Drug diversion red flags - MPJE

With the growing national focus on the Opioid crisis, pharmacists play a key role in preventing Opioid abuse and over use. A key role of pharmacy staff if to detect and stop drug diversions. Questions related to drug diversion can appear on the MPJE so make sure as a pharmacist you are aware of these red flags and that you train your staff accordingly as well. Your pharmacist license and pharmacy registration can be impacted if drug diversion happens during your watch. The FDA revoked the pharmacy registration for a few pharmacies. Details about this can be found on the FDA law blog here.

We are capturing below some FDA published red flags related to diversion that every pharmacy staff member should be trained to identify:

  1. Multiple customers filling prescriptions written by the same prescriber for the same drugs in the same quantities

  2. Customers with the same last name and street address presenting similar prescriptions on the same day or within a short time span

  3. Two short-acting opiates prescribed together

  4. Patients traveling long distances to fill opioid prescriptions

  5. Drug cocktails

  6. Payment by cash

  7. Unusually large quantity of a controlled substance

  8. Pattern prescribing

  9. Irregular dosing instructions

  10. Lack of individualized therapy or dosing

  11. Early fills/refills

  12. Other pharmacies' refusals to fill the prescriptions