I am well aware that pharmacists can and do refuse to fill opioid prescriptions. The difference is that they refuse to fill opioid prescriptions based on fill p

I am well aware that pharmacists can and do refuse to fill opioid prescriptions. The difference is that they refuse to fill opioid prescriptions based on fill patterns that are suspicious for criminal activity: If one person came in with an oxycodone prescription from Dr. A last month and Dr. B last week and from Dr. C today, that triggers some alarm bells and the pharmacist may refuse to fill the prescription. If Dr. A is writing 10x more opioid prescriptions than any other physician, that may also raise suspicion. What a pharmacist does NOT do is refuse to fill an opioid because they think the prescriber or the patient is being dishonest about the prescribing reason even though they don't have any specific evidence to support that. What a pharmacist does NOT do is refuse to fill an opioid because in their opinion it is unethical to take opioids for any reason, even reasons that are considered medical standard of care. But that is exactly what happens with misoprostol. Some examples: Refusing to prescribe due to ethical beliefs: > A Walgreens pharmacist refused to provide an Arizona woman with miscarriage medication, citing his ethical beliefs.... Several days before going to Walgreens to pick up the medicine, Arteaga’s doctor told her that there was no fetal heartbeat and she would have a miscarriage.... Walgreens said in a statement that the company had contacted Arteaga and apologized for the handling of the situation. However, the pharmacy chain noted that the pharmacist had not violated its policy with his refusal. Source: https://www.cnbc.com/2018/06/25/walgreens-pharmacist-refused-womans-prescription-for-mis-carriage-meds.html https://www.cnbc.com/2018/06/25/walgreens-pharmacist-refused... Side note - This is a miscarriage. What ethical beliefs apply when the fetus is already dead? Refusing to prescribe due to not believing the patient and/or prescriber: > A Michigan woman says a pharmacist for a regional supermarket chain denied her medication prescribed to treat her miscarriage because it was against his religious beliefs.... He could not “in good conscience fill the prescription” because he thought she wanted to use it to end her pregnancy, the letter states.... Peterson explained to Kalkman that her doctor said the fetus was not viable, but he responded “that was just [her] word," the letter says. Source: https://www.nbcnews.com/news/us-news/meijer-pharmacist-denies-michigan-woman-miscarriage-medication-citing-religious-beliefs-n921711 https://www.nbcnews.com/news/us-news/meijer-pharmacist-denie... Refusing to prescribe with no explanation at all, even when the indication is universally uncontroversial: > One Austin pharmacy chain sent a letter to doctors in December saying it would no longer provide methotrexate, even for ectopic pregnancies.... “I have interviewed 20 practicing OB-GYNs, and almost all of them have said they had a patient who could not get a prescription filled at a pharmacy when they had an ectopic pregnancy,” said Dr. Charles Brown, the Texas representative on the board of directors for the American College of Obstetricians and Gynecologists. Source: https://archive.ph/UWtgu https://archive.ph/UWtgu