It’s an unspoken rite of passage in Retail Pharmacy.

Something we don’t talk about during Pharmacy School, but we know it’s lurking, waiting for us when we graduate from school.

We all hear the painful, agonizing stories from our comrades in arms.

Drug seekers wearing us down little by little, day by day.

Anxiety for when those same patients return every single month.

Stressful, tense situations where emotions and stakes are high.

Uncomfortably long-winded conversations.

Legitimate prescriptions that could result in patient harm and get our licenses revoked.

Refusing to fill the wrong prescription could lead to corporate corrective action or even litigation.

We spend years studying and practicing to get our doctorate degrees in Pharmacy, but are wholly unprepared for the onslaught of stress and responsibility awaiting us in real life.

Dispensing narcotics in Retail Pharmacy is a beast of burden, and keeps so many of us awake at night, long after the pharmacy gates close.

Here are some signs and symptoms that indicate your cortisol levels may be elevated over narcotics.

1. You Lie to Your Patients

Have you ever looked at your patient straight in the eye, and said, “Sorry, we don’t have this in stock,” knowing that you have a full safe?

Maybe you have concerns about filling.

Maybe you observe some red flags.

Or maybe the prescription just doesn’t look good.

There’s a million reasons to not be truthful.

But the fact remains that if you have to lie, you’re not fulfilling your role in the treatment process.

Lying usually happens to avoid confrontation.

It’s much easier to back out of a conversation and avoid a full-blown refusal to fill protocol if the patient is turned away for another reason.

But what happens when the patient says, “That’s okay; I can wait for you to order it?”

What now?

If you’re original reason to turn your patient away is due to inventory, what prevents you from ordering the medication?

You’re now trapped into lying more to solidify your position.

Lying not only harms the patient by delaying therapy, but it forces you to confront the issue right then and there, whether or not you’re ready for it.

What happens when your team observes you lying?

Many technicians know our inventory when they type up prescriptions.

When you lie to your patients, it gives your technicians permission to do the same.

The culture starts to shape around double standards and subjective refusal to serve patients.

And the worst thing that can happen: when the patient catches you lying.

Follow up questions like, “When will your next order come in?” and “Can I put this on hold until it comes in?” will pressure you to make quick, unilateral clinical decisions with very little data.

You don’t want to be caught off guard and pressured in a social interaction when a clinical analysis is required.

2. You Look Only at the PDMP

The PDMP gives you historical data, trends, and risk scores from the NarxCare scale.

This enables us to see a potential for abuse due to pharmacy shopping, doctor shopping, early fills, interactions with other controlled substances, etc.

But if you use ONLY this data in your clinical decision-making for opioids, you will more often than not prematurely turn people away.

When the PDMP is the sole basis for your refusal to fill, your ability to contain risk and de-escalate tense situations decreases.

Refusing to fill solely due to “early filling” or “doctor shopping” are hard to back up as well.

These are not unarguable facts, but rather implications or accusations which do not always hold up.

You can state that they are too early to fill, but what’s stopping them from arguing about the 3-day grace period permitted by law?

Corporate policies may offer some ammunition in this kind of warfare.

But even then, you’re going to hear continuous resistance.

What’s stopping them from dropping off a risky prescription to be put on hold for you to deal with later?

Similarly, switching providers/pharmacies is not illegal; it’s simply a red flag to monitor for.

There are plenty of valid, lawful reasons to switch pharmacies.

Change in address, establishing new care, insurance requirements, etc.

Many factors that the PDMP does not have ability to analyze.

In order to strengthen your clinical making decisions, you need more than just one source of information.

Otherwise, prepare to be owned by the day-to-day grind of needy narcotic patients.

3. You Don’t Look at the PDMP

On the other hand, you may work at a high-volume pharmacy where you are lucky to have even 30 seconds to analyze a new prescription.

In these moments, you may be tempted to use prescription elements and red flags only to screen patients.

But how effective can you really be with this small amount of information?

