Tag: Oregon Board of Pharmacy

License Applications and Renewal Applications for Nurses and Pharmacists

Posted on September 28, 2023 by - Licensure

If you are a practicing pharmacist or nurse in Oregon, you have already applied for a license and will periodically apply to renew your license with the Oregon Board of Pharmacy or Oregon State Board of Nursing. License applications, including license renewal applications, often ask a question similar to this question:

“In the last 3 years, have you been arrested for, charged with or cited for any crime, offense or violation of the law in any state or US jurisdiction or foreign authority?”

It is surprising how often pharmacists and nurses answer this type of question wrong.

Two common mistakes made by pharmacists and nurses

Most often, when pharmacists or nurses answer this question wrong they do so for one of two reasons, (a) because the charge or citation “for any crime, offense or violation” was dismissed, or (b) because the record was later expunged. These are good outcomes, and you are to me commended. Unfortunately, pharmacists and nurses sometimes conclude that because a charge was dismissed, the arrest was wrong, and therefore the arrest doesn’t “count.” Or, pharmacists and nurses sometimes conclude that because the conviction was later expunged, there is no record of the arrest, so arrest doesn’t count. Don’t make these mistakes.

But were you arrested?

It is necessary to read each license application or license renewal application carefully, and to answer each question accurately. The question quoted above asks, “have you been arrested . . . .” Although the charge may have been dismissed, or the conviction and underlying record may have been expunged, you were still arrested, and that fact will not change, but can most often be satisfactorily explained.

When in doubt, consult a medical licensing attorney

If you have questions about how to answer a question on your license application or license renewal application, or you doubt that your negative legal history can be satisfactorily explained to your licensing Board, you are encouraged to consult an attorney having experience working with the Oregon Board of Pharmacy or the Oregon State Board of Nursing.

Pharmacist ponders opening medical marijuana dispensary

Posted on August 22, 2017 by - DEA Prosecutions, Licensure

This might be a bad idea–for the pharmacist

In recent years, a number of states, including Oregon, have “legalized” marijuana for medical purposes (and in fewer states, for recreational use).  As reported in the Okeecheobee News, Florida voters recently approved legalization of medical marijuana and now Florida cities must decide whether to opt out.  If the Okeechobee City Council decides to allow medical marijuana dispensaries within city limits, one local pharmacist urges that he be considered to run the dispensary, but that might be a bad idea–for the pharmacist.

Florida pharmacist Steve Nelson acknowledges that “medicinal marijuana is not an easy issue,” but he is sympathetic, and he has seen the benefits of medical marijuana in treating seizures, terminal cancer, and chronic arthritis.  I don’t doubt him. Mr. Nelson is also quite experienced (40 years as a pharmacist) and appears cautious, urging the city council to be careful, to ensure adequate controls are in place.  One difficulty, according to the Okeecheobee News, is that the city would have “little power” to regulate medical marijuana because “regulation falls to [the] new state law.” It is not that simple, however.

Marijuana: a Schedule I banned substance under federal law

Despite Florida’s new state law, marijuana is still a Schedule I banned substance under the Controlled Substances Act (CSA), meaning that without a research permit or exception, marijuana cannot be possessed, prescribed, or dispensed for any purpose under federal law, and therein lies the rub.  Over the course of his 40 years experience, Mr. Nelson has practiced pharmacy with a state license as authorized in great part by a federal Registration administered by the DEA.  Now he wants to dispense marijuana contrary to the CSA’s drug schedules and DEA oversight?

Admittedly, for a number of reasons, federal law banning marijuana has been lightly enforced and, in those states where marijuana is “legal,” a lax attitude also prevails among the general public.  However, for those of us that possess a professional license, and especially healthcare providers also possessing a DEA Registration, we are held to higher standards.  In my experience, when there is a Board investigation, marijuana, medical or otherwise, is a complicating factor.  I know this to be true for Oregon physicians, whether recommending marijuana for medical use, or consuming marijuana for recreational use, and I fear my experience will prove true for Mr. Nelson should he choose to run a dispensary.  Yes, I know, Mr. Nelson’s state license and federal DEA Registration are not necessary to run a dispensary under Florida’s new law.  Still, Mr. Nelson is a state-licensed pharmacist, with two pharmacies dispensing controlled drugs as authorized by the CSA pursuant to separate DEA Registrations – does Mr. Nelson really want to run a third operation dispensing a Schedule I substance banned under the CSA?  As a lawyer, I recognize the legal distinctions and I can make the arguments to support Mr. Nelson’s goal of running a dispensary but, as a practical matter, I see the risks of unwanted scrutiny, and more.  Much more.  I earlier commented on physicians, marijuana, the new DEA, and the Oregon Medical Board and marijuana, the practice of medicine, and the Oregon Medical Board, cautioning Oregon physicians physicians not to become complacent when involved with marijuana.  I have also defended pharmacists and physicians for dispensing lawful drugs.  Given my experience, I cannot imagine recommending that a state-licensed, DEA-registered practitioner dispense a Schedule I banned substance, even if its “only” marijuana.

