Should I report apparent theft of "controlled substance" prescriptions?

May 6, 2011 2:52 PM

Should I report the apparent recurring theft of my (perfectly legal and medically appropriate) prescriptions for controlled substances (written prescriptions, not actual drugs)?

For a chronic medical condition, I take 2 prescription medications that are "Schedule II controlled substances" under Federal (US) and NY state law. I've been taking them for years, with no abuse or other significant problems, and my doctor and I are both comfortable with that. I have a good relationship with my excellent doctor, and with the independent local pharmacy that I use. But:

Four times in the past year, written, completed prescription forms which my doctor has mailed to the pharmacy, which is less than a mile away from the doctor's office, have disappeared. Each time, the doctor's staff assures me they have mailed them; the pharmacy says they never received them. On one miraculous occasion, an envelope that left the doctor's office with 2 scripts in it reportedly contained only one script when it arrived and was opened at the pharmacy. Hmm. I'm inclined to believe that all the individuals I'm dealing with are honest and professional, but clearly, something is going wrong somewhere.

I'm more than a little bit nervous about having my name, address and date of birth out there in criminal hands, together with the information that an array of highly desirable prescription drugs could likely be found in my house at any given time. Plus, each time this happens, I have to go through a lot of extra bother to actually get the damn pills that I need, which doesn't make being sick any more fun. So I want this nonsense to stop.

After incidents 1, 2 and 3, I spoke nicely but assertively to the doctor and the pharmacy management, and they have all assured me that they will watch for my prescriptions and treat them with even more elaborate care than is required for all controlled substance prescriptions. And yet, it happened again.

I would hate to see my doctor, or the good people at the pharmacy, subjected to any more regulatory hell or heightened scrutiny if I report this. And if I do, I don't imagine that, in the future, they would continue to go out of their way to help me as they have in the past. I've worked hard to cultivate these relationships, and I need them.

Additional considerations: switching doctors is not an option. She's the bees knees. I'm reluctant to switch pharmacies, cause my experience has been that most of the others in town are worse in various ways. The best way to handle the scripts would be for me to get them from the doctor when I see her, and take them physically to the pharmacy. I do this when I can, but I'm mostly housebound and sometimes I just can't get out. Since these are "Schedule II" controlled substances, refills aren't allowed; electronic, phone or fax prescriptions aren't allowed. An actual piece of paper is required. I don't have a friend or family member close enough to do this for me on a regular basis, so it looks like I'm going to have to continue to use the mail. Which, like so many other things, sadly does not seem to be as reliable as it once was.

1. What to do? Report or not? If so, to which agency: local police, state Department of Health, Attorney General, feds (which agency?)? Although this is not a major crime on its own, there is a lot of illegal drug activity around and local law enforcement has made it a big focus lately. If someone filled my missing prescriptions, it should be pretty easy for enforcement folks to figure out where.

2. Anyone have any suggestions for a better way (safe, legal, reliable, and maybe even easy?) to deal with getting prescriptions every month? I tried the mail order service that comes with my prescription coverage, but sometimes they are slowwww and I run out of my drugs, which makes me so very much crankier than necessary.

posted by Corvid to Law & Government (26 answers total)

You could pay for Fed Ex or a similar delivery service or pay for registered mail or go get the Rxs yourself. It's entirely within the bounds of probability that someone in the mail chain watches for mail to the pharmacy.

I would definitely report it and get the MD.'s office (as they're the senders) to do so as well.
posted by Ideefixe at 3:00 PM on May 6, 2011

(1) Just call the police non-emergency number. They will be able to direct your call. I really do think you should report it, and you should urge your doctor to report it.

(2) My off-the-wall idea is to pay for a courier to bring the prescription from the doctor's office to the pharmacy - we use them at work all the time for "cannot get lost" material. It's going to cost you, though.
posted by muddgirl at 3:03 PM on May 6, 2011

I don't know about yours, but my insurance knows when I've had a prescription filled and if it's been too many times they won't let me have it. I found this out when I tried to get a prescription filled early for a trip I was taking. It doesn't matter if the insurance is paying for it or I'm paying out of pocket. They just really have to be that controlling.

