Is there an opioid abuser at your counter?

Is there an opioid abuser at your counter? Drug Enforcement Agency (DEA) regulations hold pharmacists, as well as prescribers, responsible for the prevention of drug diversion. Drug diversion incidents occur when prescription drugs are illegally distributed, abused or used for a purpose not intended by the prescriber. Pharmacists must ensure any prescriptions they fill are for a legitimate medical purpose. This can be challenging, as prescription opioids are in high demand by abusers. 12 signs there may be an opioid abuser at your counter:

1. Time of Day – Abusers fill prescriptions at a busy part of the day in hopes that the pharmacist will be in a hurry and less attentive.
2. Tall Tales – Opioid abusers create elaborate or questionable stories as explanations for requesting large quantities of painkillers.
3.  Same Drug, Different Client – Be concerned if you witness prescriptions for the same drug by multiple clients regardless of different “medical” needs.
4. Out of the Area – The prescriptions are written by doctors at distant locations.
5. No Insurance – An abuser may pay cash for an opioid instead of using insurance.
6. Deadly Cocktail – A client has a prescription request for a combination of drugs that can be combined to form a known drug cocktail, a dangerous mix of drugs combined to create a more intense high.
7. Quick Refills – Abusers take pain medications in higher doses than the prescription advises, necessitating more frequent refills.
8. Too Many Doctors – Some abusers “doctor shop” in an attempt to find physicians who will prescribe opioids. Be wary of clients who have prescriptions from multiple doctors.
9. Not the Normal Doctor – Watch for prescriptions from doctors who do not typically work in pain management.
10. Concerning Behavior – The client displays nervous or unusual behavior.
11. Slang – They use casual street slang to describe the medication such as “oxy” or “percs.”
12. Doped Up – Abusers appear to be impaired by drugs. Slurred speech, constricted pupils, sleepiness, extreme relaxation, obliviousness to surroundings, inability to stand or sit upright or a lack of coordination or balance can all be indicators.

If you observe one or more of these signs, you may be witnessing a drug diversion incident. Documenting this incident and filing a report with local law enforcement will help curb this dangerous practice, protect your career and put your mind at ease. Find out more about these topics in the DEA Update on Regulations and Enforcement or by watching this video produced for the National Association for Boards of Pharmacy by the Anti-Diversion Industry Working Group.