Drug and alcohol abuse and the licensed healthcare professional

Posted on July 23, 2017 by - Licensure

For most people, that’s enough

Earlier this year, I needed to help a licensed health care professional obtain more treatment, so I spoke with his drug counselor, who was surprised at my inquiry.  From the drug counselor’s standpoint, my client had completed the requirements of his court-sanctioned diversion program with perfect attendance, consistently clean urine tests, and no withdrawal symptoms – so, what more was there to do?  For most people, that’s enough, and perhaps rightfully so.  But, if you’re a licensed healthcare professional, you will often be subjected to more scrutiny and more will be expected of you.

More is expected of a licensed healthcare professional

If you are licensed by the Oregon State Board of Nursing, the Oregon Board of Pharmacy, or the Oregon Medical Board, your licensing board will want to know whether your substance abuse incident (often involving a police report, arrest and conviction, or a drunk driving arrest and conviction) is an isolated incident, or part of larger problem.  If part of a larger problem, even if your practice hasn’t been affected, your licensing board may want to intervene, to gather more information, to ensure there are no public safety concerns.  If this happens to you, you need to be prepared, and this is no time to learn on the fly.

Experience gained – the truth about honesty

Two tough cases with “easy” resolutions

I have represented licensees facing allegations involving alcohol.  Two stand out favorably for lessons learned.  One had a significant alcohol history and the other a significant alcohol-related incident.  Both, however, were fully forthcoming and painfully honest when interviewed by their licensing boards, and both fully embraced and responded to their treatment.  Although both had significant issues with alcohol, the investigator, and eventually the licensing board, trusted them and their treatment.  Both licensees were treated respectfully, and both licensing boards joined in the search for solutions tailored to the individual.  Neither licensee lost much time from work, and revocation was never the issue, an optimum result for both licensees.

Three tough cases with “hard” resolutions

Two other cases stand out for lessons learned, but these were painful lessons for the licensee.  One licensee had a significant drug history, the other a significant alcohol history, but both were in denial until one was caught by testing and the other threatened with revocation of his license.  A third case stands out because the licensee had a minor alcohol history but, in the investigator’s mind, the licensee’s explanation of the incident in question was suspect.  In all three cases, the investigator did not trust the situation, which is always problematic, because investigators have resources.  In all three cases, the investigator pursued his or her suspicions until confirmed, at least in part.  These are mistakes to be avoided.

Lessons learned:

  • If you know you have an alcohol or drug problem that can be verified and warrants treatment, the sooner you accept the truth of your situation and get in front of your treatment needs, the easier it will be to maintain your medical license and restore your health.  Why wait to be caught?
  • If you have been caught, but you are forthcoming and honest about your drug or alcohol abuse, you will gain the trust of the investigator and eventually your licensing board, and your life will be easier.  Treatment and return to practice will be the goal.
  • If you have denied a known drug or alcohol problem and your explanations are suspect, you will be pursued until caught (remember, investigators have resources).  Once caught, a convincing and genuine 180 degree course-reversal will be necessary to save your medical license.

What to expect – the “balancing act”

That you may have a drug or alcohol problem alone, without more, is not enough to lose your license.  If you are a nurse, pharmacist or physician licensed by the Oregon State Board of Nursing, the Oregon Board of Pharmacy, or the Oregon Medical Board, you own your license as much as you own your car; it is your personal property, and it cannot be taken without a specified process, aka due process.  It is important to know, however, what you must concede to your licensing Board, and what you must do, to keep your license.  If you do the right things, the power to keep your license shifts to you, but if you do the wrong things, the power to revoke your license shifts to the Board.  An experienced lawyer can help you make decisions that will keep you in a defensible position.

