Dealing with forged prescriptions

Everyone has their own preferred method of dealing with forged prescriptions. Ryan at EclecticEsoteric recently asked what I would do. It so happens that Andrew at PharmCountry has a related post, so it seems an opportune time…

When you've got a forged or altered prescription, there are two basic things you SHOULD do.

1) Contact the prescriber. Verify that it has been forged or altered.
2) Initiate a PharmAlert, the details of which can be obtained by contacting your state's board of pharmacy. I believe this is how such an alert is usually initiated anyway — I'd say "always" but I haven't worked in every state, so that's impossible for me to know.

PharmAlerts start a cascading reaction. A notice is typically faxed to the pharmacy at the top of the list in your area, and they, in turn, fax to other pharmacies who fax to other pharmacies. You are also supposed to pick up the telephone, and notify the pharmacist at the receiving pharmacy as well, but we rarely do. I should take a picture of the PharmAlert notification map for my area. It's kind of nifty because one of my stores is #1 on the list. If I had to guess, I would say that the seed pharmacies at the top of the lists are probably chosen that way because they are lower volume, and it's thought that they have more time to seed the word along? I have nothing to back this up, I'm only guessing. We are responsible for notifying three pharmacies, whereas everyone lower on the list than us is only responsible for one.

Doctors' offices can also initiate pharmalerts, and often do if a prescription pad is stolen.

There are a couple of things you COULD do beyond these two steps, depending on how crazy you want to be. These include contacting the police, the DEA, and anyone else you might want to contact. It all depends on how zealous you want to be. Me? I don't bother because I don't particularly want to be a law enforcement officer. If I did, I'd work for the DEA. Some pharmacists also take the opportunity to lecture the person about altering a prescription. That's not really my style either. The person already knows they did it, and they know it's wrong. I don't need to beat it into their head, or threaten to call the police on them.

All this changes, though, if you're a habitual offender and/or I suspect there might be organized crime involved. In that case, I verify the script, call the police very quietly, and keep you waiting until the officer arrives, at which point you are arrested. And yes, it always does seem to fall on me to keep the person waiting and so on. I have no idea why. Apparently my poker face is pretty good.

Assuming no drastic measures are taken, I would also say that you shouldn't give the prescription back to the person, but I have seen it done. (An act which never ceases to boggle my mind!) By doing this, you are giving the person another chance to take the script elsewhere. This is unacceptable!

Regardless, I believe it's important to keep whatever action you decide to take low-key and professional. You are not this person's parent. You aren't the police. You are the medication gatekeeper. Politely deny them, do what you must do, and keep the ball rolling.

[tags]Pharmacy, pharmalerts, pharmacy practice[/tags]