A pharmacist's guide to prescription
• 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.
• You have a personal responsibility to protect your practice from becoming an easy target for drug diversion. You must become aware of the potential situations in which drug diversion can occur and the safeguards that can be enacted to prevent this diversion.
TYPES OF FRAUDULENT PRESCRIPTIONS
Pharmacists should be aware of the various kinds of fraudulent prescriptions that may be presented for dispensing:
• Legitimate prescription pads are stolen from physicians' offices, and prescriptions are written for fictitious patients
• Some 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 callback 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 callback confirmation.
• Computers 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 medical purpose:
• The prescriber writes significantly more prescriptions (or in larger quantities) compared with other practitioners in the area.
• The patient appears to be returning too frequently. A prescription that should have lasted for a month in legitimate use is being refilled on a biweekly, weekly, or even a daily basis.
• The 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 time.
• The patient presents prescriptions written in the names of other people.
• A number of people appear simultaneously, or within a short time, all bearing similar prescriptions from the same physician.
• Numerous "strangers," people who are not regular patrons or residents of the community, suddenly show up with prescriptions from the same physician.
CHARACTERISTICS OF FORGED PRESCRIPTIONS
• Prescription looks "too good"; the prescriber's handwriting is too legible.
• Quantities, directions, or dosages differ from usual medical usage.
• Prescription does not comply with acceptable standard abbreviations or appear to be textbook presentations.
• Prescription appears to be photocopied.
• Directions are written in full, with no abbreviations.
• Prescription is written in different color inks or written in different handwriting.
• Know the prescriber and his/her signature.
• Know the prescriber's DEA registration number.
• Know the patient, AND check 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 medication is dispensed.
• Any time there is doubt, request proper identification. Although this procedure is not foolproof, it does increase the drug abuser's risk.