Is there a way to fill my prescription (ADHD) without the usual hassle?
December 3, 2013 6:16 PM   Subscribe

I have to take 60 grams of Dexedrine every day. I get monthly prescriptions (no refills allowed) and every month it's a nightmare to get them filled. Is there a way I can avoid this?

Most pharmacies tell me they are out and ask me to come back in a week, but when I go back after a week they still don't have it in stock! The pharmacy closest to my home is particularly weird about this, because they even remember my name when I need to fill other prescriptions, but they behave like it's the first time they see me every time I go for this particular med! They also behave like they have never heard of it before, and of course like they had no clue I need it every month for the past year and a half!

Pharmacies refuse to tell me if they have it in stock over the phone, so I end up driving to each pharmacy a couple of times (first round, then one week, then a second round). On an average month I end up not taking these meds for a week or so (I try to start the process early but many times I end up short), which really disrupts my life.

Is there a way I can avoid going through this every month, or at least do you have any recommendations of pharmacies that are more helpful? I have tried different locations of CVS, Walgreens, Walmart, Rite Aid.

I also wonder if the home delivery services online can help me, but I'm not sure they deal with controlled medications.

Finally, do you have any ideas on why this is such a pain in the ass? What is the deal with my local pharmacies?
posted by Tarumba to Health & Fitness (31 answers total) 4 users marked this as a favorite
Ask your prescribing doctor about mail-order pharmacies. Perhaps he or she has some experience with them and delivering tightly controlled drugs that require a new prescription each month. Then again - is Dexedrine one of those that require a paper prescription delivered in person, like Percocet? That could complicate things.

Get help from your doctor's office. If they can recommend a hospital pharmacy to use, that may give you better consistency on stock.
posted by WasabiFlux at 6:27 PM on December 3, 2013 [1 favorite]

Best answer: Go to an independently owned pharmacy. They will be eager for your business and will certainly learn your regular schedule better than a mega-chain.
posted by Rock Steady at 6:31 PM on December 3, 2013 [11 favorites]

Not a pharmacist, but a frequent customer. Having a relationship with one regular pharmacist certainly helps me. I wonder if you talked with the one you deal with the most, about a week before you go to the doctor, and let him know the situation, if that would help.

You wouldn't be asking if it was in stock, since that seems to be something they either can't or don't want to answer, but letting them know that you'll be bringing in a prescription from Dr. A for X amount of drug Y on date Z, and you want them to have a chance to include it in their weekly order to the company.

If that isn't helpful, maybe your doctor's office would be willing to call the pharmacist enough in advance that they have time to get it in stock. I know they can't call that particular prescription in, but they might be willing to say patient A will be bringing in a prescription for X amount of drug Y on date Z, and you want them to have a chance to include it in their weekly order to the company.

Caveat: I've never actually had to do either of these, and I'm sure it would 100% depend upon the individuals involved. I'm just imagining what my pharmacist and doctors would probably do if I kept having this problem.
posted by The Underpants Monster at 6:31 PM on December 3, 2013

is Dexedrine one of those that require a paper prescription delivered in person, like Percocet?

Yeah, it's a schedule II. I (and many others) had similar problems filling Adderall scrips a couple of years ago. Last time I saw my doctor she mentioned that Dexedrine was having those same supply issues now.

Basically, other than changing meds, there's not much you can do. Might have more luck establishing a relationship at an independent pharmacy.
posted by ndfine at 6:35 PM on December 3, 2013

You mean milligrams per day. right?
posted by hortense at 6:36 PM on December 3, 2013

Best answer: I wonder if you can contact the pharmacist at your nearest pharmacy and just explain the problem to them and ask how to resolve it. (Speak to the actual pharmacist, not just a tech.) Give them your doctor's information so they can confirm that this is a standing prescription.
posted by elizeh at 6:36 PM on December 3, 2013

Best answer: They have my birthdate memorized at my pharmacy, and it didn't help. I give them extra time by skipping doses on the weekends and seeing my doctor every three weeks and then, on the day that they are legally allowed to dispense the medications, they have to order more because there's none in stock. This is with two weeks' warning of when they'll need to have some ready!

