The Pharmacist's Responsibility to Evaluate Suspicions Prescriptions 46 Food, Drug, Cosmetic Law Journal 1991

46 Food Drug Cosm. L.J. 467 (1991)
The Pharmacist's Responsibility to Evaluate Suspicions Prescriptions

handle is hein.journals/foodlj46 and id is 497 raw text is: The Pharmacist's Responsibility to Evaluate Suspicious
Prescriptions
DAVID B. BRUSHWOOD*
JEFFERY J. CARLSON**
I. INTRODUCTION
Pharmacists are trained as health care providers, not as law enforce-
ment agents. Yet, because many of the medications pharmacists routinely
dispense are subject to illegal use,' pharmacists have been conscripted into
the war against drugs as key players in an overall program designed to
prevent illicit drug use.' When a suspicious' prescription is presented to
a pharmacist for filling, the pharmacist's law enforcement function re-
quires that he or she take whatever steps are reasonably necessary to ver-
ify the validity of the prescription. If the prescription turns out to be inva-
lid, then it should be refused. If it turns out to be valid, then it may be
filled. Unfortunately, because it is not always possible to recognize or
* Mr. Brushwood is a Professor at the University of Florida, College of Pharmacy, Gainsville,
Florida.
** Mr. Carlson is a Partner in the law firm of Dickson, Carlson & Campillo, Santa Monica,
California.
1. Three of the top 10 and 17 of the top 100 most frequently prescribed drugs are classified as
controlled substances due to the possibility of illegal use. See 199 AM. DRUGGIST, Feb. 1989, at 46.
2. Pharmacists are subject to regulation both as practitioners within the health care system and
as product distributors at the final link in the drug distribution chain. The emphasis in pharmacy
practice and in pharmacist education has focused on the patient rather than on the drug product in
recent years. The lack of emphasis on the product is potentially at odds with a regulatory system that
requires placing primary emphasis on the integrity of the system, rather than the best interests of
patients. For an insightful discussion of the conflict between the pharmacist's role as a health care
provider and the pharmacist's role as drug distributor, see Manassee, Medication Use in an Imperfect
World: Drug Misadventuring as an Issue of Public Policy, Part 1, 46 AM. J. Hosp. PHARMACY 929
(1989); Manassee, Medication Use in an Imperfect World: Drug Misadventuring as an Issue of
Public Policy, Part 2, 46 AM. J. OF Hosi'. PHARMACY 1141 (1989).
3. For purposes of this article, a suspicious prescription is one for a controlled substance
which is presented for filling under circumstances that are out of the ordinary to the extent that a
pharmacist either does or should develop a subjective feeling that things are not quite right. The
prescription may be for an unusually large quantity of a medication, it may have directions that are
not appropriate, it may be issued by a doctor who usually does not prescribe this type of medication,
or the pharmacist may simply believe that something is amiss without being able to explain the basis
of that feeling. Prescriptions that are invalid forgeries, but which are done so well that they are
beyond suspicion, do not fall within the scope of this article. Some prescription forgeries are done so
well that they fool the physicians whose names have been forged. See Torrence, What To Do When
Someone Wants A Dubious Rx Filled, 180 AM. DRUGGIST, Dec. 1979, at 32.
4. There may be other reasons to not fill a prescription. The drug may be out-of-stock, or the
pharmacist may be unfamiliar with the medication and not trust his or her own ability to dispense it.
The body of law relating to controlled substances deals only with the responsibility to not fill prescrip-
tions because they are invalid. Under limited circumstances, pharmacists may have a responsibility to
not fill a prescription, even though it is valid, because the prescription is so potentially harmful to the
patient that it would be malpractice to dispense the medication. See Brushwood & Lively, Refusal to
Dispense a Prescription: What is the Law?, NS29 AM. PHARMACY 645 (1989).

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