When is it illegal to fill a prescription for a controlled substance?
I have had the same family doctor who has been treating my chronic pain for 20 years. The pain is caused by multiple conditions including degenerative disc disease, arthritis, multiple herniated discs, sciatica, canal stenosis, and scoliosis to name a few. He has tried everything including physical therapy, water aerobics, chiropractic, steroid injections, and narcotic pain medication.
As the pain continued to increase over the years, I went from vicodin to percocet to oxycontin. When 20mg of oxy twice a day wasn't working, my family doctor sent me to a pain specialist. This was about six months ago.
Due to multiple other health conditions, I have been seeing my family doctor every month for the last 10-plus years. During our monthly appointments, we discussed my progress with the pain specialist. I told him that he had passed me off to his LPN and that they were unable to find a medication to control the pain. I told him the oxy was more effective than what they were prescribing.
Even though he knew I was being prescribed other narcotics by the pain specialist, he continued to write a prescription for the oxy every month. However, I never had the prescriptions filled for several reasons. Mainly, I knew my insurance would not cover two high-powered pain medications, and I wasn't about to pay $350 for the oxy.
In early November, I mentioned to the pain specialist's LPN that I was scheduled to have rectal surgery the first week of December. She told me that because I had been on some form of narcotics for the last 20 years, my body's tolerance for pain medication was so high that I would experience excruciating and unbearable pain after the rectal surgery. I asked for a couple of extra pills for post-op pain, and she refused.
Needless to say, I panicked. I dropped off one of the oxy prescriptions from my family doctor, just for peace of mind. My plan was to put the pills in the medicine cabinet and take them only what I needed to survive the post-surgery pain. The LPN scared the crap out of me. With the pain she promised me, I would not be able to get out bed, go to work, or take care of my kids.
When I went back to pick up the prescription, the pharmacist said my doctor told them not to fill it because I was already being treated by another physician for pain. Two days later, I received a letter from my family doctor and another from the pain specialist. Both of them had "terminated" me as their patient due to "illegal" behavior!
First of all, what is illegal about filling a valid prescription that was written for me by my family doctor of 20 years? It's not like I stole his prescription paid or forged his signature. This was a REAL prescription-the same one he had been writing every month for a year.
I called him to explain why I wanted to fill the prescription and faxed him the five other unfilled prescriptions to prove that I had not had any of them filled. I also asked him what I did that was illegal. To my shock, he refused to speak with me and said if I ever called his office again, he would call the police and have me arrested!
The whole situation is ridiculous. I could get into the whole issue of why he didn't just pick up the phone and call me instead of throwing me to the lions like a piece of meat. After 20 years, we had become friends. We had been to each other's homes. He wrote letters of recommendation extolling our virtues when we adopted our two kids.
The problem now is, with it being the holiday season, I could not find a new doctor to see me until December 23. I will run out of pain medication on December 15. Because I am in poor health, it is likely that the withdrawal symptoms I experience will actually cause me to die!
My question is as follows: Is it legal for me to fill one of the other five unfilled prescriptions my family doctor wrote for me? I am not receiving pain medication from any other source (the pain specialist terminated me, too).
I have heard horror stories about people being on some sort of "DEA" list and actually being arrested when they went to have a prescription filled. In my case, if I cannot fill one of these prescriptions, I will probably die between December 15 (when my pain medication is depleted) and December 23 (when I see my new doctor).
You certainly are in a difficult situation and there's not an easy answer to your questions. First, let's address why or when it is illegal to fill a prescription for a controlled substance. Most pain specialists require you to enter into a contract with them that has very specific rules you must abide by in order for them to continue to treat you. One of those rules is that they are the only doctor who will treat your pain. If you had such a contract, by trying to fill a prescription for pain medication from another doctor, you broke that legal contract. Also, getting opioids from more than one doctor is a key clue that someone might be abusing drugs, so pharmacists are very alert to that situation. Why your family doctor continued giving you monthly prescriptions is beyond me. He should have known better.
Do not try to fill another of the oxycodone prescriptions. As it is, you're probably going to have a difficult time getting any doctor to treat your pain. If you try to fill a prescription from a doctor who has terminated you, you not only risk possible arrest, you will pretty much guarantee that no one will ever give you pain medications again. I know that's not fair; and I certainly understand why you felt it was necessary to fill the prescription. However, when it comes to opioids, the medical profession is not very forgiving. Doctors are too afraid of being prosecuted themselves to take a chance on a patient they're unsure of.
