Prescription Medicine - refill on board?

[notentirelynormal]

Another thought - can your doctor write your prescription for 3 times the normal use? In other words, instead of take 1 pill a day - take 3 pills a day with no refills. Then when you get home have write the proper dosage.

Edited December 27, 2013 by notentirelynormal
.

[N410MP]

Bottom line - problem solved. Thank you all very much for all the helpful suggestions.

 

Some thing that didn't work:

 

• Customer Service at HAL. The furthest I got was the phone number for their Fleet Medical Department. Always got an answering machine, and never got a returned call. So I don't know if they could have helped or not, they chose for whatever reason to not try.
  
• Filling the prescription at another US pharmacy. The pharmacies we talked to in Georgia, which is only 1.5 hours away, wouldn't. I don't know if they were aware of Tennessee's law and chose not to circumvent it, or if they are unable to fill a prescription for a Doctor from another state, or what.
  
• Filling it in another country. I attempted to contact all the pharmacies in Papeete, which is where we'll be when our existing scripts run out, and never got a response. That was a wild long shot, but tried it anyway. Might have had more luck in person, particularly if we spoke French, don't know.
  
• Using an international pharmacy chain. The only one we could find was WalMart, with their first outlet in Hong Kong. She would have been out for a month by then, and the pharmacist at our local WalMart was pretty sure he would not be able to transfer the prescription there. He'd never tried, didn't appear anxious to, and was pretty sure it wouldn't work.
  
• Writing the script for a longer time, intending to fill it in Florida upon departure. It's not real clear in the law, but our Doctor was concerned that if he wrote a prescription that he knew was illegal to fill he might be inviting trouble.
  

What finally did work was for our Doctor to write the script for a higher dose, such that we could split the pills to get the correct amount of drug per day. So instead of the 10 mg pills we want, we now have 30 mg pills. Still the same physical size, just more drug and less filler. The pharmacist was unable to claim he was out of 30 mg, and give us 3 times as many 10 mg. He tried, but can't modify the written script even for something like that. It will be an interesting exercise to 1/3 a pill that is only about 1/4" in diameter. Our Doctor had suggested this solution last summer when we first alerted him to our travel plans, but this time around we were told by his staff that he couldn't do it. I finally got suspicious that maybe staff was trying to protect their Dr, and contacted him outside of the office. That worked, and allowed him to see a little of what his staff was doing without his knowledge. That would not have worked had he not been a personal friend, one of the many advantages of living in a small town.

 

 

So thanks again for all your help, particularly Hlitner and notentirelynormal (love that handle). This situation will continue to get worse as we crack down on drug abuse, and as we continue to get older. Hopefully there will be a better solution for the next cruiser.

[NMLady]

I'm glad you finally found a solution. Buy a good pill splitter since splitting those into thirds will be a challenge. I have small pills to split in half, that have a demarcation line on them, and even with a pill splitter, sometimes I get 'crumbs' of one half.

[Sherlock43031]

your Doc could lose his license for fooling around like this and he should be damn glad his staff is discouraging to folks who ask. if I was on his staff and he called me out because I told a patient he could not do something illegal my next call would be to the Rx board. because if I know he is breaking the law and I don't report him I'm helping him. not to mention the odds of you being able to split a pill into thirds remotely accurately.

Edited December 29, 2013 by Sherlock43031

[notentirelynormal]

your Doc could lose his license for fooling around like this and he should be damn glad his staff is discouraging to folks who ask. if I was on his staff and he called me out because I told a patient he could not do something illegal my next call would be to the Rx board. because if I know he is breaking the law and I don't report him I'm helping him. not to mention the odds of you being able to split a pill into thirds remotely accurately.

 

So how would you suggest he get his life saving medication?

 

I was going on a cruise and needed a dose of diabetic medicine. It was before my "month" was up so I had to call the insurance company from the pharmacy. They kept on insisting that I could only get part of the extra. The problem is the dose comes prepacked from the manufacturer. There was a large and small container I could get. They wanted me to take the small then during the cruise get the rest of the prescription. I said, sure, no problem. Could I get the name of the person from the insurance company that is going to swim out to the ship and give me the remainder? The guy thought about it for a minute and said but that's the way it needs to be done. I said again, who is swimming out to give it to me. Then ding ding ding he got it - and approved my prescription.

