Today was the worst day of my professional career. In the nine years I have been a pharmacist, nothing bothered me like today did.
I had gone in to work for my wife at her store to cover about 3 hours, and a gentleman presented a prescription for a narcotic. The problem was, he was one of my customers from my store, and this prescription was for a different name. And we were busy. Very busy. I stood there puzzled and stared at this guy with his 2-year-old son in his arms and knew his first name, but could not remember his last name.
Finally, I came down from the raised dias like an angel of death and confronted him. I told him that I recognized him from my store and called him by his first name that I remember. He denied that I knew him and denied that name. I then called my store and got them working on the case. I asked him for some identification. He could not provide any. (His wife had it in her car...) I called my store again and by use of our computer systems being linked, I dialed into my store's records and finally found his profile by searching every listing with his true first name. I knew I had the correct person then. I then asked him to acknowledge his full name by calling him by his first and last name, asking if that name meant anything to him. He denied that name, again. I told him then that without ID and without a way to verify his identity given on this prescription, I had to call the doctor.
At this point, he was getting a little antsy, shifting his son back and forth in his arms. I too was beginning to waver in my approach and was actually starting to wish he would just leave, but he refused to leave. He refused to give in that I was right and he was submitting a forged prescription...
So as I am on the phone with the doctor's office, he comes back around the corner again and asks to speak to me, and I give him the "talk to the hand" signal. I give the office the name on the script and the drug and directions. They mention that they will research it and call me back. AT THIS POINT, he caves in and tells me that my suspicions are correct and that the script that he presented to me is a phony.
I am mad, and I am frustrated. I knew I had him pegged and called him by his real name twice . I even offered that he should leave and whether he came back was up to him, but that he shouldn't. But he did not listen. He pushed and pushed until I had no choice but to call the doctor.
So after speaking to the doctor's partner, she requests that I fax a copy of the prescription to her to verify that it is false. I do, and she confirms that it is a forgery, and with a phony identity to boot. I ask if he is a patient there being treated in any way. She says his is not. I ask if they are willing to treat him for his addiction. She says that no they are not. He has broken the law. All the while, he is standing there pleading with me to help him and to not call the police. I ask the doctor if this prescription was signed by the doctor, and she confirms that is was not. I ask if they intend to press charges, and she agrees that he broke the law and the authorities must be contacted. I tell her that I understand and hang up the phone, immediately calling 911.
The police are then notified and I have the dubious distinction of telling this man that I had to call the police and that the doctor has been notified. He is crying, and begging me to help him because of his child. I feel like smashing something and crying, upset to the point that my hands are shaking. And I blew up. I got mad.
You see, my wife, who is 8 weeks pregnant, was coming in to relieve me in about 10 minutes after this transpiring. This poor man brought this situation to my doorstep and then is standing there begging me to not press charges, and I actually want to believe him and help him. But I cannot. I explain that my hands are tied and that the doctor wants to press charges and I am required to call the police.
He then asks if he can talk to the doctor, and I call them on his behalf. As he is talking to the office, 2 troopers come in and I introduce myself and the situation. They proceed to handcuff him and hang up the phone. The little boy begins to cry and the man is very upset. The troopers begin to drill me with questions and seem a bit irritated to have to be handling such a menial task (in their estimation). As the detective and another trooper enter the store, the initial trooper even tries to pass off the case to the detective. Good thing I knew the detective.
So to make the story even more sorrowful, this man's wife is a nurse at the doctor's office in which he was forging blanks for a narcotic. So who knows how far this will go.
So what is this to me?
I used to believe very strongly that the law was black and white, and that life is very black and white, with little or no room for interpretation. Today, I watched a man separated from his son and they hauled both of them away in a police car, with the dad in handcuffs. I will never forget the look on that little boy's face.
And no matter how rational I try to be and explain that I was really only doing my job, I will always feel some responsibility to that man's undoing.
posted
Alucard, perhaps this isn't his undoing at all. Perhaps it's the beginning of him realizing that he does indeed have a problem and needs help. For some people it takes hitting the very bottom before they can see their situation a bit more clearly. Think of the strain his addiction must have been putting on his marriage and family. I've had 2 family members with addictions and it's horrible.
