Robber, Faker, Methamphetamine Maker

Along with the increase in other pressures involved in pharmacy practice, the amount of robberies have increased , and the vulnerability we feel standing there behind the counter has added another nerve-racking dimension to our job. We are sitting ducks. The "security" system consists of "high definition" video cameras . Those grainy images on the tv news are supposed to help the public identify the latest hooded wonder, but they are little consolation to the employees involved in one of the most traumatic events of their lives. Adding insult to injury, upper management has become increasingly callous to our plight and harasses employees to show up to work their next shift,  implying that you are not a team player if you can't bring yourself to return to the place where 24 hours ago you had a gun pointed at your head.

We have always had patients who have trouble limiting their use of pain medication and nerve medicine.What happens in a lot of cases is that people get hurt in an accident or at work, and then it seems that they never get weaned down off of the medication. In fact, the dose and amount of medications seem to escalate over time. Pain has a huge psychological component, in other words, it is self perpetuating. The more you hurt, the more tense and anxious you get, which in turn makes you hurt worse. Unfortunately, addressing this component of pain management takes time, commitment, and collaboration between the physician, the patient, and ancillary practitioners, such as counselors, physical therapists, massage therapists, and mental health professionals.

Many patients sign a pain contract , promising to only see practitioners in one pain management group. They also promise to limit the number of pharmacies they visit. It gets a little dicey for them and for us when glitches in the system occur and their prescriptions are delayed. When a patient is desperate and in pain, they  are willing to try anything to get their medication. The stories they fabricate would be funny if the situation wasn't so sad. "I was sitting by the pool, and I dropped my bottle and all my pills spilled out on the pool deck, and my dog got hold of some of them and died". Couldn't you have saved at least some of the pills? ''It was raining".

Then there are the people who sell their medications. When we see a carload of people come through drivethru  and pick up scripts for boatloads of pain meds, it does not inspire our confidence that this is a legitimate transaction.

Last but not least are the Meth Heads who come in and buy pseudoephedrine and ephedrine tablets. We are pretty good at spotting these people, and our goal is to get them out of the store as soon as possible. It is hard not to profile someone who has tattoos and piercings everywhere, talks 90 miles an hour and can't stand still, is exceedingly polite (until the state limit is exceeded), and talks about how their poor old Granny needs this medicine so badly. Spare us the stories, we will sell it to you if it goes thru on the register. We hate doing it, but we let the State Police do their job and try to stay neutral.

So, forgive us if we are a little jaded. It would be so much easier to believe all the stories and excuses, but we are entrusted with patient safety. We hate being the drug police, but this is yet another component of our job that we do not control. As the big dufus in Blazing Saddles said so eloquently "Mongo just pawn in great game of life".

 Later,

BP