Walmart in North Wilkesboro, NC, Refuses to Fill Buprenorphine Prescriptions

 

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When one of my patients told me he could no longer fill his prescription for Suboxone films at Wal-Mart, I was puzzled. Surely this couldn’t be true, especially not in an area of the country where people die from opioid use disorder too frequently.

My patient said, and I have no way of verifying this information, that the DEA visited  the Walmart in North Wilkesboro, NC, and told them if they continue filling prescriptions from the doctor at the pain clinic, they would be accused of some sort of collusion. In response, the Wal-Mart – allegedly – decided not to stock any form of buprenorphine.

Yes, my fingers itched to call Walmart to determine if this was true.

Completely in keeping with Walmart’s reputation for efficiency, I was cut off the first two times I asked to speak to a pharmacist. On my third try, I left my cell number and asked the pharmacist to call me. Surprisingly, he did call, after only fifteen minutes or so.

I asked him if it was true that Walmart no longer fills buprenorphine prescriptions, and he said yes, that’s true. I asked was that for all forms of buprenorphine, including the films, Zubsolv, generics, etc., and he said yes, all of them. He was obviously reticent to give any further information. I asked him if that was for one doctor, and if my patients could still fill prescriptions there. Again, he answered that Walmart had decided not to stock any buprenorphine  products for any patient or doctor. Starting to feel a little riled, I asked him if he thought that decision would interfere with appropriate treatment of a potentially fatal illness, he just repeated Walmart had decided not to stock buprenorphine at all.

So that’s that, right?

I don’t think so.

At a time when Congress passed CARA, the Comprehensive Addiction Recovery Act, which contained specific provisions to increase access to buprenorphine, Walmart’s pharmacy refuses to sell buprenorphine?

At a time when Health and Human Services passes a new law enabling physicians to have up to two-hundred and seventy-five patients instead of only one hundred patients, Walmart’s pharmacy refuses to sell buprenorphine?

During the same week that NIDA, the National Institute on Drug Abuse, announces increased access to buprenorphine will help the opioid overdose epidemic, Walmart’s pharmacy refuses to sell buprenorphine?

Can buprenorphine be misprescribed and misused? Yes, of course it can. Not as often as all other opioid pain medications, but it can be misused. But I don’t know of any pharmacy that refuses to stock all opioids just because some patients misuse them. That’s not appropriate. Walmart hasn’t stopped selling prescriptions for Opana, oxycodone, hydrocodone, Xanax, Valium, or clonazepam.

So can’t we – and by we, I mean the brain trust that is Walmart –  think of a better option than refusing to sell buprenorphine to any patient, rather than pinpointing the real problem?

I wanted to hear the reasoning behind this decision, so I called Walmart’s corporate office, the division of Media Relations. I told the nice lady answering the phone that I was a doctor who treated addiction, and that I also had a blog. I told her about the local Walmart pharmacy’s unusual decision, and I wanted to hear Walmart’s side. I wanted to know the reason Walmart decided not to stock buprenorphine in the middle of an opioid use disorder crisis.

I waited on hold for a long while, and then the lady, Delores, said she didn’t have any information on this but that she would look into this and call me back. I gave her my cell phone and I’m still waiting.  Since this was all done on a Friday afternoon, I’m not surprised I didn’t get a return call yet.

I’m going to make some noise about this one. I’ll keep you posted.

In the meantime, I’m not going to spend any money at Walmart. I know Walmart won’t miss the couple of hundred dollars my family spends each month on household items and some groceries. But if you see me at Food Lion, Lowe’s Foods, or even better, the IGA, you’ll see a smile on my face as I check out. My decision won’t break them, but it will make me feel better.

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24 responses to this post.

  1. Wow! This may turn into a BIG story … I’m going to take a wild guess and say the root cause was someone at Walmart not understanding pharmacology, yet making a pharmacology policy decision. It also odd how they specifically targeted only Bupe. I wonder if it’s (only) a local thing? We’ll see. Keep us posted!