 

Somewhere along the way common sense has to take over and in the OP's situation he is in a catch 22. He's not trying to skirt the law, he's trying not to die because of a law that doesn't allow for special circumstances. I hope neither you or someone you love needs medication and is unable to get it because a healthy person didn't think it out.

[dibh1129]

Call your insurance rx department and ask to speak to a supervisor. They should be able to override the refill to allow it earlier. You may need to provide them with documentation for your travel plans.

[sherilyn70]

This has been a very interesting thread since I get a class II controlled substance for pain. I cannot get it in a higher dose and split pills since it's a sustained dose. I'll have to plan ahead for June now and is good to know that.

 

Sent from my Samsung Galaxy S4

[Shmoo here]

Call your insurance rx department and ask to speak to a supervisor. They should be able to override the refill to allow it earlier. You may need to provide them with documentation for your travel plans.

 

If you had read the explanation the OP provided, it's not the insurance company that's denying the extra medication, it's the law in Tennessee. Tennessee implemented a law that those particular types of medications can only be filled for 30 days at a time.

 

Quoting the OP:

 

Our Doctor, Pharmacist and insurance company all have no problem with this. However, the Great State of Tennessee, where we live, does. They passed a law last October limiting the size of any Schedule II drug prescription to 30 days. Period. No exceptions. Our Pharmacist called the State, and was told it was a hastily constructed law, they were working on getting it amended to allow for special circumstances, but as of today there is no legal way around it.

[Sherlock43031]

wife has had 2 knee a year apart. in Ohio to get schedule II controlled substance like oxycodone, vicodin, percocet etc.. you must present a signed in blue ink prescription in person (can not be called in like most rx) and it can not contain any refills. if you need another 30 days or 10 days whatever you need a new script.

 

all of this gets reported to the Feds and a visit from them is a bad thing. as far as how he is going to get the meds he should have scheduled his trip for the following week.

 

Schedule II substances are those that have the following findings:

The drug or other substances have a high potential for abuse

The drug or other substances have currently accepted medical use in treatment in the United States, or currently accepted medical use with severe restrictions

Abuse of the drug or other substances may lead to severe psychological or physical dependence.[25]

Except when dispensed directly by a practitioner, other than a pharmacist, to an ultimate user, no controlled substance in Schedule II, which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act (21 USC 301 et seq.), may be dispensed without the written prescription of a practitioner, except that in emergency situations, as prescribed by the Secretary by regulation after consultation with the Attorney General, such drug may be dispensed upon oral prescription in accordance with section 503(b) of that Act (21 USC 353 (b)). Prescriptions shall be retained in conformity with the requirements of section 827 of this title. No prescription for a controlled substance in schedule II may be refilled.[33] Notably no emergency situation provisions exist outside the Controlled Substances Act's "closed system" although this closed system may be unavailable or nonfunctioning in the event of accidents in remote areas or disasters such as hurricanes and earthquakes. Acts which would widely be considered morally imperative remain offenses subject to heavy penalties.[34]

These drugs vary in potency: for example fentanyl is about 80 times as potent as morphine (heroin is roughly four times as potent). More significantly, they vary in nature. Pharmacology and CSA scheduling have a weak relationship.

Schedule II substances are typically only given once a month. Federal law does not allow refills to be given. If the doctor thinks it's necessary he/she can write three separate 30-day prescriptions to the patient.[35]

Edited December 30, 2013 by Sherlock43031

[Shmoo here]

wife has had 2 knee a year apart. in Ohio to get schedule II controlled substance like oxycodone, vicodin, percocet etc.. you must present a signed in blue ink prescription in person (can not be called in like most rx) and it can not contain any refills. if you need another 30 days or 10 days whatever you need a new script.

 

all of this gets reported to the Feds and a visit from them is a bad thing. as far as how he is going to get the meds he should have scheduled his trip for the following week.

