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Walmart announced Monday the retail giant will begin to restrict opioid prescriptions to help stem the deadly drug epidemic.
"Walmart and Sam's Club pharmacies are set to limit customers' acute opioid prescriptions to a seven-day supply, with up to a 50 morphine milligram equivalent maximum per day, the company said in a news release.
The new rules align with the Centers for Disease Control and Prevention's guidelines which suggest "three days or less will often be sufficient" for those prescribed the painkillers, and "more than seven days will rarely be needed."
foxnews.com/health/2018/05/07/walmart-to-limit-opioid-prescriptions-at-pharmacies-amid-epidemic.html
[Ed Note - This is for initial acute opioid prescriptions only meaning short duration as opposed to chronic or long term prescriptions or courses of treatment.]
(Score: 4, Funny) by AssCork on Wednesday May 09 2018, @01:57PM
Ah, "acute" vs "chronic" - so no "new druggies" only "established druggies" will be permitted. Nice.
Just popped-out of a tight spot. Came out mostly clean, too.
(Score: 0) by Anonymous Coward on Wednesday May 09 2018, @01:57PM (21 children)
So Walmart is arrogating to itself the right to change a doctor's prescription?
(Score: 0) by Anonymous Coward on Wednesday May 09 2018, @02:02PM (20 children)
Doctors are part of the problem here. Ever heard of kickbacks?
(Score: 5, Insightful) by Runaway1956 on Wednesday May 09 2018, @02:19PM (19 children)
You're not wrong, but you're not entirely right, either.
The pharmacist's job is to full prescriptions. The doctor decides what you need, how much, and how frequently you should take it. If there is any question from the pharmacist, he need only pick up a phone to verify what is on the prescription. If, on the other hand, the pharmacist is half sure (or more) that the doctor is part of the problem, THEN the pharmacist need pick up the phone, and talk to the law.
Yes, doctors are part of the problem. But, that doesn't give a bunch of asswipes in Northern Arkansas the right or the authority to override the doctor's decisions. WTF does any Walton know about suffering? If they get the teeniest little headache, they can rest their tiny little heads on cushions stuffed with hundred dollar bills, left to them by Old Man Sam. And, you can bet your ass that they get all the drugs that they need or want.
(Score: 1, Informative) by Anonymous Coward on Wednesday May 09 2018, @02:21PM (4 children)
Don't get me wrong, I completely agree with you. I was just pointing out that you shouldn't give doctors 100% trust just because they are doctors. There are problems in many other areas too.
(Score: 0) by Anonymous Coward on Wednesday May 09 2018, @02:42PM (3 children)
well, you're the one who decided to phrase it as if you were arguing. it doesn't matter if doctors are "part of the problem". the point was whether freaking walmart should be overriding doctor's prescriptions, basically.
you shouldn't need a prescription for anything. it should either be legal or not and everything(i'm not going to think of all the possible exceptions. if you think of something legitimate, good for you.) should be legal unless there's fraud or actual force involved. all of this control is un-american.
(Score: 2) by Immerman on Wednesday May 09 2018, @03:51PM (2 children)
Would you extend that to antibiotics - those drugs whose over- or under-use both increase antibiotic resistance in the microbial population, so that the entire human population suffers from less effective antibiotics because Jane Average wants to take antibiotics for her cold or flu (or any other viral infection, against which antibiotics are useless)
(Score: 1, Insightful) by Anonymous Coward on Wednesday May 09 2018, @04:33PM (1 child)
The consequences of that are significantly different from the consequences of opioids. The problem with this hysteria is that we're going from one extreme (too many people prescribed opioids for frivolous reasons, etc.) to another extreme where it's hard to get opioids even if you're in extreme pain and they're the only thing that helps.
(Score: -1, Troll) by Anonymous Coward on Wednesday May 09 2018, @06:28PM
If you need drugs to continue living then you are devil spawn who is better left to die in a gutter!
Just ask Jesus, he only turned water to wine as part of God's Honeypot program with Satan. That is why Christians don't get along with Catholics so often, the whole wine / communion thing. Druggie cannibals, how uncouth.
