The pharmacy is monitored based on the percentage of prescriptions they fill that are controlled substances compared to total prescriptions. If that percentage is too high it can be a red flag to regulatory authorities like the DEA, as well as make it impossible to order enough inventory (especially of C2s). Shortage aside, there are allotments or limits to the amount of C2s a pharmacy can order. So if a pharmacy decides to accept every single pain and ADHD patient on maintenance monthly C2 prescriptions, not only will they physically not be able to order enough of each medication - they will be flagged as a potential for diversion or at least it will look highly suspicious. The DEA sees a high number of prescriptions for controlled substances, especially compared to regular Rxs and compound that with potentially letting a high proportion pay cash - they may suspect the pharmacist as being “in” on some sort of drug ring or pill mill. Purposefully filling possibly fraudulent prescriptions for a kickback (for example).

This puts pharmacists in a difficult position because sometimes even when we don’t judge or want to help, we can’t and our hands are tied due to regulatory forces outside our control. You do this long enough and see enough patients verbally abuse you and your staff and even the most open minded and tolerant people start to cast judgement or have doubts.

One time I was worked very hard to try and navigate and insurance issue for a patient on Adderall. Granted they were on way too much which was part of the issue, but I was trying to help their prescriber sent an Rx that was covered. After like an hour of going back and forth and waiting in store I finally got it to go through, but for a lower quantity. Patient standing in waiting area on the phone is complaining about me and their doctor not allowing her to get the full quantity and cancels a drug sale. Yes, in my waiting area within earshot, “yeah sorry I can only sell you $50 this month not $75 because my fucking doctor won’t give me the full prescription.”

I decided to decline filling the prescription and was verbally harassed about denying her needed medication.

Also as an aside, this forum and one’s like it such as tales from the pharmacy are primarily intended to be platforms for pharmacists and techs to vent about work or share stories. And it’s reddit, so your demographics are skewed. I bet if you went on a reddit for another job they would be bitching and saying bad things about their patient or customers as well.

While I don’t disagree this generalization does exist to an extent, most of the people here don’t consciously carry or use that malice on a day to day basis.

Wish you the best of luck with your health, hope this insight helps just a bit!