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Prescription Pad Theft and Abuse

By Cliff Rapp, LHRM, Vice President of Risk Management, FPIC

A major problem facing healthcare professionals today is the abuse of prescription drugs and diversion of medications. A prescription drug abuser may prey on the sincere efforts of healthcare professionals to eliminate pain and suffering, and provide comfort for a patient. Frequently, prescription drugs become a very valuable product for the drug trafficker. The theft of prescription pads and medications occurs in a variety of ways. Every physician and healthcare professional should safeguard against becoming an easy target for drug diversion.

The most effective method of combating prescription drug abuse is through education and communications.

What You Should Not Do When Confronted by a Suspected Drug Abuser:

  • "Take their word for it" when you are suspicious
  • Dispense drugs just to get rid of drug-seeking patients.
  • Prescribe, dispense, or administer controlled substances outside the scope of your professional practice or in the absence of a formal physician patient relationship.
  • Accuse the patient or advise third parties.
If you discover a loss of controlled substances or theft of prescription forms, you are required to notify the Drug Enforcement

Agency (DEA) and your local law enforcement.

What you Should Do When Confronted by a Suspected Drug Abuser:

  • Perform a thorough examination appropriate to the condition.
  • Document examination results and questions you asked the patients.
  • Request picture ID or other ID and Social Security number. Photocopy these documents and include in the patient’s records.
  • Obtain authorization from the patient to contact their previous practitioners, pharmacist, or hospital (in order to confirm patient’s story).
  • Confirm the current address and phone number at each visit.
  • Write prescriptions for limited quantities.
  • Refer the patient for treatment of substance abuse. Document refusal of treatment.

To Avoid Prescription Pad theft and Abuse, it is a good idea to practice the following risk management principles:

  • Secure inventory of prescription pads in locked area.
  • Number your prescription pads; keep count of all prescription pads by having staff document a weekly inventory count.
  • Keep one prescription pad in your pocket for use in your office.
  • Do not leave prescription pads in patient rooms or at workstations.
  • Do not have your DEA number pre-printed on prescription pads.
  • Do not give your DEA number to anyone in your office.
  • Do not allow anyone else to sign your prescription pads.
  • Do not pre-sign any prescriptions or prescription pads.
  • Maintain a current list of medications prescribed for each patient, along with dates and numbers of refills (including samples) to monitor the patient’s medication use.
  • Know your employees. Conduct a preemployment criminal background investigation and pre-employment drug screening for potential employees and include a policy for random drug testing in your personnel manual.

Cliff Rapp is Vice President of Risk Management for FPIC (First Professionals Insurance Company), a leading provider of professional liability insurance for physicians, dentists, and other healthcare providers in Florida, Georgia, and Arkansas.

Information in this article does not establish a standard of care, nor is it a substitute for legal advice. The information and suggestions contained here are generalized and may not apply to all practice situations. FPIC recommends you obtain legal advice from a qualified attorney for a more specific application to your practice. This information should be used as a reference guide only.