this post was submitted on 03 Jan 2026
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Mildly Infuriating

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"How do we ensure our patient drops and loses ~80% of his pills and that he slices the absolute fuck out of his fingers in the process?"

They're locking my mental health goals behind a fidgety Saw trap built from scissors and miserliness.

I've had boxes where there were several single pills snipped from their blister packs rattling around in them. These pills in particular are tiny, like you can't even feel them in your mouth when you take them, but they expect me to be able to finesse one out of a single blister with at least 3 extremely sharp and piercing corners on it ๐Ÿ˜’

If you're a pharmacist and you do this, please go ahead and take the pills yourself, you clearly need 'em more than I do, ya sick fuck.

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[โ€“] SirMaple__@lemmy.ca 5 points 5 hours ago

Blister packs should be illegal. Creates waste. All pills should come in recyclable plastic bottles.

[โ€“] diemartin@sh.itjust.works 11 points 9 hours ago

Here in my country (at least public healthcare, which my mother and I use, and the private provider my grandfather uses), pharmacists give you enough full boxes to cover the month, even for controlled substances, even if that means giving a few extra pills.

As an example, I take 1 ยฝ Risperidone pills daily, which makes 45 pills a month. Boxes are 20 pills each, so they give me 3 boxes (60 pills). The leftovers helped me a couple of times I was sick or otherwise couldn't get the refill on time.

There was only one time where they gave me two boxes and a blister (50 pills), but it was still a full blister.

[โ€“] papalonian@lemmy.world 128 points 18 hours ago (5 children)

Uh, former pharmacy tech here... I don't know what you want us to do. If I have a strip of, say, 10 pills, 2 rows of 5, and I get a prescription for 6 pills, that means I'm gonna have a strip of 4 pills left over. If I get a prescription for 9 pills, there's gonna be a single one left over. Do you want these pills to just be thrown away? If they don't have enough pills on hand to make your prescription with the full sheet, would you rather they delay your prescription so they can order some nicer looking ones?

I get that it can be frustrating dealing with those blister packs, but freaking out at the pharmacist/ tech that a. did not put the pills in a blister pack and b. doesn't have any option but to dispense medication on hand, seems pretty misplaced. Like, I wouldn't think something was wrong with the Walmart cashier for selling me a pair of scissors in security packaging.

[โ€“] SaveTheTuaHawk@lemmy.ca 8 points 8 hours ago

People bitch about everything they don't understand. Some meds are too fragile to just put into a plastic bottle, or exposed to air.

[โ€“] Noodle07@lemmy.world 26 points 16 hours ago (1 children)

It's so weird to me as here we just get one box of pills and done ๐Ÿคท

[โ€“] starlinguk@lemmy.world 5 points 10 hours ago (1 children)

Here we usually do too, unless the doctor prescribes a weird number for some reason.

[โ€“] bluesheep@sh.itjust.works 4 points 10 hours ago (1 children)

My doctor doesn't even prescribe an amount. I just get whatever amount the pharmacy feels like. I've gotten a box with 30 pills (one daily so enough for a month), box with 60, back to 30, and the last time they gave me a box with 100. I'm not complaining, less refills so less hassle but it kinda makes me wonder how they decide the amount lol

[โ€“] starlinguk@lemmy.world 2 points 5 hours ago* (last edited 5 hours ago) (1 children)

Here the doctor decides, thank God. It means she can prescribe months worth of meds and I only pay 5 Euro. I always have to pay those 5 Euros for any amount (unless it's asthma meds, those are free).

[โ€“] bluesheep@sh.itjust.works 1 points 4 hours ago

I think I pay a flat rate as well, not so sure tho haven't checked in a while. But just like you it's a couple of euro so it's not that bad of a screwover I suppose

[โ€“] kungen@feddit.nu 29 points 17 hours ago (2 children)

Tbh, a pharmacist shouldn't really do anything with the actual medication other than dispensing it correctly. In Sweden, every package is individual; the pharmacist should never be opening them nor touching the blisters in normal cases. It significantly reduces risks for the patient and ensures traceability.