(Score: 1) by nitehawk214 on Wednesday May 09 2018, @02:32PM (10 children)
The problem is that doctors fuck up... constantly. Pharmacy systems catch a lot of drug interaction warnings that doctors simply miss. Also, they can catch things like "doctors A, B, and C, independently prescribed oxycontin for this patient" Those three doctors did not know about each other because the "patient" failed to mention it. Of course if they had taken these to three different pharmacies they might get away with it.
But you are right in that it isn't as simple as "pharmacists rule doctors drool" or "pharmacies should just dispense as many pills as the piece of paper says, why would they turn down money?" Some people simply need a metric ass-ton of pills because our healthcare system wont pay to deal with chronic issues... or there just isn't a treatment available.
Clearly this is just an effort by Walmart to get people that want lots of pills to go to a different pharmacy so that when public outcry rises up, they can point the fingers at their competitors. Hey, maybe that can drive the last few non Walmart pharmacies in town out of business. Win-Win.
"Don't you ever miss the days when you used to be nostalgic?" -Loiosh
(Score: 2, Interesting) by Anonymous Coward on Wednesday May 09 2018, @02:47PM
yes, and walmart has a long history of totalitarianism in the guise of patriotism. they were one of the first big companies to sign up for the "if you see something, say something" campaign from your pals at the Dept of Faderland Tyranny.
(Score: 4, Insightful) by Thexalon on Wednesday May 09 2018, @03:30PM (4 children)
It's also important to note that there's no bright line between somebody with a legitimate medical need for painkillers, and somebody addicted to opioids. A lot of the efforts to try to combat heroin (which I'm generally for since I've lost 3 acquaintances already to it) are trying to draw that line, but there's no clear way to do it.
For instance, I know a guy who is on just about every painkiller under the sun due to his chronic back problems. He has received the best treatment they can manage for his condition, involving multiple surgeries, but the treatment mostly focuses on keeping his legs functioning and still leaves him with lots of pain. So definitely a legitimate medical issue. But if you talk about even considering forcing a reduction in his prescription due to the addictive aspects of what he's taking, he starts sounding not much different from a drug addict worried about losing his supply, and I have little doubt that if his prescriptions were cut off he'd at least consider getting something on the black market.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 4, Interesting) by HiThere on Wednesday May 09 2018, @05:30PM (3 children)
And, of course, the problem is worse than that. He doesn't just sound like a drug addict, he *is* a drug addict. It may have been caused by a treatment for pain, but that's orthogonal.
Another problem is that opioids are terrible for chronic pain. After awhile they essentially become less useful than aspirin...but by that point you're addicted, so there's additional pain over quitting. And at least some people become sensitized in a way that increases the baseline level of pain.
AFAIK there *isn't* a good treatment for chronic pain. Well..... A few decades ago I read that LSD had been used successfully to treat the pain of terminal cancer patients. It didn't actually kill the pain, but they stopped caring. Possibly extensive training in mindfulness meditation would work, but I believe that that years (or decades?) of training, and you need to start ahead of time. There have been reports from China that proper acupuncture can eliminate pain sufficiently to allow major medical operations...but I haven't even trusted it for minor pains. That would clearly depend a great deal on the skill of the practitioner. It would seem like magnetic induction on the neurons should do the job quickly, but I haven't heard of that being experimented with, and I have no idea what it would do as a long term treatment. Then there's always an injection of lidocaine into the appropriate neural connections. That works, and if done properly a single shot is reportedly good for days, but it's really intrusive, and you've got to get the right spot every time...over and over.
IOW, AFAIK there *isn't* a good treatment for chronic pain...or at least not one that's quick and legal.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2, Informative) by Anonymous Coward on Wednesday May 09 2018, @06:27PM
This article: https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-germany-vicodin.html [nytimes.com]
isn't specific to opioids, but does show, to me, why Americans are in such a mess with this. And, having living in Europe for a long while, I can echo a lot of this article. The doctors in europe have a different mentality. Americans want to cover the pain and forget about the underlying issue causing the pain.
(Score: 4, Insightful) by sjames on Thursday May 10 2018, @12:01AM (1 child)
Sure, there aren't good treatments for chronic pain, so what do you suggest? Blow their heads off with a shotgun or just deal with the fact that acciction is their best option?
Even if there was some sort of "super aspirin" that had no side effects, zero addictive properties, and perfectly eliminated any pain, chronic severe pain sufferers would still be effectively addicted to it. They wouldn't dare miss a dose or they would experience searing agony until they got their fix. They would be addicted in the same sense that a type 1 diabetic is addicted to insulin.