The only solution that will work is to get a relationship with a pharmacist that won't screw you over. I'm still looking for mine - I ended up going almost seven weeks between "date I handed in the script" and "second fill" for Adderall this last time around.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 6:36 PM on December 3, 2013

Response by poster: yeah 60 my meds for a couple of days now!

Thanks everyone for the great suggestions!
posted by Tarumba at 6:42 PM on December 3, 2013

Best answer: Is there a hospital with a pharmacy near you? I have one near me and back when it was adderall that was in short supply, the hospital pharmacy had it even when no cvs or walgreens seemed to.

I've also had luck calling and using the phrasing "Can you fill a prescription for..." so maybe that could work. Might also try asking when or how often they get deliveries and see if you can line that up with your refill schedule.
posted by matildatakesovertheworld at 6:51 PM on December 3, 2013 [2 favorites]

Best answer: Finally, do you have any ideas on why this is such a pain in the ass? What is the deal with my local pharmacies?

My guess is that some pharmacies don't want to deal with filling a lot of stimulant prescriptions because it's the latest big scare in the news, the DEA is probably keeping a close watch on those particular records, and so they keep their stocks low in the hope that some patients will go somewhere else and they won't have more stimulant scripts than they can easily keep a track of.

If I'm right, that may be something that building a relationship with one local pharmacist may help with.

(Seconding elizeh on speaking to the pharmacist him- or herself.)
posted by The Underpants Monster at 6:53 PM on December 3, 2013

Best answer: Can you try to build up a reserve? How soon before your current prescription runs out can you fill the next prescription? Does your doctor have samples he can gice you?

Does your doctor recommend a particular pharmacy? Are there other folks who take the same thing that you take in your area? Where do they go?

Also mail order. And hell, maybe call the pharmaceutical company and see if they have suggestions. Might be a long shot but they have a vested interest in making sure you have access to their product.

I have a prescription that can be difficult to obtain (though not at all like what you're dealing with). I usually only take half a pill a day so I can stretch one month's supply. As a result, I have an extra bottle and another waiting for me at the pharmacy. Can your doc write you a scrip for bigger pills?
posted by kat518 at 6:54 PM on December 3, 2013

Have you tried switching to adderall? Either instant release or extended release. I've never had a problem getting either at Walgreens.

Dexedrine might be rare enough that pharmacies simply do not want the hassle of stocking it. I think there are pretty tight controls (like nightly inventory kinds of things) on controlled substances.
posted by gjc at 7:04 PM on December 3, 2013

Best answer: I take Concerta and have gone through the same problems at all of the places you listed. I have worked in a particular hospital for almost 20 years and they did the very same thing to me two weeks ago. It was as though I was a total stranger, not someone the pharmacist speaks to 5 days a week!
The only pharmacy I have found to be helpful, communicative, and cheerfully willing to take my money for my prescribed medication is Target. The pharmacy at Target has proactively called my insurance company to correct a copay mistake for the Concerta (charging me for brand-name when I was dispensed generic), they let me know if I don't have any rx's on file before I run out, and they always have my pills when I come in each month.
I can't praise Target pharmacy enough, they're wonderful.
posted by notaninja at 7:12 PM on December 3, 2013 [3 favorites]

Best answer: When you must get your prescription today, try a Walgreens near a student population, they will generally have plenty of ADHD stimulants in stock.

For long-term, you need to let your favorite local pharmacy know you are having to go elsewhere and would rather let them handle it.

In my experience it only takes up to 2 days for them to get your meds in stock if they're out, if they are squirrely pin them down on looking up the supplier and when they deliver. You can't always rely on other people using their executive skills for you, sometimes you have to help them help you.
posted by evariste at 7:16 PM on December 3, 2013 [1 favorite]

Best answer: another option is to see if your doc will write you a script for 120mg. still get it filled every month, but then for when you have those weeks you're with nothing, you'll have been cutting the pills in half and so will have extra. understanding doctors will often do this, because fuck the man.
posted by misanthropicsarah at 7:19 PM on December 3, 2013 [2 favorites]

Best answer: The pharmacy closest to my home is particularly weird about this, because they even remember my name when I need to fill other prescriptions, but they behave like it's the first time they see me every time I go for this particular med!