Remarkably, even if you have received a “notice of revocation” of your license, it may not be too late.  I can think of two cases in which I was retained after a notice of revocation had issued but we were able to turn both cases around by quickly doing the right things in a genuine way (sometimes the notice of revocation is the final wake-up call).  In a third case, however, I was not able to help – the problem was inexcusable dishonesty and the board did not see any way to fix that kind of problem.

One final thought: be forthcoming with your lawyer too

I am not gullible, but I can be mislead and, unlike your investigator, I will not fact-check you except in the rare case.  As I write this, I can think of three licensees that misled me and their licensing boards, until they were caught.  I believed all three.  In two of the cases, the licensee denied a drug or alcohol problem and denial was recognized as part of the disease.  I understand that dynamic and your licensing board will too.  There will be some sympathy, so long as no further mistakes are made.  In the third case, however, no such luck. I was present with the licensee when, during a tape-recorded board interview, the licensee was confronted with evidence that disproved the licensee’s prior answers.  It was a painful moment for me, and certainly for my client, and there was no disease to blame, just dishonesty. Ouch.

The bottom line is that if you are honest, your licensing board will do much to work with you, but if your board thinks you can’t be trusted, you’ve made your situation much worse.  Finally, if saving your license is your most important objective, be honest with your lawyer too.  Your lawyer can help you to make the right decisions, present difficult problems in the best light, accept responsibility where you must, and defend the rest.

. . . a little more about reports to the National Practitioner Data Bank (NPDB)

Posted on June 12, 2017 by - Licensure

I recently wrote about the consequences of stipulating to a temporary restriction on your medical license.  One such consequence is a report to the National Practitioner Data Bank (NPDB).  A data bank report, like professional discipline on your license, will complicate your professional life.  All too often, however, the focus is on avoiding or mitigating professional discipline while the likelihood of a data bank report and its impact is forgotten.  Whether you are a physician, pharmacist or nurse, the preferred resolution to a Board investigation is both non-disciplinary and not report-able to the NPDB.

The National Practitioner Data Bank (NPDB) guidebooks

Whether an incident must be reported to the National Practitioner Data Bank is well beyond the scope of this writing.  The point of this writing is simply to raise awareness and to provide two NPDB resources, the 200-plus page “guidebook” for the National Practitioner Data Bank and a short summary of NPDB reporting “triggers.“

Beware when consenting to a temporary restriction on your medical license

Posted on June 9, 2017 by - Licensure

How long? – Longer than you think, plan for the “duration”

Physicians, pharmacists and nurses under Board investigation are occasionally asked to sign an Interim Stipulated Order (ISO) or Interim Consent Order (ICO) accepting a voluntary restriction on their license or, worse, suspending practice pending the outcome of the investigation.  Although it may be suggested that the voluntary temporary restriction could soon be lifted, frequently the process necessary to resolve the issue will take six to 12 months, often longer for physicians due to the complexity and risks associated with a physician’s practice and the Medical Board’s case load.

What else? – Consider the following:

  • National Practitioner Data Bank (NPDB) reports

A physician, pharmacist or nurse consenting to a restriction on his or her license will also need to manage the consequences of a report to the National Practitioner Data Bank (NPDB).  There are many events that will trigger a data bank report and consenting to a restriction on your license to practice medicine, pharmacy or nursing, is one of them.

  •  Board Certification, credentialing, and/or employment

A board certified physician consenting to a restriction on his or her medical license should assume, until it is established otherwise, that his or her board certification will be withdrawn, and that credentialing may be at risk too.  Further, some employer’s will terminate a restricted physician.  The Veterans Administration (VA), for example, requires every physician to have at least one unrestricted medical license.  While it is possible to practice with a restricted license or DEA Registration, it takes planning.

  •  DEA Registrations

A prescribing physician, physician’s assistant (PA), or nurse practitioner (NP) should also consider the impact of a restricted license on his or her DEA Registration.  Remember, in order to hold a DEA Registration, the Drug Enforcement Administration (DEA) requires every DEA Registrant to possess valid state authority to prescribe controlled substances.  Consequently, if you consent to a restriction on your prescribing privileges, or consent to voluntarily withdraw from practice pending the outcome of an investigation, you should be ready for a call from a DEA agent requesting the surrender of your DEA Registration.  Thus far I have had success convincing the DEA to await the outcome of the investigation, but nothing is certain, and you should need to plan accordingly.