And remember, as badly as you feel - it was out of your hands. Big hugs to you all the same, because I'm sure it was an incredibly difficult situation.
Posts: 2578 | Registered: Apr 2004
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posted
You did do the right thing, but I won't pretend that will make you feel better.
One thing that worries me is that I will have to work my best to send people to jail who I personally think shouldn't be there. That's going to be rough.
In this situation, why didn't the guy just leave when you called the doctor? What would you have done? I really hope he stole those slips and his wife wasn't involved.
posted
Thanks, Kama. My poor technician was standing there sobbing and my wife had just came in as the police did. I had to brief her on the situation and she actually had to sit down. I couldn't tell her what I had done until I took her to the back where no one was looking, because I was afraid that I too might crack and begin to sob. It was an excruciatingly emotional duty for me to perform.
Posts: 1870 | Registered: Mar 2003
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posted
I can certainly understand your angst and while I realize that any platitudes I offer will, most likely, mimic thoughts you've already had I offer the possibility that you may have saved that child from a worse fate.
Posts: 2022 | Registered: Mar 2004
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posted
I know you know that you are not responsible. He is the only one responsible for his actions. It is really, really a shame that it had to happen with his kid there... but maybe this way he will get the help he needs. Maybe this will be the breaking point for him, and he will turn his life around.
If you hadn't been there, and hadn't called him on it, it would have just gone on and gotten worse. If you had let him go when he asked, he might have sworn never to do it again, but the craving would have gotten the better of him eventually.
You know all this, and it doesn't make it hurt less. I hope someday it will.
Posts: 7954 | Registered: Mar 2004
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posted
Dag, as soon as I reach for the phone, most seekers go running out the door. I gave him at least 3 chances I can think of to hightail it out of there, but he did not. I am guessing that he assumed his wife's employment would shield him from any wrongdoing.
What would I have done? Stayed in bed.
Posts: 1870 | Registered: Mar 2003
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It sucks that you had to go through that, but you shouldn't feel responsible for it. The man was the cause of his own undoing. Who knows what he may have done if he got the narcotics, or what the affect will be on his son. There's too many unknowns for you to try and assign guilt to yourself. You just have to trust in the fact that you did the right thing.
Posts: 21898 | Registered: Nov 2004
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posted
You gave him every chance to hightail it, Alucard, and the fact that he didn't is probably a sign of how far into the addiction he is. I am so sorry for your pain.
Posts: 10890 | Registered: May 2003
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posted
Its better the kid is separated from his dad, rather than being slapped around or OD'd from a high, irrational father. There is no shame in what you did.
Posts: 450 | Registered: Nov 2004
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posted
You know, Lyrhawn, I have told myself anything that I can imagine, like, what if he took those meds and killed himself and the boy in a car crash. But still no matter what, I still feel sick to my stomach that I had to do what I did.
And make no mistake, I have had more seekers arrested that I can honestly remember. I actually have a folder on forged prescriptions and forgeries that I keep on file at my store. This one just really hit home mainly because of his son being there.
Posts: 1870 | Registered: Mar 2003
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posted
Alucard, no matter how you feel, you are a paragon of virtue. Strength, Man.
Your story fills me with respect for you. I feel your pain, but someone had to intervene here. That little boy deserves better. You certainly did the right thing.
I would invite you to tie one on tonight, were you here. Instead, just have a beer for me.
If you want validation: you have it from me, for all that's worth.
Posts: 1843 | Registered: Aug 2003
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Ginol, up until today, I would have agreed with you.
Seeing how that boy loved his father, I would have done anything in my power to see that man get help and to recover than to put him in a cell and divide their family.
Hopefully, this will be the wake-up call for this guy to do just that. I feel no shame. I feel extreme guilt for making a 2 year old get his first ride in a cop car because of the decisions his father and I made.
