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I hope this does not offend anyone who is a pharmacist or otherwise knows a pharmacist well. There are those on the board who will know more about this law. My question is this a new law or an existing one that Walgreens is just now acting upon.

I understand the need to police controlled substances. But, I do not see how pharmacists will know what conditions require what medications. Up until now, pharmacists have only questioned amount given, contraindication, allergies, etc. and have been very good at that. I simply don't see how I am going to have the time or the desire to convince a pharmacist why my patient needs a particular drug. I suppose depending on whether this is a new thing that only Walgreens is instituting, my only recourse would be to send the patient to a different pharmacy. It won't be an issue with MaineCare as they are only allowed 15 days of opiates per year. That makes it rather easy.

Walgreens wants to ensure that our patients continue to have access to the medications they need while fulfilling our role in reducing the potential abuse of controlled substances. Our intent is to
partner with you to ensure that patients receive their appropriate therapy and that the necessary information to confirm the appropriateness of the prescription is documented to satisfy DEA
requirements. This process is designed to protect both you and the pharmacist.

According to Title 21 of the Code of Federal Regulations, section 1306.04, pharmacists are required by the DEA regulations to ensure that prescriptions for controlled substances are issued for a
legitimate medical purpose. The regulation states the following:
A prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his
professional practice. The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription. An order purporting
to be a prescription Issued not In the usual course of professional treatment or In legitimate and authorized research Is not a prescription within the meaning and Intent of section 309 of the Act (21 U.S.C. 829) and the person knowingly filling such a purported prescription, as well as the person issuing it, shall be subject to the penalties provided for violations of the provisions of law relating to controlled substances. Our pharmacists are required to take additional steps when verifying certain prescriptions for controlled substances. This verification process may, at times, require the pharmacist to contact you for additional information necessary to fill the prescription. While the information requested may vary, potential
questions could include information about the diagnosis, ICD-9 code, expected length of therapy and previous medications/therapies tried and failed. Privacy laws allow you to share this information with
another healthcare professional who is providing care to the patient.
We realize that this process may generate questions and concerns from both you and the patient and we will do our best to respond in a professional and courteous manner. We recognize that sharing
appropriate information with our pharmacists may require additional time from you or your office staff and we want to thank you in advance for partnering with us to provide the best care to our patients.
Be well,
Your Walgreens

The tide has turned. When I started it was all about treating the 5th vital sign of pain. Now that hydrocodone can go for $20+ a pill and generate the crime needed for that, our priorities have changed.

To me this is a business strategy to position Walgreen's on the right side of the tracts. This may do more to help Walgreens recruit and retain pharmacists than anything they could do besides double salaries. Do you want to deal with narcotic abusing patients all day long? Make it difficult and let them go to CVS.

We use some kind of pain treatment for just about all our patients, but we refer the "demanding" pain patients to the pain management doctors. We started using a controlled medications agreement for all controlled substances. The primary doctor and pharmacy get a copy. We only give 3 months of Rx for schedule 3-5, and only 1 month for schedule 2 drugs. We will not call in Rxs for controlled meds, they have to have an appointment.

Very inconvenient for the patients I trust.

All of these policies in our office got developed and started last year because the hand writing was on the wall from the government. When California started wanting continuing education in pain management, you knew a change was coming.

Thanks Dan. I agree. I really wish the government would stay out of medicine, but that seems to be long gone.

I don't mind MaineCare telling me 15 days a year without a PA. Or any other stipulation the government comes up with. But, I am just not going to enter a dialogue with a pharmacist so he/she will agree to why my patient needs Vicodin.