It is a bit less efficient though, as pharmacies need to stock up different qualities of the same dosages: Stilnoct(zolpidem) 10mg for example has two different packages: 14 tablets, or 28 tablets. If you have a prescription for 28 tablets, you can't buy two 14-tablet packages. And if you were to have a 14 prescription, you can't buy the 28 and ask the pharmacist to throw away the other blister. But I think it's a worthy tradeoff to eliminate the majority of human mistakes.

[โ€“] bleistift2@sopuli.xyz 6 points 14 hours ago

A few years ago Germany started to ensure that blisters are not repackaged, too.

[โ€“] Buffalox@lemmy.world 8 points 15 hours ago* (last edited 15 hours ago) (1 children)

In Sweden, every package is individual;

Same here in Denmark.
The only place I've ever seen pills given out of the package is at the vet and in hospitals or by a doctor, and it's for obvious reasons dictated by circumstances.

If we need 10 of some pill, they come in boxes of 10. I have no idea wtf is going on with splitting up packages to get 20?

PS: The example with the vet was worm treatment, those pills were in individual blisters, and you can get only one at a time I think due to EU regulation. It was then put in a package made specifically for that. And there were no sharp edges.

We used to get 3 at a time, to administer as needed, but apparently we aren't allowed to get more than 1 at a time now.
Also the price has trippled to buy 1 compared to what 3 used to cost. So a 10x price jump!!!

[โ€“] orclev@lemmy.world 10 points 14 hours ago (4 children)

This is interesting. Do all pills come in blister packs in Denmark? Over in the US it's actually somewhat rare for prescription medication to come in blister packs. Typically over the counter prepackaged medication will come in blister packs, but prescriptions are almost always unpackaged pills in a bottle. The pharmacist counts out the number of pills and puts them in the bottle as well as attaching its label to match the prescription. Prescriptions are typically written based on pills per day and the number of days to either take the medication or else for the prescription to cover. E.G. the doctor makes out a prescription like "take one pill twice a day for 60 days", and then the pharmacist will give you a bottle with 120 pills in it.

[โ€“] MarieMarion@literature.cafe 4 points 9 hours ago

France: never seen a bottle IRL. Used to be blister packs, and if you needed 21 pills but they came in packs of 20, you got 19 too many and they lived forever in your medicine cabinet.

Now pharmacists are allowed to open packs of antibiotic pills and only dispense the exact number you need, and pics like the OP can happen. Most pharmacies don't do it though.

[โ€“] Buffalox@lemmy.world 4 points 13 hours ago (1 children)

Almost everything is blister packages, which I personally find a bit annoying.
We can't even get normal pain killers without them being in blister packages, and we can only buy limited amounts to prevent teen suicide attempts by painkillers.
That part however I'm OK with, because allegedly it's supposed to actually work. ๐Ÿ‘ ๐Ÿ˜€

[โ€“] Mirshe@lemmy.world 2 points 3 hours ago (1 children)

Honestly, I can see that. A lot of suicides are spur-of-the-moment, and the more a person has to actively work at it, the less likely they are to actually follow through on the attempt. Even just those couple seconds of working at it to get a whole box of blister packs open could be enough for a lot of people to stop, think, and say "actually wait".

[โ€“] Buffalox@lemmy.world 1 points 3 hours ago

Yes but more than that, the packages are also too small for use for suicide attempts. So you need to stack up with a few packages first too.
It's a minor inconvenience, but I'm OK with it, because they claim it is actually working.
I never really thought so much about the time it takes to squeeze out the number of pills it takes to work. Which absolutely may be a factor too.

[โ€“] BorgDrone@feddit.nl 5 points 14 hours ago

Here in the Netherlands Iโ€™ve never had any medication that wasnโ€™t in blister packs. They are always full boxes. Boxes have anti-tamper seals and a unique serial number that the pharmacist has to scan when issuing (to prevent fake medication). Pills are individually packaged to prevent contamination.

