Trouble Filling Xanax After Being Prescribed Opioids

Meri asked

I have a few questions and a dilemma. I had surgery on my ankle and was prescribed opioids. As the weeks went by, I went lower and lower on the dosage and stopped. Around this time, I wanted to get my Xanax refilled. My regular doctor was off and I saw one I've never seen before and she flagged me! Even though I explained the situation that I was off the opioids from surgery, she didn't want to hear it.

My usual doctor is back and knows me for years and years and is trying to get me unflagged. The CVS I deal with now just questions everything from the dosage to the number of pills I get. I can't stand it. As somebody that suffers from severe anxiety, what am I supposed to do now that my chart has been flagged and I can't get my medication? I am having panic attacks and need my medicine.

Answer

Hi Meri. Thank you for your question. I don’t know all of the specifics since I am uninvolved in your care. Due to that, I don’t know that I will be able to give you any precise answers, but I have been the pharmacist in similar situations more than once, so I hope my advice helps a bit.

First, I can certainly understand how this situation would be difficult for you. I know that panic attacks can be debilitating and the anxiety caused by being out of your medication can definitely exacerbate the problem.

I imagine that your local pharmacist was concerned about you taking both the alprazolam (or under the brand name Xanax) and the opiate that you received after your surgery. Using both medications can lead to unintentional overdose and death. It’s dangerous enough that in recent years, the FDA has warned all health care professionals to avoid using these drugs together if possible.

As a pharmacist, we are responsible (along with your physician) for all of the medications that we dispense. If you were unintentionally overdose, both the pharmacist and physician could potentially be held legally responsible or lose their licenses to practice. Due to these factors, and you seeing a new telehealth physician that probably didn’t know your past medical history, they may have been especially hesitant to prescribe alprazolam if you recently had an opiate pain medication filled. Likewise, your pharmacist may have been hesitant to fill a prescription for it.

Since you were able to stop taking your pain medication after surgery, I would try to talk to your regular physician about restarting your alprazolam. I would also speak to the pharmacist at your local pharmacy and let them know that you will not be taking any more of the medication that you received after surgery, and that you plan to restart your alprazolam. If that is unsuccessful, you may want to have your primary physician reach out to the pharmacy. If you have a legitimate need, I imagine that pharmacy will fill a new prescription as long as they think that it’s safe.

Lastly, it might be a good idea to reevaluate how you are managing your panic attacks. Again, I don’t know your medical history or any other medications that you are presently taking. Alprazolam works great to treat a panic attack, but it’s not very effective at preventing them. If you are not already taking something to help to prevent panic attacks, it is probably a good conversation to have with your physician.

I hope this helps and please write back with any follow-up questions!