We need better treatments for pain, but until they get here, we need to not screw with people who already have enough problems. Perhaps we could bump up the schedule and move on to the next moral panic. Perhaps over-loud stereos, stinky colognes, or farting in the elevator.
(Score: 0) by Anonymous Coward on Thursday May 10 2018, @01:53PM
True, true.
But, what is it about either Americans or American medicine? You don't see these issues in Europe. Are Americans wimps, or do Europeans just cope better with pain, or are the practices in Europe better?
(Score: 2) by frojack on Wednesday May 09 2018, @08:25PM (3 children)
Read the last sentence in TFS: Maybe click the link in that sentence.
[Ed Note - This is for initial acute opioid prescriptions only meaning short duration as opposed to chronic or long term prescriptions or courses of treatment.]
Walmart's action refers to the broken arm, the surgery recovery, etc: initial acute opioid prescriptions.
This has nothing to do with the patient under long term pain management patient by a doctor in that field.
Haven't you heard? Obama care solved all these issues.
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(Score: 3, Insightful) by sjames on Thursday May 10 2018, @12:29AM (2 children)
There are some injuries out there where it doesn't take a genius to predict that the severe pain will last longer than 7 days. People in that situation are exactly the people who don't need to be dragged out of the house for an unnecessary doctor visit so they can get a refill on an unnecessarily short supply of medication.
The determined abusers manage to get their fix even while in prison. They'll get around this too. The people who get the shaft here will be those who have a legitimate need.
(Score: 0) by Anonymous Coward on Thursday May 10 2018, @01:58PM (1 child)
I know a person that works as a receptionist at a dentist office. 75% of the calls and walk-ins, 75%!!!, are people trying to get "meds". This is in an area that is the news quite often for opioid related issues.
(Score: 2) by sjames on Saturday May 12 2018, @08:20PM
I'm not all that surprised. However, the Walmart policy isn't going to do anything to address that.
(Score: 3, Informative) by frojack on Wednesday May 09 2018, @08:12PM (1 child)
Actually I suggest you have a mistaken understanding of a pharmacist's job, or the training involved, and the laws they must follow:
They generally know more about drugs than the doctors prescribing them.
Further, the federal laws and state laws impose a duty not to fill prescriptions they know to be illegal or dangerous, even if a phone call to the doctor results in confirmation. Especially in cases of suspected "doctor shopping"
Texas examples here: https://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/conf_2012/sept_2012/houston/gdodson_1002.pdf [usdoj.gov]
Here's a summary of various state laws, pay attention to part III: Obligation of Pharmacists to Decline to Fill or Refill Prescriptions
http://www.namsdl.org/library/171EFA8E-19B9-E1C5-3193B89790E83B30/ [namsdl.org]
No, you are mistaken. I've always had this sig.
(Score: 2) by Runaway1956 on Thursday May 10 2018, @01:37AM
That is when he picks up the phone I mentioned, and instead of calling the doctor, he calls the law. He probably doesn't dial 911 in this instance, instead dialing the nearest office of the state police. Regular beat cops probably aren't trained or equipped to deal with a doctor abusing prescriptions. But, the pharmacist almost certainly knows which local agency is trained and equipped to deal with such a case.
However, the pharmicist with the script in his hand is the proper person to make such a determination. Not a bunch of hillbilly corporate heads in a building overlooking I-49 in northwest Arkansas.
Those corporate heads are only interested in public opinion and profit - they have no idea how legal any particular prescription might be.
(Score: 2) by digitalaudiorock on Wednesday May 09 2018, @10:15PM
I actually mostly agree with this in principle. Here's a rather astonishing and similar scenario however: I know someone who lives in Georgia. You can get whatever absurd Oxy prescription that any doctor wants to give you filled, yet my friends wife cannot get prescriptions for allergy meds filled due to state law because they can theoretically be used to make meth! The irony is almost painful.
(Score: 3, Interesting) by All Your Lawn Are Belong To Us on Wednesday May 09 2018, @02:58PM (4 children)
ADA Lawsuit for unlawful interference with a person's diability coming in 5... 4... 3... 2...
This sig for rent.
(Score: 2) by DeathMonkey on Wednesday May 09 2018, @06:00PM (3 children)
Disabilities are chronic, not acute, so they shouldn't be affected.
