Posted by 3 Beer Effect on May 17, 2002, at 10:53:31
Questions for anyone with Schedule II prescriptions (ADD stims, "oxy" morphine painkiller derivatives like Percocet etc):
The DEA rules are kind of confusing to me. I live in Texas, where I believe for schedule II prescriptions the standard rules apply such as triplicates, must fill within 7 days, can only dispense one month supply at a time etc.
But went I was in college in Austin, I had a friend whose Primary Care doctor (in Houston) would mail him Adderall 20 mg. I'm fairly sure that he meant that his doctor mailed him the actual Adderall & not a prescription, b/c I asked him about it twice, but could be wrong. But he also had know his doctor all his life since he was a child. I guess how a doctor wants to prescribe & "bend" the rules/follow loopholes depends a great degree on the level of trust & how long you have been his patient.
Also, when I first started taking Ritalin 20 mg bid from my primary care physician I had HMO Blue Insurance. For some reason, HMO Blue would allow my doctor to write for a 3 months supply of Ritalin (& i'm assuming other schedule II stims) and it would be covered & I was charged 3 copays. I don't know where I read or heard about this special HMO Blue policy (I think either my doctor told me or it was on there website or policy book somewhere), but I did this for over a year with no problems. He would write the prescription for dispense #180 and of course there would be no refills which aren't allowed, but I would get a big bottle of 180 20 mg Ritalin from Eckerd's- who knew it was a three months supply because I told them & they would charge me 3 copays. (there's a tiny chance this might have been Prudential HMO insurance but I'm almost positive I had HMO Blue at that point).
So does HMO Blue allow 3 months of ADD schedule II stimulants, or just Ritalin in particular, or is Eckerds just the lousy/unknowledgable drug store chain I suspect it is? (the 1st time I got a Remeron, & later a Klonopin prescription they had neither). I know go to Walgreens which is much more professional, always has what I need in stock (even slower selling things like Dextrostat (the other 'sort of a name brand' Dexedrine) 10 mg tablets #120/month. BUT Walgreens is very strict about following the rules/state laws, so I don't want to ever have my psychiatrist write a three month supply & have them turn it down- I would have to drive all the way back to his office 35 minutes away in Dallas to get a new prescription cause they can't call in Schedule II stimulants like Dextrostat. At my Walgreens, I've seen several middle-aged professional/wealthy people (e.g. productive law-abiding citizens) where their doctor wrote a prescription for hydrocodone (Schedule III) & they said they would like the name brand Vicodin instead & Walgreens flat out turned them down every time.
On a slightly entertaining side note, some 'pop-culture' book I read about being a prescription pillhead/junkie called "Pills a go go" said Walgreens easily has the best security (I think atleast over $65,000-$100,00 worth or more per store) so if you break into a pharmacy (at night) or write a fake/tamper with the writing (add extra numbers/refills) to your prescription, don't go to Walgreens or you will land up in prison!I now have HMO Blue again (thank god, because I had the crapola Cigna for a few months) but have only been seeing my current psychiatrist for about 6 months. I don't think he trusts me enough yet, so I probably will have to drive back to Dallas from Austin, TX (3 hours) once a month for my ADD stimulant prescription during the Fall & Spring semester.
I would get a psychiatrist in Austin, but that is a hit or miss proposition. Most doctors hate me since "I know my stuff" about psychiatric meds. The pyschiatrist I have now is is pretty laid back, & pretty much just listens to me & says okay but also offers useful suggestions (like perhaps you should try a 1 month trial of Concerta, then Adderall, then Focalin this summer & then pick which one works best) which is nice. He is also the only non-benzophobic doctor i've ever ran into. For my social phobia he prescribed 4 mg/day of Klonopin without me even asking (which is the high end of the 2-4 mg/day recommended Klonopin (divided tid) Social Phobia dose range. I was quite taken aback- eventually 4 mg of Klonopin was too much- couldn't get out of bed in the morning because the 2 mg bedtime hypnotic dose was too much & lasts too long. I switched to currently 1 mg breakfast, 1 mg lunch, & 1 mg when I get off work (8 pm) to ease work related anxiety & to help my hypnotic Sonata 10 mg work (As I soon found out Sonata is so lousy it won't work by itself- I plan to switch to Ambien 10 mg ASAP).
My previous psychiatrist (in Austin) was "benzophobic" & "ADD stimulantophobic" so I had to quit the best anti-depressant I have taken to date, Zoloft 100 mg, because of simple but quite severe insomnia. He wouldn't provide more than 0.5 mg per day of Klonopin! I had to pull teeth & show him medical literature from Roche saying doses below 1 mg are worthless/no diff than placebo to get him to bump it up to 0.5 mg 2x per day! I probably could have stayed on Zoloft by taking Ambien at night & lowered the Zoloft to 75 mg but that's all in the past- I didn't really know anything about psychopharmacology back then.
Sorry for rambling, but the short version of this overlong essay is this important question-
Does HMO Blue have a special policy of allowing the doctor to write 3 months of ADD Schedule II stimulant medications, or just Ritalin, or did my doctor & Eckerds pharmacy just not know what the heck they were doing?Thanks,
3 Beers
poster:3 Beer Effect
thread:106771
URL: http://www.dr-bob.org/babble/20020517/msgs/106771.html