What does your conversation look like with the patient?

When you don’t use all the resources available to you, you’re looking at the patient’s physical appearance.

You’re looking at the quantity of the prescription.

You’re looking if they’ve filled at your pharmacy before and what medicine they’re currently taking.

This is the number one reason patients complain about being judged or discriminated.

That’s because when they are being told their medicine can’t be filled, there isn’t enough information presented to justify the reason.

Now you’re not just fighting a clinical case.

You’re fighting an uphill battle on a discrimination accusation.

4. You Only Use Red Flags

You see the patient at the counter.

Maybe their clothes are ragged, or they look like they haven’t showered for weeks

The prescription in their hands looks like it’s been through hell and back: coffee stains, wrinkled, half torn, and with 3 different pen colors on there.

Maybe the patient smells like cannabis, or their physician is located clear across town.

Any of these lead us to form a pretty terrible picture of a new patient dropping off narcotics.

You rarely see all of these present simultaneously.

But you’ve been conditioned.

At the first sign of anything, the alarm bells are going off in your head.

The first words you think, and that inevitably come out of your mouth are, “Sorry, but..”

You instinctively try to find justifications for refusing to fill before you even see the prescription and review the medical profile.

But a red flag alone cannot adequately explain the purpose behind refusing to fill.

A red flag is not a valid reason by itself.

It is only an indicator that something else may warrant attention.

Red flags like distance of the doctor’s office, cash paying patients, pharmacy shopping, etc. by themselves are not illegal or harmful.

It’s what the indicators say about the patient’s health conditions or potential for risk.

So, when you refuse to fill a patient’s prescription based off of any one negative indicator, patient healthcare is potentially impacted.

You may be leaving a legitimate patient behind.

The arguing and resistance of the masses increase.

The complaints to corporate and Board of Pharmacy come at you in waves.

5. You Ignore Red Flags

Sometimes, you don’t see the hard copy for a new opioid prescription.

Whether it’s a technician that failed to show you, or a prescription being taken in on a different day, you lost the opportunity to screen the patient before it’s accepted into the computer system.

At this point, the patient might have left.

Your ability to learn from, influence, and educate the patient goes down.

Then, every minute you hold onto the prescription is a minute longer of potential emotional escalation.

Who knows what trauma that patient has experienced at other pharmacies?

Your refusal to fill via phone or after an hour-long wait may be just enough to set them over the edge.

Conversely, you may see that it’s a brand-new patient with no fill history, yet choose to ignore red flags.

Cash-paying patient?

Dangerous interactions?

It’s already in the system, so you think that someone must have looked at this prescription beforehand.

You have 500 other prescriptions to verify, so you give them the benefit of the doubt.

But there aren’t any notes in the profile, and no documentation on the hard-copy image.

But your mental bandwidth is completely spent.

You only have so much energy and resources.

So, you verify through the alerts and red flags, choosing to take on this small amount of liability and risk.

The outcome?

The new patient does not get a clinical screening.

You fail to use your license in this moment.

You miss an opportunity to validate this patient’s treatment.

And you set the precedent for the next pharmacist who verifies that this patient should continue this unverified treatment regimen.

The cycle repeats over and over, compounding the risk your pharmacy takes on.

6. You Don’t Talk to the Prescriber

Through the hustle and bustle of retail pharmacy, you will see many prescriptions that you have questions about.

What is the treatment plan?

What is the true medical condition for the patient that warrants this alarming regimen?

On paper, the prescription doesn’t look good.

Maybe it has dangerous interactions, and the only information you have is anecdotal.

Thirty years on this high-dose regimen with multiple drug interactions.

In this moment when the prescription is brought to your attention, you look at the PDMP and call the doctor’s office to validate its legitimacy.

You ask about the diagnosis code and if the patient can fill 3 days early, but you choose to skip the clinical review with the doctor.

What does this do?

Leaves your questions unanswered and fails to paint a full picture of the patient and their treatment.

