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]
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Forged prescriptions…
OnThePharm tells us what to do in these cases….
Trackback by Trusted.MD Network — June 20, 2007 @ 8:59 am
Thanks for the reply. I did hand the script back to the person, which I knew was a bad idea, but I wasn't really sure what to do.
if I knew it was a forgery, is it really ok to just keep it? I guess so, oh well. I like to learn things the hard way anyway.
Comment by Ryan — June 20, 2007 @ 5:00 pm
Hey, thanks for the link. I only wish we had been able to catch that adipex patient. I keep wanting to get someone caught and taken out in handcuffs, but unfortunately, I'm only the tech and the RPh gets to make the decision. (my pharmacists are either too scared or too indifferent to actually follow up on it.)
If we confirm that something is fake (or can't confirm that it is real) we usually stick our label on the back along with our phone number. That alone usually keeps it from getting filled somewhere else because our labels are too sticky to pull off without ripping the script
Comment by Andrew — June 20, 2007 @ 6:18 pm
As I understand it, the written prescription is the property of the patient. Unless you are positive it is a forgery, I would give it back.
Comment by Kirsten — June 24, 2007 @ 6:51 am
If I suspect it's a forgery, I'm going to hold onto it until I can verify one way or the other. It's the doctor's property, as far as I'm concerned, and I don't want them to (possibly) get into trouble for drug distribution. Then there's always covering my own ass. I'd rather get slapped on the wrist for bad "customer service" than fill a fake script.
The "patient" can go screw. If they can't wait 12 hours (it's popular to come in 10 minutes before closing), then I guess they'll have to go to the ER.
What you don't know, and you'll have to just accept, is that I'm pretty darn liberal when it comes to filling prescriptions. For what it's worth, I've never called an office to find out that the prescription is real. It's always been fake. So it stands to reason that I've filled some fake ones — in fact, I know I have — and I'd rather fill a fake one than deny a patient who is legitimate and in need.
Comment by RJS — June 24, 2007 @ 8:50 am
I just had another fake script, this one called in. And we got her arrested too. (See my blog for more details). I just hope she pleads guilty so I don't have to go to court.
Comment by Andrew — July 4, 2007 @ 12:12 am
Hey you "wannabe" cops–If you like to play narc so much, you should have been DEA agents instead of pharmacists. You need to get over your sadism Andrew. These people whom you take so much pleasure in busting, as it were, are in need of medical attention one way or another. You really should be ashamed of yourselves. They will meet with a bad ed in their addiction without you playing God, or pathetically trying to at any rate. I've never seen such a bunch of high-school hall-monitor antics from supposed professionals in all of my life, let alone my career a neurologist. Pretty lame, sergeant dork…
Comment by doctor bryan — March 29, 2008 @ 7:09 pm
[...] KevinMD, this advice on dealing with them from OnThePharm: Everyone has their own preferred method of dealing with forged prescriptions. Ryan at [...]
Pingback by GruntDoc » Blog Archive » Forged Scripts — April 3, 2008 @ 2:29 am