As many people continue to show up to dispensaries with forged signatures for drugs, fake prescriptions remain a concern for health professionals.
In fact, the Pharmaceutical Society of Jamaica said that pharmacists see fraudulent prescriptions daily, and described the situation as troubling.
"It is always a topical issue and concern for us as pharmacists. Each day you see them and they keep increasing," Immediate Past Secretary of the Pharmaceutical Society of Jamaica Kevar Bennett told the Jamaica Observer.
And he said that where there is prescription fraud, the drugs being sought after are usually anti-depressants, high-inducing drugs, addictive drugs, sleep aids such as Xanax, and pain medication such as Panadeine, Panadeine F and morphine.
"Experience and training as a pharmacist would have given you some amount of knowledge about the prescription, and especially if you're working in a particular area for some time, you would have been familiar with the different doctors in your area, because we have seen their prescriptions over and over. So, we know what their prescriptions look like, how they sign their prescriptions, and how they write their prescriptions," he continued.
Bennett said pharmacies are vigilant and look out for spelling errors or misspelling of drug names, incorrect dosing, labels and packaging that is not in relation to a registered pharmacy.
Special attention is also paid towards prescriptions that have unusual directions, and other information that seem unusual on the prescription, Bennett added, noting that oftentimes, pharmacists know which medications are in high demand that patients want to get illegally.
"Sometimes, for our regular patients, we look at their history to see what is the pattern of dispensing and spot if there are any red flags. However, if the patient is new to us, we look at the prescription more carefully than if it is a regular customer. If something appears to be very strange to us, we will often call the office of the doctor who wrote the prescription to verify. And, if we can't verify because we are not able to reach the office or doctor, we do not fill the prescription until we can verify it."
Attorney-at-law Kemar Setal warns people who present fake prescriptions that such a practice is fraudulent.
"The prescription must be from a doctor's office or hospital which would have the name and logo. Plus a doctor's signature has to be on it and name. It is fraud. It is uttering a forged document," he told the Sunday Observer.
Bennett said that when people are caught with these fake prescriptions, their reasoning remain the same, with no admission of guilt.
"They say it was written by their doctor, they say they are leaving the country so the doctor gave them excess supply, they say they ran out of the medications and couldn't afford to go and see a doctor so they ask a friend or someone with limited medical knowledge to write it for them, or they say they lost their medication or shared it with someone or a relative so their supply ran out," he related.
The Pharmacy Act states that every prescription for a drug shall include the date, name, age and address of the person for whom the prescription is issued.
In addition, there must also be the name, the generic name, and the quantity of the substance to be supplied; adequate directions for the use of the substance prescribed; the usual signature of the prescriber and his name in legible print form, along with the address, telephone number and registration number of the prescriber.
"The issue that we have to deal with as pharmacists is that the doctors do not write their names legibly on the prescription, and sometimes there is no stamp to verify. What is usually presented to us on a prescription is a signature that we can't even make out at times. We would then have to call the doctor for verification which impeded the process for a longer time to fill a prescription," Bennett explained.
"When a prescriber does not follow the law as outlined in the Pharmacy Act of 1975, it gives leverage to illegitimate persons to compromise a prescription or forge a doctor's signature and make up a prescription and present it to you as the pharmacist. Oftentimes they just practise how the doctor writes and in some cases, it is hard to decipher the real from the fake one. And if you're not careful and have some amount of experience, you will be caught in dispensing these medications to the persons."
President of the Jamaica Medical Doctors Association Dr Mindi FitzHenley told the Sunday Observer that prescription fraud is a major concern in the medical fraternity, and for that, she said doctors are forced to always be on guard.
"Normally, how it would go is the doctors keep the prescriptions on hand and sign it or stamp it and give it to the patients, especially those doctors who are in the Government service. We really do try to protect it as much as possible. We do try and safeguard and tell all of our doctors to ensure they keep these things on hand."
Fitz Henley noted, however, that there are many instances in which people will visit health centres or hospitals with ill intentions to get their hands on prescriptions.
"You can imagine in the middle of an emergency; the last thing you're thinking is 'oh, let me try and protect my prescription pad and my stamp.' The first thing you're doing, is running to the patient. It's the same thing with cellphones, and persons have unfortunately taken doctors and other health-care workers wallets, money, when we are rushing to help others. That has been at hospitals as well as health centres," she related.
"It is a huge issue for us when this happens, because when your own information is used on fake prescriptions, your signature and your name, you have to report this to the Medical Council of Jamaica, and you have to get a whole new medical identification number. And of course, nobody wants their name to be associated with fake prescriptions," Fitz Henley added.
She told the Sunday Observer that there haven't been many reports in recent time.
"I know that some time ago, they actually took a surgeon's entire prescription pad and was using it to get pain medication. Luckily, it was caught pretty quickly by the pharmacy, so they called the doctor and alerted them. The person was going islandwide with the prescriptions to try and make it harder to catch."
Fitz Henley stressed that these issues underscore the need for good relationships within the medical fraternity.
"...So that when they see things, they can alert you, or check and see if it was really you. I work very closely with the pharmacists in my general zone, but even at private practices where a lot of my patients may frequent, they would call me and say, 'Hey, this doesn't look like your signature' or 'this doesn't look like your handwriting.' Again, we rely on that teamwork approach in the health-care system."
Meanwhile, Bennett has praised "insurance companies such as Sagicor", which have put a system in place to minimise the occurrences of prescription fraud.
"They have mandated that the doctor's name and registration number must be legibly present and imputed in the system for a prescription to be accepted under their insurance scheme and for claim."
The National Heath Fund (NHF), Medcus Health and Canopy have applied similar systems.
"When these companies come in to audit the pharmacies, any anomaly identified will be subjected for verification and if it cannot be validated, an audited report will subsequently follow and the reasons why the claim was not honoured," Bennett said.