Can You Only Fill Controlled Substances At One Pharmacy?

OatI asked

I found a much better price (over ABC pharmacy) with GoodRX, so I used a coupon at a pharmacy which I haven't used in a year or so. I asked my doc to send a new script to this new pharmacy with the great price. ( I didn't try to transfer the doc's first 'ABC' script between 'chains'. ) The pharmacist said 'I've got to ask you...what is your plan going forward?' I asked what she meant. She told me that I had to use one pharmacy for all of my controlled substances. I asked, 'Is this a GoodRx thing'(?), and she said no; It is a DEA requirement. She showed me some printout of people, or stores that she said 'she had to call' before filling my new Lyrica prescription. I am on 3 controlled substances from 2 different docs; doc is my PCP and one is a psychiatrist. This was in Pennsylvania and all scripts are quite current. Is there a new DEA law in play which I don't know about or did she just not want to take the time to call whomever? I know from a previous conversation that she purchases the drugs for the entity where she is employed. Can you comment on what may be going on?

Answer

Hi Oat and thank you for your question. There is no DEA law (i.e. federal law) stating that you can only fill controlled substance prescriptions at one pharmacy location. However,  I can give you my thoughts on your interaction based on my personal experience as a pharmacist over the last decade.

First, while I’m sure that your prescriptions are perfectly fine and legitimate, your behavior might have inadvertently raised a few red flags.

There are a few red flags that pharmacists experience that may lead them to suspect diversion of a controlled substance. Specifically, I’m on the lookout when I fill a controlled substance for a patient who is unfamiliar to me, when they are on multiple controlled substances, when different physicians write for controlled substances, when they use multiple pharmacies, and when they offer to pay with cash or a discount card. Lastly, I don’t know when you last filled your Lyrica, but if it was more than a day or two early from your previous fill, that would raise another red flag.

Pharmacists have quite a bit of liability when we dispense medications, especially controlled substances. We need to make sure that they are being prescribed safely, for an appropriate condition, and do our best to prevent diversion. I don’t think that any pharmacist enjoys playing the role of “narcotics police” but unfortunately it’s an important part of the job.

Every state has their own laws and regulations regarding how controlled substances are filled. Additionally, every pharmacy has their own individual policies on new fills for control substances as well. I’m not licensed in Pennsylvania, so I don't know your specific laws...but again, there is no federal law stating that you can only fill at one pharmacy (I am also pretty sure there are no state laws in this regard). Nevertheless, I have made many phone calls like the one you described and have turned away prescriptions for controlled substances if I see that a patient is filling multiple controlled substances from different prescribers at different pharmacies.

From a safety standpoint, it’s a good idea to choose one pharmacy. If I fill a prescription for Lyrica and it turns out that there is a drug interaction from another prescription that I filled two weeks ago, there’s a good chance that I will catch that interaction and manage it appropriately. If you filled one prescription at my pharmacy, and another at a neighboring pharmacy, we probably won’t catch a dangerous drug interaction. 

While you certainly have the right to fill your prescriptions at whatever pharmacy you choose, the process will probably go much more smoothly if you stick with one pharmacy. I don’t think twice about refilling a Lyrica prescription for a patient that has been getting it refilled at my pharmacy every month for a few years. If it’s a brand new prescription from an unknown person that is being filled under a discount card or for cash; I’m going to give that prescription a bit more scrutiny.

I hope this helps to shed a bit of light on your situation. Feel free to write back to us in the future.