Fake scripts

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pharmd201389

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10+ Year Member
I know it's not our job to be the police- and trust me, I give patients a lot of leeway when it comes to controlled scripts.

But then, every day, you get that one Oxycodone 10 mg QID #120 or that Hydrocodone/APAP 10/325 QID #120 that you just KNOW is fake. The person dropping it off is not in any pain whatsoever and is talking like a perfectly normal human being.

To me, if someone has to be on 40mg of oxycodone a day for a month straight, then he/she has to be in excruciating pain. And this is just not the case with the people who drop it off.

You know that it's fake- what do you do? I usually pretend to check to see if we have it in stock and then just lie and day we don't. If they ask me to call other pharmacies, I say that I can check in my computer to see who has it in stock and none of the pharmacies carry such a high quantity because it is unusual and 120 tablets usually aren't given out (this always kind of scares them.)

Do you guys do the same? Has anyone actually kept the script and then called the forged script hotline? Or would that bring too much heat?
 
pharmd201389 said:
I know it's not our job to be the police- and trust me, I give patients a lot of leeway when it comes to controlled scripts.

But then, every day, you get that one Oxycodone 10 mg QID #120 or that Hydrocodone/APAP 10/325 QID #120 that you just KNOW is fake. The person dropping it off is not in any pain whatsoever and is talking like a perfectly normal human being.

To me, if someone has to be on 40mg of oxycodone a day for a month straight, then he/she has to be in excruciating pain. And this is just not the case with the people who drop it off.

You know that it's fake- what do you do? I usually pretend to check to see if we have it in stock and then just lie and day we don't. If they ask me to call other pharmacies, I say that I can check in my computer to see who has it in stock and none of the pharmacies carry such a high quantity because it is unusual and 120 tablets usually aren't given out (this always kind of scares them.)

I work with a detective. I'm near a big city so I get my lions' share of fakes. After making certain it's a forgery I call him. I tell the patient it will be ready in 45 minutes. They come back to buy it and they get arrested. They search their car and confiscate all the rest of their money and drugs and tow their car. I rarely go to court because they always plead guilty for a lower sentence as long as they agree to go to rehab. If my detective is unavailable I tell them we don't have it. When they ask me to call another pharmacy I tell them they won't answer that on the phone. I've had 210 people arrested in this fashion in the last 3 years. If we all worked together on this we could chase a good portion of the abusers either into rehab,prison or into abusing another drug such as heroin.
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Just say you're not going to fill it and that's the end of it. Getting the police involved is too much, we don't have time for that. Try it once and you'll see why.
 
I worked in a pharmacy for a while, and I saw my share of fakes. (Oxy written on a planned parenthood script with white out still visible etc.).

However...

Aside from policeman and detective, its also not your job to qualify whether someone is in pain. Maybe they appear well because they are pain patients who are properly medicated... did you ever consider that?

I remember this problem with methadone. No pharmacist in town carried it, because they all believed is was simply a drug of abuse, and only attracts current or former heroin addicts. And instead of saying this, they all responded like the OP when patients came in... they lied..... pathetic
 
fishsnack said:
I worked in a pharmacy for a while, and I saw my share of fakes. (Oxy written on a planned parenthood script with white out still visible etc.).

However...

Aside from policeman and detective, its also not your job to qualify whether someone is in pain. Maybe they appear well because they are pain patients who are properly medicated... did you ever consider that?

I remember this problem with methadone. No pharmacist in town carried it, because they all believed is was simply a drug of abuse, and only attracts current or former heroin addicts. And instead of saying this, they all responded like the OP when patients came in... they lied..... pathetic
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I totally agree with this statement, when I worked in retail and I felt like it was some shakiness with a script I would just simply say we do not have it in stock.... Another thing to think about is whether this person is picking the meds up for an elderly family member. To alleviate stress on yourself with the police and all the drama, just say we don't have it. Your "retail pharmacy" is not going to appreciate you anymore if you become their pharmacy police.... 😉
 
pharmd201389 said:
I know it's not our job to be the police- and trust me, I give patients a lot of leeway when it comes to controlled scripts.