Posts: 1870 | Registered: Mar 2003
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I literally went from this situation above, and then left my wife and this mess and went to my store, where I've been since one-o-clock. I haven't really taken the time to sit and digest everything, until now, and I got a little bit upset again.
And rest assured, on the outside, I still appear to be the Teflon Man. Just don't tell anyone about the mushy side, OK? Posts: 1870 | Registered: Mar 2003
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posted
Look at it another way. Maybe he wasn't an addict, but a dealer, and he could have gone from there to take his 2 year old with him to a deal. You really did the right thing.
Posts: 666 | Registered: Dec 2003
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posted
Alucard, I just wanted to say thank you for calling the police on this man. I don't mean that in a heartless way and I am in no way glad that this man's son had to go through what he did, but I think as a few others have said, the man may need it to get his life back on track.
And I say thank you as an aunt of three beautiful little girls who have a father who is addicted to heroin, a mother who smokes marijuana, and who live with an aunt (her mother's sister) who is in and out of jail because of drugs. I just wish I had the strength or courage to do something about their habits because they've proven they won't-they've been using for at least the past 7 years with two failed attempts at rehab.
Sometimes people need a wake-up call and I hope that man got one today.
I hope things get better for you soon.
Posts: 378 | Registered: Aug 2004
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posted
Alucard, my wife works in a pharmacy, as you know, and she has had similar things happen to her. I know it isn't easy, but it was for the best for everyone invloved.
This may help the man get help he would have otherwise denied he needed. It may get a narcotics ring put out of business.....that is how most of them get their drugs, by having an insider steal a pad and write scripts.
You did the right thing. I'm sorry it hurts so much. I've been in a vaguely similar position--being responsible for somebody being led away in cuffs and tears, who really needed it. Which doesn't mean I have any advice, because I don't. But if it helps, I understand what you're going through. I really respect you for making a difficult choice.
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posted
I'm sorry for the upset this caused you, but thank you for doing the right thing for that child, for that man, and just the right thing, period. (((hugs)))
Posts: 21182 | Registered: Sep 2004
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posted
For some reason, I get the odd feeling that this guy may have brought his son with him to do this for the very reason you're suffering. I wonder if he was using the child as a way to get away from having the police called on him, relying on the sympathies of kind people like yourself to keep himself out of jail. I feel for the child, but the father's actions seriously make me sick. Why would a parent take their child with them while they were doing something they knew was illegal? ACK! I don't know if I would have done the same thing as you. What you did took incredible courage and care.
[ January 08, 2005, 12:37 PM: Message edited by: Boris ]
Posts: 3003 | Registered: Oct 2004
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You did right, my friend. I'm proud of you, not only for having done this, but also for worrying about it so much. It shows compassion. I'm sorry you had to do such a thing, but I know you know it was the right thing...
Posts: 4816 | Registered: Apr 2003
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posted
Hard stuff. It never gets easier. And when you do look askance at those who happen not to be seeking, then it is terribly insulting to them. But if you don't ... ah, well. No way to win. Posts: 2919 | Registered: Aug 2004
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posted
Wow, Boris, that's a really good point. I hadn't thought of that.
And it just goes to show why this *was* the right thing to do. All drug users have other things in trheir lives that will suffer if they get arrested, but everything in their lives suffers while they are addicted. But some of them have the decency not to use their small children as a shield. This guy didn't have that decency, and for once his ploy did not work.
Posts: 13680 | Registered: Mar 2002
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posted
I agree that you did the right thing. It's the law and you really had no other choice.
The law needs reforming, so that people get the help they need. But until that happens, you HAVE to follow the laws. You can't know in that situation who this man is or why he's trying to get those narcotics. He could have a chronic illness with a lot of pain and the doctor is too scared to prescribe the meds. Or he could be an addict. He could be a dealer. There's no way for you to know, so the only thing you CAN do is what you did. The not knowing is the thing. And if he does have one of those illnesses, it will come out in trial, and maybe--hopefully--it will draw enough attention to be the case that changes the system so doctors will be allowed to prescribe needed medications without fear of losing their licenses. That can only happen with the right attention to the problem. So, whoever this guy is, you did the right thing. This can be the catalyst to reform of the man, or to reform the system. Both of which are good things.
