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The heart of this policy is Title 21 of the Code of Federal Regulations, Section 1306.4 (2) which explains that a pharmacist has a corresponding responsibility to ensure that any prescription for a controlled substance that is dispensed is done so for a legitimate medical purpose (3). Ironically, this policy places patient safety at risk by obstructing the delivery of patients’ medication as it requires the gathering of information above and beyond requirements set forth by state and federal regulations before an opiate prescription for chronic non cancer pain (CNCP) may be dispensed to the patient.

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Per the Deputy Assistant Administrator, Office of Diversion Control, DEA, (in a personal discussion) the DEA does not issue therapy “guidelines”.

Additionally, there are reports that Walgreen pharmacies are not only limiting the quantity of an opioid prescription to 120 doses, but then requesting from the provider a second prescription for the remaining balance of the first prescription.

Walgreens is apparently misinforming patients and providers for the reasons this additional information needs to be collected by telling them any combination of the following: that the DEA has issued new guidelines; that and/or the Board of Pharmacy has enacted new regulations; that the patient’s insurance company is requiring this.

Further confusion exists as to the “guidelines given by the DEA” to limit quantities of certain opiates to #120 doses.

In Virginia, the State Board of Pharmacy ruled that Walgreens’ actions appeard to violate no rules or regulations of that state.

In New Mexico, the State Board of Pharmacy (NMBOP) defines unprofessional conduct as, “Participation in a plan or agreement which compromises the quality or extent of professional services, or facilities at the expense of public health or welfare”(5). It is much longer than the usual blogs posted here, but addresses an important issue to our profession. Money doesn’t talk it swears Bob Dylan; It’s Alright Ma, I’m Only Bleeding Pharmacy has struggled with the nature of its duality; trying to balance the two agendas of being a patient care profession, or a profession driven by business interests.Additionally, on fall 2012, the DEA issued an Immediate Stop Order (ISO) at Walgreens Distribution Center Jupiter, Florida because their business constituted an imminent danger to the public safety (1).There is the issue of a retail pharmacists having corresponding responsibility with no corresponding authority.But in the end, as a definition of unprofessional conduct, as defined by the NM BOP is,” Participation in a plan or agreement which compromises the quality or extent of professional services, or facilities at the expense of public health or welfare”, then Walgreens is engaged in unethical practice as evidenced by: There is no other health care profession that would allow this.By this very definition it seems clear that Walgreens is engaging in unprofessional activity in New Mexico; just by reading this regulation, the issue seems cut and dry.

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