New Pdoc Very Strict with Controlled Meds

[CrazyRedhead]

Yes, I have a new pdoc since September.....**SIGH**....So far we have had only 2 phone appts due to COVID....Not sure when I'll need to go in person, he thinks maybe in January 2021.

Anyway, I only take one controlled medication, which is clonazepam......He agreed to continue the clonazepam, although he is with a teaching hospital, which generally frowns on benzos.......I told him that at least I can sleep with the clonazepam.

But, here's the kicker, folks......He allows no early refills, at all......My pharmacy allows 2 days early on controls, which gives me some leeway if I need to pick up a couple days early......I don't pick up early all the time, but since I depend on someone else to take me to the pharmacy, there have been some occasions that I have picked up early....My previous pdoc knew I was a responsible patient, so she didn't really care if I filled it one or two days early.

Well, new pdoc says that some doctors would think I abused the medication on those times I picked up a day or two early..... **SIGH**.....(He checked my fill record on the PMP (prescription monitoring program)........Unfortunately, I don't have many options in my area as far as pdocs go, so I had to go with this teaching hospital in my area for a pdoc.

So, I can't fill the medication until I am literally ALL OUT--there is no room for error.......Seems a little draconian to me, but I guess at least he let me continue this med.....What if something happened unexpectedly, and I couldn't make it to pharmacy on that exact day---a snowstorm, no transportation available?........I guess I'd be out of luck?

Does anyone have a doc who is this strict about controls?.......Any thoughts or opinions appreciated......Thanks.....

 

Edited October 13, 2020 by CrazyRedhead

[BostonGirl123]

I don't have any good advice other than I'm also terrified of running out of meds. None of mine are controlled though. The few times I've come close to running out, I've broken pills in half to make it last longer. I know this is not a good idea. I had to do this once when a prescription I ordered through an online pharmacy was 2 weeks late and I was scared to call my doctor ( which I know doesn't make sense either). I would bring this up with your prescriber and be blunt with them about your concern. Tell them "what happens if I run out of meds and there's a snowstorm and I can't make it to the pharmacy". Then see what they have to say. As your doctor they should be able to give you a straight answer or solution for this situation. I did this with my new psych and he was understanding. 

[star_stuff]

That doc should have been more accommodating. I get meds from the VA, which is about as draconian as it gets about fill dates on controlled meds, but my doc writes them so that I usually get mine when I still have a week to go. If the doc is the one who's the problem, I'd start looking for another. 

[Banana Smurf]

I have never had a doctor that even mentioned picking up meds, including controlled meds, a couple days early, but I usually pick mine up late because I suck like that and forget to take them sometimes and develop a backlog, then forget to refill until my bottles are empty.  My pdoc had asked me whether I am still taking Klonopin and to make sure that I take it when he was the one prescribing it.  I was scheduled to take it 3 times a day, but I was worried about taking it that often and often took it less.  I mentioned this worry and he suggested taking it as prescribed to worry less.  I think that he was also checking this monitoring service.  I do not have a daytime dose anymore, so I probably should have paid more attention.

Edited October 17, 2020 by Banana Smurf

[CrazyRedhead]

7 hours ago, BostonGirl123 said:

 Tell them "what happens if I run out of meds and there's a snowstorm and I can't make it to the pharmacy". Then see what they have to say. As your doctor they should be able to give you a straight answer or solution for this situation. I did this with my new psych and he was understanding. 

Thanks....I plan to discuss this with him at next appointment, because we do get bad snowstorms sometimes during the winter.....I hope he can give me s straight answer.

[CrazyRedhead]

4 hours ago, star_stuff said:

That doc should have been more accommodating. I get meds from the VA, which is about as draconian as it gets about fill dates on controlled meds, but my doc writes them so that I usually get mine when I still have a week to go. If the doc is the one who's the problem, I'd start looking for another. 

My pharmacy allows 2 days early on controls, which is common for most of the pharmacies here.

Are you really getting controls 7 days early because of the way your doc writes them?

I wish I had the choice of getting another doc, but there's a shortage of pdocs around here that are even taking new patients.

Edited October 18, 2020 by CrazyRedhead

[CrazyRedhead]

4 hours ago, Banana Smurf said:

  I think that he was also checking this monitoring service.  I do not have a daytime dose anymore, so I probably should have paid more attention.

Yes, any doc or pharmacist can check the prescription monitoring program (PMP), for controlled meds prescriptions, and when and where you filled them.

[Catnapper]

It could also be a result of how draconian your particular state is, too. I used to live in South Carolina and in the little town I lived in the pharmacists were all sticklers for the exact time a new prescription could be picked up for any controlled substances. Since I lived way out in the country this was a major hassle. And if you're using insurance, they also may be playing a role behind the scenes and not approve a med to get filled until the last moment. 

The other thing about the role of the state is that not only do their electronic systems keep tabs on patients, they also keep tabs on doctors so the doctors can get in trouble if it looks like they're over-prescribing. 

[star_stuff]

20 hours ago, CrazyRedhead said:

My pharmacy allows 2 days early on controls, which is common for most of the pharmacies here.

Are you really getting controls 7 days early because of the way your doc writes them?

I wish I had the choice of getting another doc, but there's a shortage of pdocs around here that are even taking new patients.

Yes. He writes them to "deliver by xx-xx-2020". At the VA, you can either pick meds up or have the pharmacy mail them. So, usually, I get mine while I still have about a week left. Since he started doing that, my anxiety about running out diminished a lot.

