Pharmacist Suspended for Forging a Prescription for Codeine Amid Alleged Threats

The General Pharmaceutical Council (GPhC) Fitness to Practise Committee investigated a pharmacist after he was convicted of forging a prescription for codeine and presenting it as genuine at a Boots pharmacy.

On 27 July 2020, the pharmacist:

1. Created a false prescription for 2000ml of codeine using the details of a former university acquaintance who was a prescriber.
2. Presented the prescription to a colleague (Witness A) at Boots pharmacy, hoping it would not be dispensed.
3. Failed to report alleged threats from an unknown male who had approached him outside his home and demanded he supply codeine.
4. Was confronted by Boots pharmacy staff, who identified inconsistencies in the prescription and reported him to the police.

The GPhC became involved after the pharmacist was convicted at Wiltshire Magistrates’ Court on 14 April 2021.

Findings:

The Fitness to Practise Committee found that the pharmacist’s conduct amounted to serious professional misconduct, considering:

1. Forgery of a Prescription for a High-Risk Drug (Codeine):
   • The pharmacist knowingly created a false prescription for a highly addictive opioid.
   • Codeine misuse is a significant public health concern, and this act had the potential to contribute to the illegal supply of controlled drugs.
2. Failure to Seek Help or Report Threats to Authorities:
   • The pharmacist claimed he was threatened by an unknown male outside his home and feared for his safety.
   • Instead of reporting the threats to the police, his employer, or colleagues, he chose to forge a prescription.
   • The committee accepted that he was coerced but found that his response was inappropriate and unlawful.
3. Dishonest Use of Another Pharmacist’s Prescriber Details:
   • The pharmacist used the identity of a former university acquaintance (a prescriber) without their consent.
   • When Boots pharmacy staff contacted the prescriber, they denied writing the prescription.
   • This act risked damaging the professional reputation of the prescriber.
4. Colleagues Immediately Identified the Fraudulent Prescription:
   • Boots staff became suspicious due to:
     • The large quantity of codeine requested.
     • Missing patient details, such as the date of birth.
     • Unfamiliar prescriber details.
   • Staff contacted the prescriber, who confirmed that the prescription was fraudulent.
   • The police were called, and the pharmacist was arrested.
5. Court Conviction and Sentencing:
   • The pharmacist pleaded guilty at Wiltshire Magistrates’ Court on 14 April 2021.
   • He was sentenced to:
     • 8 weeks’ imprisonment, suspended for 12 months.
     • 100 hours of unpaid work.
     • A £128 victim surcharge.
     • £85 costs to the Crown Prosecution Service.

The court noted:

“The registrant was placed in a difficult situation but had a duty to report the threats rather than forge a prescription for an addictive drug.”

GPhC Determination on Impairment:

The GPhC ruled that the pharmacist’s fitness to practise was impaired, citing:

• A serious breach of trust and professional integrity.
• Failure to report the threats to authorities, leading to criminal behaviour instead.
• Risk to public confidence in the pharmacy profession.

The committee stated:

“Pharmacists are gatekeepers of prescription medicines. The Registrant’s actions fundamentally undermined public trust in the profession.”

Despite the pharmacist’s claim that he deliberately inserted errors in the prescription to prevent it from being dispensed, the committee found that this was not a justification for dishonesty.

Sanction:

The committee imposed a 4-month suspension, considering:

• Aggravating Factors:
  • Forgery of a prescription for a highly addictive opioid.
  • Failure to report alleged threats and taking inappropriate action instead.
  • Using another pharmacist’s details without consent.
• Mitigating Factors:
  • The pharmacist was under duress and feared for his safety.
  • He did not financially benefit from the forged prescription.
  • He showed remorse and insight into his actions.
  • Positive professional references indicated that he had otherwise maintained good clinical practice.

However, the committee concluded that:

“While removal from the register was considered, the mitigating factors—including the registrant’s remorse and lack of personal gain—meant that a suspension was the proportionate response.”

A review hearing was not required, as the committee was satisfied that the pharmacist had demonstrated sufficient insight and was unlikely to repeat the behaviour.

Key Learning Points for Pharmacy Professionals:

This case highlights critical lessons regarding ethical decision-making, professional accountability, and handling coercion.

1. Forgery of a Prescription is a Serious Offence with Severe Consequences:
   • Even if done under duress, forging a prescription is a criminal act.
   • Pharmacists must report such situations rather than attempting to resolve them dishonestly.
2. Reporting Threats is Crucial:
   • The pharmacist should have contacted the police and his employer immediately.
   • Failing to report coercion led to further professional and legal consequences.
3. Pharmacists Must Protect the Integrity of the Profession:
   • Using another professional’s details without consent is unethical and can damage reputations.
   • Dishonesty, even under pressure, erodes public trust in the profession.
4. Regulators Consider Context, But Dishonesty is Still Sanctioned:
   • The committee acknowledged that the pharmacist was threatened but still imposed a suspension.
   • Pharmacists are expected to uphold ethical standards even in difficult situations.