Just calling the doctor’s office and talking to a medical assistant usually is not enough, unless they have specialized training and can interpret clinical data.

But more often than not, we get a sub-par clinical validation for the medical profile and treatment regimen.

Treatment optimization, patient behaviors, and enhanced counseling opportunities may be overlooked, and you continue to build a patient population that treats your pharmacy like a dispensary instead of respecting you as a healthcare provider.

7. You Don’t Calculate MME

How many times do you judge a prescription based off the quantity of tablets or day supply?

It’s a false sense of security.

The number of tablets doesn’t signify the potential risk of the medicine.

It’s more about the potency of the medicine.

We compare opioids to morphine, and this should be one baseline metric to analyze.

If you don’t routinely calculate morphine milliequivalents, you may be arguing with patients over filling #150 hydrocodone/APAP 10/325mg (50 MME), but letting #60 oxycodone 30mg go through (90 MME).

While either of these prescriptions may be perfectly appropriate for a patient, you must add the potency screening to your clinical review to get the full picture and scope of their treatment.

All it takes is simple math or using an in-app calculator.

Failure to do this step will result in fighting the wrong battles and over-representing the true risk of certain prescription regimens.

8. You Use 90 MME as the Law

On the other hand, you may be proficient at calculating MME.

You might have memorized the thresholds for your fast movers.

Sixty milligrams of oxycodone is 90 MME, and 90 mg of hydrocodone equals 90 MME.

So, you fill anything under 90 MME without hesitation.

It’s covered by CDC guidelines, so the risk level is low, right?

But not all prescription regimens are created equal.

Someone on the newer side of opioid treatment has a much higher overdose potential on a 90 MME regimen.

You have to ask what the other variables are, and this is just the beginning.

Conversely, you may refuse to fill anything over 90 MME, citing CDC guidelines and the evidence-based safety risks.

Again, not all patients are treated equally, and blanket policies only work in the short term.

Compound this unsafe practice of unilateral policies over time, and you will inevitably harm a patient.

How long have they been on their treatment regimen?

What other therapies, medicinal or non-medicinal have they tried?

Are they stabilized on their regimen?

Do they have a good prognosis or is the treatment palliative?

What’s the end game for the patient?

The failure to screen properly results in patients with optimization opportunities being missed and legitimate patients being sent around to scour the streets.

9. You Tell Patients to Go to the Pharmacy Across the Street

You may have gotten to the point where you held your ground and refused to fill someone’s prescription.

But what happens next?

They ask, “What am I supposed to do?”

You don’t want anything to do with them, so the easiest solution is to let someone else handle this problem.

Telling a patient to go elsewhere when they don’t understand why is the definition of discrimination.

I won’t fill for you here, so take your prescription down the street.

The only time directing a patient or funneling them to a specific store should be an option is when your pharmacy is literally out of stock.

“The other pharmacist told me to come to your pharmacy.”

However, many practitioners choose to refuse based off of subjective reasoning and subsequently tell patients to go down the street to their competitor.

If the patient doesn’t know the exact reason why their prescription is being refused, it doesn’t solve anything.

The patient will either have trouble filling their medication or another pharmacy will be given the burden of this ticking time bomb.

The first stop for a patient may be benign.

A caring explanation goes a long way.

But when the patient is passed from pharmacy to pharmacy, a 3rd or 4th stop causes so much anxiety and frustration.

This is how situations escalate at the pharmacy counter, with yelling, threats, and complaints.

It’s the constant aggravating factors and lack of communication that causes the explosive narcotic encounters.

10. You Don’t Know What Your Ordering Limit is

Another problem at the pharmacy is the flagrant use of the phrase “We hit our ordering limit.”

While this can be true, the ordering capacity doesn’t stay maxed out.

It resets every month, and is measured by a few factors: quantity per active ingredient and volume of scripts.

If you don’t know how this is calculated or when your ordering capacity resets, how can you accurately predict when you can order more medication?