Bottom line: Plan for all the consequences of a restricted medical license

If you are a physician, pharmacist or nurse under investigation and your licensing Board requests that you consent to one or more restrictions on your medical license, you need to know that the restriction will probably last more than a few months and there are numerous other consequences to consider depending upon your type of practice and level of licensure.  Each case is different and there may be more to consider than is discussed here. Diligence and planning is required to survive a restriction on your medical license.

Physicians, pharmacists, and nurses: Are you stressed by license or renewal applications?

Posted on May 22, 2017 by - Licensure

I have written on this topic before. Ten months ago I wrote about mandatory reporting requirements and the dreaded “yes questions.” Nineteen months ago I asked whether license applications or license renewals caused a sinking feeling in the pit of your stomach and wrote about that. Today I am revisiting this topic because it is part of my practice every week. Recently, I helped a new graduate make her first license application and a seasoned professional file his license renewal application. Both had alcohol-related incidents to report and explain. Last week I also helped three nurses and two physicians that were either “caught,” or otherwise had to self-report and explain alcohol or drug activity. It should come as no surprise then that the Oregon State Board of Nursing, the Oregon Board of Pharmacy, and the Oregon Medical Board are all well experienced with substance abuse issues and arrest records. The good news is that whether you are a nursing, pharmacy, or medical student, a recent graduate, or a licensed professional, if you have a substance abuse issue or arrest record, much can often be done to help you obtain or maintain your professional license.

Forward thinking medical students have time to act before applying for licenses

One forward thinking pharmacy student and another forward thinking medical student wanted to determine before starting their educations whether their arrest records involving drugs or alcohol would preclude them from obtaining a pharmacy or medical license upon graduation. The medical student would also need a DEA Registration. One nice thing about helping students at the beginning of their educations is the element of time. I can help a student anticipate what lies ahead, and understand what he or she can do ahead of time to improve the odds of being licensed upon graduation. Much can be done to help students prepare themselves well before it is time to apply for that first license.

Recent medical graduates likely have more to help their license applications than they know

If you are about to graduate as a nurse, pharmacist, or physician, and the thought of applying for your first license causes a sinking feeling in the pit of your stomach, there is reason to be hopeful. It is my experience that whatever drug, alcohol or arrest history is in your past, there will be many positive things to stress in your favor when applying for your first license. You are a new graduate after all, so you have done a number of things right; what are they? The key to this approach, however, is that whatever drug, alcohol or arrest history is truly in your past. If, for example, you have a drug history and you are arrested for a drug violation while your license application is pending, that new drug arrest presents a much more difficult obstacle to overcome.

Help for seasoned physicians, pharmacists, and nurses when renewing

Licensed professionals must report certain drug and alcohol related activity, convictions, and some arrests and often seek help with their license renewals. If you find yourself in this situation you are not alone, and the Oregon State Board of Nursing, the Oregon Board of Pharmacy, and the Oregon Medical Board are all well experienced with drug, alcohol, and arrest records.

Recently, I helped one licensed heath care professional complete his renewal application. He had an alcohol related incident since his last renewal but he had also done everything necessary to take care of his health and return to work. His renewal application made clear that insufficient explanations and/or documentation could delay his renewal. Fortunately, he did the hard work before I became involved and my role was limited to assisting his explanation and assembling the documents I knew his licensing board would expect to see to ensure he is healthy, competent, and safe to return to work. Despite his report of a significant alcohol related incident, his renewal went through without further effort.

Some time ago, I helped an out-of-state nurse obtain her Oregon nurse’s license. Her situation was not uncommon. When she was young, she incurred a relatively minor drug and arrest record about the same time she obtained her first nursing license, so her first nursing license issued with heavy restrictions and those restrictions that were never lifted. When she called upon me to help her apply for her Oregon nurse’s license, she was emotionally beaten by the restrictions that had haunted her practice for a decade. Once we started working together, I was impressed by all that she had accomplished personally and professionally since she was first licensed. Whatever happened a decade ago was old history, no longer relevant in gauging who she is today. All that we needed to do was organize and present her accomplishments in a way that could be understood and verified by the Oregon State Board of Nursing. Her unrestricted nursing license quickly issued, with no interview and no further questions. I was happy for her and impressed by the Oregon State Board of Nursing for processing her nursing license application so expediently.

Pharmacists, physicians and nurses: Is your state licensing Board friend or foe?