(Score: 2) by DannyB on Wednesday May 09 2018, @06:28PM
Do you think Walmart knows the difference between the two?
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2) by All Your Lawn Are Belong To Us on Wednesday May 09 2018, @10:37PM
Maybe not. [disabilitysecrets.com] There appears to be some law that timing has little to do disability but severity does. [laborandemploymentlawcounsel.com] All it should take is a particular case where the person was unable to refill after seven days either because of pharmacy refusal or patient leaving the area of the pharmacy and needed a longer supply.
What this does is take the choice out of the physician's hands. As above, physicians can make errors. But neither the pharmacist nor the federal government should be allowed to have control of what the physician's treatment options are. If there is any regulation it belongs at the state medical board level. As some states do, maintain registries at the state level, [wi.gov] and some of them require practitioners to check and document the checking [ilpmp.org] in the state's database. Then hold providers accountable in cases of opiate deaths where overprescription happened.
I also wonder what this will do to things like hospice care, which is not acute care but I'll bet there will be screwups where this will be interpreted as "every initial prescription fill." Physicians do not have to include diagnoses on their prescriptions, generally. (They have to document them.) So, more work for the physician's staffs, also.
This sig for rent.
(Score: 2) by All Your Lawn Are Belong To Us on Wednesday May 09 2018, @10:39PM
And one other thing now that I think of it.
You go to urgent care for your condition. You're told to follow up with your PCP. You call the PCP's office. "Nope, two weeks is the earliest we have, sorreeee!"
Now what? Well, you go back to the urgent care, and pay another visit fee to see if you can get an extended supply. Another $100 plus drug co-pay, please.
This sig for rent.
(Score: 0) by Anonymous Coward on Wednesday May 09 2018, @03:18PM
That way the price and demand on the street soars, along with various crimes for the users to afford their habit, as well as an increase in private prison repeat customers.
(Score: 2) by Hartree on Wednesday May 09 2018, @04:13PM (1 child)
A company internal policy overrides a doctor's prescription. How is this different from a small drugstore refusing to fill a birth control prescription?
I realize there is a problem with opioids, but this borders on crossing the boundary from pharmacist to practicing medicine in much the same way that insurance companies are effectively over-ruling treatment decisions by being able to decide what will be covered and not and have the decisions made by people who are not licensed physicians.
(Score: 2) by AssCork on Wednesday May 09 2018, @06:11PM
A small unincorporated business is not afforded the same legal protections of "personage" as a full-fledged corporation.
A corporation can refuse to do something that conflicts with it's religious beliefs, however other legal entities (eg a "Trust", "LLC", etc) will have to fight for that right (and win) in court.
Just popped-out of a tight spot. Came out mostly clean, too.
(Score: 2) by DannyB on Wednesday May 09 2018, @06:27PM
First, I have to spot one of the unhelpful, unfriendly droids with the blue smok that says: How May I Hurt You?
Hey, I have a question.
Suppose I fill my Hydrocodone in 30-tablet bottles which constitutes a supply of anywhere from 5 months to 11 months? How would you quantify what is a seven day supply? Especially since when I take it or how much is unpredictable?
Thanks for your unhelpfulness!
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2) by krishnoid on Wednesday May 09 2018, @07:24PM
We appreciate your hard work in stemming this epidemic. Have you thought about using your almighty powers to legalize cannabis [cnn.com] to help even further? Or maybe offer needle exchanges so people who turn in a dirty needle can get an acupuncture needle to self-administer pain relief?
I bet the American people would totally get behind you on all of these suggestions. At least it would help hide some of those silly Russia problems in the news cycle.
(Score: 3, Informative) by Revek on Wednesday May 09 2018, @09:45PM
My son takes two schedule two medications. We had to stop using walmart to get them filled since they said they don't keep them in stock if they don't any remaining prescriptions on file for them. Just in case you don't know, schedule two drugs require a written prescription and cannot be filled for more than thirty days. As a result walmarts policy guarantees that you will have to wait an additional 4 to 7 days to get these type of prescriptions filled there. I switched away from them for the four generics drugs I take daily and saved 40 dollars a month. In short walmart is the worst place to get a prescription filled. This policy is ridiculous since an initial prescription probably is a result of injury. Whereas a ongoing prescription is a sign of abuse.
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