it back to her.

But when you lie to me and then don’t even apologize about it, I get even. I filled out a Fax Net form (an online form to report forgeries, bogus scripts, doctor shopping, etc to the Board of Pharmacy). I also sent a fax to the doctors’ offices with a copy of the Fax Net form informing them of her doctor-shopping/pharmacy-shopping behavior. The Fax Net form gets faxed from the Board of Pharmacy to every pharmacy in the valley.

I feel bad for people with legitimate pain - they need control of their pain, that is often why they are acting out and showing drug-seeking behavior. But doctor shopping and abusing the system will only eventually get you cut off. This woman needs to see ONE doctor for pain medictions that don’t include acetaminophen. Maybe her liver can still be saved.

I wish her luck. But I still hope she doesn’t lie to other pharmacists in the future.