All we know in corporate pharmacy is that someone upstairs sets an arbitrary ordering limit for us.

But that limit changes with organic growth.

If your business is growing, then so does your ordering limit.

But more often than not, pharmacists will use the threshold warning of 85-95% to announce blanket refusals to fill that persist until the end of time.

“We can’t dispense to you because then we won’t have enough for our regular patients.”

“We hit our limit, so we’ll never be able to order more for anyone.”

Sometimes, this warning will apply because you can see when the next fill will be due for certain patients.

But citing an ordering limit without knowing when or how you can order more does nothing for the patient and only creates more ill-will and frustration.

How do you like repeating the same messages over and over to patients?

Soothing their broken hearts and de-escalating their frustrations with no way to really solve the problem gets old after a while.

11. You are Consistently Told That You’ve Exceeded Your Ordering Limits

However, one thing stops you from proactively ordering medication.

You may know when your ordering capacity resets, but you still consistently reach your threshold.

Corporate has warned you that surpassing your threshold will result in punitive action and investigation.

This is a risk factor because the necessity for ordering such high quantities shows that the proportion of tablets per dosage per patient is higher than the standard amounts.

This can happen organically due to growth, but constantly exceeding means that your pharmacy takes in opioid quantities that are heavily skewing the ratios the distributors abide by.

Do you consistently take in quantities greater than #120?

Are these primarily narcotic patients with no other medications on file?

Are you the central hub for the highest risk regimens from all over town?

If your ordering limit continually gets exceeded, that can mean a few different things.

You are ordering in large batches without regard to the actual drug movement and sales trends.

Your patients’ pain medication regimens are on the higher end of the spectrum.

Or, you have no idea what is going on in your pharmacy, and are churning through tons of high-risk opioids.

12. You Don’t Have a Clear Reason to Refuse to Fill

You just have a gut feeling.

Something doesn’t feel right, nor does the prescription look good on paper.

The patient may have some red flags, but nothing concrete warrants a refusal.

You might not want this patient at your pharmacy for other reasons.

The way they talk signifies that they could be a problem every month.

They may be demanding or abrasive.

But at the end of the day, you don’t know how to communicate the exact reasons you want to turn away some patients.

Sometimes, you think you have reasons, citing resources or the PDMP.

But the patient still wants to argue their way out of it.

The only way a patient can argue is if they don’t understand the principle behind the refusal.

There’s nothing to argue if the reason is based off fundamental truths.

But if you consistently cite rules or policies (especially unilateral ones) that you don’t understand fully, then you are opening yourself up to escalation from patients who want to use their own logic and thinking.

13. You Repeat Things Like, “I Just Don’t Feel Comfortable.”

This is similar to not having a clear reason to fill.

So, you resort to repeating the same message over and over.

You have so many things going on, but you know your decision is right.

You just don’t have the vocabulary or the time to go into all the details.

The last patient you tried explaining the CDC guidelines to just kept arguing over and over with everything you said.

There are 5 patients in line, all looking your direction.

You feel the overwhelming pressure of business, metrics, and regulatory compliance all at once.

The “I just don’t feel comfortable” line is a common go-to because a patient or physician will have a hard time arguing your feelings.

But eventually, someone will call you out on your blanket statement.

When Board of Pharmacy follows up on a complaint, you will have to justify your reasoning with something more substantial.

14. You Don’t Know How to Communicate the Reason

You might have your reasons, but have trouble explaining in a diplomatic or professional way.

How do you explain your concerns about pharmacy shopping?

How do you tell the patient that a medication regimen they’ve been prescribed for 10 years is concerning without causing emotional distress?

Can you explain a refusal to fill for a doctor who routinely over-prescribes?

Sometimes, when you’re so busy doing 10 things at once, just the thought of having to confront a patient, deal with their frustration, and then de-escalate their emotions is so exhausting.

So, you may get stuck and want resort to quick-fix solutions to get them to leave the pharmacy.