Posted on August 9, 2016 by - Licensure

To report or not report: Discipline versus a Letter of Appreciation

Reporting troubling information to your licensing Board and navigating the subsequent investigation is seldom one’s first choice, but it can be done well, and it may spare you from discipline later. You might even discover that your licensing Board is your friend and ally. To illustrate this discussion, I am using two cases involving pharmacists and the Oregon Board of Pharmacy, but the same principle can apply to nurses before the Oregon State Board of Nursing and physicians before the Oregon Medical Board.

Two pharmacy cases that make the point

In one case, the pharmacist in charge (PIC) was managing a pharmacy technician whose qualifications to hold her technician’s license were suspect. The PIC did not report the technician, believing the Board of Pharmacy “would not have done anything” to help, since the Board licensed her in the first place. As he would later learn, however, had he made an appropriate report to the Board, he would have satisfied his professional obligation to report, while simultaneously gaining the Board’s participation in the problem, relieving him of much responsibility. A simple report to the Board would have spared him the grief that followed as he sought to manage a problem he could not manage, and should have instead reported. In the end, his failure to report the technician, and to work collaboratively with his licensing Board, proved a costly lesson: discipline.

By way of comparison, in an another case, the PIC discovered an ongoing drug theft that occurred on his watch, a drug theft that perhaps should have been discovered sooner. Nonetheless, his drug inventory reconciliations uncovered the drug loss and, through his extraordinary efforts, he identified the technician responsible for the drug theft. His reports to the Oregon Board of Pharmacy and the Drug Enforcement Administration (DEA) were timely, and his participation with the Board during the investigation was exemplary. In the end, he was not disciplined, but instead received a letter of appreciation from the Oregon Board of Pharmacy.

The moral of the story

The crucial point not to be missed is that these two pharmacists could have reversed their fortunes (good or bad) by simply reversing their decisions to report to the Board (or not to report). I can assure you that the pharmacist that reported to the Board in the second example above (involving the drug theft), and then experienced the benefit of reporting, will do so again, should the need arise. As for the other pharmacist, the one that chose not to report his technician’s lack of qualifications, and faced the consequences, next time, he too will report to the Board.

Licensure applications and the dreaded “yes questions”

Posted on July 12, 2016 by - Licensure

I recently discussed a few of the many mandatory reporting obligations imposed on physicians and nurses. Today I want to discuss the “dreaded yes questions.”

A dreaded yes question is a question you want to answer “no,” but truthfulness requires that you answer “yes,” hence the question is dreaded.

For example, last week, a physician asked me how to answer a boilerplate question found on many residency applications, and a nurse asked me to help her report a drug and alcohol-related arrest on her renewal application. The question on the residency application asks, “Is there anything in your past history that would limit your ability to be licensed or would limit your ability to receive hospital privileges?” To answer this question, one would need to know what kind of things limit the ability to be licensed, or to gain hospital privileges. Without relevant experience, this question will be difficult to answer. The renewal question for the nurse, involving drug and alcohol-related arrest and her renewal application, was much more straight forward.

License renewal applications and DUII arrests and convictions

I am often asked about the need to report driving under the influence of intoxicants (drunk driving or DUII) arrests and convictions, and less often about the need to report a drunk driving arrest that did not result in a conviction. One recent case illustrates the complexity of the various mandatory reporting requirements. I represented a physician who had been arrested, but was not convicted, for driving under the influence of intoxicants. The physician was licensed in three states. The phrasing of the question on the renewal applications was all important, and it differed state-by-state. One state required a conviction to be reported, but not a mere arrest. Another state required that the arrest be reported, regardless of whether there had been a conviction. The third state was a close-call case.

What to do with close-call questions on license renewal applications

Occasionally, the facts and circumstances, combined with the phrasing of the question on the renewal application, will make the answer too close to call with desired certainty. Is these cases, an experienced healthcare defense attorney can advise you on the risks of not reporting, versus the benefits of reporting to ensure compliance with your mandatory reporting requirements. An experienced healthcare defense attorney can also do something you should not, and that is to make a call to the right person at your licensing Board, in an effort to learn more, but without disclosing your name.

One final caveat about the failure to report

In my experience, those choosing not to report a reportable incident deeply regret that decision once the incident comes to the attention of their licensing Board. The failure to report simply adds another layer to the investigation and exposes you to additional scrutiny because your veracity is now in question.

