NEWARK – As part of Attorney General Jeffrey S. Chiesa’s multi-tiered strategy to fight the growing epidemic of prescription drug abuse, and following an extensive dialogue with representatives of the pharmacy industry and law enforcement, the New Jersey Division of Consumer Affairs and State Board of Pharmacy today published a fully modern set of “Best Practices for Pharmacy Security” to help prevent drug theft and diversion at retail pharmacies.
“Stolen prescription drugs, like drugs obtained through fraudulent prescriptions, inevitably make their way into the hands of those seeking to abuse them,” Chiesa said. “This list of security practices, developed in close coordination with stakeholders from both government and industry, represents the best steps pharmacists can take to protect their inventory from diversion and ensure that medication is dispensed only according to a valid prescription.”
The Best Practices for Pharmacy Security are now posted on the Board of Pharmacy website as recommendations for voluntary compliance by New Jersey’s pharmacies. They include specific recommended measures, above and beyond those currently required by New Jersey’s Pharmacy Regulations and Controlled Dangerous Substances Regulations.
“While every pharmacy may not be able to adopt all of these security recommendations, we are encouraging them to move toward implementation of these best practices,” Eric T. Kanefsky, Acting Director of the New Jersey Division of Consumer Affairs, said. “Incidents of theft at New Jersey pharmacies are not common, but when they do occur they often involve significant diversion of Controlled Dangerous Substances which pose a grave risk of addiction, overdose, and death.”
The Best Practices recommendations are designed to help prevent the loss of Controlled Dangerous Substances and other drugs due to robbery, burglary, and employee theft, as well as to identify and curb doctor-shopping and the fraudulent use of forged, altered, or stolen prescriptions. The Division of Consumer Affairs and Board of Pharmacy developed the list as the result of a year-long process of in-depth research and dialogue.
The Division began by holding a Pharmacy Security Summit in January 2012, and a follow-up summit in September. The participants included representatives of chain and independent pharmacies, healthcare systems, drug manufacturers, academics, and law enforcement agencies such as the U.S. Drug Enforcement Administration and the State Commission on Investigation. Board of Pharmacy members, and staff of the Division’s Enforcement Bureau, also participated. The Division drafted the best practices after considering the ideas and concerns of the Board of Pharmacy, the summit participants, and other pharmacy groups and trade organizations.
The process included an assessment of the various logistical and personnel concerns of large and small pharmacies, as well as the needs of pharmacies in New Jersey’s urban, suburban, and rural areas. It also included an assessment of today’s realities in the areas of crime and the illegal diversion of prescription drugs.
During 2012, New Jersey pharmacies reported to the Division of Consumer Affairs a total of nine armed robberies, seven incidents of break-ins or customer theft, and 24 incidents of theft by pharmacy employees. There are 2,128 pharmacies in New Jersey.
Examples of the Best Practices suggestions include:
- New Jersey pharmacies are required by regulation to maintain a monitored security system. The Best Practices more specifically recommend a system with a cellular backup in case of power outages or attempts to disable the system. They also recommend video surveillance in certain areas of the pharmacy; physical barriers; height markers – to help identify suspects – at exit doors; and other basic physical security measures.
- Pharmacies should maintain a perpetual inventory of all drugs identified as having a high potential for abuse or a high street value. The inventory should include specific information, logged each time a quantity of the drugs is received or dispensed. Pharmacists should verify the inventory’s accuracy once per month, with a manual review of all records related to certain drugs. If the pharmacy employs more than one pharmacist, the same pharmacist should not conduct the monthly verification count during consecutive months.
- If a pharmacist has a substantiated concern that a specific doctor may be indiscriminately prescribing Controlled Dangerous Substances, the pharmacist should report the concern to the Board of Medical Examiners and the New Jersey Prescription Monitoring Program.
- If a pharmacist suspects a prescription may be forged or altered, he or she should call the doctor’s office to confirm the prescription. The pharmacist can ask the doctor’s office for a faxed confirmation of the prescription. Before calling, the pharmacist should independently verify the doctor’s phone number and check whether it matches the number on the prescription.
- If a pharmacist is unfamiliar with a patient who picks up a Controlled Dangerous Substance prescription, the pharmacist should require photo identification at the time of purchase. Photocopies of the identification should be stapled to the original prescription or scanned into the computer profile.
- Written prescription blanks should not be kept where consumers can reach them or see confidential patient information.
- Drugs classified as Schedule II and Schedule III Controlled Dangerous Substances should be kept in a safe or locked refrigerator. Only licensed pharmacists should be permitted to access the safe. Will-call bins for Schedule II and Schedule III CDS should be located in the pharmacy’s secured prescription area, within the pharmacist’s unobstructed view.
- Pharmacies should have a secure area for receiving packages known to contain CDS. Pharmacies should receive such shipments only during posted store hours, when a pharmacist is present to accept and sign for the delivery.
- All pharmacists should register with the New Jersey Prescription Monitoring Program, and regularly access it when filling prescriptions in order to identify possible doctor-shopping or abuse. The NJPMP, maintained by the Division of Consumer Affairs, is a database that tracks the prescription sale of Controlled Dangerous Substances and Human Growth Hormone.
Chiesa noted the scope of America’s prescription drug abuse problem is staggering:
- New Jersey in 2011 saw more than 8,600 separate admissions to State-licensed or certified substance abuse treatment programs due to prescription painkiller abuse – an increase of more than 200 percent over the past five years, and nearly 700 percent since the beginning of the decade.
- In June 2011, the New Jersey State Commission of Investigation reported that a growing number of young people are abusing prescription drugs, and noted a significant trend in which the practice has led to increases in the number of young people addicted not only to painkillers, but to heroin as well.
- Every day, 40 Americans die from an overdose caused by prescription painkiller abuse, according to the U.S. Centers for Disease Control and Prevention. Overdoses of opioid prescription drugs now kill more people in the U.S. than heroin and cocaine combined.
- The U.S. Drug Enforcement Administration has reported that two in five teenagers mistakenly believe prescription drugs are “much safer” than illegal drugs.
Chiesa and Kanefsky thanked Executive Director Anthony Rubinaccio of the State Board of Pharmacy, Deputy Attorneys General Megan Cordoma and Jodi Krugman of the State Division of Law, and Investigator Michael Westenberger of the Division of Consumer Affairs Enforcement Bureau for their role in developing the Best Practices for Pharmacy Security.
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