When a doctor terminates a patient, he is required by law to give the patient written notice that allows a reasonable length of time for the patient to find another doctor. If the patient needs care during that period of time, the doctor must continue to treat her/him. Not doing so is considered patient abandonment. If you feel that either doctor did not give you adequate notice or provide care that you needed during that time, you need to talk to an attorney. If you can't afford an attorney, see if your area has a Legal Aid Society. Here's a link to an article by an attorney with more information about patient abandonment: http://www.gilliland.com/CM/Articles/PatientAbandonment.asp
But I know that doesn't help your immediate concerns about withdrawal. I don't know of any way to get more medication unless you can find a doctor who will see you before you run out. Here are a few suggestions for dealing with potential withdrawal:
• I don't know what dosages or how often you take our current medications, but if you can, try reducing the amount you take beginning now so the supply you have now will stretch for a longer period of time and get you closer to your appointment. If you are taking the extended release forms of any medications, DO NOT cut them to reduce the dosage as this can cause too much of the drug to be released into your system at one time and can result in a dangerous overdose. Just take them less frequently.
• If you do start to have withdrawal symptoms, go to the Emergency Room. Be prepared – they will most likely treat you as a drug seeker. Although they probably will not give you the medications you currently take, they can give you mediations to help reduce your withdrawal symptoms.
• Consider getting into a treatment program to break your dependence on opioids before you run out. Dr. Christina Lasich has an excellent article on Suboxone, a new drug being used to help patients get off of other opioids. Toward the end of the article she gives links to programs that use Suboxone. You can read her article here:
I wish I had more encouraging answers for you. I do wish you the best and hope you're able to find a good doctor who will understand your situation and be willing to work with you.
The law appears to be more aimed at protecting doctors than the patients. I assume what happened is that your first physician recieved a very nasty letter stating what the law is and that he might concievably be breaking it by treating you and informing him of the possible consequences for doing so like losing his license (and possibly worse).
The big problem for him is that it sounds like he, in fact, was breaking the law by continuing to provide you with pain prescriptions while you were seeing another physician for pain. He was the knowledgeable party; he essentially got you into trouble by giving you prescriptions you didn't know that you shouldn't fill.
You have a good case to make that you were an innocent party to another physician's negligence and you have the unfilled prescriptions that could help you prove it. Quite frankly I think your first physician made a real mistake by treating you the way he did. You are, after all, in a position to call attention to his negligence.
Good luck with the surgery!
For one thing you can not get controlled drugs by 2 different docs. that is a no no. you are taking too many. the only thing i will say is no you can't die, but you will want to. you are going to end up in the emerg. room with the withdrawl so bad you are going to scream. You can go to a pharmacy that you have never been to before, say you do not have ins. and pay the $. You are in bad bad shape. You poor thing. I was onlt taking 6 vicodin a day for 1 year and I stopped and I thought I was going to die. Endd up in the emergency room. usually when you go to another doc for the same condition, they make you sign a wavor saying that you will not fill scripts by any other doc eventhough you may have a script. they do that so you wont take more than subcribed. it is to protect you. well, and them.
I dont think you will get arrested! As for filling the script, you have the right for one of the Doctors to wean you off the narcotics before kicking you out. I can almost bet you were terminated because when you went to the Pain Management Dotor you probably signed a form that you dont recall that states, no one else will treat your pain and you will not take narcotic pain medication from anyother source. When the two found out you were terminated. THAT PART IS VERY COMMON! As for being scared about the Colonoscopy, yes, if you have been and are on narcotic pain medication, not only the post-op but the actual procedure (unless you request to be asleep) will be so excruciating you will have hard time. Request you be put to sleep, then post-op ask the Doctor that performed the procedure (if in pain post-op) to prescribe you something for it. Then you have a valid RX with a new dotor with reason. Though he/she should/will probably only prescibe for 3 to 4 days supply and then no need for the meds DUE TO THE COLONOSCOPY ANYWAY! The problem is that opiates completely tear up your intenstines and they actually become dependent on them too, perhaps that is why you are having problems to begin with, not sure. I do know when I quit opiates I could tell how bad they messed with my stomach and bowel behavior they help the pain so much as with many meds but there is a side-effect we pay the price for with everything we put in our mouth, unfortunately!
Good luck and as for the RX, if they did not wean you, that is against the law and you can go after either one of them legally, if you have a script to get you off the meds I would personally use it but would not run it through your insurance WHATSOEVER!
good luck and perhaps you might want to see a physician that prescribes Suboxone, get off all the opiates - with virtually no withdrawls - and re-evaluate your pain condition. Then you can re-seek appropriate Doctors to help you. If you do not do that I do not see any Doctor seeing you that would not think you had/have "drug-seeking behavior.
Good Luck and Best Wishes.
JH in Oregon
find a methadone clinic and talk open and honestly about your situation. i had one help me for about a year until my insureance was turned on. don't give up just keep looking up.