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Drug seeking patient - possibly distributing; response?

August 2, 2016
 
Question:

Hi Jennifer,
 
Have a patient in my NY practice who came in twice for a controlled substance. Seemed legitimate so I prescribed. I checked i-stop (new york state controlled substance monitoring website) and see she is getting the same script from 5 doctors, sometimes paying with insurance, sometimes using cash.

What do I do next?  I reported it through the I-stop website already. I see she always gets it at the same pharmacy so there is someone there who is in it with the patient.  Its way too much for her to consume so i am sure she is selling it.

The patient made an appointment 2 days from now. Do I see her? Refuse seeing her?  See her and ask her if she is abusing (which I know she is not?).

She and the pharmacy might be running a drug ring here!!

Thanks,
Dr. R

Answer: 

As an initial comment, a problem I see that should be corrected going forward is, please check I-Stop BEFORE you prescribe the first time.  You are required to check prior to prescribing, and the registry is meant to be taken into account in your prescribing decision.  

You are not required to continue treating the patient unless she has an ongoing condition you are seeing her for and a transition to a new physician would be necessary from a medical standpoint - doesn't seem to be the case here. You can cancel and send notice of termination of physician-patient relationship. If you feel compelled to bring her in, i recommend doing so in conjunction with a formal reporting to the NYS Bureau of Narcotics.  Regardless of whether you bring her in or not, you may wish to report.  

Reporting - 
Contact
Bureau of Narcotic Enforcement
Riverview Center
150 Broadway
Albany, NY 12204
Telephone: (866) 811-7957
Fax: (518) 402-0709
E-mail: narcotic@health.ny.gov

Telephone Instructions

Please note the telephone menu has been updated as of May, 2013

Main Menu Options are 1-3

  • For all general questions regarding controlled substances including the Official Prescription Program, the I-Stop Prescription Monitoring Program, and Licensing press 1.
  • For questions regarding suspicious or illegal activity involving controlled substances, press 2.
  • For questions regarding subpoena requests, press 3.
  • To repeat this message, press 4.

For your Regional Office and more information about reporting, click here.  To the extent you can, track any reporting, possibly by sending by email so you have a written record.  


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