drug diversion

[akaykay]

do you guys think pharmacists should be required to participate in preventing drug diversion.


personally, i feel like there are so many pharmacies that have drug diversion that it would be pointless to let them catch the bad guys when some are the bad guys themselves. I think only the dea and physicians should be involved.
what do you guys think. What are some pros/cons to this debate (i'm thinking about presenting this argument to a debate class), even though i know the majority will say pro.

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[PharmDstudent]

do you guys think pharmacists should be required to participate in preventing drug diversion.

Pharmacists prevent drug diversion every day by doing the following:
1) maintaining Sudafed logs
2) checking tamper-resistant scripts
3) checking refill histories of controlled drugs, e.g. they won't fill controlled substances if it's too early
4) turning away suspicious customers
5) checking patient identification if the patient is afraid that an unauthorized person will try to pick up their script

 

[Hels2007]

Pharmacists prevent drug diversion every day by doing the following:
2) checking tamper-resistant scripts

Note: in those states that have them. The universal federal requirement has been pushed back because of many problems and disruptions in care it would cause.

 

[PharmDstudent]

Note: in those states that have them. The universal federal requirement has been pushed back because of many problems and disruptions in care it would cause.

Yeah... we're stuck with 'em here. Every Medicaid script requires an additional override in our system. It's the same at CVS too.

*PharmDstudent shrugs shoulders and shakes head sideways*
It's just another hoop for the pharmacy to jump through (if you ask me).

 

[FruitFly]

Pharmacist responsibility with respect to drug diversion:

www.deadiversion.usdoj.gov/pubs/manuals/pharm2/2pharm_manual.pdf

The DEA website (along with state Bureau of Narcotic Enforcement sites) would be your best resource for learning the legal requirements of pharmacists, as well as helpful information with regards to being alert and how to make your pharmacy less of a target with regards to the ever-rampant crime of diversion.
/End Crimedog spiel.

 

[Priapism321]

do you guys think pharmacists should be required to participate in preventing drug diversion.


personally, i feel like there are so many pharmacies that have drug diversion that it would be pointless to let them catch the bad guys when some are the bad guys themselves. I think only the dea and physicians should be involved.
what do you guys think. What are some pros/cons to this debate (i'm thinking about presenting this argument to a debate class), even though i know the majority will say pro.

I feel like the entire premise of your argument actually makes little to no sense at all. Pharmacists shouldn't be involved in preventing diversion because some pharmacists are diverters themselves? What? Is this the argument? How is a Physician going to be the primary preventive measure against drug diverters at a pharmacy? Or do you think the DEA can handle the day to day diversion at your local Walgreens? Your argument against pharmacists participating can be turned right around and used for physicians I believe (see http://www.deadiversion.usdoj.gov/crim_admin_actions/crim_actions.htm). That is only last names A-F. Maybe I am missing something here, but I've been staring at your post for several minutes hoping it will begin to appear somewhat coherent. Hasn't happened yet, so I am pressing submit.

But....

For the record, I am convinced I am reading this wrong and someone will correct me shortly.

 

[FruitFly]

The only thing one could say in the face of such an argument is the major reason why pharmacists are involved in preventing drug diversion.... because they are the gatekeepers of the drugs, have access to a lot of records that physicians and other practitioners do not have, and that prescription drug abuse amongst minors and folks in general has been on the rise, surpassing illicit drug abuse.

 

[PharmDstudent]

I feel like the entire premise of your argument actually makes little to no sense at all. Pharmacists shouldn't be involved in preventing diversion because some pharmacists are diverters themselves? What? Is this the argument? How is a Physician going to be the primary preventive measure against drug diverters at a pharmacy? Or do you think the DEA can handle the day to day diversion at your local Walgreens? Your argument against pharmacists participating can be turned right around and used for physicians I believe (see http://www.deadiversion.usdoj.gov/crim_admin_actions/crim_actions.htm). That is only last names A-F. Maybe I am missing something here, but I've been staring at your post for several minutes hoping it will begin to appear somewhat coherent. Hasn't happened yet, so I am pressing submit.

But....

For the record, I am convinced I am reading this wrong and someone will correct me shortly.

The question is very confusing.

I think what the OP is trying to ask is if it's the pharmacists' duty to prevent drug diversion.
What the OP probably doesn't realize is that pharmacists are already involved in preventing diversion because of the laws and policies that exist.

 

[bananaface]

For the OP, are you meaning to discuss prevention of diversion by healthcare staff, by the general public, or both?

Here in IA we are required to report diversion or suspected diversion by pharmacy staff to the board. It seems kind of big brother having moved from a state where reporting was non-mandatory and employers often chose not to report to avoid potential lawsuits. But, having heard about pharmacists getting passed from chain to chain in WA and no one being legally able to warn the hiring store under b/c of employment verification laws, I can see the benefits.

 

[akaykay]

Ok. looking back I should have just directly posted the question I wanted to ask. I'm doing a debate on whether pharmacists should be required to particpate in law enforcement programs focused on preventing drug diversion. I'm suppose to be the "con" side and I can't think of much. The only things I can think of are:

1) increased training and time--a burden on pharmacists
2) drug diversion already occurs in pharmacies, and is highest among health care professionals, so in a way we would be training and further providing knowledge to pharmacists on how they can prevent from being caught (to those that are involved)
3) that this type of program would have a small impact overall on drug diversion because there is still diversion occuring thru internet pharmacies, doctor shopping, and drug theft (personal homes, businesses, etc)
4) we can't really be able to detect prescription forgery without some confident way (e.g. tamper-resistant pads), but this hasn't went into effect in my state.

I know my arguments are somewhat weak, but I haven't been able to find any articles/websites on this topic (against it) and i'm stronly on the pro side, so i'm confused.

 

[bananaface]

Downsides could also be shutting off a part of the healthcare system for those who use illicit substances (they don't come in b/c they are afraid to be ID'd and arrested) or offering less than optimal care to patients b/c you aren't aware of all the substances they are taking (b/c they are afraid to tell you).

I wouldn't buy #2, above. The more educated you coworkers are, the more likely they are to catch you too. If you want to argue #2 you'll need to provide some sort of stats that support the scales being tipped in the direction of increased abuse.

Also, RE #4, the DEA disagrees: http://www.deadiversion.usdoj.gov/pubs/brochures/pharmguide.htm#char I've seen lots of fun stuff - tracings, photocopies, mismatched ink and/or handwriting, Rxs from physicians I know are out of town for the week from patients who "just came" from their office, stolen Rx pads, even refills added in crayon.

 

[RxWildcat]

regarding #2, pharmacists are at the top of the list of drug diversion among healthcare professionals (followed closely by dentists), but this is contributed to ease of accessibility. #3 is non-sense, its like saying, if they don't commit this crime they'll commit another, so we shouldn't bother enforcing this law. As far as #4, I can spot a forgery a mile away most of the time. There have been a few that almost got me, I usually go back to an old rx and compare MD signatures.