I'd report it just in case your insurance is a pain like mine. At least then you'd have some kind of paperwork to back up your claims. If somebody is using your DOB and other personal details, your insurance might catch wind. I'd also be concerned about identity theft, but I tend to be a little paranoid about that.

I'm also with Ideefixe, my first thought was that it's somebody between the doctor's office and the pharmacy. Mail with Social Security checks have been stolen in the past, it wouldn't surprise me if pharmaceutical mail is the new target.
posted by TooFewShoes at 3:04 PM on May 6, 2011

Also, I found this "Electronic Prescriptions for Controlled Substances" which took effect in July of last year. It requires a special system on your doctor's end and on the pharmacy's end, but your doctor could suffer penalties if she continues to ignore theft of prescriptions.
posted by muddgirl at 3:08 PM on May 6, 2011 [1 favorite]

Contact Postal Inspector?
posted by zeikka at 3:10 PM on May 6, 2011 [3 favorites]

Could you ask your doctor to mail it to you instead of the pharmacy? Or to alter the envelope so it looks fatter? (Say put in a couple extra sheets of paper) and perhaps leave off the return address? Something so it doesn't look like the regular mailing in case someone is keeping an eye on it.
posted by SpaceWarp13 at 3:16 PM on May 6, 2011 [1 favorite]

zeikka is right. Someone is stealing mail and the postal inspector needs to get involved.
posted by birdherder at 3:18 PM on May 6, 2011 [1 favorite]

Yes, report it. Someone in the chain is going to get suspicious if the prescription is being refilled more often than it should be. The person who takes the heat will probably be your doctor. That's not good for anyone.

Also you have no idea where in the chain this is happening and reporting it will go on the record. Rest assured that yours is not the only one that's getting pilfered, and it will set up a body of evidence that will catch the jerk, wherever they are.
posted by Ookseer at 3:18 PM on May 6, 2011

According to this, if your pharmacy has a copy of the original, signed prescription form from your doctor for a Schedule II drug, the doctor's office can legally authorize refills via fax. If your doctor is not willing to fax refills I would advise that you offer to pay X amount extra per prescription to have it sent via certified mail (signature required). If this is too much trouble for the doctor's office, do you have a friend or relative who would be willing to pick up a dozen or so certified mail forms and cards from the post office for you? You could fill them out with all the relevent information and then mail the package to your doctor's office for use in your next several months' worth of prescriptions. It would be interesting to see how many (if any) got "lost" when mailed certified.

But also do send a letter to your local postmaster, with a copy to your doctor's office and the pharmacy, detailing your concern over the missing prescriptions. This way you've at least begun a paper trail lest there be questions from your insurance company in the future.
posted by Oriole Adams at 3:24 PM on May 6, 2011

You don't know where in the chain this is going wrong. It could be at the doctors' office, it could be the postal service, and it could be the pharmacy.

I'd definitely consider reporting it to the police, but I'd probably inform your doctor and pharmacist that you're going to do this if it goes missing one more time. I'd probably also report it to your local post office (giving dates of when the prescriptions went missing so they can look at their shift patterns), again saying that if it happens again, you're reporting it to the police. And do this in writing.

You say that you don't have friends or family close enough to pick up the prescription and get it filled for you - but you might be surprised at people's willingness to help. It's not a big thing to do, especially if you ask as a one-off. (Unless you meant "not close enough" in a geographic sense, in which case it might be trickier...)
posted by finding.perdita at 3:27 PM on May 6, 2011

I am a pharmacist, and I don't know a single pharmacist who wouldn't be sick to her stomach over the disappearance of the prescriptions - Controlled substances are a serious business. If it were happening in my pharmacy I would designate one person only (i.e. pharmacy manager) to open envelopes from your doctor's office. Other than that, there's not much the pharmacist can do to be sure s/he is receiving the envelope in the first place. There are a lot of places it could be intercepted.