I know how you feel. One time my usual pharmacy was out, and when I asked them to call the nearest branch, the pharmacist told me without skipping a beat that they were out as well. I stood at the counter, called the other branch, and was told that they did have some in stock. I politely informed the pharmacist that there was some in stock, thank you very much.

Every month is a hassle, but I go back with absolute unfailing confidence time after time. You and I are doing nothing wrong. I smile at the suspicious glances, make polite small talk, and all in all act like I'm filling any other prescription. I don't let them bully me or make me feel like a criminal. If they are rude and unhelpful, I ask questions. How can I make sure this doesn't happen next time? Is there a branch that more regularly keeps in stock? Should I talk to my doctor about prescribing a different brand or dosage? etc.

I have found that some pharmacists and pharmacies are better than others, so you might want to try somewhere new. If all else fails, I would encourage you involve your doctor. Mine was appalled at my pharmacist's behavior and offered to call on my behalf if it would help. She also suggested, as someone did above, that I go to the pharmacy near the local university where her patients never had problems. Good luck.
posted by snarfles at 7:38 PM on December 3, 2013 [2 favorites]

I ran into trouble with my ADD meds being in shortage for awhile, and never had any trouble at all--zero--getting pharmacies to tell me whether Adderall was in stock, over the phone, although they wouldn't guarantee me that it still would be by the time I got there. You're sure literally all of them refuse to do that much? That would be very, very weird to me.

I will say though that I've been doing this awhile and there's never any real sign of recognition from the pharmacists, I don't think that chains really tend to get people who care enough to pay attention to the fact that you've been there every month for the past six months.

If you can split pills, I would encourage looking into whether you can manage okay on half doses on days when you don't have much to do, which also helped me when I couldn't find it anywhere. I didn't really consider raising the issue of asking for a higher dosage from the doctor, but I'm not sure I would have been comfortable with that, personally.
posted by Sequence at 7:46 PM on December 3, 2013

Response by poster: I already cut my doses, this is how I try to manage but it's not enough. And it may be a new or local policy, but it is not okay to give narcotic stock information on the phone here in VA.

They do remember my name the times I am getting other prescriptions filled, which makes me think they have a beef with this particular one. To tell you the truth they make me feel like an addict when I deal with them.

Thanks everyone! I marked all suggestions I am trying and will report back!
posted by Tarumba at 7:58 PM on December 3, 2013 [1 favorite]

Best answer: And it may be a new or local policy, but it is not okay to give narcotic stock information on the phone here in VA.

Dexedrine is a Schedule II non-narcotic, if that matters.
posted by snarfles at 8:37 PM on December 3, 2013

Best answer: I got sneery shit all the time from CVS and Duane Reade when filling Adderall prescriptions and now only the fancy compounding pharmacy gets my business. Every employee there knows my name and the specific brands I prefer and the direct contact info for all my doctors if something looks amiss on my prescriptions. Fuck big chain pharmacies forever.

Also, if your doctor does not give you a few months worth of prescriptions dated a month ahead for each, you should get that sorted out ASAP. I have 4 months worth of scripts stuck to my fridge right now.
posted by elizardbits at 8:39 PM on December 3, 2013 [3 favorites]

Also, if you happen to be on any kind of government assistance healthcare, this plus the additional imagined stigma of taking a tightly controlled medication will cause all kinds of stupid ignorant judgement from people; pharmacists are no exception to this icky bit of human nature.
posted by elizardbits at 8:41 PM on December 3, 2013 [1 favorite]

Is Dexadrine expensive? If it is, you're pretty limited to using whatever pharmacy costs the least, I suppose, but if it isn't, by all means get yourself to a small, independent pharmacy and have a conversation with the pharmacist there. Let him know what you've been going through, give him your physician's phone number and fax number and get your script faxed to the small pharmacy several days in advance of when you actually need the medication. I get wonderful help from my local independent pharmacist who keeps my prescriptions up to date, contacting the doctor for refills in advance of when they're going to be needed, so I'm never running out of medications or needing to ration them out.

