urgent advice needed re. lost script

[sula]

Hi there

i am currently in the 4th day out of treatment due to a prescription being lost/not filled in by either the pharmacy or my drug worker. As the DW is not back at work until tomorrow i have no idea how this has happened. I have not missed any appointments etc and was due to see him, as per our monthly arrangement, this Wednesday and the last script would have been from friday 2nd to Friday 9th March.

The pharmacy (i pick up weekly by the way) is in the same building as my doctor's surgery and the drug worker is a visiting specialist there but based a mile away at the drug service place.

When I went on Friday one of the receptionists at the doctors tried to get one of the GPs to do a temporary script until Monday but they wouldn't do it.

I have spoken to the drug service today (Monday) and they can't do anything until my drug worker is back tomorrow to tell them where this missing script is.  They also don't have a doctor at the drug service today to do a temporary one.

So, 4 days out of treatment. Not my fault. luckily I always keep a few days in hand so I'm not ill yet but my query is, don't they have some sort of legal responsibility/duty of care to ensure that treatment is continued when it's not due to client behaviour?/

At this point no-one knows if the pharmacy has mislaid the script (my DW would have put a month's worth of scripts into the chemist for me as I was too unwell to see him last time due to other health issues but that's normal for me anyway and doesn't usually cause any problems)  or if its a mistake by the DW or if its stuck in a drawer somewhere in the doctors office.  No-one knows.

Its Monday afternoon and I'm waiting for the surgery to get back to me to see if one of the GPs will write one out which according to a DW I spoke to this morning they should have done for me on Friday anyway.

What are my rights in this situation?   Any advice greatly appreciated.

[OP8S]

There seems  to be a incredible lack of communication between your DSP , Pharmacy & your GP. I'd of thought if the pharmacy & the DSP were to inform the Dr of the situation providing proof of your situation then you'd of been given something to keep you well until the DW in question returns to sort out this shambles.
What DSP is it ? No need to say the region if it's one of the big providers. Some DSP's that are highly motivated to get you off your script might even make your DW think that this is a cunning plan to reduce you? That's maybe a bit cynical (?) Have you told anyone that you like to keep a few days worth of your weekly dispensed script stashed ? If not then don't, that will give them the perfect reason to put you back on more frequent collections, even though it's there mistake. I believe it's illegal to stash it.

Besides that I'd make a formal complaint about their practice to the manager of the DSP & the CQC telling them how ill you have been. If you get weekly take home I'd think you give tests negative for other opioids apart from meth have you had to use on top because of your DW's possible mistake? Someone's made a balls up, I'd want to no who & how. If you're not going to give a positive morphine test then they will think that you're 1 week into methadone withdrawal. I'd be careful what I said in case I wouldn't them reason to change your weekly pick up.
Certainly complain though,to everyone involved in Drug services in your area. Be interesting to hear what the outcome is tomorrow, it's hard but try not to lose it, that's just another reason for them to mess you around.

[sula]

Hi OP8S

Thank you for replying. I've just got back from the doctor's surgery where the duty doctor has given me a temp script for 30 ml until the DW comes back to work tomorrow and this gets sorted out.

I take your point about not admitting stock piling but unfortunately I've already done that and admitted both to the GP and the drug service that I kept a small amount aside for emergencies simply because a Friday pick -up, with no out of hours service anymore, makes me very nervous.  I've never needed to use the spare meth until now though but thank god I did have it.

My argument would be that without the spare meth i would either be incredibly unwell by now and/or have been forced to score street meth or gear (bearing in mind also that I've not used illicit drugs for about 6 years now so have no idea of strength/tolerance)

I'm usually on 90ml a day, not from any raging habit, lol, but because I've gradually been increased due to break through pain that was assumed to be due to becoming immune to the effects of the lower dose (in fact my last post on this forum was about this and whether I should ask for an increase etc)

But, as you can imagine, being on 90ml is a bit of a burden when things go wrong. I also admitted to having some spare so the GP would realise that I still have quite a lot in my system and therefore not just give me 30ml on the assumption that I'm starting from zero as of today but she wouldn't listen, I guess they do have to be careful not to overprescribe but still...

If I needed insulin or heart medication I wonder if the doctors wold be so reluctant to do a replacement script?  It really annoys me how just because of one characteristic, opiate dependence, people are assumed to have all sorts of moral failings and can't be trusted.

So, at the moment I have this 30ml and have used up my stock pile. I'll be fine and I don't anticipate that they'll use the stockpile against me as the drug worker was aware of it as well but it will be interesting to see what happens next as they always like to blame the client somehow.

The service is provided by the local NHS mental health service but they do seem keen on recovery although no-one's pressured me into anything as i think I'm a lost cause!

I'm definitely going to complain. I really like my DW, and mistakes happen but I'm furious with the lack of help from the GP surgery and the refusal on Friday to do a replacement.

Also, on Friday I wasn't sure if my scripts were done by the doc at the DS so didn't press the point but apparently they are actually signed by a GP at the surgery so there was no reason not to do one other than the fact it was late and the DS was closed so the GP couldn't verify anything. But they could have just asked the pharmacist downstairs to confirm that I usually pick up on a friday and was due that day.  As I said, if it was insulin or something they wouldn't have been so callous.

Onwards and upwards.