You didn't mention whether you are the one who eventually goes to the pharmacy to pick up your prescription (pills) once it is filled. If you or a family member does this, can you have the prescriptions mailed to your home and then wait in the store while they are filled? I DO appreciate that it's hard for you to get to the office and pharmacy each month, but mailing them isn't working out for anyone. (Having seen how many people try to divert drugs, I would not feel comfortable having prescriptions for myself mailed in this manner.) I know it's not as convenient to wait, but hopefully the pharmacy will appreciate what you've been through and will give you a little priority. Talk to the pharmacist (nicely, respectfully!) and see what they can do in that regard.

If you do report it, calling the local police as muddgirl suggested is definitely the way to go - they are the ones who handle local drug diversion issues most of the time. And if all involved parties are innocent, nothing more than a few questions/investigating will happen to them. If they are not innocent... well... then they deserve it.
posted by keribear at 3:27 PM on May 6, 2011

Oh. I'm so sorry for not reading the question. :/ Fail on my part. I agree wholeheartedly with finding.perdita, however. People will help you. At least if the prescription is mailed to your home you are eliminating one possible route of diversion.
posted by keribear at 3:29 PM on May 6, 2011

Response by poster: Lots of useful responses here--more please!

I've tried having the doctor mail the scripts to me; when she does that, I've gotten them reliably. But then what? I have to get them to the pharmacy somehow, by mail (unreliable) or by me (even less reliable). That's why we started the mail-directly-to-the-pharmacy system. It worked fine for a while.

Once the paper scrip is actually at the pharmacy, getting the pills to me is easy--they deliver. I tip generously; they deliver cheerfully.

I agree, friends etc. are much more willing to help than people generally assume, and that's how I solved the problem this month. But the people who are available to ask for this favor are not in the same town, so I can't rely on them to do this regularly. And pharmacies are (appropriately) spooked about handing these prescriptions over to a "friend."
posted by Corvid at 3:45 PM on May 6, 2011

Explain to your doctor what's going on, ask them to write you an extra two weeks worth and fill it, then keep those as a buffer in case mail pharmacy service is slow. Then just use the mail order pharmacy.
posted by mrs. taters at 3:48 PM on May 6, 2011

Maybe your doctor could use more non-descript envelopes, and omit anything indicating it's a doctor's office from the return address. If it's a postal worker, maybe that would take care of the problem. Maybe they could also buy special tamper evident envelopes (though I guess that would defeat the purpose of making sure the envelope is non-descript). If it's a postal worker stealing your scrips one of these steps might help eliminate the problem.

On preview though, it seems less likely that it's a postal worker since they get to your home just fine. Either that or it's most likely the carrier that delivers to the pharmacy (if it is a postal worker at all). You should make sure you mention that they have always gotten to your home just fine if/when you report this to the postal inspector.
posted by gauchodaspampas at 3:56 PM on May 6, 2011

If your pharmacy delivers, have them pick-up too. Have the prescriptions sent to your house and have the driver stop by on another delivery run and bring it back later that day or the next. Your pharmacy should agree to this readily.
posted by JohnnyGunn at 4:01 PM on May 6, 2011 [3 favorites]

Have the doctor mail the prescriptions to you a month early, so when the pharmacy delivers your pills, you can hand them the new prescription right then and there.
posted by Vaike at 4:03 PM on May 6, 2011 [4 favorites]

I suppose it's possible that a postal employee is steaming open the envelopes and stealing the prescriptions, but it doesn't make a lot of sense to just take the scrip they need and then reintroduce the tampered envelope and the undesired scrip into the mail system.

I bet your doctor has a problem with one of her office staff. Doctors are people too, and she may just be having a difficult time accepting that this person with whom she works closely has a problem. If this is happening to you, it's happening to other people. You need to report it.
posted by thinkingwoman at 4:14 PM on May 6, 2011 [1 favorite]

Best answer: Considering that you've already spoken with your Doc and pharmacist and had no results, I'd have to report it to the Post Master/Inspector as was mentioned already.