Schedule II substances are those that have the following findings:

The drug or other substances have a high potential for abuse

The drug or other substances have currently accepted medical use in treatment in the United States, or currently accepted medical use with severe restrictions

Abuse of the drug or other substances may lead to severe psychological or physical dependence.[25]

Except when dispensed directly by a practitioner, other than a pharmacist, to an ultimate user, no controlled substance in Schedule II, which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act (21 USC 301 et seq.), may be dispensed without the written prescription of a practitioner, except that in emergency situations, as prescribed by the Secretary by regulation after consultation with the Attorney General, such drug may be dispensed upon oral prescription in accordance with section 503(b) of that Act (21 USC 353 (b)). Prescriptions shall be retained in conformity with the requirements of section 827 of this title. No prescription for a controlled substance in schedule II may be refilled.[33] Notably no emergency situation provisions exist outside the Controlled Substances Act's "closed system" although this closed system may be unavailable or nonfunctioning in the event of accidents in remote areas or disasters such as hurricanes and earthquakes. Acts which would widely be considered morally imperative remain offenses subject to heavy penalties.[34]

These drugs vary in potency: for example fentanyl is about 80 times as potent as morphine (heroin is roughly four times as potent). More significantly, they vary in nature. Pharmacology and CSA scheduling have a weak relationship.

Schedule II substances are typically only given once a month. Federal law does not allow refills to be given. If the doctor thinks it's necessary he/she can write three separate 30-day prescriptions to the patient.[35]

 

How would that help? OP is taking a 4 month cruise. Starting a week later (as if he could) won't change the fact that he needs medication for 4 months and the law only allows 30 days to be dispensed at a time. He can't just run home to pick up the next 30 day prescription (3 times).

 

ETA: Unless you were responding to the first original poster (who started this thread in 2011). The question at hand now was just posted a few days ago.

Edited December 30, 2013 by Shmoo here

[notentirelynormal]

wife has had 2 knee a year apart. in Ohio to get schedule II controlled substance like oxycodone, vicodin, percocet etc.. you must present a signed in blue ink prescription in person (can not be called in like most rx) and it can not contain any refills. if you need another 30 days or 10 days whatever you need a new script.

 

Schedule II substances are typically only given once a month. Federal law does not allow refills to be given. If the doctor thinks it's necessary he/she can write three separate 30-day prescriptions to the patient.[35]

 

Well this example just goes to show how things vary state to state. My doctor can fax the prescription to the pharmacy for those 3 drugs like all my other prescriptions and it can have more then one refill as the doctor prescribes, different strengths and can be in pill form or liquid. I can also get the same prescription filled by two doctors at the same time at the same pharmacy covered by the same insurance. For example, surgery with two different doctors and I only have a few pills left over from the first surgery so the second doctor gives me more. For California it is a regular prescription. It is obviously not a federal law because like I said, no 3 parter and refills are allowed.

Edited December 30, 2013 by notentirelynormal

[Sherlock43031]

Well this example just goes to show how things vary state to state. My doctor can fax the prescription to the pharmacy for those 3 drugs like all my other prescriptions and it can have more then one refill as the doctor prescribes, different strengths and can be in pill form or liquid. I can also get the same prescription filled by two doctors at the same time at the same pharmacy covered by the same insurance. For example, surgery with two different doctors and I only have a few pills left over from the first surgery so the second doctor gives me more. For California it is a regular prescription. It is obviously not a federal law because like I said, no 3 parter and refills are allowed.

 

 

what are you smoking? these post always turn into a waste of time.

[notentirelynormal]

what are you smoking? these post always turn into a waste of time.

 

I'm trying to explain to you in your narrow vision that other states have different rules. I haven't had a 3 parter prescription in over 40 years and I've had Darvocet (before they pulled it from the market) and Vicodin prescriptions several times in the past few years and my mom has had oxycodone and percocet a lot and never ever needed a special restricted prescription. I can't help it if you aren't as informed as you think you are.

 

It appears that the STATE the OP lives in has strict rules for certain drugs limiting them to a 30 day prescription. Period. No exceptions. No way to allow exceptions if you are going to be out of the area for an extended period and your doctor can't help and you can't pick it up in the foreign countries he's going to.

 

You, yourself, submitted an example where you can use different methods to get more by using different methods or strengths. It won't work for this guy because his STATE has declared it illegal so his doctor can't write the "out of state" prescription. We don't know what drug he is using BUT the three you listed are not that special in California. I don't care if you don't believe that the doctor could write me a prescription for 2 pills every four hours for 30 days with refills and it would go over just fine. It's a fact. Sure every state has to follow the rules but the rules are based on the state's requirements - not federal. That's what started this thread - the STATE denying the guy, not the Federal government. He could get his prescription in a different state but he'd have to get a different doctor.

