Corresponding Responsibility Law

What do the corresponding responsibility obligations require a pharmacist to do when a pharmacist is presented with a prescription for a controlled substance drug? (California Health and Safety Code section 11153(a)). To comply with the corresponding responsibility requirements, and before dispensing a prescription for a controlled substance to a patient, a pharmacist is required to conduct a reasonable investigation to determine whether the prescription for the controlled substance is issued for a legitimate medical purpose. To do so, the pharmacist, using his professional judgment, is required to assess some factors, including:

1. Whether the prescription is facially valid
2. Contacting the prescriber if there are questions or concerns regarding the prescription
3. Talking to the patient to determine if the patient is on other prescription medications or if the patient has tried other pain prescriptions and
4. Determining where the prescriber’s office is about the pharmacy and the patient’s residence

The corresponding responsibility law also requires a pharmacist to review and evaluate a patient’s use of controlled substance prescription drugs. A pharmacist can review a patient’s usage of all controlled substance prescription drugs by accessing a state-wide system known as the Controlled Substance Utilization Review and Evaluation System (CURES). CURES tracks controlled substance prescription drug history information for all patients who have received controlled substance prescription drugs in the state. Information obtained from CURES and a pharmacist’s education, training, and experience are valuable in preventing prescription drug abuse and drug diversion. For instance, by obtaining information from the CURES system, a pharmacist can determine whether a patient is receiving prescriptions for controlled substance medications from more than one prescriber or receiving prescription drugs from multiple pharmacies, circumstances that, if present, would indicate potential drug abuse or diversion.

Based on my experience representing pharmacists in the State of California who were facing disciplinary charges related to the corresponding responsibility laws, I highly encourage all pharmacists to use the CURES system when presented with a prescription for a controlled substance prescription drug. I also encourage all pharmacists to look for what has been described as “red flags” when they are evaluating a prescription for a controlled substance prescription drug. In addition to the above factors to consider, some of the “red flags” to look for are:

• The patient’s age (a relatively young individual presenting a prescription for a strong pain medication)
• Method of payment (cash payment for pain medications)
  Large quantities of controlled substance prescription drugs
• Patients come to the pharmacy in groups
• Patients from the outside of a pharmacy’s trade area (typically outside of a 5-mile radius)
• The pharmacy is a long distance from the prescriber’s office

At the Marcarian Law Firm, we handled some of the most significant corresponding responsibility cases against pharmacies and pharmacists in the state.

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