[โ€“] kungen@feddit.nu 3 points 14 hours ago* (last edited 14 hours ago)

There are bottles as well, but it's not as common. And they're factory-produced bottles that are tamper resistant -- not like those orange ones in the US. So it's basically the same safety as blisters, other than its easier for the patient to spill.

I'm not 100% sure, but I think most of the groundwork for this situation is from EU Directive 2001/83/EC. Medical products need to have a lot of information provided, and it just gets simpler to have boxes with blisters to meet all the requirements, and gives safety at the same time.

I can't imagine how hectic it must be for pharmacy techs in the US. Despite requiring 5 years of school to be a pharmacist here, the job is basically being a glorified cashier... Unless the person has any questions, you simply check their ID, check in the national registry that enough time has passed since their last collection (particularly if it's a controlled substance), collect a package from the shelf, print out a label to put on the box (containing their name, doctor, dosage, instructions), scan the label and package, collect payment, and that's it.

[โ€“] rollerbang@lemmy.world 4 points 16 hours ago

I hear you. They should be on a roll, like film ๐Ÿ˜

[โ€“] myplacedk@lemmy.world 2 points 17 hours ago (1 children)

If I have a strip of, say, 10 pills, 2 rows of 5, and I get a prescription for 6 pills, that means I'm gonna have a strip of 4 pills left over. If I get a prescription for 9 pills, there's gonna be a single one left over. Do you want these pills to just be thrown away?

Order of 6 pills - give a 3x2, you now have a 2x2.

Order 9 pills - give the 2x2 and a 1x5, you now have a 1x5.

I see your problem, but I don't see how that can turn into "a 10x1, a 4x1, a 2x1 and another 2x1" as your best choice. That looks like he got the left-over-pile after a day of ever order getting from a new pack.

Honestly, I don't know why you even have to open a package. I've never seen that, and I've been in some long pharmacy queues. Never been to US though.

If I need exactly 10 pills, I get a box with 10 pills, packed in a factory like any other box of pills.

[โ€“] papalonian@lemmy.world 27 points 17 hours ago* (last edited 17 hours ago) (1 children)

That looks like he got the left-over-pile after a day of ever order getting from a new pack.

I'm saying that's exactly what happened.

Never been to US though.

Things are done very, very differently here than most places. Blister packs are pretty uncommon, as are "per-patient" packages.

We rarely get bottles of 14, 30, 90 or whatever to give to the patient. It's usually a giant "stock bottle" of like, 100, 500, 1000 pills that get counted out according to the prescription.

Your example of using the leftover from one script to the next works if you're a single person in a small-ish pharmacy and it's an uncommon drug, but when you're one of 4 techs in a shitty retail pharmacy, you're not going to ask every other person if they have a 2x2 strip of this med in their pile of go-backs, or spend time min-maxing the most efficient way to get the most pills in the least amount of strips. You're gonna fill the thing as quickly as possible, because the medicine is what's important, and you're not gonna hold the backlog of prescriptions up because someone wants the nice complete pack of 10 and not the leftovers that are bound to pile up.

[โ€“] curbstickle@anarchist.nexus 2 points 11 hours ago

a shitty retail pharmacy

AKA pretty much every pharmacy these days, since these pharmacy companies are large enough to own the insurance companies.

What a fucking disgusting mess the US medical industry is.

[โ€“] Apytele@sh.itjust.works 1 points 8 hours ago

I'll raise you the time I decided to be menace and put a blister pack back in the pyxis like this:

(to be clear, this was neither a high alert med nor a narcotic)

[โ€“] atrielienz@lemmy.world 22 points 16 hours ago

This is likely the fault of the pill manufacturer who the pharmacy is at the mercy of.

[โ€“] FriendOfDeSoto@startrek.website 13 points 17 hours ago (1 children)

In Japan, this is the norm. They'll throw each drug in its own zip lock bag but piecemeal like that is all you'll get. And people grow really old over here.

