Prescription Sharing Explained in Federal Statutes
When dealing with the sharing of prescription medications — likely involving people who have an interest in the medication for themselves for a possible medical treatment — it is important to understand what federal law has to say about the issue and the potential consequences when those laws are violated.
Specifically, such actions are prohibited under 21 U.S. Code § 333, which states that anyone who "gives away any [prescription] drug or devices or attempts to so counterfeit , imitate, or impersonate the label or labeler thereof" or "refills any [prescription] which was not issued legitimately, or who has under his control or possesses any [prescription] drug or device which he does not have effectual control thereof," shall be "guilty of a misdemeanor, and on conviction thereof shall pay a fine of not more than $1,000, or face imprisonment for not more than one year, or both such fine and imprisonment."
What Happens When You Illegally Share A Prescription?
Although there are some situations when it is not illegal to share medications, the overwhelming majority of situations do not allow individuals to do so. In these circumstances, the issue is much more than simply a health risk. It is also a legal risk. Federal law forbids individuals from sharing prescription medications such as Accutane, Suboxone, Xanax and Stemetil. Violating those regulations can result in severe penalties, including fines or imprisonment. It can also increase the chance that someone will become addicted to drugs or abused. In addition to getting in trouble with the law, individuals caught for sharing drugs may face criminal charges. Consumers found guilty of such behavior are sometimes required to attend mandatory treatment for addiction or abuse. The severity of the crime they committed is the most critical factor that determines their eligibility for this type of sentence. Even when a person is eligible for treatment, there are many other factors involved that can stop them from receiving the help they need. In conclusion, the risks and consequences of sharing prescription drugs is high, and should not be considered by anyone who has received medication from a physician. By obeying federal laws on prescription sharing, individuals can keep themselves and their friends safe from addiction and abuse.
Prescription Sharing Exceptions
While sharing medication is generally forbidden, the federal government does carve out some exclusions where the act of sharing may, in fact, not be illegal. For example, short-term, emergency prescribing and dispensing is permitted in certain situations. This occurs when a physician or pharmacist receives a verbal authorization, which may be communicated through a third-party between the prescriber and dispenser, for an unfilled prescription for a non-controlled or controlled substance for an emergency situation. In this case, the quantity prescribed must only be sufficient to treat the immediate emergency and should not exceed the amount needed to treat the emergency for that day.
Similarly, some distribution of controlled substances may be allowed through qualified government programs offering prescription medications for free or at a reduced rate for those with low incomes. States have long-run Medicaid programs, and in recent years, the federal government has implemented the more comprehensive Medicare program, which also provides prescription coverage for prescription drugs for seniors and disabled persons. The Office of Inspector General has come to agreements with the federal government and certain manufacturers to allow sharing of prescription drug samples under defined, limited circumstances.
Health Services Providers and their Role
Healthcare providers and their institutions have also been identified as a potential source for furthering compliance with the federal regulations. Most critically, the physician who is writing the prescription is an important element of final compliance with the federal requirement that "prescriptions be issued in the usual course of professional practice and not for ‘additional’ prescription use." The Federal Drug Enforcement Administration counsels that "[p]hysicians are legally obligated to deny requests for controlled substances that are not related to a patient’s current treatment or need and to use good judgment in determining whether to prescribe addictive medications for therapeutic purposes." In addition, it encourages physicians to review patient requests for prescription drugs carefully and maintain a detailed medical record for each patient, including documentation of all written prescriptions and their date of issuance. Moreover, it recommends asking patients why they chose to come to one’s office "rather than seeking treatment from their regular physician or other available sources, to discourage those who claim that no one else will treat them…" Consensus among physicians also suggests that supply of addictive medications is best controlled through effective utilization management for such medications . Thus, the physician is the final decision maker on whether to write the prescription and on the amount of the prescription to be written.
Pharmacists at community pharmacies are also encouraged to seek to prevent prescription drug sharing. The National Association of Boards of Pharmacy (NABP) promotes the adoption or strengthening of state laws or regulations to require pharmacists: Aside from enforcement action against physicians for the alleged dispensing of a controlled substance without legitimate medical purpose, in violation of state law, health insurance or managed care organizations are also becoming more involved in identifying potentially inappropriate prescribing, although the "rules" as to what is inappropriate are often defined by the organization itself. A growing number of private payors and pharmacy benefit managers are requiring funds for prior notification of the dispensing of a prescription, especially for drugs that may be abused or misused, or are requiring members enrolled in a drug management program to obtain medications only from certain pharmacies. Another tactic for dealing with prescription drug sharing now being employed by private payors is Mandatory Mail Orders. Therefore, managed care organizations and other health insurance companies are also beginning to take a more active role in providing guidelines and monitoring for potential avoidance of the federal drug diversion requirements.
Handling of Unused Drugs
Patients who are prescribed medications that they either do not finish may be unsure how to properly dispose of them. The Federal Government has published guidelines for the safe destruction of prescription drugs. There are several options available, including the following:
Take-back Events
The U.S. Drug Enforcement Administration (DEA) sponsors controlled substance take-back events at certain locations around the country. These events allow the public to bring unused or expired controlled substances and prescription medications for disposal. The DEA provides a list of upcoming take-back events, as well as a collection of other disposal options.
Mail-back Programs
To obtain a mail-back program, consumers can ask their local pharmacist if they have one in place already. If not, consumers should talk to their pharmacist or health care provider to find out which mail-back options are available.
Hospital or Clinic Collection
Some hospitals and clinics have safe collection containers for unwanted medications, including controlled substances. Ask your pharmacist or health care provider if any facilities near you offer collection containers.
Long-Term Care Facility Disposal
Federal law requires long-term care facilities, such as nursing homes, to dispose of unused portions of controlled substances in accordance with their own procedures, as well as those established by the State. Patients should not dispose of their medications themselves; the disposal is in compliance with Federal law.
Educating Yourself About Prescription Laws
Raising public awareness of the dangers associated with the illegal dissemination of prescription medications is a key factor in reducing incidents of this alarming trend. Education campaigns concerning federal prescription drug laws are the best means of helping citizens understand why sharing their medications with friends and loved ones is a risky proposition. While increasing awareness surrounding the issue of abuse and misuse of drugs is vital in reducing prescription drug problems, it is equally important that campaigns are informative, but not overly fear-inducing. For example, educating the public about prescription drug laws and use through the lens of following the law is a good start to ensuring that prescription drugs are not shared amongst parties for illegal or immoral purposes.
The public should understand that raising awareness about the dangers of prescription drugs must not be misinterpreted as an advocacy for laws that limit access to medically necessary prescriptions. While adherence to prescription drug laws should be strictly followed, that should not come at the expense of patients’ health and welfare. Prescription drug laws are designed to help protect patients from drug abuse and misuse , and also to keep prescription drugs out of the hands of the black market where they are misused and abused in ways not in line with their intended purpose of improving quality of life in patients who genuinely need them. Thus, raising awareness of prescription drug laws should include education about the lawful use and distribution of prescription drugs, and how those processes are integral to keeping people safe and healthy.
Bringing public awareness and education to bear on this issue may take many forms, such as billboard advertisements, television and radio public service announcements, pamphlets, and other educational materials. In addition, creating a "digital toolbox" dedicated to prescription drug-related information may be another way to promote a better understanding of prescription drug laws. Through social media, online articles, or online videos, the public can be informed of what the law restricts and the legal consequences for breaking such laws. Further, digital information can be distributed widely and quickly, effectively educating more people per dollar than other means.