Magazine article Drug Topics

Drug-Seekers in the Pharmacy

Magazine article Drug Topics

Drug-Seekers in the Pharmacy

Article excerpt


It was 8 p.m. on a Friday night. All was quiet in the pharmacy until a woman at the drop-off window startled me by shouting out a hearty and jovial "Hello!" She proceeded to make breezy small talk, asking how I had been, and she even knew my name. I was sure I had never seen her before.

I thought, She's talking a lot, but I'm not sure that she has really said anything. People who act like this are either drug reps or someone who wants me to dispense narcotics for all the wrong reasons.

She obviously thought I was going to fall for that long-lost-pal routine. Did she really believe I wouldn't know she got my name and face from the picture on the outside wall?

Reluctantly, I walked over to the counter. Her pretentious smile widened as I approached. I looked down at the paper she held out. Sure enough, oxycodone 30 # 240, issued by a doctor two states away - with a patient address that was two states away in the opposite direction.

"You must be in a lot of pain,'' I said gravely. She looked down for a second and changed her smile to a wince.

"It hurts so bad."

I said, "With that level of pain and at that dose of oxycodone, it may not be safe to drive as far as you drove to get here."

Her demeanor suddenly changed and she demanded, "Are you going to fill my oxies or not?"

"No," I said. She looked bewildered and surprised.

"That's all you're going to give me, is a no? Aren't you going to tell me that you don't have it? You can't just refuse to fill it."

"I can and I just did."

'It's not up to you to determine whether I'm in pain."

"I didn't say you're not in pain. I just said that I'm not going to fill it."

She started spouting four-letter words and got even angrier when she saw they had no effect.

"Leave now, or I'll call the police," I said.

"I'll find someone to fill it sooner or later," she said as she stormed out.


There are numerous situations in which a diligent pharmacist has genuine difficulty in determining the legitimacy of a narcotic prescription. The-all-toofamiliar scenario I just described makes the decision easy. We are told that federal and state laws provide a good set of guidelines, but they don't seem to cover all situations. Either way, for all narcotic prescriptions, professional judgment should be exercised with vigilance.

Unfortunately, pharmacists frequently surrender and dispense under duress, despite their suspicions. In this way, they unintentionally contribute to the pervasive and growing problem of prescription drug abuse.


A common reason that pharmacists may override their own judgment is fear of being sued by the patient or the provider.

However, specific provisions in federal and state regulations give pharmacists the prerogative to refuse to fill on any legal or pharmacological basis.

In fact, the same regulations also forbid a pharmacist to fill a prescription that a pharmacist knows or has reason to believe will be misused, abused, or diverted. A pharmacist is much more likely to face legal ramifications for filling such a prescription rather than for lawfully refusing to dispense.

However, a pharmacist can be sued for making slanderous or false statements about a patient or prescriber. So pharmacists refusing to fill a prescription should explain their decisions in a friendly but uncompromising manner; dte professional judgment; and avoid making subjective statements about the patient and/or prescriber. …

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