[LostLocalMan]

Yes there is a lot of gatekeeping happening across the board. From my wife's experience living just outside of Portland Oregon:

- Prescription has been cancelled twice for no real reason.

- Pharmacists have refused to give more than one month at a time more than once.

- Even if everyone is on board and not hostile she's only able to get a few months at a time so she has to do this multiple times a year.

I can't imagine how it'd be if we lived in a more conservative state or in a more rural area.

[giantg2]

I've had some prescription issue for other meds as well. Usually an issue of the insurance or pharmacy, not a political motive. They don't like to give long term supplies given the expiration is 1 year from manufacture.

[LostLocalMan]

At least once she's been lectured about starting a family by pharmacists when trying to pick up her prescription which caused us to switch to a different pharmacy.

It's possible it's all imagined, but I don't really understand why a pharmacist would only give one month when the prescription is for multiple months, or why the prescription can't be for longer as to require less doctors visits / bills. We certainly haven't had the same experience picking up other prescriptions.

[giantg2]

"why the prescription can't be for longer as to require less doctors visits / bills."

They aren't just renewing your prescription? Most places see you once, or once per year, and then just keep renewing it.

Most insurances/pharmacies even have partner mail order services where you can turn on auto-renewal and auto-refill. That might be a good option to look into.

[giraffe_lady]

Your original question was whether there were barriers. Now you're clarifying you mean political barriers determined by the intent of the provider, which is of course opaque to us. Is it possible under these constraints to describe a barrier you'll accept?

[giantg2]

Generic issues are not barriers, especially if they are not universal. There are online services that can cheaply provide these services conveniently. Just because someone uses a provider that provides poor service is not a barrier when alternatives exist.

[dboreham]

The one month at a time thing is coming from insurance companies not the pharmacy.

[hombre_fatal]

Not necessarily. Pharmacies have arbitrary power.

My doctor gives me a three month prescription for a scheduled substance and I've had a couple pharmacies reject it because it's "sketchy". Of course, they never offer to call my doctor to confirm anything. They just smirk and cross their arms.

[mcpackieh]

Well what do you really expect from pharmacies, when failure to exercise such discretion can get them sued for millions or even billions of dollars? Blame lawmakers and lawyers.

https://www.nbcnews.com/news/us-news/cvs-health-agrees-5b-se...

https://www.npr.org/2021/11/23/1058539458/a-jury-in-ohio-say...

https://www.nytimes.com/2021/11/23/health/walmart-cvs-opioid...

[giantg2]

Even OTC amphetamines have purchased limits, some imposed by law depending on the state.

[hombre_fatal]

I guess you're suggesting that they rejected my prescription because of supply issues, they openly said it was because it was suspicious (3-mo in cash), and also Vyvanse hasn't had shortages like generic amphetamine in 2022-2023.

Also, I think you mean OTC amphetamine alternatives since amphetamine is sched I.

[somebodynew]

Amphetamine (Dexedrine) is schedule II, not schedule I. Doctors cannot generally prescribe schedule I substances like LSD. Pseudoephedrine is a substituted amphetamine so referring to it as "an OTC amphetamine" is technically reasonable although potentially misleading.

[CydeWeys]

These pharmacists have very real personal liability if they end up getting fingered as being a supplier of components used to make illegal drugs. That's why they look askance at this prescription.

[giantg2]

Not supply issues, meth manufacturing suspicion. Yeah, precursors to their manufacture.