I cannot imagine how that would make me feel in your place, all I can say is I would probably be bawling my eyes out and unable to function. The idea of causing pain to that little boy....little boys love their daddies, no matter what and he's too young to understand why he's being taken away. Man, it does break the heart.
But, I'll reiterate what others have said - you did the proper thing professionally, you handled it like a true professional, and you gave this person every opportunity. You are an example of what I want every pharmacist to be - compassionate, but professional. The fact that this bothers you so much speaks highly of your character. I just hate you had to go through it, and I'll say a prayer that man gets help for his own sake, and that of his son.
Posts: 14428 | Registered: Aug 2001
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quote: One thing that worries me is that I will have to work my best to send people to jail who I personally think shouldn't be there.
Do you mean, "Shouldn't be there" as in they committed the crime but would be better off not going to jail for it, or "shouldn't be there" as in they did not commit the crime?
Posts: 6367 | Registered: Aug 2003
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posted
Never the latter. I may have to prosecute someone in a close case who I think may not be guilty, as long as I present the evidence correctly to let the jury decide. Especially when the actual events are undisputed and only elements such as intent or reasonable belief of imminent danger are involved. But not if I know they are innocent - my proper choice would be to refuse to prosecute, and resign if necessary.
However, I contemplate having to prosecute people and seek jail time in accordance with my office's policies for guilty defendants even when I think the punishment is unsuitable.
posted
Ah, okay. I was going to say that I would have a serious moral problem with the second situation. Posts: 6367 | Registered: Aug 2003
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I prefer to believe that in this case, the man may have been asking for help in the most desperate way. Not leaving when you gave him three (3!) outs makes me think this.
Whatever his deal, you did the right thing, and I am proud of you. Sad for you, but proud.
posted
Adding my support and agreeing with the strong possibility that the wife was involved (too suspicious otherwise) and that the child was being used as a shield. I know it will be hard to digest and deal with, but I know you'll get there.
Posts: 4515 | Registered: Jul 2004
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quote:so doctors will be allowed to prescribe needed medications without fear of losing their licenses.
You have GOT to be kidding! Sure, that is what the problem here was..not ENOUGH drugs available to him.
The reasons that MD's won't prescribe large amounts of drugs to people is that there are safe limits to what a person can take, and if a MD goes past those recommended levels he is endangering the patient, not to mention risking his license to practice. Pain management is not always cut and dried, but the reasons people do this crap ISN'T because the system is broke an, and Md's are afraid of losing their licenses...it is because the potential for abuse.
Alucard, while it wasn't easy it WAS the right thing to do. And it speaks volumes about you that it was so hard to do....and that you did it anyway.
posted
Alucard, you definitely did the right thing. And the little boy probably was a shield. That was my first thought also.
Kwea. There are actually a lot of people in severe pain who need high doses of narcotics chronically. That is why we have long-acting narcotics and narcotic patches etc. And the safe limit varies greatly from patient to patient, whereas the doctor's comfort using these drugs, especially chronically or at high doses, is usually on the low side. Many people do not get adequate pain control or have to deal with suspicious healthcare workers on a regular basis. Yes, getting sued for giving too much medication and getting sued for not giving enough medication are both possibilities. I know I am terrified. It is a fine line.
I even know a family doctor in town who deals with this by refusing to prescribe any narcotics, at all, to anyone. I think that is going way too far. It does make the job easier, though. All those miserable, bothersome, chronic pain patients will just choose to go elsewhere. Like to me, for example. Which isn't fair to them or me. Not to mention she must have a lot of miserable patients in pain from injuries that she won't prescribe short term pain meds for. OTOH, I had three patients switch to me from someone who was too lax and gave out too much medication and they don't understand now they need to follow some rules. They are used to just winging it and taking pain pills whenever they want. They are constantly pulling things on me. I suspect I'll be firing them soon, if we can't come to some sort of solution. Doctors really don't get enough training on how to deal with this.