But then, every day, you get that one Oxycodone 10 mg QID #120 or that Hydrocodone/APAP 10/325 QID #120 that you just KNOW is fake. The person dropping it off is not in any pain whatsoever and is talking like a perfectly normal human being.

To me, if someone has to be on 40mg of oxycodone a day for a month straight, then he/she has to be in excruciating pain. And this is just not the case with the people who drop it off.

You know that it's fake- what do you do? I usually pretend to check to see if we have it in stock and then just lie and day we don't. If they ask me to call other pharmacies, I say that I can check in my computer to see who has it in stock and none of the pharmacies carry such a high quantity because it is unusual and 120 tablets usually aren't given out (this always kind of scares them.)

Do you guys do the same? Has anyone actually kept the script and then called the forged script hotline? Or would that bring too much heat?
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This is exactly why some doctors don't respect pharmacists. Who are you to tell someone that they are in an appropriate amount of pain for narcotic analgesia?
 
Because, they are walking, talking, laughing, smiling, and appear to be in perfect health.

Someone who is like this should NOT BE ON 40MG OF OXY A DAY especially for months at a time.
 
pharmd201389 said:
Because, they are walking, talking, laughing, smiling, and appear to be in perfect health.

Someone who is like this should NOT BE ON 40MG OF OXY A DAY especially for months at a time.
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I want you to research the phrase "pain management". They are walking, talking, laughing, and smiling because their pain is in control! Mother of god...

owlegrad said:
I am sorry but if the person isn't crying in pain I will not fill an oxy script. That's just the way we roll.
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That's why you're a bad pharmacist. Harsh, I know, but true. You are trying to practice medicine in the least possible way and it's very upsetting.
 
Don't always assume it's fake just because the patient doesn't appear to be in pain. It could always be someone else sent to pick it up for them because they are at home in pain and have a hard time getting out.

If the script is questionable in regards to its validity I would call the prescriber's office and verify with them if it's legit. If it's fraudulent report it and don't fill it.
 
BenJammin said:
I want you to research the phrase "pain management". They are walking, talking, laughing, and smiling because their pain is in control! Mother of god...



That's why you're a bad pharmacist. Harsh, I know, but true. You are trying to practice medicine in the least possible way and it's very upsetting.
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So what would you do if you think a script is fake but the doctors office is closed and you can't get in touch?

Tell them to come back the next day?
 
Oxy 30? Take 1 tablet by mouth 5 times a day? #150? Cash paying patient? Patient appears to be in perfect health?

Are you freaking kidding me? Are you trolling or are you a drug addict yourself in disguise?
 
pharmd201389 said:
Oxy 30? Take 1 tablet by mouth 5 times a day? #150? Cash paying patient? Patient appears to be in perfect health?

Are you freaking kidding me? Are you trolling or are you a drug addict yourself in disguise?
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Huh? If your state has a drug monitoring program then why are you being such a baby? Sounds like to me you'd rather discriminate against people than actually be a pharmacist. Go ahead and dismiss me as a troll, the rest of us dismiss you as an idiot. Can't believe you are/will be licensed.
 
npage148 said:
Thanks for passing you problems off on other stores

What would you do if they said, "ok order it in for me please?" Refuse to order it?
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We get so many fakes in my area all of the other stores know this is the procedure. They really don't mind. We are all playing the same game. If they ask me to order it I tell them it will be in in two days. I take a picture of the script with my phone as I look in the safe. The next day I call to verify it. If it's fake I either confiscate the script when they come back or have them arrested on the spot.
 
pharmd201389 said:
Because, they are walking, talking, laughing, smiling, and appear to be in perfect health.

Someone who is like this should NOT BE ON 40MG OF OXY A DAY especially for months at a time.
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owlegrad said:
I am sorry but if the person isn't crying in pain I will not fill an oxy script. That's just the way we roll.
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Guys, open a frickin science book because you are sounding like a couple *****s. I am embarrassed that you are pharmacists.
 
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pharmd201389 said:
Because, they are walking, talking, laughing, smiling, and appear to be in perfect health.

Someone who is like this should NOT BE ON 40MG OF OXY A DAY especially for months at a time.
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If it is an appropriate amount of oxycodone to manage their pain, they may be.

