The purpose of this
guide is to ensure that controlled substances continue to be available
for legitimate medical and scientific purposes while preventing their
diversion into the illicit market. It is not the intent of this
publication to reduce or deny the use of controlled substances where
medically indicated. Nothing in this guide should be construed as
authorizing or permitting any person to conduct any act that is not
authorized or permitted under Federal or state laws.
abuse of prescription drugs-- especially controlled substances--is a
serious social and health problem in the United States. As a healthcare
professional, you share responsibility for solving the prescription drug
abuse and diversion problem.
- You have
a legal responsibility to acquaint yourself with the state and
federal requirements for dispensing controlled substances. You also
have a legal and ethical responsibility to uphold these laws and to
help protect society from drug abuse.
have a personal responsibility to protect your practice from
becoming an easy target for drug diversion. You must become aware of
the potential situations where drug diversion can occur and
safeguards that can be enacted to prevent this diversion.
dispensing pharmacist must maintain constant vigilance against forged or
altered prescriptions. The law holds the pharmacist responsible for
knowingly dispensing a prescription that was not issued in the usual
course of professional treatment.
guide will help you meet these responsibilities.
of Fraudulent Prescriptions
should be aware of the various kinds of fraudulent prescriptions which
may be presented for dispensing.
prescription pads are stolen from physicians' offices and
prescriptions are written for fictitious patients.
patients, in an effort to obtain additional amounts of legitimately
prescribed drugs, alter the physician's prescription.
- Some drug
abusers will have prescription pads from a legitimate doctor printed
with a different call back number that is answered by an accomplice
to verify the prescription.
- Some drug
abusers will call in their own prescriptions and give their own
telephone number as a call back confirmation.
are often used to create prescriptions for nonexistent doctors or to
copy legitimate doctors' prescriptions.
The following criteria may
indicate that the purported prescription was not issued for a legitimate
prescriber writes significantly more prescriptions (or in larger
quantities) compared to other practitioners in your area.
patient appears to be returning too frequently. A prescription which
should have lasted for a month in legitimate use, is being refilled
on a biweekly, weekly or even a daily basis.
prescriber writes prescriptions for antagonistic drugs, such as
depressants and stimulants, at the same time. Drug abusers often
request prescriptions for "uppers and downers" at the same
appears presenting prescriptions written in the names of other
- A number
of people appear simultaneously, or within a short time, all bearing
similar prescriptions from the same physician.
"strangers," people who are not regular patrons or
residents of your community, suddenly show up with prescriptions
from the same physician.
of Forged Prescriptions
looks "too good"; the prescriber's handwriting is too
directions or dosages differ from usual medical usage;
does not comply with the acceptable standard abbreviations or appear
to be textbook presentations;
appears to be photocopied;
written in full with no abbreviations;
written in different color inks or written in different handwriting.
- Know the
prescriber and his or her signature;
- Know the
prescriber's DEA registration number;
- Know the
the date on the prescription order. Has it been presented to you in
a reasonable length of time since the prescriber wrote it?
When there is a question
concerning any aspect of the prescription order, call the
prescriber for verification or clarification.
Should there be a discrepancy,
the patient must have a plausible reason before the prescription
medication is dispensed.
time you are in doubt, you should request proper identification.
Although this procedure isn't foolproof (identification papers can also
be stolen or forged), it does increase the drug abuser's risk.
you believe that you have a forged, altered, or counterfeited
prescription -- don't dispense it -- call your local police.
you believe that you have discovered a pattern of prescription abuses,
contact your State Board of Pharmacy or your local DEA office. Both DEA
and state authorities consider retail-level diversion a priority issue.
Loose or routine dispensing
procedures, without controls and professional cautions, are invitations
to the drug abuser. Proper controls against fraudulent prescriptions can
best be accomplished by following common sense, sound professional
practice, and using proper dispensing procedures and controls.
Have your pharmacy staff help
protect your practice from becoming a source for prescription drug
diversion. Become familiar with which drugs are popular for abuse and
resale on the streets in your area. Drug abuse prevention must be an
ongoing staff activity.
Encourage local pharmacists and
physicians to develop a network, or at least a working relationship,
which promotes teamwork and camaraderie. Discuss abuse problems with
other pharmacists and physicians in the community. Most drug abusers
seek out areas where communication and cooperation between health
professionals are minimal because it makes their work so much easier.
This information came from a NIDEA online article.
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