I don't find this mildly infuriating. I think this is a responsible way to deal with a precious resource.

[โ€“] theneverfox@pawb.social -3 points 11 hours ago (1 children)

Pills aren't really precious resources... They cost like cents to make, aside from a few very expensive special ones

The expensive part is all markup

[โ€“] papalonian@lemmy.world 7 points 8 hours ago (1 children)

The expensive part is all markup

So we can waste the pills if we find a way to keep all the markup safe?

Also the idea that pills costs "cents to make" is pretty flawed. Even if you ignore all of the R&D money that goes in to making newer pills, the sterilized environment they need to be manufactured in is gonna jack the cost up too.

It's like saying a cup of fresh, ice cold water that you're getting handed to you in the middle of the desert is only "a few cents worth of water". Yeah, but the fact that it exists in the middle of the desert for you to consume is what made it a "precious resource".

[โ€“] theneverfox@pawb.social -3 points 8 hours ago (1 children)

The r&d costs come from government grants these days

Yes, a sterile lab is expensive, but like normal business expensive. It's very achievable to build, drug cartels manage it just fine. Universities and YouTubers have no problem doing it with pretty modest funding

Yes, there's overhead. But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing

That's why other countries can afford to sell them for cents - they really are that cheap to make

[โ€“] papalonian@lemmy.world 8 points 7 hours ago (1 children)

Yes, a sterile lab is expensive, but like normal business expensive. It's very achievable to build, drug cartels manage it just fine.

This bit right here told me that I didn't need to take this too seriously. An actual medical lab is not comparable to cocaine plants in the Congo.

But the pills themselves? The materials and production cost is cents. They themselves cost basically nothing

This is the exact same point from the previous comment. You cannot just look at the material cost of something and say, "see? It only costs cents to make." Go buy a part that goes in a car engine - it's just a few cents worth of metal! But, you can't just take a hunk of metal and magically form it into car parts, there's a manufacturing process and it's expensive. That's part of where the cost comes from. It doesn't matter if you can make the most expensive pill in the world out of 10 cents of flour if you need a $10 million dollar assembly line to process it and turn it in to what is useful. They aren't just taking a premade substance and pressing it into pills, there's numerous chemical reactions and processes taking place.

That's why other countries can afford to sell them for cents - they really are that cheap to make

You start your comment off with saying that R&D is subsidized, and end with saying "other places can sell them for cheap cuz they really are that cheap." In these other countries, the drug company is not selling the medication directly to the public for pennies, it's getting subsidized by the government to make it affordable for citizens. Granted the government is not paying US cash prices, but companies simply are not selling direct to consumers for 10x less than other places.

Look, this is coming from someone who fucking hates the predatory medical industry, especially that of the US. I used to work as a very small cog in it. There are absolutely places where prices are disgustingly manipulated and people are taken complete advantage of. Things exist today the way they are because of corporate greed and the continuance of putting profit over people. We can accept all of this as true, and still recognize that producing drugs at a medical grade, with medical levels of consistency and purity, is a difficult, expensive task that requires resources to accomplish. Medication needs to be cheaper (it's my belief that it should be no direct cost to the user), but momentum is instantly removed from the cause when we use arguments based on a limited grasp of reality.

[โ€“] theneverfox@pawb.social -1 points 6 hours ago (1 children)

I think you're misunderstanding what I'm saying.

