“I’m about to run out of my hormones….my Adderall..my blood pressure meds.”
“My pharmacist said he sent a FAX…I need an early refill…I’m leaving for Paris in 3 days!”
Okay, okay, slow down.
I’m going to walk you through the incredible complexity of rules and regulations concerning your prescriptions. On the one hand, my dedicated staff gets about a hundred or so requests every day, from patients, pharmacists, insurance companies (they’re the worst).
You need to know (and probably don’t) there are State of Illinois and Federal regulations that must be followed, otherwise your prescription will be automatically blocked by some computer, somewhere. Another hurdle is your health insurance company which can randomly decide not to cover your medication or medications (“not on our formulary”) or change your pharmacy (“please move all your prescriptions to Walgreen’s”). This means, of course, you calling us to do this work.
Most confusing to patients are requirements for prescription refills.
First, the so-called controlled drugs, which are divided into schedules: Schedule I through V
Schedule I are never prescribed by physicians although you’ve certainly heard of heroin, LSD, cannabis, peyote. At present, they have no FDA approved medical use.
Schedule II, also known as “controlled drugs”, are opioids for pain (oxycodone, Norco, Morphine), meds for ADD (Adderall, Ritalin). These are quite carefully controlled and you need a new prescription every month. Yes, a face-to-face office visit is required to prescribe a Schedule II drug, unless the patient has a psychiatric disability or substance use disorder. This is due to a proposal from the DEA that requires an in-person exam before prescribing a Schedule II medication, with the exception of an initial 30-day prescription period. The proposal aims to prevent online over-prescribing of controlled medications. To continue to be prescribed Schedule II drugs, a patient must be seen in office every 6 months. The Illinois Prescription Monitoring Program tracks everyone’s use of these meds. Early refills and automatic refills are not allowed. If you lose your prescription, it will not be replaced. If your prescription is stolen, you must file a police report and bring it to our office for a replacement.
Schedule III drugs are monitored by your health care practitioner rather than the State. These have a potential for abuse and dependence but less so than those in Class II. These include Tylenol #3, ketamine, testosterone, psychostimulants (armodafinil). You will need an office visit (telemed is okay) every six months to get Schedule III prescriptions renewed, but an in person visit is required once a year.
Schedule IV drugs have an even lower potential for abuse and dependence. The common antianxiety meds (alprazolam, clonazepam), sleeping meds (zolpidem). You will need an office visit (telemed is okay) every six months for schedule IV prescriptions but an in person visit once a year.
WHAT ABOUT ALL THE “NON CONTROLLED MEDICATIONS”?
Then of course, there is “everything else”. Your meds for cholesterol, thyroid, diabetes, arthritis, depression, blood pressure, your heart and so forth. At least here at WholeHealth Chicago we do try to make our best effort to reduce your number of medications, but sometimes you’re stuck taking a few.
The most efficient way to get a prescription refilled from WholeHealth is to request the refill through the pharmacy you initially filled it. As I said, we get hundreds of prescription refill requests daily, so sifting through ten different communications for the same request creates a backlog for staff.
Here are some suggestions to make medication renewals a little easier for yourself:
- Stick with one pharmacy, get to know the pharmacist if possible. Investigate the small independent pharmacies in your area.
- Bring in all your current medications so she can enter them in her system.
- Try to get all your medications synchronized (filled at the same time) and always request your doctor to write 90 day supplies with 3 refills. This will cover you for a year and save you multiple boring trips to the drugstore.
- Investigate the mail order pharmacies like Express Scripts, Caremark, or Amazon. I am receiving very positive reviews from patients.
- When you need a refill of a noncontrolled med, contact the pharmacy. If your chart shows you can have a refill, it will be given to you without contacting us. If you are overdue for a visit (like a thyroid blood test), then you’ll be told by the pharmacist “you need an appointment”.
- HOWEVER, WHEN YOU NEED A REFILL OF A CONTROLLED MED (ADDERALL, NORCO, ETC.) CALL US ONE WEEK IN ADVANCE. DUE TO NATIONAL PRODUCT SHORTAGES, TRY TO LOCATE A PHARMACY THAT HAS YOUR MEDICATION.
- If you have an Illinois address but live part time out of State, your ability to fill a controlled medication from an Illinois licensed physician will vary from State to State. I would tell you to “just ask a pharmacist in that state” except too many times they aren’t sure of the answer themselves!
You might want to mark this Health Tip as a “SAVE” because some time in the future when you are asking one of my staff “Where is my prescription?”, she’ll refer to the Health Tip of 8/27/24 (which will be updated when the rules change again!). You can also see our formal medication refill policy on our website under the “Resources” tab.
Be well,