Follow up on Pharmacy Failings



In the August 1, 2016, issue of Alcoholism and Drug Abuse Weekly, the editor, Alison Knopf, wrote an interesting article summarizing her research into pharmacy refusal to stock buprenorphine products. (website: )

Regular readers of my blog will recall entries last month that described how our local Walmart pharmacy at first refused to stock any buprenorphine product. Then a few days later, after some political pressure was applied by people with clout,  Walmart  changed their minds, and proclaimed that all Walmart pharmacies will stock buprenorphine products.

Ms. Knopf did more research into what happened, and describes it in the ADAW article. While the local pharmacist didn’t comment directly, a representative from the American Pharmacists’ Organization described what usually happens in such cases.

Apparently, DEA agents came to the North Wilkesboro Walmart Pharmacy, and told employees that they were investigating a buprenorphine prescriber (thankfully not me). Perhaps using some scare tactics, the agents told pharmacists that if they continued to fill buprenorphine prescriptions from the prescriber in question, they could be guilty of conspiracy and charged a large fine. Obviously worried, the Walmart pharmacists “over-reacted” and decided for a brief time not to stock buprenorphine or fill it, in any form.

I have to wonder why the DEA wouldn’t take their concerns to the physician in question, or to the state medical board, rather than try to strong-arm pharmacists.

The ADAW article went on to quote ASAM (American Society of Addiction Medicine) president-elect Kelly Clark, M.D., who said that organization has received reports from other areas of the country of pharmacies refusing to stock buprenorphine.

Dr. Tom Reach, president-elect of the Tennessee Society of Addiction Medicine, was quoted in the same article, saying he’s had the same problem in Eastern Tennessee. In that area, the problem isn’t limited to only Walmart pharmacies, but also Walgreen’s and CVS. Dr. Reach said they are building a class action case against these pharmacies. He also mentioned he’s keeping a database of all the pharmacies in Tennessee and West Virginia that refuse to prescribe buprenorphine.

I’m glad the problem in my area has been fixed. And I’m dismayed to discover the problem still exists in other parts of the country.

With so many people dying of opioid overdoses, physicians need pharmacists to help us treat these patients, not to put up roadblocks to treatment.

4 responses to this post.

  1. I just recently discovered this blog, and I really like it! Thanks!
    Im from Norway and have been receiving maintenance treatment for the last 13 years ( buprenorhine (both Subutex and Suboxone), methadone, and now, lastly, morphine sulphate, which without doubt is the best).
    In Norway heroin is in many cities no longer to be found, mostly due to almost everyone in need receiving buprenorhine (and som methadone). Of a population of 5 millions, 7-8000 users get buprenorphine and methadone.
    In Norway doctors aren’t allowed to prescribe buprenorphine. You can only get treatment from clinics (every city and place has its own clinic)

    We have user organizations who are fighting for our interests – less urine testing, more rehabilitation, more drugs to choose from (morphine: Substitol and Sevre-Long), heroin, levi-methadone etc.


  2. Posted by michael dowling on August 18, 2016 at 9:10 pm

    Walmart today refusing to fill subutex unless pregnancy or allergy one other indication… never mind if you are unemployed with a working spouse or working a minimum wage job— you’d have to pay over 1/4 your family income….


  3. Posted by CHRIS dockery on January 8, 2017 at 10:17 am

    Been going to Walmart pharmacy in kingsport Tennessee almost 6 years now getting subutex and without notice on December 28 I go to fill my prescription and they tell me they will no longer fill then unless I have hep c something I have never had so I call cooperate and ask them is this their policy and they say no it’s just the head pharmacist opinion and no further explanation and no other pharmacies are taking more patient I’ve tried at least 100 I’ve filed a complaint with Walmart ethics hopefully will hear something back soon


    • Tennessee is a little different (an understatement if ever there was). I think state legislators got involved to decide not to allow the monoproduct unless there were specific reasons. I’m unclear how much latitude the prescriber even has. I don’t think that it is left up to the pharmacy.


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