March 1st, 2014

angry, angry Elmer Fudd

Some pharmacists suck

I had another pharmacy experience today, which prompted me to finally write a letter to CVS:

CVS Corporation
Customer Relations
One CVS Drive
Woonsocket, RI 02895

March 1, 2014

Dear Sir or Madam:

Over the course of the past two months, I’ve had some very unpleasant experiences with the pharmacy at CVS Store #10121 in Berkeley, California. Most of these interactions happened in December 2013, in the days immediately surrounding Christmas Day, and I had considered writing this letter at that time, but decided to let it go. Unfortunately, today I found myself with a need to visit this pharmacy again, and the pharmacist’s disrespectful behavior encouraged me to finally write this letter.

I have been taking Xanax in varying doses for years, but at the end of 2013, my doctor and I decided to experiment with Xanax XR as a potential replacement for the regular Xanax. I took a few days of XR samples, supplemented as necessary with my regular (non-XR) Xanax tablets to ease the intended transition, but the XR did not seem effective for me. My doctor and I decided that it was worth trying for a bit longer to see if the XR would work, though, so he wrote me a Xanax XR prescription, which I got filled at CVS Store #10121 on December 17, 2013. Our intention was that I would continue to try the Xanax XR for a bit longer to see if it became more effective, supplementing with the regular Xanax as necessary, then discuss our further course of action when we saw whether the XR was reducing the amount of regular Xanax I needed to remain functional.

A few days later, I found that my regular, non-XR Xanax prescription had not been refilled, despite my doctor’s request. The pharmacy had not contacted me or indicated any problem so I phoned to speak to one of the pharmacy staff on 12/23/13 to find out what was going wrong, and they told me that the pharmacist had made the decision to override my doctor’s orders because he felt that the alprazolam XR prescription should replace the previous alprazolam prescription. There were two very serious problems with the pharmacist’s behavior in making this choice:

1. The pharmacist did not contact either me or my doctor in any way to consult with us either before or even after making this unilateral decision. He simply chose not to fill the prescription without explaining his reasons. I had expected that a pharmacist would play a crucial part in my health care team, working together with me and my providers to make sure that I received the best care possible. This pharmacist, however, seemed to ignore the potential input from anyone else and made a decision alone, instead of inquiring about what health factors might have led my doctor to write both prescriptions. The pharmacist seemed to value no one’s opinion but his own, which I find unprofessionally arrogant … or, at the very least, unprofessional and careless.

2. The pharmacist did not, apparently, take potential withdrawal effects into account. The new Xanax XR prescription was for a significantly lower dosage of Xanax, which we had planned, of course, to supplement with the normal Xanax tablets as needed. When the pharmacist chose not to refill the prescription for the regular Xanax tablets, he effectively cut my Xanax dosage in half, with no tapering at all. Since my doctor and I were not even certain at that time whether the XR was benefiting me (and, in fact, we decided soon afterward that it was not, and I discontinued taking it), the pharmacist had in effect decided to suddenly stop giving me any Xanax at all. There was no indication that a sudden reduction in dosage was necessary or advisable. Even if a doctor does recommend such a drastic reduction in Xanax dosage, research indicates that the reduction should be done gradually. This pharmacist chose to put me at an unnecessary risk of withdrawal without even consulting me or my doctor about the necessity of doing so.

If this pharmacist had bothered to contact me or my doctor, he would have learned many useful pieces of information, such as the fact that I have a history of hospitalization for suicidal ideation. Some of the common withdrawal effects when someone abruptly stops taking Xanax include severe anxiety, depression, and extreme outbursts of emotion, the combination of which is extremely dangerous for someone at risk for suicide. This CVS pharmacist’s decision not to consult anyone before refusing to fill this prescription could literally have killed me. I find the carelessness with which this pharmacist risked serious and potentially lethal withdrawal symptoms both morally reprehensible and medically irresponsible. It was only thanks to my doctor’s aggressive, persistent insistence that the pharmacist agreed to fill a prescription for any additional Xanax at all, which luckily allowed me to get past the point of establishing that the XR was not effective for me … and allowed me the time to transfer my prescriptions to a Walgreens pharmacy. I did not wish to continue to place my health in the hands of someone who had endangered my mental and physical health with their carelessness and arrogance.

This pharmacist’s unprofessional attitude was made only more clear to me when I found myself needing to visit Store #10121 pharmacy again today. Since my experience in December, I had not visited this store again, but the store is located directly across the street from the office of my primary care physician, and so it is the most convenient in an urgent situation. I visited my doctor’s emergency hours today (Saturday) and left with a prescription, which I reluctantly took to the pharmacy at Store #10121. Despite my past experiences, I was willing to give it another try. I tried to be calmly friendly and treat the staff as I would anyone else with whom I had an exclusively business relationship, but from whom I needed help.

The pharmacist on duty at CVS Store #10121 (I believe his name is Paul) refused to fill my prescription and sent me away with a smirk and the childish comment, “You made it clear you were disappointed with our service, and I would hate to disappoint you again.” The flippancy of this remark (“I would hate to disappoint you again”) encouraged me to write this letter at last. I did find another pharmacy today, as there are many in our city, but my life had once again been made more difficult in an already difficult time, thanks to the behavior of this particular pharmacist.

I don’t plan to return to CVS Store #10121, despite its convenient location only a few blocks from my house. I am hesitant to patronize CVS at all, and I plan to advise friends and family to avoid the chain, as well. I feel that my well-being has been repeatedly disrespected at your store, and I don’t wish to give my money to a company that treats me in such a way. Just to be clear, I had never reported this pharmacist’s behavior to the store manager before today, and so I don’t feel that these unprofessional interactions should reflect badly on him. He offered to handle the situation himself when I spoke to him today, because he assured me that this is not the way that customers are treated in their store, but I feel that there is little in his power to change the attitude of this particular employee and so I wanted my experiences to be documented.

I suggest you reevaluate the judgment, cooperativeness, and professionalism of your pharmacists.


Kimberly A——

cc: Sonny Singh
Store Manager
CVS Store #10121
2655 Telegraph Avenue
Berkeley, CA 94704