Pharmacy. Jim Plagakis. Pharmacist

GET THIS!!!

From Drug Topics, 7/16/2001
Study by a Georgia State University researcher named Dean Dabney, Ph.D.

95% OF ALL PHARMACISTS HAVE DIVERTED PRESCRIPTION DRUGS FOR THEIR OWN USE.

65% OF THESE PHARMACISTS STOLE THE MEDICINE FROM THEIR PLACE OF WORK.

40% OF THESE PHARMACISTS HAVE ENGAGED IN THE ILLICIT USE OF POTENTIALLY ADDICTIVE MIND ALTERING DRUGS (PAPDs
potentially addictive pharmaceutical drugs).

20% OF PHARMACISTS SURVEYED REPORTED 5 OR MORE EPISODES WITH PAPDs.

6% OF PHARMACISTS SURVEYED REPORTED MORE THAN 10 EPISODES.

6% OF PHARMACISTS SURVEYED IDENTIFIED THEMSELVES AS DRUG ABUSERS.

7.5% OF THE THOSE WHO IDENTIFIED THEMSELVES AS USERS HAD FORGED PRESCRIPTIONS.

24% OF THESE PHARMACISTS STARTED WITH PAPDs WHEN THEY WERE IN COLLEGE.

64% WERE OUT IN THE WORK FORCE WHEN THEY STARTED SELF- MEDICATING

42% OF PHARMACISTS SURVEYED HAD WITNESSED ILLICIT USE OF PAPDs.

65% HAD WORKED WITH A PHARMACIST WHO CONDONED SELF- MEDICATION.

30% PERSONALLY APPROVED OF SELF-MEDICATION.

The title of Carol Uken’s article is: PHARMACY CULTURE CONDONES R.Ph. SELF-MEDICATION.

I know some of you are looking at your fingernails right now. I’m talking about you!
You 5 out of 100 who are pure, don’t read this. It may give you ideas. Actually, I am wondering about you.

We are talking about 95 out of 100 pharmacists diverting prescription drugs. We are not even talking about the students, the interns and the technicians.

So, you say, “I had a sore throat. I know that my doctor prescribes Z-Packs for practically everything. So, I bought one. I didn’t even steal it. Sorry, that is still diversion.

“I hurt myself in a skiing accident. My shoulder was dislocated. I needed something so I copped a couple generic Darvocet-N. What’s the big deal? It was 20 cents for goodness sake. I deserve it. I worked a half hour beyond my quitting time to help get caught up and I won’t get paid for it. You are going to nickel & dime me on this?”

Hey, in the early 1980s, I actually watched the pharmacy manager take Percodan, a tablet at a time, from the big jug, and pop them. He did have a skiing accident. It was nothing to him. Doesn’t everybody do this?

“Come, on, man. Leave me alone. I’ve got it handled. It’s just a few hydrocodone/APAP. I can quit any time. I’m fine filling prescriptions. I did not fall asleep at the wheel. The guy in front of me slammed on his brakes.”

I worked for awhile in an independent drug store in Pittsburg, California. This was in 1966. The pharmacist I worked with was putting HCTZ tablets in vials labeled hydralazine. He filled KCL 10% Rxs with Phenergan with Codeine. After awhile, the owner called an ambulance to come get him. We actually thought that he was mentally ill. Duh! Wake up! I know what the hell he was doing now.

A pharmacist in Bellingham, Washington took Klonopin with no doctor’s prescription for years and still does. He tried to stop and ended up with A-Fib and a huge bill for the relief pharmacist service while he was withdrawing, he says. He went back to klonopin and will never stop, he says. Why stop? He owns the store. There is no one to stop him.

For a decade, in the 1990s my doctor prescribed diazepam, 5 mg a day for muscle spasms associated with progressive post polio muscular atrophy. Like a dummy I took it. I thought I knew the dangers. I’m a pharmacist. That’s like reading a book on sky-diving and thinking you know what it’s like to jump out of an airplane. The benzodiazepines are a brutal class of drugs.

Starting in August, 1999, the day my mother died and I had to work because the manager refused to cancel her Tupperware party, I increased my dose to 10mg a day without telling my doctor. I diverted one 5 mg tablet a day for 6 months. That $5.00 worth of diazepam has cost me thousands and thousands and thousands of dollars in lost wages. It has cost me 6 years of interminable difficulties, almost unbearable distress and many nights of interrupted sleep, days of pacing the floor. It has taken me years to get back.

