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    Opioids prescriptions: Are pharmacists waving white flags?

    Ken BakerKen BakerI am concerned about the increasing problem of pharmacists being pressured to turn down legitimate prescriptions. What particularly concerns me is that in some cases real pain patients have been refused prescribed medication.1 In one case, I wrote about a patient who left the pharmacy not only in pain but also in tears after being accused by a pharmacist of being a drug abuser.1

    Increasingly pharmacists are told to solve the overuse of drugs by adopting an attitude of: “when in doubt, don’t fill.” Pharmacists have a legal and ethical duty to refuse to fill prescriptions when they know — or by applying their knowledge and experience should know — that they are not for a legitimate medical purpose. 

    Tools, not answers

    To assist the pharmacist, a list of “red flags” has been developed. In a perfect world, a “red flag” should be resolved before the prescription is filled. But “red flags” are tools, not answers. The real answer must be found in the question: “Is this prescription for a legitimate patient with a legitimate medical need?”

    If patients are taking too much medication or refilling it too early, this may be a “red flag” pointing to a pharmacy and medical problem, not a legal problem.  The pharmacist’s job is to work with the patient and the prescriber to resolve pharmacy and medical problems.

    If the pharmacist decides that the patient is not in legitimate pain and that there is no legitimate medical purpose for the prescription, then the pharmacist has decided the Rx is not valid. In that case, as a pharmacist and a former prosecuting attorney, to me the answer seems relatively easy — a crime is being committed and the police need to be notified. 

    The pharmacist need not call the police while the person is still in the pharmacy, as that may be dangerous, but the prescription should not be filled and the police should be notified when it is safe for the pharmacist to do so. 

    Kenneth R. Baker, BS Pharm, JD
    These articles are not intended as legal advice and should not be used as such. When a legal question arises, the pharmacist should ...

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