[sherilyn70]

Well this example just goes to show how things vary state to state. My doctor can fax the prescription to the pharmacy for those 3 drugs like all my other prescriptions and it can have more then one refill as the doctor prescribes, different strengths and can be in pill form or liquid. I can also get the same prescription filled by two doctors at the same time at the same pharmacy covered by the same insurance. For example, surgery with two different doctors and I only have a few pills left over from the first surgery so the second doctor gives me more. For California it is a regular prescription. It is obviously not a federal law because like I said, no 3 parter and refills are allowed.

 

That's great that your doctors can do that, but most states have laws against that. In Ohio I cannot get more than 30 days of oxycontin at a time, the prescription cannot be called in and it cannot have refills. I have to see my doctor in person to get it refilled even though they know it's for my cancer.

 

Sent from my Samsung Galaxy S4

[Sherlock43031]

Well this example just goes to show how things vary state to state. My doctor can fax the prescription to the pharmacy for those 3 drugs like all my other prescriptions and it can have more then one refill as the doctor prescribes, different strengths and can be in pill form or liquid. I can also get the same prescription filled by two doctors at the same time at the same pharmacy covered by the same insurance. For example, surgery with two different doctors and I only have a few pills left over from the first surgery so the second doctor gives me more. For California it is a regular prescription. It is obviously not a federal law because like I said, no 3 parter and refills are allowed.

 

http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml

Can a Schedule II controlled substance prescription be refilled?

 

No. Prescribers should mark zero (0) or no refills (NR). The new tamper-resistant forms include an area for refills because the form can be used for any controlled or non-controlled substance prescription

 

in the same link is another link to a list of schedule 2 drugs.. I'll assume you can read it for yourself.

Edited December 30, 2013 by Sherlock43031

[notentirelynormal]

http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml

Can a Schedule II controlled substance prescription be refilled?

 

No. Prescribers should mark zero (0) or no refills (NR). The new tamper-resistant forms include an area for refills because the form can be used for any controlled or non-controlled substance prescription

 

in the same link is another link to a list of schedule 2 drugs.. I'll assume you can read it for yourself.

 

I will inform all my doctors that you know more then them and that they should be arrested for their ignorance. I will also advise Costco and Blue Cross they are wrong too. Has it occurred to you that in California it's just possible that those drugs aren't considered a Schedule II controlled substance. I have zero interest in reading the entire link you sent. I'm just giving you my experience. Apparently you can't accept that.

 

Sherilyn70 - I could easily call my doctor on the phone and say I wanted more Vicodin and they would refill my prescription without a visit. I've never used the other two but my mother has and I don't believe she would have to go in either. The doctor already knows her issues (from doctor and hospital visits) so they would just prescribe it for her if she had issues - except her issues often need hospitalization. Clearly California has different laws then other states.

[Sherlock43031]

I will inform all my doctors that you know more then them and that they should be arrested for their ignorance. I will also advise Costco and Blue Cross they are wrong too. Has it occurred to you that in California it's just possible that those drugs aren't considered a Schedule II controlled substance. I have zero interest in reading the entire link you sent. I'm just giving you my experience. Apparently you can't accept that.

 

Sherilyn70 - I could easily call my doctor on the phone and say I wanted more Vicodin and they would refill my prescription without a visit. I've never used the other two but my mother has and I don't believe she would have to go in either. The doctor already knows her issues (from doctor and hospital visits) so they would just prescribe it for her if she had issues - except her issues often need hospitalization. Clearly California has different laws then other states.

 

I just linked you to the official CA Rx site.. do whatever you like wth the information. maybe you could call the CA Rx board and point out where their web site is wrong. even give them the name of your doctors who agree with you.

 

have a nice day.

[iheartbda]

That's great that your doctors can do that, but most states have laws against that. In Ohio I cannot get more than 30 days of oxycontin at a time, the prescription cannot be called in and it cannot have refills. I have to see my doctor in person to get it refilled even though they know it's for my cancer.

 

Sent from my Samsung Galaxy S4

Exactly the same in Pa.

Hope you're doing well and I see you have a cruise booked....good for you.:) We did Canada/New England in Oct. and loved it. Two words of advice, LOBSTER ROLLS.:D

Well this example just goes to show how things vary state to state. My doctor can fax the prescription to the pharmacy for those 3 drugs like all my other prescriptions and it can have more then one refill as the doctor prescribes, different strengths and can be in pill form or liquid. I can also get the same prescription filled by two doctors at the same time at the same pharmacy covered by the same insurance. For example, surgery with two different doctors and I only have a few pills left over from the first surgery so the second doctor gives me more. For California it is a regular prescription. It is obviously not a federal law because like I said, no 3 parter and refills are allowed.