I will write down the whole story one day, just not yet. I think it begs to be heard. By pharmacy students, in particular.

YOU GUYS OUT THERE NEED TO WATCH YOUR BACKS! 40 out of a 100 of you are doing this with mind- altering pharmaceuticals illicitly. You have got to take care of it yourself. I do not think that our profession, in general, is ready to take its head out of the sand. Is this some of the profession’s “dirty laundry”?

By the way, I’m good. Victoria is good. We have a good life, a fine life in Galveston.

I am working as much as I want right now. I have two certified technicians almost all the time. You know from that, I do not practice at a chain store.

“Take out the da da and then the trash”. Rock ‘n Roll from way back. I can’t remember what words/s da da is. Help me!

Yesterday, Elke, an absolute artist CPhT, took a 60 second break from her duties to comment on my work ethic. Elke is an owner’s dream. Not one penny gets by her.
She squeezes out every cent from every prescription. She has a European work ethic.
If only she could teach young Americans how to make a living.

Elke said to me, “You are only the second pharmacist I have worked with who takes out the trash. You fill bottles and vials when we are getting low. You haul in boxes of labels.” Elke smiled. “You work hard. I like that.”

I also clean my tools after compounding. I have no problem counting pills. I will pour, lick and stick when it is wanted and needed. I may be a pharmacist, but I am still one of the team. I could step back and let the techs (there are usually 2 of them with me) do the grunt work. I could do the elite work, the checking of prescriptions and the counseling.

I love counseling. It looks to me that, during an average shift, there may be ten opportunities of value. Counseling chances when you damn well better counsel because this is serious business. I love those chances. I take the vials and go and sit down with the patient. I get to rest my seriously compromised legs and I have noticed that the patients seem to like the casualness. When I go sit down to counsel for five minutes, I know that Elke and Lynnette, a younger, competent CPhT, will keep things warm for me.

I digress, sorry! Lynnette said, “Yeah, Jim. Why do you take out the trash? I’ve never seen a pharmacist take out the trash.” She smiled. “Now, don’t get me wrong, Jim. I like it that you take out the trash. You don’t have to stop because of me.”

I explained that I was not so important that I can’t work like she does.

The seed of this ethic was planted at Cook Drugs in Ashtabula, Ohio in 1957. Dolph Hale had hired me as a “stock boy”. I went in for my first shift on a snowy Saturday morning just before Christmas. Dolph immediately took me to the back of the store. On the way, I got a glimpse of Frank DeDomenico, a 20 something pharmacist working in the “Prescription Room”. There was a hint of aldehyde aroma in the air. I was hooked.

Dolph led me to the bathroom. He handed me a bucket, a cloth, rubber gloves, cleaner, a toilet brush and Windex. “Make it spotless,” he said. “I am not so important that I cannot clean the toilet,” he said. “I’ll take my turn just like everyone else. Today, it is your turn.”

I cleaned like a fool, hating the strong smells of the 50s noxious chemicals I was using.
I made the bathroom squeaky clean. Dolph approved. When he was taking me down to the basement that was piled high with REXALL private label everything that I would haul up to the sales floor and stack, he said, “That is a good lesson, Jimmy. Don’t forget it when you are a pharmacist.” How did he know? I was 16 years old. How did he know?