However, a patient on high dose narcotics for several months should (generally) have a long acting medication and use the short acting for breakthrough. Not having a prescription for one would make me wonder if it's a fake or if their pain is actually being appropriately managed.
 
slimcutt said:
Guys, open a frickin science book because you are sounding like a couple *****s. I am embarrassed that you are pharmacists.
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I am sorry you feel that way, but I at least expect a patient on oxy to be crying or at least moaning in pain. If they can't even do that much, why should I fill a script?

And don't get me started on people who have medicaid and have the audacity to own nice things.
 
Here's how you manage questionable scrips:

During physician hours:
Call MD's office. "Hi this is the pharmacist from Drug Mill Express. I have a patient here that is new to me with a prescription for oxycodone and I would just like to verify it with you. Thank you." Done. Easy. Be sure to Google the office phone number. Don't go off whats on the script.

After hours/weekend:
"Hello. Sure, we can fill your prescription. It's my policy to verify narcotic scripts for patients who are new to this pharmacy. We'll have it ready in the morning (or on Monday if it's a weekend). In the meantime, can I interest you in some products to help with those skin popping lesions? I can also recommend a nice sturdy toothbrush for you." If the script is fake, they will always say they need it sooner than that and take it elsewhere. True chronic pain patients don't let their suppy run out on a weekend, and if they do, they go to the pharmacy where they have established care.
 
owlegrad said:
I am sorry you feel that way, but I at least expect a patient on oxy to be crying or at least moaning in pain. If they can't even do that much, why should I fill a script?

And don't get me started on people who have medicaid and have the audacity to own nice things.
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Why would they be crying if they have controlled chronic pain?
 
When I worked retail, I called to verify all rxs for potent opioids. If I couldn't verify, I didn't fill. And I confronted people with fake scripts, telling them they could go to jail. They always denied it. Sometimes I confiscated the script.

I'm not so into customer service.

@ BenJammin, if you read this article and still think that pharmacists who question the practice of prescribing large quantities of opioids to young and healthy people are practicing medicine without a licence, I have other articles, such as the appropriate treatment of chronic non-cancer pain, and the principles of evidence-based medicine.

Despite the escalating use and abuse of therapeutic opioids, nearly 15 to 20 years later the scientific evidence for the effectiveness of opioids for chronic non-cancer pain remains unclear. Concerns continue regarding efficacy; problematic physiologic effects such as hyperalgesia, hypogonadism and sexual dysfunction; and adverse side effects – especially the potential for misuse and abuse – and the increase in opioid-related deaths.

Americans, constituting only 4.6% of the world’s population, have been consuming 80% of the global opioid supply, and 99% of the global hydrocodone supply, as well as two-thirds of the world’s illegal drugs.
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owlegrad said:
I am sorry you feel that way, but I at least expect a patient on oxy to be crying or at least moaning in pain. If they can't even do that much, why should I fill a script?

And don't get me started on people who have medicaid and have the audacity to own nice things.
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Come spend a day in my oncology clinic. You will see plenty of people who would be crying and moaning in pain if we didn't have it well controlled with pain medication. Well controlled means no symptoms, which means no need to cry or moan in pain.
 
ucrx said:
Come spend a day in my oncology clinic. You will see plenty of people who would be crying and moaning in pain if we didn't have it well controlled with pain medication. Well controlled means no symptoms, which means no need to cry or moan in pain.
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Much different than a family prac who has 2 dozen patients on 180 oxy/month
 