Maybe lying sounds good, or resorting to any of the previously mentioned mistakes.

This ultimately hurts patients, and can lead you down a dark hole depending on which quick-fix solution you use.

And it doesn’t help you when another narcotic patient just like them arrives shortly after.

In the end, there’s so many of them, and only one of you.

15. You Fill for Patients When They Get Upset or Complain to Your Boss

After refusing to fill for someone, you just know that you’re going to hear about it later.

You failed to de-escalate the situation.

Shots were fired.

Patient left the pharmacy ranting and raving.

Or, security had to escort them out.

Or worse, the police were involved.

The following day, you get a call from your boss following up on this patient.

You try to explain the situation objectively, but your boss decides it’s too much risk and makes you fill for this patient.

You try to defend yourself, but it’s too late.

The pressure to meet business demands clouds your judgement.

You just want the bleeding to stop, so you give in.

This only happens because you failed to de-escalate the patient before they left.

The end result?

You having to endure this patient as they assume full control over you at the pharmacy.

Consider your license meaningless and your worth as an employee zero.

16. Your Boss Makes Clinical Decisions for You

He or she doesn’t trust your judgement.

You try to explain your side of the situation, but they don’t even want to listen.

They’re just worried about the patient’s complaint and possibly suing the company.

So, you’re forced to fill a prescription you don’t believe in.

You have to walk away with tail between your legs.

Scanning out a gift card, apologizing to the patient, and sucking it up every single month they come back to pick up their narcotic.

Why does this happen?

Why are pharmacists with doctorate degrees completely and utterly silenced when it comes to narcotic dispensing and complaints to headquarters?

It’s because of the company brand image.

There is a lack of communication between governing bodies and professional reputation.

When pharmacists are caught between DEA, BOP, and their own licenses, they aren’t thinking about the company’s brand image.

What could be a tense situation and refusal to fill could turn into media threat and even millions of dollars in fines and litigation.

Upper management doesn’t want to step in and take on liability, but their job is to protect the company and you from regulatory threat.

So, in a last-ditch effort to “protect you” or “save the company,” they strip you of your autonomy and force your clinical hand.

You’re left standing, with no clinical power, no status, no respect, holding your private parts while trying to do your job.

Now, you doubt yourself with each narcotic fill and have to make a phone call before every refusal you want to make.

Walking on egg shells at the pharmacy.

Painful.

17. You Don’t Know the Clinical Guidelines for Opioid Dispensing

How often do we have the time, energy, and resources to fully utilize our PharmD and pharmacological background?

Much of the time, we are making split decisions in the moment, with little to no clinical information.

We barely have enough time to conduct a PDMP.

But when we make decisions based off of inadequate data, this increases the odds that a patient will make your life miserable.

It’s like going to the DMV to get your driver’s license, but the gatekeeper doesn’t know anything about driving or auto laws.

How frustrating it would be to be held hostage with someone who doesn’t even have the background knowledge or time to explain why you failed the driving test?

But every day, pharmacists practice opioid dispensing without knowing the full scope of the prescribing guidelines.

Sure, the guidelines are meant for primary care physicians, but we all need to hold each other accountable.

How can we help if we don’t have all the information?

Can we really explain opioid treatment to patients if we don’t even know the guidelines for their diagnosis and prescription?

How can we be part of the healthcare team if we can’t even speak the same language?

If you don’t know the guidelines, physicians probably walk all over you when you voice your concerns.

18. You Only Think About Short Term Consequences

In the moment, we are thinking about two things:

1) The patient’s safety

2) Our personal liability

It’s easier to see that refusing to fill prescriptions can negatively impact both of those things.

However, we fail to think about the long-term impact.

We make decisions simply to satisfy the problems in front of us: safety and risk.

But what about compassion and healthcare outcomes?

The solutions will differ, and the risk will be mitigated if spread over time with complete medical information.

Imagine what conversations with the doctor would sound like if we took the time to consider the long-term outcomes vs. just the short term.