Back in the late 80s, the store manager came to me and said, “Naas called. He found a pharmacist.” I was the pharmacy manager of a Pay ‘n Save Drug Store in Oak Harbor, Washington. This was on Whidbey Island, north of Seattle, a gorgeous place, where Orcas played at Deception Pass, where hundreds of Bald Eagles had their rookery a few miles away on the Skagit River. This was not a place where pharmacists roamed. For more than a month that autumn, I had been running the pharmacy alone. Six tens and closed on Sunday. My diet for 6 days was horrible. Peanut butter, trail mix, Snickers Bars, Diet Cokes, Fritos and other assorted salty snacks. I was clinically constipated according to the prevailing alternative medicine opinion. Robert Gray, the colon man, would have just shook his head. I ate too well on Sundays. I laid around too much on Sundays in withdrawal from epinephrine surges all week long. I watched NFL football until I did not give a damn who won. I did not go out on Sundays. I was near collapse. So, it follows that I was beside myself with glee to hear the pharmacist news. But, why was the store manager shaking his head, an emphatic “NO.”?
“What?”
“We’ll keep looking.”
“Come on, John. I can’t keep working 60 hours and 6 days a week. It is killing me.” I will eagerly admit that, about now, you can bet your towkas on this: IT WAS ALL ABOUT ME!!!
“It’s a woman. We can’t hire a woman.” He couldn’t even use the appellation SHE. He had to say IT.
“So what if she’s a woman?”
“I don’t want a woman back here. A woman can’t do this job. It requires two twelve hour shifts a week.”
We fought and I won. We hired a woman new to Oak Harbor, mid-thirties, the wife of a naval aviator. This was the home of Naval Air Station Whidbey. As a rule, the officers’ wives were well educated.
Cheryl came on board and she insisted that her name tag read: DOCTOR CHERYL MARINAKIS. John, the manager, went ape shit. “She’ll make you look bad. You’re not a doctor.” I told him that I did not care. I just wanted a pharmacist. A warm body with a license would do, but this woman looked to be competent, professional as well as good looking. He relented with a loud grumble.
Cheryl was a trim, fit, well-proportioned woman. She worked her 2 twelve hour days each week, plus three sixes, wearing a tailored skirt and high heels. How was this possible? The techs started wearing skirts, but, alas, not the heels. We had the most professional looking pharmacy in the chain. This has been a long lead-in to a simple statement. This is the 21st century and pharmacy is increasingly becoming a woman-led profession. There will always be a significant spot for men. Especially in management, when the company does not want gaps in employment to have a baby or raise kids. Companies don’t say it, but they look for male managers.
I have written women & pharmacy columns 3 times during my 18 years of appearing in Drug Topics, JP at large. In all three I said that pharmacy is becoming a women’s profession. That it was a great place for mothers to make a great buck without having to work 5 shifts a week. More power to ya. I also speculated that the average woman pharmacist did not work the full career that men are expected to work. This phenomenon is one of the causes of the pharmacist shortage, I presented. The first time, I GOT CREAMED. Any mail is good mail, but this was ridiculous. The second time, I received bad mail, but not of the HATE variety. Just a few years ago, women pharmacists wrote and agreed with me. Time does make a difference. Someone is growing up.
Jim Plagakis

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I honestly do not think that the retail pharmacy industry could handle all of the work if all the mail order outfits went out of business tomorrow. We are already stretched to the limit. Our counseling on a pain medicine is, “This is a narcotic. It may impair your ability to drive or work with dangerous equipment. Good Luck.” Can you even imagine how far behind you could get if the patient was a nothern European with her incessant “Why?” questions? Your eyes would glaze over. She wants a mini-series consultation. If SHE sounds like she is from Scandanavia… RUN AND HIDE. You’ll be screming with internal terror if you let her get started. You say, “This is a very good drug for what ails you.” She says, “Why?” You say, “It is been shown to be very effective.” She says, “Why?” You end up screaming, “Because I said so.”
Can you imagine doing more Rx than you do now, with no more help. Hey, look around, there is no one out there who wants to work with you. They all have jobs that gave them a car, gives them a bonus, gave them $25,000.00 to just take the job. Three weeks vacation right out of the box. It pays them $100,000.00 or more. Why move? Here is why:
A good friend of mine in Alabama (You know this guy, he writes a lot on the Message Board, the famous Krag) just told CVS that he would happily write them a check for his sign on bonus if he could find the appropriate PART TIME job. He’s over 50 and can easily make $75,000.00 dollars working three tens. He wants a life, for goodness sake. He does not need 5 days in the crusher. He does not need to hear the store manager say, “District says we have to cut cashier hours.” Bull shit! We do not need to put up with that crap. How about cutting the pharmacy hours back to 10AM to 6:PM, 6 days a week because I’m outta here and the only pharmacist you have says NO to working more than 6 days, 48 hours. Go for it, Krag. Nose to nose! Get exactly what you want.
Listen, you guys, the baby boomers want to be healthy, vibrant, youthful and sexy and they will pay big for it. They have gobs of money. They will not be getting “old” like your grandfather did. They will be living life to the fullest and that includes consuming medical care in great big bitefuls. This is a good thing for them and a good thing for anyone trained to provide health care.
You got it made, folks. Stop the bitching. You do not have to put up with anything!
More later. I’m gonna go read the Sunday New York Times. It may take me until Tuesday
Jim Plagakis