1. Taking Precautions
In issuing prescriptions, physicians should take the following precautions, which are considered to reduce opioid misuse:
1. Fax prescriptions directly to the pharmacy.
2. If using a paper prescription pad:
- Use carbon copies or numbered prescription pads.
- Write the prescription in words and numbers.
- Draw lines through unused portions of the prescription.
- Keep blank prescription pads secure.
3. If using desk-top prescription printing, it is especially important to write a clear signature and not use a scribbled initial.
4. If using fax or electronic transmission of the prescription (in jurisdictions that permit it) ensure confidentiality, confirm destination, and retain copies.
5. Promote patient’s use of a single dispensing pharmacy.
2. Accessing Drug Databases
If available, physicians and pharmacists should access electronic prescription databases that provide information about patient prescription history.
Greater collaboration with other healthcare providers can also contribute to reduction in prescription fraud.
1. Pharmacists are often in a position to alert physicians to possible opioid misuse, e.g., double-doctoring, potential diversion or prescription fraud. Pharmacists are considered part of the patient’s “circle of care;” special consent is not required to speak with the pharmacist.
2. If double-doctoring is suspected, expect the patient to consent to a consultation with the “other” prescriber(s), or taper the opioid dose and discontinue. Note: The prescribing physician may contact the “other” physician(s) without the patient’s consent if the patient is considered to be at significant risk of overdose.