    Reply

  2. Posted by Trudy duffy on July 24, 2016 at 1:58 pm

    Thank you. Will be checking where I live in Florida at local Walmart for pharmacy policy.

    Reply

  3. Posted by Bess Stanton on July 24, 2016 at 2:10 pm

    Jana this needs to be further publicized and we all must boycott Walmart. Would the local paper do an article on this ?
    Bess Stanton MD

    Reply

  4. Posted by Diana Goodwin on July 24, 2016 at 2:12 pm

    When I picked up my son’s prescription for Suboxone 2 weeks ago at the Walmart in Asheville, I was told the same thing by the pharmacist. I was told a store level manager would call me after I expressed my outrage, but of course it didn’t happen. I’ll be calling the store tomorrow as well as calling and emailing ONDCP. I recommend contacting the Congress persons that sponsored CARA. I’m willing to organize a massive blowback against Walmart, via government contacts and contacting Walmart corporate, if anyone is interested.

    Reply

  5. Posted by Matthew McClure on July 24, 2016 at 3:12 pm

    I don’t believe it is corporate wide. Our local Walmart filled a script Friday, and one that is about 60 miles from my office filled one Thursday.

    Reply

  6. Posted by Chestercounty on July 24, 2016 at 3:39 pm

    You are boycotting Walmart when the real culprit here is the DEA. CVS recently paid a significant settlement for selling various opioid Rxs and the DEA could similarly punish Walmart. My guess is this will be rolled back with the excellent efforts you make. In the meantime, it seems your local Walmart’s hands are tied.

    Reply

    • Posted by shifter9A on July 25, 2016 at 12:10 am

      That was a couple particular CVS franchises in Florida who were complicit will pill mills. If that were their reasoning, they would have removed the hard core Schedule II full agonist opiods first, not Bupe.

      Reply

  7. Posted by Paul S. on July 24, 2016 at 5:18 pm

    When I went to work at the clinic last Thursday, I was told the WalMart pharmacy in Williamsport, PA was no longer filling any buprenorphine prescriptions.

    Reply

  8. Posted by meghan tweedy on July 24, 2016 at 6:38 pm

    I live in San Diego, one of the largest cities in the nation with many Walmarts. I went to the two nearest me to fill my suboxone prescriptions and both informed me that they do not carry ( stock ) it. I asked if they would order it and keep it in stock for me since I get my other meds from them and they said no. It’s policy and I’ll have to go elsewhere to get suboxone. It’s very frustrating. I tried the Vons near my house but they’re hit and miss. Sometimes they’ll have it but most of the time they tell me it’s on backorder. It was on backorder so often I took the hint and went elsewhere. Finally I found a Rite Aid, “not” close to my house that keeps it in stock and makes sure I get it when needed. It took 5 out of 6 tries to finally find a pharmacy that did not treat me or the drug like a pariah.

    Reply

  9. Posted by Kristy on July 24, 2016 at 7:13 pm

    I do not have a problem with a pharmacy not stocking a product. That is very common. They usually can get it in for a patient within 24 hours.

    What I do have a problem with is the REFUSAL to fill any buprenorphine. The Walmart in New Philadelphia, OH refuses to fill any buprenorphine of any formulations (film, Zubsolv, generics) either. A pain clinic/pill mill and a pharmacy both got shut down and the docs and pharmacist lost their licenses for diversion a few years ago. This is how our local Walmart justified their decision. There is one bupe clinic (about five waivered docs) in the whole county and the largest retailer refuses to fill. They will fill any schedule II opioid for pain, adderall, benzo for anxiety though. And, a lot more than 100 patients per Doctor. A HUGE barrier for patients! Cannot wait to hear more on this from you and Walmart’s answer to refusing to fill.

    Reply

  10. Doesn’t this violate the ADA in some way?

    Reply

    • Since sublingual buprenorphine only has one FDA-approved indication for use, it would seem to me a clear violation of ADA. But I’m no lawyer, and it’s hard to think a big corporation would do something they could be sued for.