In some parts of the country this is a huge business and I bet that you're not the only victim in this case. In fact this sounds pretty typical: they only do it so often that it could appear to be a simple error while doing the same to many other people. I'm not a big "call the cops" guy, but stuff like this could be lethal if someone ODs or has a bad reaction. I think I'd feel some duty to report it.
posted by snsranch at 4:23 PM on May 6, 2011

Is the pharmacy off on their own, or is it in a grocery store, small shopping center or the like? What about your doctor's office? In a building with a bunch of other doctors?

I kind of suspect that someone is snatching some envelopes from your doctors out box or pharmacy's in box steaming a few, and keeping a few of the interesting ones. At the pharmacy end they might just be grabbing ones with interesting return addresses.

It would be interesting to see if the problem went away if your doctor started putting your return address on the envelopes instead of hers.
posted by Kid Charlemagne at 5:16 PM on May 6, 2011

Best answer: I would ask that the doctor's office fill out this form whenever one goes missing. The party who mailed it should be the one to report it missing, since everyone else is just taking their word for it.
posted by soelo at 5:33 PM on May 6, 2011 [1 favorite]

Response by poster: Getting an extra 2-week supply as a buffer would help; I'll see if my doctor is willing to do this. Getting the scripts a month in advance, to give to the driver when he delivers, is a nice idea too, and I'll check it out. Unfortunately, practical approaches like those push up against the edges of the very rigid regulations constraining use of these drugs, and doctors and pharmacists are not very willing to test the limits. Me, neither.

Kid Charlemagne: the pharmacy is off on its own. It's the only independent pharmacy left in the town, maybe in the County. For people so inclined, any mail addressed to them would be a sweet target. They've told me that only a select few people handle incoming mail, in a locked room.

The doctor is a sole practitioner with a small staff in a fairly large medical building, so there could be access there.

The envelopes that have gone missing have been hand written by me, with my return address on them. So they don't look like they come from a doctor's office, but they do necessarily look like they're addressed to a pharmacy.
posted by Corvid at 5:59 PM on May 6, 2011

Try the envelope dodge, but in reverse: make it look like anything BUT a personal communication from a person which might contain a prescription. Make it look like junk mail. Or make the return address something like:

Corvid Plumbing
your address
your city, state zip

(In my case, I use Priority Mail envelopes to send my similar scripts to the idiots at the mail order pharmacy. Mostly because it has to get there within 7 days, but also because it is trackable. Costs $4.50, but it's only once every three months.)
posted by gjc at 9:13 PM on May 6, 2011

Definitely report it. Hell the postal inspector really took our report of stolen coffee quite seriously. I'd imagine stolen drugs to be taken with the same or even more seriousness.
posted by mmascolino at 2:55 PM on May 7, 2011

Of course you should. Start with the postal inspector, they have the most experience with this sort of thing.
posted by anigbrowl at 10:34 PM on May 7, 2011

Response by poster: Update: I decided not to take any specific action until I had a chance to talk to my doctor again to find out if she had figured anything out with the pharmacy. Ouch -- touchy subject. The missing scripts never turned up, and were rewritten. No one else's prescriptions were affected, only mine. When I asked if it had been reported anywhere, she said (snapped), "of course I reported it! It's my practice too!" She's normally very friendly, open, and warm; this visit, she was curt and crabby. Maybe she was having a bad day for some totally unrelated reason. Anyway, since the #s on the missing prescription forms have been flagged as invalid in The System, supposedly no one would be able to fill them.

Here's what we decided to do. Controlled substance prescriptions can be written for 3 months, but the doctor will only use that procedure when dealing with a mail-order pharmacy, not local stores. So I'm going to try that. Theoretically, I'll be able to order the prescriptions on-line by email (easy) in sufficient time for them to mail them to me before I run out. I'll pay for expedited shipping. I hate to take my business away from the local guys, but I gave them more than a fair chance, and it didn't work out.
posted by Corvid at 11:17 AM on May 27, 2011 [1 favorite]