Prescription Meds While On The Road

[Roy W.]

We were away from our Florida home and in New York State for 14 weeks this summer and experienced problems renewing prescription medications some of which are controlled substances. I use Walmart as my Rx provider and found out that prescriptions can only be transferred one time. We didn't have too much trouble transferring Rx to NYS, but when we came back, Walmart required a written script from my doctor to refill my prescription. The doctor said he would not give me a script because the one he wrote originally still had refills left on it. Walmart however would not recognize the refills, and said when Rx are transferred back to the original store it has to start with zero refills.

How do other travelers address this problem?

[MCJones]

I use AARP for my meds and they will send my 90 day supplies to any address I request as long as the prescript still has a refill. My doctor sends the prescrips via computer to AARP when needed. I know this can be a pain so good luck. mark

[Jamie65]

We use Walgreens and do not have to transfer prescription's, just fill at a different store.

[Bigd9]

All pharmacies must abide by state laws. The problem you are experiencing is not a WalMart problem, but a state to state problem.

Certain pain and other medicines are controlled substances and the pharmacy might not be allowed to fill them, unless the prescription is written on that states approved prescription pads.

One solution would be to see a doctor in your current location and have them contact your doctor back home. Maybe the two Docs can get together and have the doctor in your current local write a new script.

Another possible solution would be to get someone back home to send you the meds overnight delivery. I'm not sure of the legality of this so be careful.

Good luck and please let us know how you solve this problem.

[Fred and Bonnie]

Another possibility is Express Scripts


Fred

[ed6713]

Here is the issue you are dealing with on Class 2 meds. A lot of the really potent drugs have been reclassified as Class 2.
Vicodin and other prescription painkillers will soon be harder to get
What tighter restrictions on hydrocodone products mean for you.

U.S. healthcare providers write more prescriptions for Vicodin and other narcotic painkillers that combine the opioid hydrocodone with acetaminophen (the active ingredient in Tylenol) than for any other drug. But as of Oct. 6, 2014, when a new ruling from the Drug Enforcement Agency goes into effect, those medications and other hydrocodone-combination products are going to be harder to get.

For more than 40 years, medications that combine hydrocodone and other drugs have been classified as Schedule III controlled substances, but the new rule bumps them up to the stricter Schedule II category. Regulatory agencies have been considering the change for more than a decade, but increasingly grim statistics arising from the opioid epidemic in this country has created a sense of urgency. According to the national Centers for Disease Control and Prevention, abuse and misuse of opioid painkillers send half a million Americans to the emergency room each year for complications from the drugs and claim the lives of 46 people a day, or nearly 17,000 a year.

For more on the risks associated with opioids as well as tips for safe use of those and other pain relievers, see our special report "The Dangers of Painkillers."

The movement of hydrocodone-combination drugs into the Schedule II category has been a long time coming, Marvin Lipman, M.D, chief medical adviser for Consumer Reports, said. The added restrictions will make it more labor-intensive to prescribe and dispense these medications, but that should also decrease unwarranted prescriptions and encourage more selective use of the drugs.

If you are one of the hundreds of thousands of Americans who take one of these drugs, you may be wondering how the switch to Schedule II will affect how you get your medication. To answer that, we turned to our Best Buy Drugs team and medical advisers for the straight scoop on the impending change.


What does it mean when a drug is classified as 'Schedule II'?

Drugs with a potential for abuse are classified by the DEA as controlled substances, and divided into five categories, or schedules.

Schedule I drugs are mostly illegal substances that are not considered to have a medical usefor example, heroin and the street drug Ecstasy. Schedule II drugs have acceptable medical uses, but have a high abuse risk and can lead to physical and psychological dependence. Most narcotic painkillers, including fentanyl (Duragesic, Sublimaze, and generic), hydrocodone alone (Zohydro ER), morphine, oxycodone (OxyContin and generic), oxycodone combined with acetaminophen (Percocet and generic), are already classified as Schedule II. The new rule moves hydrocodone-combination drugs into this category with its chemical cousins.

Schedule III drugs includes a few drugs such as acetaminophen with codeine (Tylenol with codeine and generics) and some stimulants and anabolic steroids, which have a lower abuse risk than Schedule II drugs and are less likely to lead to addiction.

Schedule IV and V drugs, which include sedatives such as alprazolam (Xanax and generic), diazepam (Valium and generic), and lorazepam (Ativan and generic) and some prescription cough drugs, carry the lowest risk of abuse.

How does the switch to Schedule II change the way prescriptions are handled?

Schedule III, IV, and V drugs carry far fewer restrictions. Your doctor can write you a prescription or phone or fax it into your pharmacy. You can also refill your prescription up to five times in six months without going back to your doctor.

With Schedule II drugs, on the other hand, your doctor must write the prescription on paper or electronically transmit it to the pharmacy using a secure system. (Nationwide, about 70 percent of physician practices are now set up for e-prescribing.) He or she can fax a prescription to the pharmacy, but unless it is for a patient in a long-term care facility or hospice program, you will still need to present the paper prescription to pick up the medication.

In addition, refills are not allowed with Schedule II drugs and many states and insurance companies only allow you to get up to a months worth on a single prescription. But your doctor can write multiple prescriptions for a total of up to 90 days worthfor example, three 30-day prescriptionswith instructions to the pharmacist to fill them sequentially. If you need to take the drug for longer than three months, though, youll need to go back to your doctor for another prescription.

What if I need the medication after office hours or theres some other reason I cant get a paper prescription from my doctor?

In emergency situations your doctor can phone in a prescription for a few days worth of a Schedule II drug, but must still follow up in writing within a certain number of days, depending on the state. If you need additional medication after that, youll need another prescription.


Can I fill my prescription while traveling out of state?