[Gearhead]

Does your doc know you’re dependent on other people for rides?

[CrazyRedhead]

12 hours ago, Gearhead said:

Does your doc know you’re dependent on other people for rides?

Good idea........I told him I don't drive anymore, but I will tell him specifically, at the next appt, that I depend on rides from others to get to the pharmacy.

16 hours ago, star_stuff said:

Yes. He writes them to "deliver by xx-xx-2020". At the VA, you can either pick meds up or have the pharmacy mail them. So, usually, I get mine while I still have about a week left. Since he started doing that, my anxiety about running out diminished a lot.

Wow.....,You do have a very nice and compassionate doc.

Edited October 19, 2020 by CrazyRedhead

[CrazyRedhead]

On 10/18/2020 at 2:04 AM, Catnapper said:

It could also be a result of how draconian your particular state is, too. I used to live in South Carolina and in the little town I lived in the pharmacists were all sticklers for the exact time a new prescription could be picked up for any controlled substances. Since I lived way out in the country this was a major hassle. And if you're using insurance, they also may be playing a role behind the scenes and not approve a med to get filled until the last moment. 

The other thing about the role of the state is that not only do their electronic systems keep tabs on patients, they also keep tabs on doctors so the doctors can get in trouble if it looks like they're over-prescribing. 

Hmm.......I know laws can vary from state to state, but I have never had a doc this strict.....Other docs I've had, never really had concerns about me filling 1or 2 days early if I needed to......All the pharmacies in my area allow 2 days early on controls........Maybe this doc is so draconian because he practices at a state-supported teaching hospital--that's my guess, anyway.

I don't think my insurance has much to do with it....They always paid for it no problems if I filled 1 or even 2 days early.

I do realize that some rules have to be in place regarding controls, but I think some docs are swinging too far in the other direction, and being unreasonable when they are saying no refills until you're all out....**SIGH**.

Edited October 19, 2020 by CrazyRedhead

[jarn]

I think that's so wrong-headed.  Here (Canada - Ontario) the rules for my ativan are no different than any other of my meds.  

I'm sorry you're dealing with this - yikes.

[CrazyRedhead]

1 hour ago, jarn said:

I think that's so wrong-headed.  Here (Canada - Ontario) the rules for my ativan are no different than any other of my meds.  

I'm sorry you're dealing with this - yikes.

Thanks....Yes, I believe Canada is a much more civilized country than the U.S., in so many ways.

[Catnapper]

6 hours ago, CrazyRedhead said:

Hmm.......I know laws can vary from state to state, but I have never had a doc this strict.....Other docs I've had, never really had concerns about me filling 1or 2 days early if I needed to......All the pharmacies in my area allow 2 days early on controls........Maybe this doc is so draconian because he practices at a state-supported teaching hospital--that's my guess, anyway.

I don't think my insurance has much to do with it....They always paid for it no problems if I filled 1 or even 2 days early.

I do realize that some rules have to be in place regarding controls, but I think some docs are swinging too far in the other direction, and being unreasonable when they are saying no refills until you're all out....**SIGH**.

 

In South Carolina I had a cool pdoc, and insurance didn't care, but the pharmacy sure did. There was less than 12 hours before I would meet the two day time frame on a refill, and despite knowing that I lived 30 miles away, they wouldn't fill it so I had to go back the next day. It was for Ambien and I don't understand how you can get high from it since it just knocks me out. This happened multiple times.

As my pdoc at the time said, if you give certain people a little bit of power they'll lose their common sense and become complete sticklers for rules.

So disheartening and such a pain to deal with!

[CrazyRedhead]

16 hours ago, Catnapper said:

As my pdoc at the time said, if you give certain people a little bit of power they'll lose their common sense and become complete sticklers for rules.

So disheartening and such a pain to deal with!

I agree 100%........For me, it will be one more thing to stress about, and I have enough stress already......**SIGH**

[Iceberg]

It’s still only been a couple months, who knows maybe you will build mutual trust and a longer leash. 
 

it’s. An interesting concern though, I understand abusers may want it early, but 2 days of pills doesn’t seem that perilous. If you’re not abusing than what is the point of that measure ? 

[sugarsugar]

I’m not very organized so that would be really hard. Maybe knowing you need a ride will get you a couple days more, I hope so. 

[Iceberg]

I am just a little surprised that the doc who is supposed to treat your anxiety is doing something to crank up your anxiety 

Not sure if this would help, but do you have the option for mail order? That way it’d come to you 

[CrazyRedhead]

On 10/20/2020 at 1:01 PM, Iceberg said:

It’s still only been a couple months, who knows maybe you will build mutual trust and a longer leash. 

Hopefully so.....

 

On 10/20/2020 at 1:01 PM, Iceberg said:

it’s. An interesting concern though, I understand abusers may want it early, but 2 days of pills doesn’t seem that perilous. If you’re not abusing than what is the point of that measure ? 

I can't understand haggling over one or two doses.........IMO, that's ridiculous.........I don't understand what his point is, either, to be honest......Maybe he just doesn't like giving benzos, but since he 's keeping me on them, he's going to tighten up his control over the script.

I truly wish I had more of a choice when I had to get a new doc.....I didn't leave my last one by choice--she retired, so I was forced to find someone else, and not many options in my area, as I've said before......**SIGH**

Edited October 21, 2020 by CrazyRedhead