Sunday, April 18, 2010

COR 103 & the BS detector

In community pharmacy, you always need to have your BS detector fully engaged. Usually it's used to test the story that a patient is using in an effort to obtain their controlled substance prescription several days before it is due.

As a community pharmacist, you develop this sixth sense almost automatically. It only takes about six months on the job to have a fully-functioning BS detector. Having been a community pharmacist for fifteen years, including stints in the inner-city, I would say that my BS detector is finely-tuned.

Sunday we had a call come in to the pharmacy. My lead tech took it. It was a call to identify the tablet. The caller said that he had found some tablets while cleaning his son's room and wanted to identify them. My tech's computer froze up, so she turned the call over to me.

I let the caller sit on hold for 45 seconds or so before picking it up. I let the caller explain everything to me again. It takes him about two minutes to explain everything to me that he just told my tech. His speech was a little slurred. The story has changed and now, the story is that the caller was disposing of his dead grandmother's medications and was wanting to know what he was throwing away. Now the BS detector is going off full-force. Now the challenge is to see exactly what this caller is trying to find out.

I ask for the color, shape, markings, etc so I could punch the info into the computer to try to get a match. All the caller would give me was the color (white) and the imprint (COR 103).

As soon as I pressed the enter key, the identification popped up.... Carisoprodol 350 mg by Core.

I inform the caller that, based on the information he has provided, that the tablets are Carisoprodol tablets.

What's that? he asks.

I inform him that it is a muscle relaxer.

Is it very strong?

I tell him that it's a fairly normal strength.

What is it's name again?



I even spell it out for him. I will not tell him that it is generic Soma. That would make his day to know that he bought the right stuff off of the street.

It's sad that we, as community pharmacists, have to have our BS detectors working every minute that we are in the pharmacy. It's unfortunate that so many people are seeking to escape their pain through chemistry. We live in a society that believes that there is a pill for every ill.

I don't know what the answer is. Maybe it's a ban on direct-to-consumer advertising. If the patient doesn't know about the latest, greatest medications then they won't beg their physicians for them.

Maybe it's stricter reporting requirements by prescribers on the medications that they are ordering. I believe that if the prescribers are hit with more paperwork, they won't order 75 Darvocets with 5 refills for Grandma Jones sore wrist. The same wrist that has been sore for 8 years. Mr. Smith might not get the Vicodins for the knee he hurt 18 months ago, yet refuses to get physical therapy for.

As long as prescribers continue to order the narcotics, benzos, and muscle relaxers for every Tom, Dick, and Sally that comes to the office with a chief complaint of "hurting all over", we don't have a chance at curbing the diversion of prescription medications.

But until then, I'll enjoy these next couple days off and allow my BS detector to recharge itself for Wednesday's pharmacy fun.

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