Magazine article Drug Topics

Can I Fill Self-Prescribed Rxs or Rxs for Family Members?

Magazine article Drug Topics

Can I Fill Self-Prescribed Rxs or Rxs for Family Members?

Article excerpt

When a pharmacist is presented with a self-prescribed prescription, or a prescription written for the prescriber's family member, it should immediately raise a red flag and requires close scrutiny. Is the prescription valid? If not, can the pharmacist be disciplined for filling it? The short answer is the infamous "it depends" - on whether the script is valid or not. If it's invalid and the pharmacist fills it - not an uncommon practice t disciplinary action could and should result.

First and foremost, it must be emphasized that the rules governing this type of situation vary among the states. Therefore, it is imperative that a pharmacist knows and adheres to the particular state's rules. For example, one state may consider a script invalid and therefore subject the pharmacist to discipline if filled, while the same script in another state may be acceptable and valid.

Most of the concern relates to prescriptions written for controlled substances, since they create an enormous potential for abuse and/or dependence. Likewise, prescribing controlled substances to family members is frequently associated with problems of self-medication and dependency by the prescriber and/or the family member. Therefore, restrictions on a physician s ability to prescribe such prescriptions would logically result in a decrease of this abuse potential and is justified. However, some states are more restrictive than others.

For example, in Massachusetts a physician is prohibited from self-prescribing a Schedule II through IV controlled substance. Therefore, any such script is invalid and cannot be filled. That state has concluded that the potential for abuse far outweighs the relatively minor inconvenience that is caused by requiring the physician to obtain such a prescription from another physician. Schedule II prescriptions written for family members are prohibited, due to the high potential for abuse, except in an emergency situation. That state also recommends that physicians consider refraining from prescribing any controlled substance to family members in non-emergency situations. On the other hand, Tennessee prohibits self-prescribing a Schedule II and III drug, but a Schedule IV drug is allowed in an emergency situation. Except in emergency situations, Schedule II, III, or IV drugs should not be prescribed to family members.

Other states' rules aren't as explicitly prohibitive. For example, New Hampshire simply states that it is "not appropriate" for physicians to prescribe controlled substances for themselves or to family members, except in emergencies. Montana takes a particularly interesting stance - although there is not a rule specifically prohibiting the self-prescribing of drugs or prescribing to family members, the state does inquire into such prescribing habits by exploring factors such as if the treatment is well-reasoned and well-documented, whether there's a potential dependency problem, and whether the prescriber maintained objectivity in the process. That state strongly encourages its physicians to carefully consider the legal and medical disadvantages of such prescribing. Similarly, Kentucky doesn't have any rules specifically prohibiting such prescribing, but it recommends avoiding doing so to prevent any appearance of impropriety.

Some states consider self-prescribing and prescribing to family members as unprofessional conduct, usually due to factors such as the lack of a valid doctor/patient relationship, poor medical history, and the lack of a proper physical exam. …

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