Professional Judgement

Q. Can a pharmacist refuse to dispense a controlled substance prescription?

A. Yes, a pharmacist has a corresponding responsibility along with the prescriber to make sure controlled substance prescriptions are written for a legitimate patient, for a legitimate medical need in the usual course of practice of the prescriber. Title 21 CFR 1306.04 KRS 218A.180(3)


Q. What can a pharmacist do to determine the validity of a controlled substance prescription, thus demonstrating corresponding responsibility?

A. There are red flags a pharmacist can look for when trying to determine the validity of a prescription.  This list is not inclusive and does not take the place of a pharmacist’s professional judgment. 

  • Does the pharmacist have a relationship with the prescriber?

  • Does the pharmacist have a relationship with the patient?

  • What is the distance a patient is driving to see the prescriber?

  • What is the home address of the patient?

  • In what community is the prescriber practicing?

  • Have people unknown to the pharmacist called asking if a specific medication or a specific manufacturer of a medication is stocked by the pharmacy?

  • When prescriptions are filled for one patient, do many, many more start coming to the pharmacy?

  •  Is every patient receiving the exact same prescriptions?

  • Does the prescriber take cash only?