August 23, 2023

The corresponding responsibility doctrine requires that a registered pharmacist must
ensure that the prescription presented to them is valid and for a true medical
purpose. This may entail due diligence on the part of the pharmacist by making an
enquiry to the prescriber to discuss any legitimacy concerns that a pharmacist may
have. Further, the pharmacist must satisfy themselves that the prescription was
issued in the usual course of professional treatment or in legitimate and authorized
research. 1
In the scenario, there are several instances that raise red flags and which would
require the pharmacist to make enquiries with the prescriber. They include;
i. Customers presenting in a group and have the same prescriber and
prescription – Patients A, B and C all went to the pharmacy together and
they all have the same prescription from Dr. Whitecoat. Further, patient B
and C have the same exact prescription quantities even though patient C is
an older woman. These are suspicious circumstances which should prompt
the pharmacists to make enquiries with Dr. Whitecoat as to the validity of
the prescriptions.
ii. Paying cash for an opioid – Patient A wants to pay cash for the opioid
medication he is seeking. This is a red flag as payment for opioids in most
instances will be catered for by insurance.
iii. Use of street slang to describe an opioid – Mary Evans, the young female
customer, describes alprazolam 2mg as “bars”. The use of street slang in
this instance is a red flag which should prompt a verification inquiry from
the pharmacist to the prescriber.
1 21 C.F.R Section 1306.04 (a) of DEA Regulations

iv. Unusual distance from the pharmacy – Patient A lives 75 miles from the
community pharmacy. It would be suspicious to travel such a long distance
and disregard many pharmacies along the way just to get to this particular
one. As such, the pharmacists should treat this as a red flag.
Pharmacist Jim disregards the clear red flags that occur when he is working. He
does not verify with the prescriber when customers who arrive in a group present
prescription from the same prescriber neither does he question an unusually long
distance travelled by a customer to get opioids, among other instances. As such,
he is not meeting his duty under corresponding responsibility that he is tasked
On the other hand, Pharmacist Jeff declines to fill a prescription for the customer
from the oncology clinic without giving any reason. While Jeff’s cautious attitude
may be understandable in light of his son’s passing, he must balance such caution
with the wellbeing of customers. In this instance, he should have made an enquiry
with the customer’s prescriber to ensure its validity. As such, he is not meeting his
duty under the corresponding responsibility.
The changes that would ensure Jim complies with the corresponding responsibility
bestowed upon him would be to make enquiries regarding the validity of all
prescriptions which seem suspicious. For instance, he should have called the
prescriber of the customer who had travelled 75 miles or the prescriber of the
customer who described her opioids in slang to verify validity.
On the other hand, Jeff should cease declining filling prescriptions of customers
without any reason, yet they may be in genuine need of the opioids and have a
genuine prescription. For instance, he should not have declined to fill the

prescription of the customer from the oncology clinic. Rather, he should have
made a call to the prescriber and authenticated the prescription.


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