I always wondered how the celebrities in CA had access to so many drug and now I know.;)

[Sherlock43031]

I know this horse died many posts ago.. Schedule II (and all the others) are a federal government law.

 

again from the CA Rx website..

http://www.pharmacy.ca.gov/licensing/prescribe_dispense.shtml

Can a prescriber call in or send a fax to a pharmacy for a Schedule II controlled substance?

 

No, with two exceptions. A licensed skilled nursing facility, licensed intermediate care facility, licensed home health agency or licensed hospice can call in an order or send a fax prescription for Schedule II - V controlled substances. The pharmacist must reduce the prescription to hard copy on a form of the pharmacy’s own design or produce the fax in hard copy form, and in both instances, must sign and date the prescription. (Health and Safety Code, section 11167.5.) The other exception is for an emergency where loss of life or intense suffering may occur by not issuing the prescription pursuant to Health and Safety Code section 11167. In this instance, the prescriber may call in or fax the prescription to the pharmacy. The pharmacist must reduce the telephoned prescription to hard copy form, or produce the fax in hard copy form, and in both instances, sign and date the prescription. The prescriber must, within 7 days, provide a written prescription on the new tamperresistant security prescription form (or triplicate form between July 1, 2004 and December 31, 2004). The pharmacist must notify the Bureau of Narcotic Enforcement within 144 hours of a prescriber’s failure to do so, including the date and method of notification.

http://www.deadiversion.usdoj.gov/schedules/

 

 

this DEA website is linked to from the above CA Rx website since the Feds controll what drugs are on what list.

 

Schedule II/IIN Controlled Substances (2/2N)

 

Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.

 

Examples of Schedule II narcotics include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®). Other Schedule II narcotics include: morphine, opium, and codeine.

 

Examples of Schedule IIN stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®).

 

Other Schedule II substances include: amobarbital, glutethimide, and pentobarbital.

 

Atlanta, Ga – Medpage Today reports that an FDA (Food and Drug Administration) advisory committee has voted 19 to 10 in favor to move drugs made from hydrocodone combination from Schedule III to Schedule II category of controlled substance. Drugs such as Vicodin, Lortab, and Norco now fall in to the restrictive schedule II category of controlled substances.

 

as far as your idea that other states have other rules all the text and links are for the California Board of Pharmacy

[iheartbda]

I know this horse died many posts ago.. Schedule II (and all the others) are a federal government law.

 

Maybe so, but interesting info none the less.

[Moviegirlnyorlando]

No, they do not have a pharmacy on board. You might try telling your local pharmacy that we will be out of the country on re-fill day and they might do it earlier. Up until last year I didn't know I could do this.

 

Walgreens just filled meds form me 3 days earlier then earliest (3 days before actually ran out so 6 days early ) without any hassle. Girl first said no but then when she asked phramacist she said yes, but I know this pharmacist . You might also have your doctor write you a note

[sherilyn70]

Maybe so, but interesting info none the less.

 

I agree. I finding a lot of things I never gave much thought to before. My life has really changed for me in the last year. This next cruise is the first time I've ever had to extra steps to do anything.

 

Sent from my Samsung Galaxy S4

[Sherlock43031]

I'm trying to explain to you in your narrow vision that other states have different rules

 

I will inform all my doctors that you know more then them and that they should be arrested for their ignorance. I will also advise Costco and Blue Cross they are wrong too. Has it occurred to you that in California it's just possible that those drugs aren't considered a Schedule II controlled substance. I have zero interest in reading the entire link you sent. I'm just giving you my experience. Apparently you can't accept that.

 

 

did you ever get a chance to call them?

[Tiggertastic]

you need to get your doctor to give you sufficient for the trip - I run a surgery and we only ask for proof of the trip to provide sufficient. We would much rather the patient takes sufficient than end up with issues that cause them medical issues and more costs

[SPacificbound]

She should talk with her doctor about the time she will be away. Our doctor always makes sure we have an adequate amount of the medications we need, and medications we might need. In the might need I'm referring to antibiotics, nausea, etc.