If only we had the time to discuss all the factors, increased scrutiny and discussion around clinical evidence would make sense.

But making decisions with limited foresight don’t make us feel like healthcare providers.

It will keep you up at night because of all the disrupted therapies, complaints, and belittlement from other providers.

19. You Fill High Dosages and Cocktails Just Because They’ve Been on It

Sometimes, you get that gut-wrenching feeling in your stomach when you come across a narcotic verification.

“Holy crap, this is a high dosage.”

You check for any documentation, and you find none.

Just that pesky ICD 10 code: G89.4 for Chronic Pain Syndrome.

What does this even mean?

What’s the underlying cause?

You just see that they’ve been on this same regimen for the last few years.

You feel discomfort, thinking “What is this patient going through?”

But you have 6 patients in line, flu shots being typed up, and are overdue on so many waiters.

You don’t have time for a full-on investigation of this patient’s medical history.

The previous pharmacist must have done some work on this.

They verified it, so this must be less risky, right?

If it weren’t so busy, you would sit down with this patient and have a real conversation.

But that never happens.

“Patient has been on this” and “Okay to fill” sound like good enough documentation right now.

Perfect set up for a DEA investigation.

Good luck talking your way out of those.

20. You Think Only About Your Own Liability

Sometimes, you get so nervous about doing the wrong thing, you don’t even want to deal with crazy-looking prescriptions.

What if you get sued?

Or, worse, you’ve already been sued before.

Maybe your boss or company didn’t support you.

Do you have malpractice insurance?

If a brand-new patient comes in with a super high dosage or risky combination, why are they coming to your pharmacy in the first place?

What happened at their previous pharmacy?

Something’s up, and you don’t want to be the one responsible for this.

Especially since you have a million other things to do at the moment.

There are so many reasons to say no, and so very few things to support filling the prescription.

Get that patient out of here.

Your face says it all, and predators can smell fear.

When the basis for your refusal is to cover your own butt, nothing sounds good.

You lose credibility, and your effectiveness to influence healthcare goes down the drain.

21. You Consistently Take Patients Who Only Pick Up Controls in High Quantities

You know the patient.

The ones that have only Oxycodone 30 mg on file.

The ones that have 2, 3, or 4 controls and no other maintenance medications.

They never get sick, never get their flu shot, and never want pharmacist counseling.

They literally only use your pharmacy as a gateway to dispense their opioids.

This is probably where the term “legal drug dealer” shines most.

I’m not saying that these aren’t legitimate patients.

But chances are, some of these regimens are inflated and are in dire need of optimization.

This is why opioid ordering limits are breached and ratios become skewed.

This is not a typical patient, and these regimens are far from normal.

If you feel your pharmacy demographic is the sole cause, think again.

You are letting this happen.

And patients who get everything they want tell all their friends to come.

Let one wrong patient slide, and you just 10X’ed your problem.

22. You Don’t Know How to De-Escalate

You’re afraid to confront patients about their pain medication.

You know the pharmacology and have read the guidelines.

You know the risks, and have received a ton of training.

Maybe, you even know the corporate catch phrases to de-escalate and refuse to fill.

But you still don’t feel equipped to have a full-blown conversation with an angry, fast-talking patient.

The patients don’t just roll over and accept what you say.

They put up fists, verbally attack you, and threaten lawsuits.

They throw curve-balls at you, citing racism and discrimination.

“Give me your supervisor’s phone number.”

“I’m going to record this conversation.”

Or, they happen to know some legal jargon, and try to twist your arm.

How do you prevent that from happening?

You begin to state your concerns, but then the patient speaks louder and louder, eventually talking over you.

Every word that comes out of your mouth meets interjection, and then you get frustrated.

In this moment, you may revert to a mindless, blanket refusal to fill mode.

Stress level 999.

23. Your Patients Can Out Talk You and Tell You What to Do

You’re filling risky combinations and high dosages, and you want to do the right thing.

You write notes on the bags, and in the computer profile.

