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This document has been prepared by Drugs and Poisons Regulation (DPR) to provide pharmacists with examples of scams previously used by drug-seeking patients and to indicate what steps could or should have been taken. In some of the examples, pharmacists were prosecuted for failing to comply with their legislative responsibilities. Please refer to the DPR website ( documents relating to other issues and for details of forged and stolen prescriptions that have been reported to DPR.

Impersonating a medical practitioner

A person successfully obtained pethidine injections from more than 20 pharmacies by phoning the pharmacy and claiming to be a local medical practitioner. This ruse has been used by several offenders but, in this case,the offender was particularly successful because she would:

  • attend a clinic to note the name of a female medical practitioner and determine when the female medical practitioner was next on (and off) duty
  • phone a pharmacy (in the vicinity of the clinic) and claim to be the medical practitioner
  • indicate she was making an emergency house call; had been off-duty and did not have her prescription pad; had despatched a family member to collect five pethidine ampoules; and would drop the script in to the pharmacy the next day
  • attend the pharmacy, claiming to be the anticipated family member, and collect the pethidine

Many pharmacists were not aware that they had been deceived until they subsequently phoned to remind the medical practitioner about the owed prescription.

Forgeries from a familiar patient

One pharmacy dispensed more than 100fraudulently altered computer-generated prescriptions (all for morphine ampoules) from a person well known to the pharmacists.

  • The offender obtained a genuine computer-generated prescription for five morphine ampoules each weekbut, after many such prescriptions, the prescribed quantity on subsequent computer-generated prescriptions was manually altered by the patient from five ampoules to 25, 35, 45, 55 or 75 ampoules.
  • Alterations to some of the earlier prescriptions were so poorly done that it would have been difficult to accept the alterations as genuine if the prescriptions had been examined as might have been expected if the person presenting the prescriptions was unfamiliar to the pharmacists.
  • Morphine ampoules were also supplied without prescription, at the person’s request, when the person indicated that she was on her way to the clinic.
  • The purported prescriber was not contacted, because she was considered notoriously “difficult”.

Note: Computer-generated prescriptions must not be manually altered by a prescriber. The “Criteria for computer-generated prescriptions” (available on the DPR website) requires a prescriber to destroy a prescription and generate a new one if an error is made.

Computer-generated forgeries

Forged and fraudulent computer-generated prescriptions are now more prevalent than handwritten forgeries with many successfully presented because pharmacists have assumed them to be genuine simply because they were computer-generated prescriptions.

OxyContin® and alprazolam have been the most frequently forged medications in recent years with MSContin®, Kapanol® and anabolic steroids also commonly reported.

Examples of fraudulent computer-generated prescriptions

  • The receptionist at a medical clinic obtained hundreds of pethidine ampoules by presenting computer-generated prescriptions she had created at the clinic. If a pharmacist phoned the clinic, the receptionist would commonly claim that the prescriber was unavailable but would confirm that the prescriptions had been issued for the noted patient.
  • The spouse of a medical practitioner created several computer-generated prescriptions for morphine ampoules (as many as 120 ampoules on one prescription) on prescription pages that she misappropriated from the spouse’s clinic.
  • One pharmacy supplied more than 2000 pethidine injections in less than 3 months upon presentation of forged computer-generated prescriptions. The offender commonly phoned the pharmacy and pretended to be the prescriber in order to explain the progressively larger quantities of pethidine ampoules being prescribed (up to and including 90 ampoules per prescription).

Forgeries confirmed by the prescriber

A number of cases have been noted where pharmacists have dispensed forged prescriptions, despite having phoned and spoken with the prescriber, who confirmed having written a prescription on the day.

The legitimate prescriptionwould be presented at a pharmacy where the prescriber’s handwriting was familiar and would not be questioned; the forgerywould be presented at another pharmacy on the same day with the prescriber confirming having issued a prescription if contacted by the pharmacy.

Note: On some occasions, it might be necessary to fax a prescription for visual confirmation.

Critical examination of prescriptions

A forged computer-generated prescription that identified the medication as “dextroamphetamine” was dispensed by a pharmacist.

Fraudulent computer-generated prescriptions sometimes contain misspelt words or inconsistencies that would be detected if the prescriptions were critically examined.

Atypical forgeries

An offender obtained more than 50 dexamphetamine tablets per day by photocopying repeat authorisation forms and attaching the copies to the original prescription so that he was able to obtain more than 40 supplies of 300 tablets on two prescriptions that had been issued for 300 tablets with five repeats.

There have been instances where an offender has phoned Medicare Australia to obtain telephone approval for an increased quantity before creating a forged prescription. Acceptance of the telephone approval number by PBS Online provided the dispensing pharmacist with confidence that the prescription was authentic.

Key points to consider

  • The Drugs, Poisons and Controlled Substances Act and Regulations require pharmacists to take certain steps under specified circumstances, not only if or when they are suspicious.
  • The fact that a prescription has been or appears to have been dispensed previously does not mean that subsequent prescriptions or repeat prescriptions should be accepted without question.
  • Comparing a forged prescription with a similarly forged prescription is unlikely to reveal a forgery. Some pharmacies now retain filed copies of prescriptions that have been confirmed by prescribers as a form of reference.
  • Repeatedly successful scams often involve patients well known to the pharmacy.
  • The fact that a person is well known to a pharmacist does not mean that the person is not or may not become drug-dependent.
  • Patients with genuine medical conditions can become drug-dependent due to long-term prescribing of narcotics – especially with shorter-acting drugs like pethidine.
  • Pharmacists have legislative and professional responsibilities to assess whether it is safe, appropriate and lawful to dispense a prescription and should not merely assume all is well.
  • Holding a permit to prescribe a Schedule 8 poison does not necessarily mean a medical practitioner is prescribing appropriately. Many medical practitioners have been found to have significantly exceeded the limits of their permits.

What should be done?

All prescriptions should be examined in a critical manner to detect anomalies or indications of any alterations and, when noted, the following should be discussed or verified with the prescriber:

  • Anomalies, alterations or atypical quantities – especially for Schedule 8 poisons where the quantity or number of repeats has not been written in words and figures
  • Prescriptions for Schedule 8 poisons when the handwriting is not familiar (regulation 28)
  • The identity of an unfamiliar medical practitioner who has phoned the pharmacy
  • The intended dosage when a patient is noted to be collecting medications more frequently than would be required if taken in accordance with the stated directions
  • The intended dosage when a prescriber does not include precise directions on a prescription, which is a requirement under regulation 26(3) of the Drugs, Poisons and Controlled Substances Regulations 2006.
  • Manual amendments to computer-generated prescriptions - prescribers are not authorised to make manual alterations to computer-generated prescriptions. For full details of the “Criteria for computer-generated prescriptions”, refer to the DPR website(

Stolen & forged prescriptions (handwritten and computer-generated)

The DPR website ( contains frequently updated details of forged and stolen prescriptions in two tables (beneath the pharmacists sub-heading) that allow pharmacists to search for names of purported prescribers and for the details pre-printed on the rear of stolen pages for computer-generated prescriptions. It is strongly recommended that pharmacies have this website bookmarked to facilitate prompt reference.

For further information

Department of Health (DH)

Drugs and Poisons Regulation,

GPO Box 4541

Melbourne 3001

Tel: 1300 364 545

Fax: 1300 360 830

Email:

Web:

Authorised and published by the Victorian Government, 50 Lonsdale St, Melbourne.
To receive this publication in an accessible format phone Drugs and Poisons Regulation on 1300 364 545 or forward an Email to
April 2014

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