The patch is actually quite effective (not the one used with a band-aid). If you know a Doctor in your state personally, he/she may be willing to call in a prescription for you. If not, you could try to schedule an appointment with a new primary care doctor or possibly go to the nearest urgent care center (not the E.R.). I wrote a prescription for them for my wife a few years ago and she never needed them, so we just take them with us every time. They are quite expensive and any more, most insurance companies make you pay a premium co-pay for them ($40 or more).