Sounds like Alucard, OTOH, knows exactly what to do, even when he doesn't like it. Good job.
(Edit to add: I should comment that I don't really find chronic pain patients bothersome at all. I love working with people who know how to follow the rules and can have such relief of pain that they can have a normal life. That IS the goal of treating chronic pain.)
posted
Kwea, the DEA has gone after several doctors who insist they are simply trying to manage their patients' pain. Often, in a community, there will be only 1 or 2 doctors willing to prescribe the doses needed. Such doctors often end up with an aberrant number of high-dose narcotic prescriptions.
I do not know enough to judge the merits of any individual case, but enough doctors have complained and written articles about it that there's probably something to it.
Certainly there are doctors who give out prescriptions too easily, and certainly there are some who are outright supplying illegal prescriptions. But there are also doctors who are not managing pain sufficiently.
posted
hmmm interesting discussion, but I agree, you did good. The laws are there to protect everyone, not just the patient, the pharmacist, and the doctor, but the whole population. No one can govern another persons actions all the time, and sometimes people have to make difficult decisions, but this decision was the right one to make. Question, was the person getting the same script at your store?, and if so, was he using insurance? That could lead to insurance fraud.
We have a similar situation at my store..."flea boy" actually brought in a forged script for a narc, got arrested, and a week later came back in with his girlfriend ( who decided to steal a walker from our store that night), and tried to pass another forged script while awaiting a trial on the first charge! (The nickname is because we found him pouring flea powder down his shirt a few months ago in the pet care aisle of the store.) He needs help..whether psychologic or physical....that is still to be determined, but getting arrested again proved that he has a problem and maybe he will get the help he needs. Either way...he still he still broke the law!
Next, as a patient who suffered severe back pain from a spinal injury in a minor car accident....I have seen several doctors who have handed me scripts for carisoprodol (muscle relaxer) and percocet (narcotic pain med.) after speaking to me for a few minutes. I am blonde (platinum actually ) and I, for one, hate to be "loopy" . So I take 1 or 2 of the pills as prescribed, then use ibuprofen and a heating pad until I am ok enough to move again. I have had several flareups since having an epidural cortisone injection in my spine (OUCH!), and the latest one I finally had a doctor who didn't just hand me a script for percocet! Yippee! He was checking my back and actually felt the muscle spasms that were starting from sitting up on the table without a back rest and knew that I wasn't faking the pain. He gave me tramadol for the pain...not a narcotic and not as strong as percocet, it still made me a bit loopy so I only took 2 of the 15 he prescribed. So i have had Doctors who were liberal with narc scripts, and one that I really like that was a bit more stingy. The fact that he was a hottie didn't bother me either!
Anyway, don't beat yourself up about it. If you didn't do it, perhaps it would have happened later, with worse circumstances. The child will not be "scarred for life" by this event. He may be wary of policemen, but perhaps one day his father will be a better man for you having done it. Not many pharmacists are willing to stick to their principles like you did and for that I admire you. Posts: 325 | Registered: Aug 2002
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posted
Theca and Dagonee, I know that there are problems sometimes with people who experience chronic pain, but in my experiences the large majority of people who abuse prescriptions are not abusing them because they have not received proper medication, but because they have become addicted to them and are desperate to continue their self-medication. A lot of people don't follow the proper dose requirements, but they are the same people who complain about major side-effects when they do so, such as fatigue and nausea....and they are the ones who sue when the medication has unforeseen consequences, such as liver damage or kidney failure.
Of course they have problems, they were double or triple dosing, and the medication was never meant to be taken that way! So the complications are severe at times because of the way the medication is being taken.
There is a reason Narcs are a controlled substance, and it isn't because MD's are stingy, or don't want to help people, it is because the potential for abuse and addiction is so great...leading people to do stupid things like this guy did with Alucard.