There is no way you, or anyone else, should be having to cut back on their prescribed medications because the pharmacy just doesn't get around to keeping their stock filled - that's the poorest sort of business. Your prescriptions are written by a physician, and that physician's orders are what the pharmacist should be following, period.

I can see, though, that a pharmacy may not want to confirm over the telephone that they have any quantity of a controlled substance in stock - for their own safety - and the same is true when you're standing in line with your prescription amongst a dozen other nosy people. There's a lot of risk to pharmacy personnel in today's world. Having your physician fax the script to the pharmacy directly each month - even if you have to call their office and remind them to do it - eliminates the problem and all you have to do is pick up the meds and pay for them and no one in line is any the wiser about what exactly you're getting.
posted by aryma at 9:03 PM on December 3, 2013

Best answer: I also wonder if the home delivery services online can help me, but I'm not sure they deal with controlled medications.

Okay, so there's two sorts of service you might be talking about here.

There's grey-market overseas pharmacies like Inhousepharmacy, which are borderline-legal ways of buying medications without showing a valid prescription ahead of time. Ordering Dexedrine from one of those seems like really terrible idea, if it's even possible at all. (I can't imagine it would get through customs anyway...)

But then there's also totally legitimate mail order pharmacy services inside the U.S., most of which seem to be run by insurance companies themselves. If you've got insurance with prescription drug coverage, and it gives you access to one of these, then definitely look into using it.

I have gotten my Adderall prescription filled this way (so it can be done!) and it was... definitely not perfect, but better than dealing with shortages at local pharmacies a few years back when Adderall was scarce. You will need to mail them your prescription, and you will need to sign for the delivery in person when it arrives.

Also — often mail-order pharmacies will let you get a 90-day supply of a medication rather than a 30-day supply. And astonishingly, this can even be done with schedule II meds if everyone cooperates. You need a doctor who's willing to write a 90-day prescription (many refuse) and an insurance company that's willing to cover a 90-day supply (most do but I gather that some don't).
posted by Now there are two. There are two _______. at 9:27 PM on December 3, 2013

Go to an independently owned pharmacy. They will be eager for your business and will certainly learn your regular schedule better than a mega-chain.

During the Adderall shortage I tried this route and was told by a few places they were prioritizing their regular customers and did not have enough to fill the scripts of new customers, so if, as someone else suggested, there is a shortage then this might be a problem.

What did work was having my doc's office call a local pharmacy they had a relationship with and the pharmacist even put enough aside for me to pick up immediately. It happened to be an independent pharmacy, but that was because it was the cheapest of the few they called.
posted by Schlock Puppet at 11:51 PM on December 3, 2013

Best answer: I work at a pharmacy that you have mentioned (can't say which one, but it starts with a W and and with an s), I am not a pharmacist but I work closely with them as part of the management team.

I don't understand why they would not tell you if a medication is in stock over the phone. We have no policy against that. A call to corporate (1-800-Walgreens) with the name of the store and a firm complaint against this should fix the problem as far as that goes. I can't guarantee what will happen, but usually corporate sends you a gift card in the mail and the store manager calls to tell you we appreciate your business and the pharmacy gets called out. Which it sounds like they need to be.

We have had our dispensing policy for controlled medications change recently, as per federal and state guidelines. What we follow is now called a Good Faith Dispensing Policy, which means that we will work closely with the FBI to monitor drugs at-risk for abuse and fill prescriptions only for those that we can say, "in good faith," are not being abused. This means that sometimes it takes longer to fill prescriptions depending on the state that they're filled in, as for some drugs we have to send the information to a clearinghouse that checks to make sure the patient hasn't committed prescription fraud in the past. It also means that we are being limited as to the number of pills we can actually order at a time.
It is a nightmare for everyone involved and we do our best to make sure we have the drugs in stock when we need them, but sometimes we simply aren't given them no matter how many times we order them.

