Preventing Diversion

Prescription blanks often are stolen and used to sustain abuse of controlled substances and to divert legitimate drug products to the illicit market. To prevent such diversion, prescription pads should be protected in the same manner as one would protect a personal checkbook. A prescription blank should never be pre-signed for a staff member to fill in at a later time. Also, a minimum number of pads should be stocked, and they should be kept in a locked, secure location except when in use. If a pad or prescription is missing, it should be reported immediately to local authorities and pharmacies; some areas have systems in place to allow the rapid dissemination of such information.

Ideally, the physician's full DEA number should not be preprinted on the prescription pad; most prescriptions will not be for controlled substances and will not require the registration number, and anyone in possession of a valid DEA number may find it easier to commit prescription fraud. Some physicians may intentionally omit part or all of their DEA number on a prescription and instead write "pharmacist call to verify" or "call for registration number." This practice works only when the pharmacist may independently verify the authenticity of the prescription, and patients must be advised to fill the prescription during the prescriber's office hours. Pharmacists can ascertain the likely authenticity of a physician's DEA number using an algorithm.

Another method employed by the drug-seeker is to alter the face of a valid prescription to increase the number of units or refills. By spelling out the number of units and refills authorized instead of giving numerals, the prescriber essentially removes this option for diversion. Controlled substances should not be prescribed excessively or for prolonged periods, as the continuance of a patient's addiction is not a legitimate medical purpose.

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