Triplicate prescriptions in Washington State.

Abstract

In summary, I believe that this program, although limited in scope, has been of value to our State in controlling the inappropriate prescribing of controlled substances. We have identified several problems that have been or are being addressed in order to make the program even more effective. The program targets only those prescribers who have been identified as having drug use or prescribing problems rather than subjecting all practitioners to a program for the purpose of finding a relatively small number of violators. Thus, the intimidation factor alleged to be present in full triplicate programs is absent in the limited program. It is flexible since the drugs included in the monitoring can range from a single controlled substance schedule, all schedules, or even to all prescriptions. The program includes both prescribed drugs and those administered in the office or dispensed by the practitioner. The responsibility for compliance is placed on the prescribers, not on the pharmacists. The way the law is written, the program could be expanded to include a sample of all prescribers, providing information that could be used to determine prescribing norms. Overprescribing appears to be in the eyes of the beholder. A pharmacist may view certain prescribing habits differently than a disciplinary board. The availability of norms would assist boards in making more scientific determinations regarding alleged overprescribing practices.