Drug diversion

[YourMD]

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Besides ethical reasons why do pharmacists fight so hard to stop drug diversions, when the DEA and legislative agencies continue to **** on this profession? No provider status, Tons of new schools, inconceivable employment metrics.

 

[type b pharmD]

Well, for one .. our licenses are on the line usually. We're legally obligated to make sure that narcotic prescriptions are dispensed in accordance with medical norms. We're also the stewards of the narco inventory .. so if diversion is occurring, it's our problem.

Also there is that nice feeling you get when you know you're helping keep people out of the spiral of addiction. Too many providers lives have been ruined by it..

I generally am a big advocate for personal privacy, and I could care less if someone is using drugs recreationally in their own homes, but if they're stealing it from my workplace or scamming me to get high, that crosses the line.

Once you've seen a colleague go through diversion->addiction->licensure revocation->poverty->depression and/or suicide ... you generally will understand why it's important, regardless of the legal ramifications of diversion occurring on your watch.

I'll dispense 90ct oxycontin for someone with severe chronic pain without batting an eye .. but dispensing to someone for no real medical purpose, or slacking on diversion vigilance .. that crosses the line. I think a lot of us feel personally responsible for helping to prevent the deleterious effects of such circumstances.

 

[KidPharmD]

I think the ethical reasons are big for a lot of pharmacists. There is also the pride issue. It is offensive when someone presents you with a fake/illegitimate prescription and is trying to deceive you. I used to think, "I am not an idiot, you are not getting this one bud..."

There is also the professional mandate for us to make sure that each prescritiption is legal and for a legitimate medical condition. The boards of pharmacy put this mandate on us, and the DEA has begun to enforce it. So if we don't make an effort to stop the diversion attempts then we risk our license, our livelihood, and potentially our freedom.

 

[Aznfarmerboi]

bc my states narc enforcement bangs on my door every month...

 

[Gombrich12]

All I am doing is making sure everything looks right so if the DEA comes in ex post facto I can say I did XYZ. I don't particularly care about people abusing their medications because I cannot prove it anyways. Also, the doctors will almost always say go ahead and give them their early refill. Document it and move on.

 

[KidPharmD]

All I am doing is making sure everything looks right so if the DEA comes in ex post facto I can say I did XYZ. I don't particularly care about people abusing their medications because I cannot prove it anyways. Also, the doctors will almost always say go ahead and give them their early refill. Document it and move on.

Your strategy is not going to be enough for many of the circumstances we are seeing recently. Documentation is going to show that you had reservations about filling these prescriptions. If the DEA determines the doctor is a Pill Mill, they are going to wonder why you continued to fill these Rx's even though you obviously had concerns about the legitimacy of the use of these drugs.

If you document, make sure that it is DETAILED. If your are doing early refills for controlled Rx's - remember this... Just because the doctor says it is okay, it doesn't mean it actually is legal. The doc could write for a new Rx (with increased directions for example), but a doc doesn't necessarily have the authority to say that you can fill their oxycontin 10 days early without good reason.

 

[Gombrich12]

Oh you're right about early refills, if it was a consistent thing or they kept losing their medications I would just send them away. As for shady doctors if they are using their insurance and I get a diagnosis that is reasonable I will fill it. I really don't think we can tell for sure if a patient is in legitimate need of the medication. We should err on the side of helping the patient as long as it is reasonable. Also, if you are documenting a diagnosis on every CII pain med the DEA cannot say whether you had reservations on any one script or not.

 

[TLAD123]

Besides ethical reasons why do pharmacists fight so hard to stop drug diversions, when the DEA and legislative agencies continue to **** on this profession? No provider status, Tons of new schools, inconceivable employment metrics.

Because pharmacists are the drug experts, so fighting drug diversion seems appropriate. Also, in the hospital at which I am currently placed, pharmacists are seemingly the only ones who do. When pharmacy started getting involved, the diversion was cut by half. It exists; even when you don't think it does, it does.

 

[fauxden]

It can be somewhat entertaining. Just last week I had a nice gal who from the time we met went from walking into the store just fine to hobbling in pain because her "foot was broken", it ended with her telling me "F--- you". Good times.

 

[Sunshine98]

I try to keep telling myself one day there will be a national database so that doesn't matter where they go, any pharmacy, dr or other health professional can see what a patient got filled before writing a controlled prescription. If they can put a man on the moon.....and each individual business can be kept private as all it has to list is the patient, name of drug, qty, prescriber, and pharmacy address/phone of where it got filled.

 

[extra07extra]

All I am doing is making sure everything looks right so if the DEA comes in ex post facto I can say I did XYZ. I don't particularly care about people abusing their medications because I cannot prove it anyways. Also, the doctors will almost always say go ahead and give them their early refill. Document it and move on.

The pharmacy I am work at receive issue for DEA to audit. How long suppose is pharmacy to keep records?? We always almost fill all script (also controls mostly) so keep pharmacy business but we have dont keep much record. What happen whne pharmacy dont have record? I am work at this pharmacy most time but is not in charge pharmacist and am think about go work at different pharmacy now...

 

[Jibby321]

The pharmacy I am work at receive issue for DEA to audit. How long suppose is pharmacy to keep records?? We always almost fill all script (also controls mostly) so keep pharmacy business but we have dont keep much record. What happen whne pharmacy dont have record? I am work at this pharmacy most time but is not in charge pharmacist and am think about go work at different pharmacy now...

Uhhhhhh. That's hard to read. But I think it depends on your state on how long you need to keep records. Usually like 10 years?