PILLS CAN KILL

 

Frequently Asked Questions for Healthcare Providers
 

What are the warning signs that someone is “doctor shopping”?

Answer: Warning signs would include: Patient appears restless, fidgety, irritated, or becomes easily angered.  Patient resides in another geographical region of Tennessee or resides in another state. Patient may exaggerate or feign medical problems or symptoms. Patient is reluctant to give medical history or gives vague answers. Patient asks for a specific drug “cocktail” usually consisting of hydrocodone, oxycodone, alprazolam, and carisoprodol. Patient demands prescriptions on Fridays or seeks multiple early refills. Patient lacks prescribed drug(s) in drug screen.

For more information along with resources and screening tools please see:

http://www.drugabuse.gov/nidamed/

http://www.deadiversion.usdoj.gov/pubs/brochures/drugabuser.htm

What should a pharmacist or pharmacy personnel do when a forgery is suspected?

Answer:  Forgery is a felony. If a suspected forged prescription for a controlled substance is presented to you, remain calm and non-confrontational.  To help law enforcement and assist in prosecution, try to determine the identity of the suspect, and gather proof that a fraudulent prescription has been presented. Immediately make a copy of the prescription and try to retain the original.  Next ask the suspect to present identification, specifically photo identification, and make a copy of any/all identification presented to you.  If the suspect fails to present identification, attempt to obtain as much verbal information as possible, such as a telephone number and address.

After making a copy of the suspicious prescription and asking for the suspect’s identification, contact local law enforcement in your area.  Once law enforcement has been notified, attempt to “stall” the suspect until the police arrive.  If the suspect leaves, do not hinder him/her.  Make sure to obtain good physical and clothing descriptions and a vehicle description if possible. 

 

 What is the Controlled Substance Monitoring Database? 

Answer:  The Tennessee Board of Pharmacy within the Department of Health maintains the database, which includes data on controlled substance prescriptions of schedule II through V drugs.  The database includes basic patient information, the identity of the prescribing practitioner, the pharmacy that filled the prescription, and the name, amount and form of medication that the patient received.  More information can be obtained at  http://health.state.tn.us/Boards/Controlledsubstance/index.shtml. 

What is a “doctor shopper” and is it illegal?

Answer:  A “doctor shopper” is a person who visits numerous practitioners in short periods of time specifically to obtain controlled substances. 

T.C.A. 71-5-2601, in part, specifically makes it a Class D felony for TennCare enrollees to obtain or attempt to obtain controlled substance benefits by failing to disclose to a health care provider that he or she has received either the same or a similar controlled substance or a prescription for the same or similar controlled substance from another practitioner within the previous thirty (30) days, if the person used TennCare to pay for either the clinical visit or for payment of the controlled substances

In addition, T.C.A. 53-11-402(a)(3) makes it a Class D felony for any person to knowingly or intentionally acquire or obtain, or attempt to acquire or obtain, possession of a controlled substance by misrepresentation, fraud, deception, or subterfuge.  

 What is considered “improper prescribing” in relation to controlled substances?

Answer:  Certain health care practitioners may administer, dispense and/or prescribe controlled substances, but only as authorized by and consistent with such person's professional or occupational licensure or registration law.  T.C.A. 53-11-401 makes it unlawful for any person to distribute or dispense a controlled substance in an unauthorized way, or in a way inconsistent with such person’s professional or occupational licensure or registration. 

T.C.A. 63-6-214, among other things, provides for licensure suspension or revocation for a physician or practitioner to dispense, prescribe, or otherwise distribute any controlled substance not in the course of professional practice, or not in good faith to relieve pain and suffering, or in amounts and/or for durations not medically necessary.

Some prescribing guidelines are set out in the Rules of Tennessee State Board of Medical Examiners, which can be located at http://state.tn.us/sos/rules/0880/0880.htm.  Federal rules governing the issuance, filling and filing of prescriptions can be found in 21 CFR 1306, while the Controlled Substance Act (CSA) and other federal criminal laws may be used in the prosecution of some healthcare providers.

 

Are there any legal repercussions to the pharmacists for “improper dispensing” of those medications?

Answer:  Like physicians and other health care providers, a pharmacist can also be criminally liable if he or she knowingly contributes to the illegal distribution of controlled substances, or knowingly acts as a conduit for the illegal dispensing of controlled substances. 

 

 What are the pharmacist’s responsibilities surrounding controlled substance prescriptions? 

Answer:  The Controlled Substance Act (CSA) in part provides that a pharmacist who knowingly fills a prescription issued not in the course of professional treatment may be subject to penalties outlined by the CSA.  A pharmacist should verify any prescription written outside the standards of practice.  If a prescription for the same or similar controlled substance and for the same medical reason has already been obtained from another health care provider(s), the prescriber(s) and law enforcement should be notified.

 

 What are the laws regarding the authority of a law enforcement agent to access a  pharmacy and its patient information?

Answer:  T.C.A. 53-11-406 provides that prescriptions, orders and records, and stocks of controlled substances shall be open for inspection to federal, state, county, and municipal officers whose duty it is to enforce the laws or regulations of this state or of the United States relating to controlled substances or narcotic drugs.

   

 

In an emergency, call local law enforcement or 911.