Yes, the companies need to sell the pills for a certain amount to make a profit, due to infrastructure and overhead. The R&D is a whole complicated thing, let's just lump it in as overhead and put it aside

The pills themselves cost basically nothing to produce each, a batch will cost money but normally they're consistently pumping out huge batches

So, most manufacturers have programs to retrieve pills. If you have 4 pills at the end of the roll, they can be reclaimed so patients can get a complete strip, because the pills themselves cost so little. They do the same if you end up with a small number of pills left in the big bottle, you can't mix batches because of expiration dates and expiration. So you send them back, and they give the pharmacy a credit

[โ€“] papalonian@lemmy.world 3 points 6 hours ago (1 children)

I'm sorry, I can't continue this conversation. It's clear that you're just kind of saying things that sound right. Your only argument is, "the pills themselves cost nothing to make" while ignoring everything that makes the pill cost money. Economics and cost analysis does not work that way. And in 7 years of working in a pharmacy, never once have we ever sent incomplete strips of meds to the manufacturer to get a complete pack. That is just not a thing that happens anywhere on a regular enough basis for it to be taken into consideration.

[โ€“] theneverfox@pawb.social 0 points 5 hours ago (1 children)

What do you do with expired meds, does the pharmacy eat the loss?

Do you mix and match pills with different expiration dates to fill a prescription? From different manufacturers?

I'm genuinely asking. What I described is how things work here, and while our healthcare system is insane, this is one part that makes sense to me

[โ€“] papalonian@lemmy.world 3 points 4 hours ago (1 children)

What do you do with expired meds, does the pharmacy eat the loss?

It depends. In the US we have "prescription only" medication (things like antibiotics, diabetes meds, etc) as well as "controlled" medication (things like Norco, Xanax, morphine). With my former employer, we would go through the pharmacy and find non-controlled medication that was due to expire soon (3 or 6 months, I don't remember) and send them back to our wholesaler for a partial credit. Packages had to be whole and unopened. With controlled medication, there is no sending back; the pharmacy holds the medication until it is actually expired, then sends it to be disposed of.

Do you mix and match pills with different expiration dates to fill a prescription? From different manufacturers?

Different expiration dates, yes, different manufacturers, generally no but if there's no better option we would. In the US we generally fill from stock bottles containing several hundred or thousand pills, so one bottle can last a few months worth of prescriptions. When we go from one bottle to the next, the expiration dates between the two generally won't be the same. When I left the company, we had a system that scanned the bottle we used and could read the expiration date; if the med expired in over a year, the label printed would just have an expiration date of 1 year from the current date. If it expired in less than 1 year, it would give a notification, and we'd manually enter the exact expiration date on the label.

[โ€“] theneverfox@pawb.social 0 points 2 hours ago

Ah. Laws vary by state, mixing and matching manufacturers is illegal in my state, the manufacturer must be on the bottle along with a description. I'm less certain about the expiration date thing, but I believe here they require them all to come back to the same batch in case there's an issue (including improper storage of the bottle or something)

I've been told this is how it works by a pharmacist when they were having trouble filling my rx, and we were talking about controlled substances in particular

[โ€“] poweruser@lemmy.sdf.org 8 points 17 hours ago

I just wanted to say, I enjoy your writing style. You very vividly illustrated your emotions

[โ€“] falseWhite@lemmy.world 2 points 12 hours ago* (last edited 12 hours ago) (1 children)

What's mildly infuriating is this post. How do you think they make these prescriptions? Do you ever consider how other people do their jobs before you go moaning? You're a fucking Karen.

[โ€“] surewhynotlem@lemmy.world 1 points 10 hours ago (1 children)

"they may provide a shitty product, but have you considered their feelings?"

You're allowed to be pissed off, even when other people do their best.

[โ€“] falseWhite@lemmy.world 7 points 9 hours ago (1 children)

Pharmacist does not make the product or how it's manufactured or distributed, dum dum.

[โ€“] surewhynotlem@lemmy.world 0 points 5 hours ago (1 children)

And yet it's still ok to be pissed off at the situation.

Is the problem that he insulted the pharmacist in his rant?

[โ€“] falseWhite@lemmy.world 6 points 4 hours ago* (last edited 4 hours ago)

They're clearly pissed at the pharmacists. Did we read the same rant? Why insult them at tall? Twice. Once in the title, once in the rant. It's not okay to take out your anger at people who can't change the situation for you.