The Art of Forging Prescriptions

I’m so excited to host future author and pharmacist, Amy Gale, who will be blogging on the topic of falsifying prescriptions.

Welcome, Amy!

Prescription drug abuse is rapidly growing. A large amount of popular “street drugs” are medications prescribed on a daily basis. It seems more and more people are trying to falsify prescriptions and the new trend is to “pop pills” to get high. Let’s hope this trend is short lived. So, how do you forge a prescription?

The most commonly forged prescriptions are Class III to Class V narcotics. Some popular examples are Vicodin, Valium, and Xanax.  These prescriptions are easier to falsify because they can be forged in two ways. 

First, a prescription can be called in to the pharmacy. As long as the caller has all the pertinent information and knows the physicians DEA number, the prescription is deemed valid. If a pharmacist feels the prescription is falsified, a call to the physician is warranted to verify the information. Some drug abusers are so good at impersonating a physician or office; they can fool even a seasoned pharmacist.
Second, a written prescription can be presented to a pharmacy associate. It must contain all pertinent information such as patient’s name, address, phone number, drug name, quantity, directions for use, refills, physician’s name, and physicians DEA number. A prescription can be written for any medication, but Class II narcotics (some examples are Percocet, Oxycontin, Morphine, Ritalin, and Adderall) must be physically written prescriptions with no additional refills. There are exceptions such as emergency supplies, but most fraudulent prescriptions are written for larger quantities than the emergency supply law allows.
How do I know if a prescription is fraudulent?  There are warning signs indicating a prescription may not be legitimate. The following are some common ones:
1. Prescription is written/or called in for an unusually high dosage or quantity.

2. Prescription is written in pencil or several different colors of ink.

3. Lack of standard abbreviations (every word written or spoken out completely).

4. Different handwriting styles or perfect handwriting.

5. Altered numbers in quantity and/or dosage.

6. Characteristics indicating a photocopy.

7. Out of state physicians. 
8. Paper is too smooth, no indentations from pen pressing on paper.

9. Part of physician’s signature is cut off. 

10. No perforation or residual glue at the top of paper.

11. Toner dust rubbing off or smudging on the paper.
Patients presenting fraudulent or forged prescriptions do not act like everyday customers. Here are some signs of unusual patient behavior that flags a pharmacist.
1. Requests early refills (some common excuses are vacations, lost medication, dropped in sink.)
2. Patient is willing to pay full cash price instead of using insurance or attempts to work around the days’ supply and quantity limits imposed by most insurance carriers.
3. A number of patients appear simultaneously, or within a short period of time, all bearing similar prescriptions from the same prescriber.
4. Patient is unusually anxious, out of proportion to the situation.
5. Unusually impatient for prescription to be filled and attempts to rush their prescription through ahead of others.
6. Attempts to persuade the pharmacist not to verify prescription with physician.
7. Drops off prescription right before closing and persuades pharmacist to rush it through.
8. Patient arrives within minutes of the prescription being called in by prescriber.
9. Verification callback number is cell phone or number other than physician office.
When a fraudulent prescription is presented to a pharmacist a few things can happen:
1. The patient fools the pharmacist and obtains the medication.
2. The pharmacist refuses to fill the medication.
3. The pharmacist fills the medication but alerts the DEA or local authorities and the patient is arrested as soon as the fraudulent prescription is sold.

I’d like to say I’ve never been fooled or that my patients would never try and falsify a prescription, but unfortunately that’s not true. I’ve seen it and heard it all! In my twelve years as a pharmacist I’ve even had a few people arrested. I hope you have a better understanding of how prescriptions are forged.  Feel free to ask any questions or pick my brain.


Amy Gale is a pharmacist by day, aspiring author by night. She attended Wilkes University where she graduated with a Doctor of Pharmacy degree. Her dream is to share her novel, Blissful Tragedy, with the world. In addition to writing, she enjoys baking, scary movies, rock concerts, and reading books at the beach with her feet in the sand. She lives in the lush forest of Northeastern Pennsylvania with her husband, five cats, and golden retriever puppy. Her journey to publication is just beginning, let’s hope it has a happy ending. You can connect with Amy at her website at

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