At my pharmacy we are monitored by DHEC. We are more and more being forced to scrutinize the customers who come in with narcotic scripts whether they are first timers or long term patients with a long history of pain management. We had recently had a fake script come in that later led to the bust of a very sophisticated drug ring that was going on for sometime. The script was found to be fake only after it was filled. My pharmacy is a 24 hour pharmacy so not all prescriptions can be verified at night time which leads to problems with people coming late on Fridays having to wait till Monday to get verified or a doctors office not being opened.The prescription was written for Oxycontin ER 40mg #120 BID and Roxicodone 15mg #240 QID was written for a hospice terminal cancer patient. As normal my pharmacist had notified the customer that he needed to verify the script before it can be filled. The customer complied and waited. My pharmacist had looked the script over nothing was odd about it other than being for #240 but it was understandable since it was for a hospice patient. He looked up the profile of the patient and seen they had have got the medication before and was covered by Medicaid, written by the same doctor. We are require to not call the number on the script but to check our database for the office number, in which he did and both matched. He spoke to the doctor, everything checked out fine with the medication that was being prescribed and for the amount and for the reason. It was soon filled after and sold to the customer. The next morning when the next pharmacist came in for the next shift, the pharmacist from the night who filled the prescription talked to the other about the script he had filled the following night. He did not have a smartphone nor internet access at the time of filling, so they both checked out the practice on google on the pharmacist's phone that was coming in, and nothing could be found of this practice. No office location, no info on the practices name, nothing came up. So the district DHEC officer was called in to investigate. The script that it was written on passed all the test, void holograms, DEA# passed, watermark passed. Later on more information was found out about what was going on. The people behind the operation had found out how to duplicate the security features on the paper and were printing their own scripts with a real doctors DEA#. They somehow managed to be enter in the database with the number that was on the script so it was being verified to a fake office number. The person who answered to verified was well versed and had a good amount of medical knowledge to pass off as the real thing. My pharmacist wasn't fired or fined but got a tongue lashing from our DHEC officer about the script.

This all happened on a Friday night around 9:30 pm. What I find wrong is after everything as a pharmacist is suppose to do to ensure that a script is legit, and it passes those things and it ends up being a fake, how much more could have been done other than driving to the address of the practice itself. And on top of being scolded by the officer for filling a fake script, even tho many scripts for other patients were filled before this one by other pharmacist from the same doctor under the same practice and no one thought to question it then. And that it was being covered by medicaid with no flags being thrown up from it from the Medicaid. I thought that a pharmacist was suppose to put the well being of a patient first, in this case he followed the rules for verifying and thought that a legit hospice patient was being helped. If anything I would have thought that the pharmacist would have been somewhat thanked for helping to catch this ring that was going on and helped put an end to anymore drugs from these people being put on the streets illegally.

So after that indecent, DHEC has came down even harder and are now requiring every pain narcotic, from percocets to roxicodones to be verified regardless of the purpose being prescribed or if the person is a long time patient or new one only excluding RX's from hospitals which are usually only written for less than 20. So we now have to tell our regular customers who have been getting Oxycontin from us every month for the past 3 years from doctors who some of the pharmacists know personally can not get them until they are verified. For those people it can sometimes mess up there regular schedule of taking the medications like what had happened this weekend. A lady who has been getting Oxycontin 15mg every month for the past 2 years from us, came in Friday with her new script to be filled. It was 6 pm when she came in and we told her that we are now required to verify all narcotics with the doctor. Unfortunately for her, the doctors office closed at 5pm and it was Friday and its Memorial weekend so the office won't open till Tuesday for us to verify. So for her, she will be out of pain medication for her chronic pain for 4 days and there is nothing we can do about it. All the pharmacists are afraid to even fill a narcotic now unless it verified even if it is for a well known customer.

I do understand there are some sketchy people that come in with scripts you can tell that are fake or are written for pain medications and you might think they don't really need what is being prescribed to them, I still think the pharmacist should be able to make that decision in the interest of his or her self and for the patient on whether or not to fill the script whether it can be verified at the time or not, and not be worried that they will lose their job from doing so.
 
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Corpseman said:
Much different than a family prac who has 2 dozen patients on 180 oxy/month
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Yes but the statement was that patients should be crying or moaning in pain if they are getting oxycodone. That just isn't true if their pain is managed, whether or not they have cancer pain or some other chronic pain.
 
You should call the Dr. to verify prescription instead of do a judgement on how people look. He/She might already took 1 tablet of oxycodone before come to your store...I see many patients who is my regular customer, they have a chronic pain but never show their emotion such as crying or moaning. You should be aware of someone who drop off prescription 15-30 mins prior to your closing time, new patient and no insurance.
 
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