Pharmacy Jobsworth or Normal?

[bangheadhere40]

I would like opinions on this please as I've not had this in a pharmacy before.

I took time out of work today to go and pick up a prescription from the pharmacy for my husband. It was ordered online and had been signed by a doctor, all good.

When I went the lady in the pharmacy said she wasn't going to give it out as it is too early to order it again on repeat. I explained that the doctor had signed it off and she had the signed prescription ( she doesn't know my husbands medical needs). She said no she wasn't going to give me it for him and she is sending it back to the doctor and to try in a few days.

Is this normal? I always thought if the doctor had signed it then it's good to go!

If it's a controlled drug than she was probably right.

See, this I see the kind of thing I was referring to: the idea that certain prescribed painkillers are a bit naughty or something. The patient has been medically assessed and an experienced doctor has PRESCRIBED them.

JennyR29, I do appreciate where you are coming from (and as I said earlier, I have worked in a busy pharmacy and understand the regulations and why they are there). I just resent the implication by some posters on mumsnet that patients in real debilitating pain are all potentially dodgy drug-seekers who might as well audition as extras for the next Trainspotting.

Paracetamol damages the liver though doesn't it, but what does codeine do, I always hear about how bad it is but can't seem to find anything physical it does... Apart from constipation, and other smaller symptoms.

When they were querying it the other day the dispensary asked for his number, they must have passed it onto the pharmacy I'm guessing.

Can I also pick your brains Jenni.. What are the dangers of codeine? Ie pure codeine for instance, I know they are addictive, but what physical damage do they do?

I'm only a mere nurse and clearly not as powerful as a pharmacist (!!!) but codeine can suppress respiration so potentially if you take too much you could stop breathing.

It does also have side effects such as nausea and constipation.

I think the biggest problem is that pain management is such an under resourced area. Medication can be effective but because it's cheap it's been over prescribed in the past. Now there's been a backlash and the push is to stop prescribing opioids. The problem is no one is prepared to invest in alternatives which leave the patients stuck in no man's land - no one willing to prescribe medication but equally no one willing to provide alternative treatments. Quite how they expect those of us with chronic pain to function I don't know.

I have widespread inflammatory arthritis. I need joint replacement but I'm considered too young. I can't have anti inflammatory drugs as I have Crohn's disease and had a large GI bleed. So, my joints are inflamed and worn away. Bone on bone in some cases. I can't manage to stay active, work, do exercise, cook, clean etc without pain medication and/or surgery. Some drs don't want to do surgery. Political opinion is to stop opiod pain killers. So, will the benefits system support me to stay at home, not work, have carers etc? No, obviously it won't do what should patients like me do then?

Very interesting article on paracetamol.

@tequila, so sorry to hear things are bad for you too.

I do agree that for the patient in the middle it's hard. Being told just to cut down without offering an alternative suitable solution.

Yes paracetamol can damage the liver but only usually if you overdose or have to take it long term (you should have regular liver function tests if you do).

Codeine doesn’t really have long term side effects. It’s converted to morphine by your liver (which causes the pain killing effect) then excreted by your kidneys. So it might harm you if you have poor liver or kidney function.

Interesting some people have very little of the liver enzyme required to convert codeine to morphine so it isn’t effective for them.

Really! I never knew that it was due to a low liver enzyme, so I guess that's why it works for some and not others.

This stuff really interests me actually. My point earlier was that I would think there is more chance of damage if he does just go to paracetamol ( as well as being in pain), as he would be more tempted to take extra to manage it.

Ideally it would help if they put him on pure codeine so he can try and cut the paracetamol down, but they don't like doing that do they?

@bangheadhere40

Thank you.

What makes me so angry is that, in the main, the NHS will tell you that there's nothing that can be done to treat chronic pain but be able to access private care and so many more options become available.

I've had radio frequency ablation to the nerves in my back for example, which was really effective for debilitating back pain caused by arthritis in the facet joints of my back and. SI joints. I had 3 epidurals in 5 months which really helped and now I also have a spinal cord stimulator to treat l5-s1 nerve pain.

The private pain management Dr also took so much time to get me into the right mix of pain killers so that I get maximum pain relief on the lowest doses.

I also.pay to have private physio which helps me. It's just not right to tell patients that they can't have opiate pain killers but offer nothing, apart from mindfulness, instead!

I’m on an FB group for Cauda Equina sufferers. I was operated on for CE a year and a half ago and, luckily, I have few problems, especially compared to other people. I don’t need painkillers, my issues are weird funny issues, but many people in the group do. When I was in crisis I can tell you that codeine, plus anti-inflammatories plus muscle relaxants didn’t touch the pain and I had two ELCSs with just paracetamol after the first day. It was into reliable. And yet, the recent trend against opioid addiction has left many of these people with no help whatsoever. I can see why opioid addiction is a problem, but exaggerating in the other direction and assuming that people who genuinely need these drugs can just come off them is cruel. It is also very demeaning to be treated like a junkie if you have severe, chronic pain.

Oh for goodness sake auto correct went bonkers.
Not “weird funny issues” but “ weird nerve issues”
Not “into reliable” but “unbearable”

I was given oramorph after my stomach surgery and discharged with it. I took it until the pain was bearable with paracetamol and ibuprofen and then cut down on those. I absolutely needed it when I needed it but was off all painkillers after a month. Telling me paracetamol and ibuprofen would be enough wouldn't actually make it so!

Bang, they don’t like doing it because the paracetamol acts as a deterrent for overdose. You are limited to 8 tablets per 24 hours that way.

With pure codeine you can take more and more and build up a tolerance, increasing the likelihood of addiction and overdose.

I’d be happy for the pharmacist to do this as they are trained professionals. The doctor receptionist decided to cut my mum’s prescription in half as it don’t think you need that many’ so my mum went back after half the usual time and the receptionist refused to refill the repeat prescription as it was too soon. My mum had to space put her doses to have enough tablets. She then had a massive increase in her symptoms. She went back to the gp who asked if she was taking her medication.

My mum is quite meek and just takes people at face value so she told him the receptionist had cut her prescription down and wouldn’t let her order more ( this woman is in charge of the repeat ordering service) . The GP stormed out of the room and his face was purple with rage! He came back and apologised to my mum, gave her a prescription to catch up and told her there would be no further issues with her repeat and If there were further issues she was to see him immediately. I wish I’d been a fly on the wall as he gave out to the receptionist about cutting drugs that keep someone alive despite not having a medical degree.

When my mum told me I wanted to put in a formal complaint but she wouldn’t let me.

OP - don't you know that a pharmacist Can Do No Wrong. Clearly you are grotesquely unreasonable and making things up