You actually have conversations with the patients.

But then they get mad, raise their voices, and proceed to strong-arm you into doing what they want.

They tell a sob story and list all the major surgeries they went through.

They sound so convincing because they’ve told this story hundreds of times to their doctors and other pharmacists.

And no one knows how to respond except to give way.

Something doesn’t feel right, but you don’t have the ammunition or endurance to increase the shared pool of meaning.

There must be another solution, but you can’t even get the patient to calm down and talk like a human being.

You’re mentally drained, and you can’t fight anymore.

So, you choose the path of least resistance.

You let this patient off the clinical hook this time, and now they proceed to own you every month from here on out.

24. Your Patients Yell at You Over the Counter and On the Phone

Even something as small as an early fill denial sets off your patients and ties you up for 15-20 minutes.

Reason doesn’t help in these situations.

How can you even consider bringing up high dosages, risky combinations, and gaps in therapy for a sensitive disease state like chronic pain?

There’s only one of you, and thousands of them.

Each patient yelling at you drains your energy and pharmacy spirit.

To them, it’s a fresh conversation worth fighting for because they are so emotionally and physically dependent on the outcome.

But to you, it’s the same painful situation, with a slightly different flavor, compounded over time.

What makes things worse is your lowering tolerance for emotional management.

You become the ticking time bomb instead of the patient.

And sometimes, you’re both at risk for nuclear warfare.

And each unnecessary explosion is just another chink in your workflow.

Sick patients, waiters, flu shots, pages of overdue medicine, baskets towering higher and higher.

Each bad situation stacks on the previous one.

It weighs you down, makes you cynical, and taxes your heart and passion for healthcare.

25. You Don’t Document Your Clinical Review for Other Pharmacists

You accept narcotic prescriptions and keep your reasoning to fill all to yourself.

Through the hustle and bustle of Retail Pharmacy life, nobody has time to document full-blown clinical reviews.

It may be a justified high dose, but the next pharmacist is going to just have to take your word that it’s a legit patient and treatment regimen.

Then your staff pharmacist does the same thing.

Floaters don’t want to get involved, so they just say no to everything and tell patients to come back on your day.

Soon, both you and your staff pharmacist are filling for thousands of patients on narcotics, but feeling anxious about it every time.

The sheer number of conversations and documentation that need to happen in order for you to feel good about dispensing is just too much.

How can you operate like this?

Where does it all begin?

The only way to survive the day is to tuck in your feelings and give the other pharmacists the benefit of the doubt.

But the insecurity grows each day.

Long after the pharmacy gates close, you ponder at night before bed.

Are my patients going to be okay?

What if the DEA comes and investigates?

What are you going to say?

“Patient has been on this medicine previously?”

Is that really enough to justify an adverse event like an overdose or a pill mill investigation?

What Can You Do?

No one is perfect.

We are all human and have our personal biases.

And there are countless skills and training we can take to ensure optimal outcomes for our patients and protect ourselves and our businesses.

The first step is personal awareness.

Are you making some of these mistakes?

Do you feel anxiety or stress around narcotics at your pharmacy?

Communication with your staff is also key.

Understanding the clinical guidelines and creating a narcotic protocol with your team is so important.

You need to take some of the guesswork out of the equation so operations run smoothly.

When you have thousands of patients to manage, having a system in place to deal with all of them in a uniform, consistent, and fair way is paramount.

It will make your pharmacy life so much easier, so you can get back to focusing on being a healthcare provider and having a great work/life balance.

At the end of the day, when you shut down those gates, you don’t want to be worrying about fast-paced decisions that you feel no control over.

You don’t want to worry about patient overdose, litigation, or losing your license.

You don’t want to feel like a malpractice suit can happen anytime.

That’s no way to practice pharmacy.

That is the fast-track for losing your retail pharmacy passion and stripping the world of your unique skills.

Your patients, team, and profession need you.

Don’t be caught off guard.

This is your chance to take a stand.