It depends. State laws vary on whether or not pharmacists can fill prescriptions for Schedule II drugs written by a doctor in another state. For example, pharmacies in Massachusetts will only honor prescriptions from six other states, while Texas pharmacies will fill prescriptions from all other states, provided they meet Texas requirements. Your best bet is to get your medication before you travel.

If you will be out of state for an extended time and the local pharmacies are unable to fill your prescription, you can have the medication mailed to you. Under federal law, the inner container with the medication must be clearly labeled with prescribing information (in the original container from the pharmacy is fine), but the outer packaging should not reveal the contents.

Is there any advantage to the new rules for people who take the drugs lawfully as prescribed by the doctor?

Yes. No doubt people who take hydrocodone-combination drugs long-term will miss the convenience of phone-in prescriptions and easy refills. But ultimately, closer monitoring by their physician is a good thing. One of the biggest misconceptions about opioids is that they only pose risks to people who intentionally abuse them. But even people who use the drugs legitimately to combat pain can unintentionally get themselves into trouble, especially if they take them longer term.

[scenic route]

Originally Posted by Jamie65

We use Walgreens and do not have to transfer prescription's, just fill at a different store.

X2 Never had any problems refilling any of our scripts and we've had no problem finding a Walgreens...had to backtrack 150 miles to Anchorage once for a pickup. They're everywhere...almost.

[Gary RVRoamer]

The regs on "controlled substances" are much stricter than routine prescriptions, so the "no problem" reports here may not be very relevant to Roy W's question. Both state and federal regs have to be oobserved and the pharmacy doesn't have any choice in the matter. Nor does the prescribing doctor. In addition, major chains usually have strict policies intended to make sure they do not run afoul of the regs and lose their pharmacy licenses across the board.

If Roy's insurer has a mail-order dispensing service, that may be a better source when traveling, even if more expensive on some common drugs. They usually know how to get drugs legally delivered anywhere in the USA.

14 weeks is just over 3 months, it should be practical to take your entire supply with you. Work well in advance with your physician to get a 3 month refill just before you leave.

[Fred and Bonnie]

Originally Posted by ed6713

U.S. healthcare providers write more prescriptions for Vicodin and other narcotic painkillers that combine the opioid hydrocodone with acetaminophen (the active ingredient in Tylenol) than for any other drug. But as of Oct. 6, 2014, when a new ruling from the Drug Enforcement Agency goes into effect, those medications and other hydrocodone-combination products are going to be harder to get.

We have a close friend on these meds, she mentioned to us that now she must physically visit her Dr. each month to renew the meds. (Limited to 30 day supply)

This will really put a damper on long range travels.

Fred

[Cross27]

Regarding Texas and Schedule 2 Drugs
What we are discovering is Texas pharmacies can not fill a Schedule 2 prescription from an out of state Doctor unless it's written on a Texas Prescription Form, or the pharmacy has requested and been approved to fill out of state Schedule 2 drugs. To obtain the prescription pads, it seems the doctor has to license to practice in Texas. And there are very few Texas Pharmacies on approved list, and none of the chains - Walmart, Walgreen, CVS are approved for filling out of state Schedule 2 drugs.
So as a snow bird in Texas we are having quite a challenge getting our Schedule 2 drugs.

[Gary RVRoamer]

The major mail order pharmacies usually have a licensed dispensary in any state where it is required, so they can legally deliver drugs anywhere. Medco Health, which recently acquired ExpressScripts.com, is one such. Aetna too, but they seem only to service their own policy holders.

We found out the hard way that CVS does not do this automatically. When we traveled to a state that regulated out-of-state prescriptions, we had to manually request a transfer of our prescriptions to another CVS pharmacy in the appropriate state, plus there was a different procedure for "specialty" drugs than standard ones. PITA.

As others have said, Class I and II drugs have strict federal rules as well as state ones, with limits on refills and prescription amounts that are difficult for long term travelers. The FDA is not friendly to those who lack a fixed home - they think we are either addicts or drug dealers. Sadly, they are right often enough that the lawmakers go along with them.

[Bamaman]

As has been said, prescription laws vary somewhat from state to state.

You can blame some physicians that are "candy men"--writing Class II prescriptions to drug addicts. They're charging 2x or 3x a normal office visit, and selling their soul to the Devil for the big bucks. And a few of these doctors can wreak havoc on the community. Pill heads account for a large percentage of thefts, illegal drug use and strong arm robberies in this area.

My wife's got spinal stenosis and her pain management doctor retired--tired of all the administrative crap. Her internal medicine doctor continued writing prescription for her Morphine Sulfate and other Class II drugs. Because so many of his patients are elderly and in nursing homes, the State came down on him for writing too many controlled medicine prescriptions. He told my wife to go find another pain management clinic--of which the nearest one is 70 miles away.

A proper pain management clinic is run by an anesthesiologist that has a fellowship in pain management. They're watched closely by the State and Fed's. They do urinalysis on patients monthly, and they count pills to insure the meds they're prescribing are being taken as intended--no more, no less. You've never seen so many pitiful, almost mortally sick people as what goes through such a clinic.

Though my wife takes her medicine properly, it's taken a year before they'll post date a prescription 30 days ahead. That means we cannot go anywhere longer than 60 days--or she'll miss her next appointment. It's just how it is. We're willing to stay close to home so my wife can be active and not a complete invalid.

[spritz]

I called ahead of arrival in Lake Havsco(sp) Wal-Mart and was told that they have a really hard time getting 2 of my Class 2.Narcodics .
I called the clinic that I go too at home and spoke to the pharmacist and she told me that as long as I have a hard copy script that they will fill it on the date the prescription is written and that they will mail or UPS/FedEx it to me in AZ
Maybe try you clinic, Good luck
Happy Holidays,Tim

[MSHappyCampers]

This is scary!