Q&A – Strategies for Pharmacy Owners to Reduce Internal Loss of Controlled Substances

Theft and abuse of prescription medications is a growing problem, and pharmacies are on the front line. Fortunately, there are some highly-effective strategies pharmacy owners can employ to reduce the loss of controlled substances due to internal theft.

One of NCPA’s partners in Protect Your Pharmacy Now! is RxPATROL®, a program that helps law enforcement apprehend pharmacy crime suspects and helps pharmacists protect themselves from pharmacy theft and related crimes. NCPA and Purdue Pharma L.P. (creators of RxPATROL) recently premiered the annual RxPATROL®/Protect Your Pharmacy Now! Pharmacy Safety and Security video with tips for pharmacy owners to prevent and deal with internal theft and prescription fraud.

John Gilbride, formerly Special Agent in Charge of the New York Field Division for the Drug Enforcement Administration and now Director of Corporate Security at Purdue Pharma answers some common questions with effective strategies to reduce loss of controlled substances via employee theft.

Q: What are the most important things owners should consider when confronting internal theft of controlled substances?

A: There are two specific goals every pharmacy owner should strive to attain when addressing controlled substances loss:

  • Reduce the opportunities for loss of controlled substances, and;
  • Increase security surrounding the handling of controlled substances.

Q: How would you categorize the areas of focus to achieve those goals?

A: Pharmacy owners should focus on four areas of concern that can have a dramatic impact on medication loss:

  • Limit authorized access to controlled substances;
  • Implement strong site security;
  • Apply proper drug handling procedures; and
  • Utilize stringent employee screening practices.

Q: What are the most important factors to consider regarding employee access?

A: There are two things to think about when we discuss “access.” First, think about access to your building or store. Know exactly who has keys. Make sure that all employee keys are clearly marked “Do Not Copy.” Make certain that each person who has access to alarm codes has a unique user ID and routinely double check or audit who is keying in and out.

The second area is the pharmacy—which should be keyed separately from the building and have separate alarm access and codes. Key and code access for non-pharmacy personnel should be limited, and access during operating hours should be strictly supervised. This is especially important for any visitors or maintenance workers.

Q: Are there special considerations for pharmacy layout that can make a difference?

A: Yes. First and foremost, controlled substances should be stored in a locked safe that is secure. Access to the safe should be limited to a select few employees who are always within sight of other employees. All access to and handling of controlled substances should be visible to other employees. Lastly, storage of controlled substances on your “working inventory” shelf should be within view of other employees, but out of customer view.

Q: Are cameras helpful in deterring pharmacy theft?

A: Absolutely. Visible video cameras are a highly-effective deterrent against employee theft, as well as an excellent robbery and burglary prevention measure. Here are a few important tips for camera selection, installation, and operation:

  • Purchase cameras that are high resolution and color and allow for facial recognition;
  • Make sure they are low-light capable;
  • Cameras should be focused on areas of concern such as pharmacy counter, storage areas, customers entering and leaving store;
  • Cameras should be visible to employees and customers;
  • Make certain the recording device is either secured or off site; and
  • Retain records for a minimum of 30 days.

The use of a video camera monitor is also recommended. Cameras should be checked regularly to ensure that they are operating properly, recording and are focused on areas of concern.

Q: How can I limit problems with employees?

A: Proper employee screening combined with on-going licensure checks and drug testing can be highly effective. For new employees, it is recommended to check references, do a background check, verify licensure, look for any disciplinary actions, and require a drug test.

Establishing clear policies and procedures for employee behavior in the pharmacy area will also prevent loss:

  • There should never be fewer than two employees in the pharmacy area at any given time and managers should be available to cover for breaks;
  • No backpacks, purses, coats or any other closed personal containers should be permitted in the pharmacy area;
  • Any items leaving the pharmacy area with employees should be inspected by a manager;
  • Keep the pharmacy area well organized and free from clutter.

Q: What are the best procedures for processing orders and deliveries of controlled

A: Best practices include the following:

  • Limit the number of employees who can authorize controlled substances orders;
  • Require a second signature or approval for orders;
  • Carefully manage inventory control with perpetual counts/verification.
  • Do random spot checks of high-risk products.
  • When receiving orders:
    • Always handle controlled substances first;
    • Thoroughly check the order contents before accepting;
    • Do a two person count;

Q: What are the most common scams employees use to divert controlled substances?

A: Employees who steal controlled substances often employ one of the following methods:

  • Short-count dispensing;
  • Theft from stock shelf;
  • Self-dosing on the premises;
  • Substitution of dilution;
  • Bogus written or phone-in prescriptions;
  • Pulling old prescriptions and authorizing refills; and
  • Putting filled prescriptions in trash or other items leaving the pharmacy.

Q: What should pharmacy owners do if they suspect an employee of theft of a controlled

A: Prepare a detailed list of everything that was stolen and staff members who had access to the items. Try to pinpoint a period of time when the theft could have taken place and pull security camera footage for review. You must report the theft to the police and to the pharmacy board. You may or may not choose to terminate the employee. Federal regulations require that registrants notify the DEA Field Division Office in their area, in writing, of the theft or significant loss of any controlled substance within one business day of discovery of such loss or theft. The registrant shall also complete and submit to the Field Division Office in their area, DEA Form 106, “Report of Theft or Loss of Controlled Substances” regarding the theft or loss.

Q: Is there anything else owners can do to deter theft of controlled substances in our pharmacies?

A: Stay up to date on what is happening in the industry. Educate yourself, share information, cooperate with local law enforcement agencies and be aware of the latest scams. A good way to accomplish this is through the RxPATROL.org website or by following RxPATROL® on Twitter at Twitter.com/rxpatrol. Pharmacy owners can take immediate action to fight back against pharmacy robberies and pharmacy theft by assisting law enforcement through this online database. RxPATROL® tracks, analyzes and provides information on pharmacy crime to law enforcement and pharmacies. This is the only program specifically tracking pharmacy crime. RxPATROL® also partners with Crime Stoppers and other community anti-crime programs to offer rewards for information leading to arrests for pharmacy crime. For more information visit www.RxPATROL.org


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