Tuesday, November 21, 2017


Interpretations


   Recently, I had to refill one of my many medications. This in itself is not a big deal. This particular medication is one I have been taking for more years than I can count at this point. My disease, being Autoimmune in nature, messes with the chemistry in my brain making it very difficult to fall into a deep, restorative sleep. So years ago I was prescribed Ambien and have been taking it ever since without issue.
    Of course, everything changes at some point. And for me, Ambien became Ambien ER. I had begun waking up in the middle of the night and having trouble falling back to sleep. But the ER worked. I’ll admit here that I don’t remember if Ambien was always a controlled substance or if it’s classification changed at some point along the way.
    Whichever it was, it doesn’t matter at this point. Because it is a controlled substance now and that is the point of this story. Refilling a controlled substance and trying to understand the NYS statute controlling such things.

For starters, here is the statute from January 2017:

Section 3339.3 Unless an earlier refilling is authorized by the prescriber, no prescription for a controlled substance may be refilled earlier than seven days prior to the date the previously dispensed supply would be exhausted if used in conformity with the directions for use.

    So, the way I read this, I can pick up my prescription 7 days before I run out. For example; I filled my last prescription on October 17th. It was due to be refilled on November 16th. I attempted to refill it on November 14th. I apparently opened the gates of hell, chaos ensued, security tapes were pulled, and I ended up back at the car in tears while my husband went back into the pharmacy to hear hear the outcome of their investigation. All true!

    Now the story with a bit more detail:

    First you need to know that I have essential tremor and peripheral neuropathy. My hands shake and sometimes I can’t feel my fingers. As it turns out, in October, I did drop my pill bottle and lost 2 pills. However, beyond that, my husband works at the hospital where I get my prescriptions filled (I actually HAVE to get them filled there) and we routinely get my meds on his paydays every 4 weeks-hence every 28 days. Or 2 days early. Well within the 7 days the law states.
    Apparently not. When I asked for my medication, the pharmacist was called. When I mentioned I had none left because I had lost two, she immediately stated “I cannot give you any medication. It’s too early. We’ll have to check the security tapes to make sure our techs counted correctly if you think you were shorted.” and she left. I could only mutter “But..” to the tech and wait until she came back.
    When she did, I tried to explain again that I didn’t think they miscounted and I know I dropped the bottle. She then explained that “I can’t give you any pills because you get your medication too early too much and you can only get it the day you run out now.”
    This is a very small pharmacy with a line of people in a hospital where my husband works. I felt accused at this point and about as big as a worm. This is when I heard the INTERPRETATION of Section 3339.3. It is as follows:

Unless authorized by the prescriber, a person has a total of seven early days to use for picking up any controlled substance and once exhausted, that prescription may not be picked up early any more for the life of that prescription as written.

    What this means is, if I pick up me medication early by 3 days in October, I have only 4 days left to use. Forever. Get it? I really don’t but I have done my homework and confirmed this interpretation with other pharmacists in the area. And though it’s meant to keep certain people from stockpiling medications, it creates anxiety for those who may find it difficult to get to the pharmacy on the exact day they run out of a medication that they need.
    So for those of you who are on any controlled substances for treatments of pain, sleep, depression… Be aware of your state’s laws concerning distribution. But beyond that, be aware of your pharmacy’s interpretation of those laws as well. It may make all the difference in whether you can get your refill that day or not. It did me, and it cost me 2 days sleep. But also be aware that there may be ways to sit down and work with your doctor and pharmacy to make it easier for you to deal with these regulations as well. That’s my next step.

Wish me luck!