By Alan Koenigsberg, M.D.
Earlier this week, one of my patients told me about a situation with her medications and her mother. This adult patient recently had surgery and had a few leftover narcotic medications. The surgery went well and she didn’t need more than a day or two of pain medications.
Her mother was about to undergo her own surgery and told my patient she was going to come by and get the leftover pain medicines from my patient. My patient was torn between not wanting her mother to suffer without pain meds, puzzled as to why her mother thought the surgeon wouldn’t provide pain medications and unsure about the legal and ethical ramifications of giving out her meds.
As for the legal side, please keep in mind I am a physician, not a lawyer, and my comments are meant as general guidelines, not legal advice. It is my understanding that prescription medications, especially Schedule II narcotics, are not to be given to or used by anyone other than the intended patient, under penalty of law.
Secondly, it’s just not a good idea to share narcotic pain medications; people react differently to narcotics, may need different dosages and may experience serious drug interactions. Don’t share narcotics!
Regarding sharing other medications, similar cautions. Many medications may sound similar but, again, can cause problems.
A question asked by several of my patients is about carrying prescription medications with them when traveling. Most of my patients have chosen to distribute their prescription medications into weekly plastic pill containers, with one or two compartments per day. I give them one as a new patient and suggest they buy three more. This way, when they get their monthly medications, they can spend 15 minutes and put all of their routine medications into four weekly containers and they are set for the month.
Remembering to take their medications becomes routine and easy, as opposed to opening those amber or white “childproof” pill containers every morning and night, trying to remember if they already took their daily meds.
So, while taking those weekly pill boxes might be the simplest option, I recommend taking Schedule II medications, such as stimulants for ADHD, or narcotics, in their original pill bottles. It’s free and simple to ask the pharmacist for an extra empty, labeled pill bottle and then take enough meds for the trip, plus a few extra days’ worth.
Another medication suggestion is to sign up for your pharmacy’s text reminder system, to remember to request refills. If you don’t want to do that or the pharmacy doesn’t have that option, you can set reminders in your smartphone or calendar to request refills. Missing meds, or calling for refills at the last minute, can be quite stressful.
Next, please consider putting together a comprehensive list of all of your prescription medications into your phone, or on a piece of paper you carry in your wallet. Please do this for your significant other, also. In the event of an emergency, we may not remember all the names, dosages and indications for every medication.
This can also come in handy if and when consulting with a new physician, who requests a list of all of your current medications.
When calling your physician to request refills, please have all the relevant information at hand; tell them your name, date of birth, medication names, pharmacy name, address and phone number. We generally send in all of our prescriptions electronically now and need the name of your pharmacy and their address to know where to send them. The phone number is helpful if problems arise. And please give us a reasonable amount of time to do this. We have to review your chart and think about whether the refill is safe.
Lastly, please understand about prior authorizations. Those are requested by insurance companies, not the physicians. They want to have us explain why we are requesting a branded medication instead of a generic, a higher dose than usual or some other use. We need some time to review your charts, figure out how to explain and justify what we want to prescribe and then go online and get this done.
Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas. He can be reached at firstname.lastname@example.org.