It comes up as a red flag in the system if you have jumped pharmacies frequently or if you have had the same prescription from different doctors. That isn't to say that what you're doing is wrong in any way- I certainly would have taken my script elsewhere- but the computer thinks that it is a sign that you could be shopping around to abuse or sell the drug.

Between the FBI sending us firm letters on how many drugs we are filling and the Pharmacy Board looking into the heightened sales of narcotics, some pharmacists are becoming too paranoid about which scripts they sell. They might be turning you away not because they don't have the medication in stock but because they think you might be abusing it.

Still, there should be no reason why they can't work with you on the matter. Call corporate. Tell them that you are trying to get your drugs and that no one is helping you. I can tell you that the more calm and reasoned your complain is, the further it will go. Think "I have tried many times to fill this script and no one is helping me. I have even tried to come on days when you get your shipment and no one will help me out." versus "You guys suck and I hate you and I'm never shopping there ever again!!@!@!!" even if what you feel is more like the latter.

I can also tell you that, at least in our area, the overnight pharmacists are usually more reasonable than the dayside ones. I'm not sure why this is, it might be because we have more time to sit down and talk to the patients, but you could try coming in- and do come in the store if you possibly can- and explain what's going on and see what they can do for you.

I'm truly, truly sorry that you have been experiencing this. I wish that the problems surrounding controlled drugs weren't so great, but there's no reason why you have been treated like this.

Let me know if you have any questions. I don't know what I can do, but I might be able to put you in contact with the right person to help you in your area.
posted by shesaysgo at 4:27 AM on December 4, 2013 [9 favorites]

And just to remind you, for CII scripts like dexedrine we cannot accept a faxed prescription. You must have the original physical copy for us to fill.
posted by shesaysgo at 4:28 AM on December 4, 2013 [1 favorite]

Best answer: I've gotten my Concerta through a mail-order pharmacy, and had zero problems. The biggest issue I had is that in order to do the mail-order, I had to have a 90 day script. The mail order pharmacy I used was through my insurance company, and about 2/3rd the price of filling my script at Walgreens.

I'm in NY, so I don't know if the laws are different here, but my doctor can call in a five day supply of Concerta to my pharmacy, no paper prescription required. It's only five days worth, but it can be helpful if I run out before I can make an appointment.
posted by inertia at 10:12 AM on December 4, 2013

Best answer: Do you have health insurance? I also recommend trying your mail-order pharmacy through your health insurance. This has worked for me for a similar ADHD medication with paper script and supply issues, using Caremark (CVS). They fill 90 day scripts. If I am not home to receive the package, I have to pick it up at the post office and provide an ID and signature. (In case you have the same mail order provider as I, they also require a prior authorization call or form from the doctor, which covers a year. I don't know if that is a particular of the mail order part or what.)
posted by ArgyleMarionette at 10:34 AM on December 4, 2013

Does your doctor have you on the brand Dexedrine? Maybe asking for generic substitution would help. Also if you take your paper script in a few days before you need to come back to pick it up that would work too. Most pharmacies I've been in only order their CIIs once a week, unlike the other meds they get in daily.

You could ask your doctor to give you three months worth of paper prescriptions (like, 3 slips of paper) so you don't have to go to the office every month, but there are of course rules about that, and your doctor might say no. It might make it a little easier so you could go to the pharmacy before you run out. And I'd explain to the pharmacy that they are frequently out of stock but you'd like to keep coming back each month to fill your prescription.
posted by eldiem at 11:15 AM on December 5, 2013

Response by poster: update time!

Target worked wonders!

Also, I spoke to my doctor and he gave me a 90 day prescription I can fill through my insurance and they will MAIL me the meds! Which is practical and way cheaper, because I get to pay one copay instead of three.
posted by Tarumba at 4:08 PM on December 20, 2013 [1 favorite]

Response by poster: Also, thank you for the insight, Shesaygo...I was debating whether to write them a calm and zen complaint letter but I kind of put it in the back burner when the problem got solved.
posted by Tarumba at 4:16 PM on December 20, 2013

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