I know I should. Every other pharmacist seems to care. However, I really couldn't give a flying fuck about people who abuse controlled substances. I don't care if Mr. Smith has gone to 20 different pharmacies paying cash for Vicodin in the last few days. It doesn't bother me one bit. If he wants to get high and blow out his liver, he can go right ahead. It doesn't faze me in the least bit.
That's not to say that I just hand out Percocet, Vicodin, and Valium like candy. I don't allow early refills. I won't knowingly fill a script for someone that paid cash for the same thing at another pharmacy just a day earlier. I do everything that the board of pharmacy and federal laws ask me to do for filling scripts for controlled substances. I just hate doing it.
I will not go out of my way to find out if the person is a drug seeker. I know some pharmacists who will call every pharmacy in a 20 mile radius if a suspicious looking cash customer brings in a Percocet prescription late in the evening. I just don't care enough to do that. If a new, cash customer brings a Percocet prescription to me late in the evening after the doctor's office has closed, I just fill the damn thing.
The way I see it, due to these wonderful $4 generics, controlled substances are some of the only drugs that net us a decent profit. We have to make money somehow. It might as well be from the drug addicts.
These people all eventually get caught anyway. Inevitably, they screw up and come in early for a refill, or bring in a script from a different doctor that sets off some red flags. Trust me, I am looking to bust these people. When I catch them, I do cut them off. However, I don't waste 30 minutes of my time to track down the multiple pharmacy filling history of one drug addict. I have more important things to do.
Retail pharmacists probably have the most varied list of responsibilities of any professional. We're responsible for accurate dispensing. We're responsible to make sure that the prescriptions we receive are in compliance with both state and federal laws as well as being up to the standards of the insurance companies. We're responsible for preventing drug interactions. We're responsible for counseling patients on new prescriptions. We're responsible for being the liaison between the customer and the insurance company. We're responsible for maintaining the business end of pharmacy. We're also responsible for being the controlled substance police.
Know what's the sad thing about all those responsibilities? Pharmacists seem to be the only ones that take them seriously. We call doctors about interactions every day, and they mostly ignore us. We attempt to counsel patients, but they don't have time to listen because they're in a rush, and they swear the doctor has already explained everything to them. We constantly try to keep our inventories down and dispense as many generics as possible in order to improve our gross profits. At the same time, corporate decides to give out $4 prescriptions and free antibiotics, not to mention all the $20 gift cards.
It's the same thing for the controlled substances. We've caught several customers trying to pass off fake scripts at our pharmacy. The police show up, arrest them, and then they're right back out doing the same thing 2 days later. We call doctors about patients who are filling Vicodin scripts all over the place, but the doctors keep writing them more scripts.
I don't know about everyone else, but I always feel like I'm fighting a losing battle trying to adhere to all the laws and regulations in pharmacy. I feel like we expend so much energy trying to do things by the letter of the law, but in the end, we're the only ones who care because ultimately, we seem to be the only ones affected by the regulations. Doctors, insurance companies, and seemingly even patients do whatever the fuck they want, while pharmacists are the only ones that get penalized by not following the standards.
Therefore, my response is "screw it." I'll do what I can, within reason, to ensure that my pharmacy doesn't become a Percocet addict's paradise. However, if I have to waste too much of my time to catch a drug seeker when I could be providing counseling to a good patient or filling scripts, then it's not worth it to me. After all, my time is money. Catching a drug addict brings no money to my store and is actually a waste of money when you factor in my salary for my time spent trying to catch him.
Now if the DEA starts offering rewards for pharmacies that catch controlled substance abusers, my opinion may change. Until then, sure, I'll fill that potentially sketchy (but at the moment entirely unprovable) Oxycontin prescription 10 minutes before closing on a Friday night. It won't affect my conscience one bit if the asshole OD's on it. In fact, it would probably be doing the world a favor.