Keep in mind that not only is my wife a Pharm Tech, but I was a medic in the Army....so while I wasn't writing the scripts I saw a TON of abuse in the offices where I worked, and the large majority was not because of chronic pain or injury. Most of it was for black market profit or long term addiction.
posted
Kwea, I have no doubt that the majority (vast, vast, vast majority) of drug-seeking behavior will be related to an addiction or an attempt to profit. No question at all.
But the inability for some patients to obtain chronic pain management, and some of the DEA's recent aggresive pursuit of some doctors, seems to be a very real problem.
posted
Think of it this way at least were they take him he will not beable to get any drugs, and he can be helped to treat his condition.
Posts: 12 | Registered: Jan 2005
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posted
Percentage-wise, that is still a drop in the bucket.
If a MD can show reason why he/she is recommending that level of pain med to any patient, on a case-by-case basis, then I doubt there would be any serious repercussions.
However, if their role call of patients include an extremely high percentage of patients like that, unless they work in a pain management clinic or something, then there is a problem, and they need to be watched.
There are plenty of MD's who abuse the system as well, either for profit or for their own use (or the use of their family and/or friends). There has to be SOME sort of screening process to weed them out, but it is important that MD's have a way of defending themselves against unfounded accusations too.
posted
I just wanted to take a moment to thank everyone who offered their support and thoughts on my difficult situation. I wanted to thank each of you individually and respond to each comment, but will not due to brevity. I just have to say for the millionth time that Hatrack rocks.
To summarize why I was so struck by this incident: I wasn't even supposed to be in that store that day.
I was filling in for my wife as a favor and happened to catch this guy using an alias and a forged script. If I would have stayed home, he would have filled his narcotic and been merrily on his way.
So to get philosophical on this, I spent most of the day trying to rationalize why I went to work and why this happened, and if it might have been for a far more important reason than to just give my wife a few more hours rest. I can only hope that this person gets his life on track.
I talked to the detective the Monday after this happened Friday, and they simply threw him in the county jail until his case is arraigned. I am not sure on the specifics of the law, but he is either still incarcerated, or out on bond or bail, I dunno.
I have also given much thought to the plight of the little boy. This guy ALWAYS came in with his kid, even for legitimate scripts at my usual location where I was familiar with treating him. I am most afraid that the courts will look at his behavior with son in hand and somehow alter the father/son relationship until this man rehabilitates. That is the part that saddens me most. Hopefully, he will figure that part out on his own and treat his son more respectfully.
Dag had a quote that PSI had questioned. This man broke a law and has most likely spent the night in jail. But jail is not the answer. Therapy is, so that this man can get back into being a father and less of an abuser. That is the happy ending here, and hopefully, a few others.
Thanks again for reading.
Edited for brain cloud subtituting "rehabitulates" for "rehabilitates". Oh the pain...
quote:This guy ALWAYS came in with his kid, even for legitimate scripts at my usual location where I was familiar with treating him. I am most afraid that the courts will look at his bahavior with son in hand and somehow alter the father/son relationship until this man rehabitulates. That is the part that saddened me most.
I hope they interfere with the father/son relationship. Just because he comes in with his kid does not mean that he is a good father. For all you know, he could be driving to your pharmacy while under the influence. My father was an addict and he hurt my mother and me. Of course, he was a doctor, so he easily got his own drugs. I wish someone had stopped him somehow, like you stopped that man. You've helped that child, even if it doesn't feel like it now.
Posts: 3037 | Registered: Jan 2002
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posted
I know Mrs. M. I know I did the right thing. Even if this guy does not want to acknowledge that he has a problem, he does. And he already told me so. He begged me to get him into a treatment program, just so long as I did not call the cops and have his son taken away.
Even I know that getting the police involved was the best thing for all parties involved. I just feel so sad that I betrayed this mans pleas and called the police anyway. But then again, he betrayed my trust by lying to me and trying to pass off a forgery. Still, this was not a shooting contest, and I am simply reduced to sorrow I feel for the situation that this mans bad actions have brought to his family.
I have no doubts about what I did in calling the police. I am just saddened by the domino effect that this situation will cause this family in the weeks. months, and years to come.
Posts: 1870 | Registered: Mar 2003
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