[OP8S]

Nice one, I hope things work out. I'm not surprised the GP only prescribed 30ml / daily a lot of them don't know a great deal about prescribing meth these days with drug treatment being put out to third party treatment suppliers, with it being all NHS you would think that there would be a bit more communication but in some places GP's pay no attention to what goes on in the MH Dept Drug services. Glad they don't have to put up with junkies in their waiting rooms.
Will it all get sorted out tomorrow ? Sounds as though someone's made fuck up somewhere & this needs to be brought to managements attention whether you like your DW or not, they need to have some give & take as far as prescribing goes. Nobody should, through no fault of their own be left without a script for a whole week.
You say that they're very focused on Recovery, I wonder if they will go straight back to 90ml or say that they have to increase you from 30ml now that you've been prescribed that by the GP? I don't mean to be negative but my prescriber is NHS also & I've had a shitload of hassle because it's also a pain issue.  Are you in Scotland by any chance? Send me a PM if you don't want to post info on the forum & let me know how you get on.
Whatever happens just stay cool, hopefully they'll overlook the fact that you had some stashed because they won't want a formal complaint. If they refuse to start you at 90 again use it as leverage...if you want

[sula]

Hi again

well I'm back on the 90ml as of Friday. I went from having no script from them for previous friday, saturday sunday to having 30ml on monday, from the duty GP then my DW was back in work on Tuesday and he did 50 for tuesday and wednesday  and 70 for thurs and friday and back to 90 from this saturday just gone.

But of course that's not the point. I was abandoned by my GP practice in my hour of need and I'm furious. Will definitely be making a complaint. Of course the DW was primarily at fault (no-one knows what happened to the missing script but I have a feeling he forgot to put it in the pharmacy for me when i was ill)  but the lack of compassion and flexibility from the 2 GPs who were approached by the receptionist on the Friday when it happened was awful.  I didn't speak to them myself as I didn't realise that they actually had the power to do a replacement so they were just spoken to by the receptionist who doesn't know me and has no idea that I pick up every week either so I'm not sure that she would have been a good advocate for me anyway.
The chemist is in the same building though so they could have just asked them.

I guess they all just made a whole load of assumptions and because it was too late to call the drug service they just turned their backs.  I could have been unbelievably unwell.  I have other health problems that would have been affected by sudden withdrawal of methadone. Its borderline negligence.

I'm going to phone Release tomorrow and get some legal advice.  This could be classed as discriminatory practice as  no doctor would have made assumptions about the character of a heart patient or a diabetic who , through no fault of their own, was left without essential medicine so why should a patient on methadone be treated any differently?

I'm so mad.  i'd like to see either of those GPs go through the hell of enforced opiate withdrawal.  The fact that I had a small amount spare isn't the issue as they didn't know that when they refused to help me.

When I finally spoke to my DW on the Tuesday I said I'd had some spare so the amount in my blood would not be significantly less than usual. They can do a blood test that shows concentration of meth in the system and I asked him to do this so I didn't have to be titrated up so slowly but he said the results would take 8 days so it wasn't worth it.  So it was 30, 50, 70 then 90, take it or leave it.

Before he came back another DW phoned me on the Monday and asked why I hadn't seen my DW since December. This is because I have lots of health issues and am often to ill to meet him but he's fine about it and there was no issue with any missed appointments. He explained all this to them the next day anyway but it was just typical that the DW who doesn't know me jumped to conclusions and tried to find some fault at my end.

Its always blame the client, don't trust the client, treat the client like a lesser human being. I'm sick of it. 

Any advice about complaints procedures/legal action etc etc appreciated.

[OP8S]

I'm glad you've got it sorted Sula & there was no hassle getting back to your maintenance dose. It's all a bit of a mystery as to what happened though, which for me wouldn't be a good enough excuse. How did the mistake happen, what are the DSP going to do to find out so they can make sure it doesn't happen ever again ?
I would suggest that because of your other health issues a GP  from your local surgery could maybe be a bit more clued up regarding your meth script if you can't rely 100% on the DSP to make sure that you never have to deal with this again.
If you get in touch with CAB then they will have a PALS service who can assist you to write a letter of complaint & give you the names / addresses of local NHS managers. Won't hurt to get in touch with RELEASE also, though may be quicker using the PALs service.
Again, a word of caution about your stash. I know that it's been overlooked by the DSP just now but depending on how things go they could still bring that up to use against you. Totally unfair, but possible. You'll have a better idea as to how they will react to a formal complaint yourself but maybe best talking things over with a Service User's Group if you've got one, by having a less formal chat with the manager of the DSP, your GP or even PALS. I'm afraid currently The Alliance has no funding for Advocacy services, it's a forum at the moment really. It appears we don't meet the RECOVERY= ABSTINENCE narrative to be considered for any. Hopefully things will improve as DSP's accept MMT as a valid form of recovery from chaotic opioid use.
Be good to hear how you get on though. My personal experience over the last 5-7 years is that if you want to remain maintained & not reduced then the patient needs to have a decent grip of guidelines both NICE & Orange. Knowledge is power, use it well!

[sapphire]

If you believe the Dr' s at the surgery were mostly to blame as they treated you poorly and wouldn't even consider checking your dose with anyone like the pharmacist or writi g you a new script, the best people to probably complain to are your local PALS. If you google PALS and your area, you'll find the contact details.