      Reply

  11. Posted by Matthew McClure on July 24, 2016 at 9:46 pm

    One of the local Walmart’s filled a script Friday, and one 60 miles a way filled one Thursday. Will be curious to find out if this will be a nationwide corporate policy.

    Reply

    • I’m sensing from the numerous comments I got during the day that many Walmarts, though not all, are refusing to stock buprenorphine. I’m not holding my breath, but the Walmart representative did say she would look into this issue and call me back.
      I’m very glad I work with an opioid treatment program. If worse comes to worse and all the pharmacies follow Walmart’s example, at least I’ll be able to keep office-based patients in treatment – I’d just have to switch them over to the opioid treatment program. A hassle, but do-able.
      If all pharmacies refused to fill buprenorphine, it would, in essence, eliminate office-based treatment of opioid addiction. That would be a disaster and cost many lives, so I hope we can get the issue resolved.

      Reply

  12. Posted by rick Crocker on July 25, 2016 at 11:45 am

    This effort doesn’t need to drop. This entire thread is somewhat unnerving to me as the thoughts of going to get my Suboxone refilled and being told the pharmacy doesn’t fill it anymore is scary. This is wrong on Walmarts part. They should at least be required to give you a notice of some kind that they’ll no longer fill it instead of just saying we don’t fill this med anymore, giving you a chance to find a new pharmacy that will fill it. This is BS, press on and if there’s anything I can do to help the cause let me know.

    Reply

  13. Posted by Ronny Freedom on July 25, 2016 at 11:59 am

    The real culprit here is the DEA. They threatened to arrest a pharmacist for filling a prescription of a life-saving medication in the middle of an epidemic? The DEA are the ones that limited buprenorphine treatment in the first place with their limitations in DATA 2000. The DEA are the ones that need to step back and allow people access to this medication. And don’t get me started on my thoughts about the DEA and methadone. 😉

    Reply

  14. Posted by Matthew McClure, D.O. on July 25, 2016 at 4:54 pm

    Just got off the phone with the pharmacist at the Sartell, MN Walmart. She was unaware of any corporate policy. They have lots in stock and she is much more concerned about the quantity and number of other controlled substances that pass through there than a few Suboxone prescriptions.

    Reply

  15. Posted by Andrew angelos on July 26, 2016 at 5:13 am

    I want to know if suboxone is just as effective at smaller portions than a whole strip. I’m finding it effective at 1/2 an 8 mg strip still but feel like it looses effectiveness when I get down to 1/4 or 2 mgs. I know they make a 2 mg strip but cannot get them.

    Reply

  16. Posted by jen on July 27, 2016 at 4:04 pm

    Walmart Sucks. That is all. Not just with this, but with everything. Its a horrible place. I pretty much refuse to go there and have for a long time..

    Reply

  17. Posted by Carlos on July 30, 2016 at 9:07 pm

    Isn’t this a violation of the American with Disabilities Act?

    Reply

  18. Absolutely! I am a patient of addiction as well as a Drug counselor to as many people that will listen, and I too was shocked that the local Walmart denied my prescription! It is not just Walmart it is also CVS pharmacy that had turned me away and Rite Aid! Although some of my Ex friends because I had to Remove the toxic people from life that refuse to get help can walk in these pharmacies every day they are open with opana scripts, oxycodone, and Xanax but they are welcomed with open arms! In a county where we have the highest overdose rates how can you ever turn someone away that is asking for help! That’s like me turning away a patient who needs someone to talk to especially someone who understands. However don’t understand this but I too must boycott Walmart. It does make me feel better not to shop there and I wish they could know why along with other people who I k ow have been affected by this. It forces them to spend more money on gas and drive out of county most of the time to find a pharmacy to fill their scripts like I have done. Thank God that not just another person has seen this but A Doctor knows now Someone with more ways of reaching people and more ways of getting the news out there. Thank you Dr Jana Burson! Thank you for all that you do. This is definitely a clear Ada violation!! I wish there was more I could do…

    Reply

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