Pharmacy Frequent Flyers
In almost all cases a drug-abusing patient has obtained his/her pills from a pharmacy. Typically, the patient had a written prescription from a doctor. But what if the doctor is from out-of-state, or routinely writes 5 times as many opioid prescriptions as any other doctor in town, or is known to operate a “pill mill”? Should the pharmacist refuse to fill the script?
According to a recent Columbia University survey, more than 60% of pharmacists think “it’s not my problem”. They believe it’s the sole responsibility of the prescribing physician to prevent drug abuse and addiction. But the U.S. Drug Enforcement Administration thinks otherwise and has issued guidelines for pharmacists when they question a prescription’s legitimacy. DEA says lookout if:
- The prescriber writes for so-called “antagonistic drugs” such as a stimulant and depressant at the same time;
- The patient returns to the pharmacy more frequently than expected, asserting that the prescribed quantities did not last as long as expected;
- The patient presents multiple prescriptions for the same drug written by different people (well, duh!).
- A number of people appear in the pharmacy within a short time period with prescriptions for the same drug, issued by the same physician, or a large number of previously unknown customers show up with prescriptions from the same physician.
- The customer presents a prescription that shows evidence of possible forgery, such as unusual directions or quantities, apparent erasures, unusual legibility or evidence of photocopying.
DEA obviously believes the pharmacist is more than a passive player in the narcotics business and must take responsibility for ensuring the legitimacy of the prescription being filled. That would seem apparent and it’s surprising more than half of the pharmacists surveyed would prefer to sell the drugs and not get involved.
Drugs are big business and so is pharmaceutical utilization review. Somebody needs to be watching if more than half the time the pharmacist is looking the other way. There are protocols that can stop this.