 

Licensure and mandatory reporting requirements

Posted on July 9, 2016 by - Licensure

As a licensed healthcare provider, you have mandatory reporting requirements

Upon your initial application for licensure, you will be required to answer a series of questions designed to disclose past conduct that may have an adverse impact on your ability to practice your profession. Thereafter, you have a continuing obligation to report specified incidents to your licensing Board, often within 10 days of the occurrence of the incident, or at the time of your license renewal.

The reporting laws are complex and nuanced. Although it is tempting to rationalize why the incident in question need not be reported, this is often a mistake, because the failure to report a reportable incident is itself a violation. Before you report, or decide not to report, you are encouraged to seek experienced legal counsel, to determine first if a report is in fact and law required to be made, and second, how best to make the report to minimize any adverse impact on you or your license.

For physicians, incidents subject to mandatory reporting include, but are not limited to, the following:

  • Criminal convictions or felony arrests;
  • Discipline by other state licensing boards;
  • Loss of privileges, withdrawal, resignation, or limitation of practice; and
  • Medical incompetence, unprofessional or dishonorable conduct, or physical incapacity

To get started, physicians should consult the following reporting statutes and agency rule:

For nurses, incidents subject to mandatory reporting include, but are not limited to, the following:

  • A nurse imposter;
  • Practicing nursing without a license;
  • Arrest or conviction of a crime which relates adversely to the practice of nursing or the ability to safely practice nursing;
  • Dismissal from employment due to unsafe practice or conduct derogatory to the standards of nursing;
  • Client abuse;
  • Conduct derogatory to the standards of nursing as defined;
  • Any violation of a disciplinary sanction imposed on the licensee by the Board of Nursing;
  • Failure of a nurse not licensed in Oregon and hired to meet a temporary staffing shortage to apply for Oregon licensure by the day the nurse is placed on staff;
  • Substance abuse as defined in ORS 678.111(e); and
  • Any other cause for discipline as defined in ORS 678.111.

To get stated, RNs and LPNs should consult the following chapter:

Mandatory reporting can be assisted by a healthcare defense attorney

As you can see, mandatory reporting can present complicated questions. I am frequently asked, “do I have the report this, and if so, how soon?” My initial reaction is usually accurate, but in almost all cases, I will look it up myself. The reason I look it up is that as a healthcare defense attorney, I represent too many professions (physicians, pharmacists, nurses, acupuncturists, etc.), and there are too many reporting requirements to commit it all to memory. Also, in close-call cases, accurate reporting requires some analysis, or you risk under-reporting or over-reporting. Under reporting (i.e., failing to report) exposes you to discipline and other problems with your licensing Board or other important institutions, while over-reporting (i.e., unnecessary reporting) exposes you to a process most licensed professionals prefer to avoid. So again, before you report (or decide not to), you are encouraged to seek competent legal counsel, to determine first if a report is in fact and law required to be made, and second, how best to make the report to minimize any adverse impact on you or your license.

Pharmacist sentenced to 24 years in prison; convicted on “red flag” evidence

Posted on July 1, 2016 by - DEA Prosecutions

Pharmacist dispensed without a “legitimate medical purpose”

A Florida pharmacist was sentenced last week to 24 years in prison on multiple charges that include dispensing oxycodone without a “legitimate medical purpose.”  The evidence against the pharmacist was summarized as follows:  The pharmacist (1) accepted fake prescriptions from (2) customers who came in groups (3) from far distances to get (4) oxycodone.  The prescriptions were written by (5) known suspect prescribers and (6) the patients paid a premium, in cash, for the oxycodone.  In other words, the pharmacist failed to screen for the “red flags” of drug diversion.  Here is a link to the story: http://www.pharmacytimes.com/news/pharmacist-to-serve-24-years-in-prison-for-illegal-oxycodone-dispensing.

The Oregon Board of Pharmacy expects pharmacists to screen for “red flags”

I can assure you from my work as a healthcare defense attorney defending physicians, pharmacists, and prescribing nurses against prescription drug charges by the Drug Enforcement Administration (DEA) that screening for red flags is expected of all prescribing and dispensing practitioners.  Agreeable or not, screening for red flags is also important because whether a pharmacist screened for red flags will be considered by the Oregon Board of Pharmacy and DEA drug diversion investigators whenever there is suspected drug diversion.  The Oregon Board of Pharmacy addresses screening for red flags on its website at: http://www.oregon.gov/Pharmacy/pages/index.aspx), and further links to an YouTube educational video: https://www.youtube.com/watch?v=WY9BDgcdxaM&feature=youtu.be.  If you are an Oregon pharmacist, I encourage you to view this video.