this post was submitted on 09 Jul 2025
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It's still hard for me to believe that this is how pharmaceuticals are secured.
Pharmacist: "Should we dispense this potentially dangerous drug, it's a large quantity?"
Other Pharmacist: "Of course, look at the paper, it has the correct letterhead!"
It's basically like doctors sit around with a stack full of signed blank checks in their offices, and every once in a while someone steals one and makes a huge withdrawal.
It used to be fairly normal, the pharmasists knew the various doctors in the area, and they also know what is a reasonable prescription. If there was any doubt, they'd contact the doctor before dispensing the drugs. I had the 'interesting' experience of having to go to multiple pharmacies, filling part of the total prescription at each, when I tried to fill a largeish morphine prescription for a family member. There'd been some sort of issue at the main supplier, and none of the induvidual pharmacies had much stock left. It was resolved a few dats later fortunately.
Things are a lot more digital now-a-days, which hopefully makes fraud less of an issue, and definitely makes getting medicines easier.
They also used specific medical names for things and scribbled them horribly so they'd be hard to read if you didn't know what you were looking for.
That just seems like a system that is broken by design. If the pharmacists know what a reasonable prescription is, then why bother with the prescription pad at all? Just have the patient ask the pharmacist for whatever it was the doctor recommended.
I suppose what probably happened was that initially the prescription pad was just any random scrap of paper and the doctor wrote down the prescription so that the patient didn't have to remember the exact details. But, then drugs started getting more powerful, and people started abusing them, so what used to simply be a note to help the patient remember became a secured way to authorize the pharmacy to dispense something.
If the system had needed security right from the start, it probably would have been a system where the doctor sent a prescription directly to the pharmacy via a courier, a phone call, a telegram, or something.
You're probably not far off in how the presciption pad evolved, but pharmasists, at least here, have extensive training, and some can actually write prescriptions for certain medications. The system has evolved over a very long time, and security is definitely one of those things that's had to evolve with those changes.
If you start thinking about it, most security and well being norms are just protected by people that believe in the social norm behaving correctly.
Why can't you go behind the counter, enter the kitchen and pee in a McDonald's hamburguer? Not due to some law of nature or magic force field, but because the workers (or security guard) won't let you. Why won't they let you? Due to a systematic belief system on the entity "McDonald's", their job, what's right and wrong, etc.
But they could simply let you. A banker could let you take a few $100 bills. The consequences are almost entirely based on social rules.
Sure, but those are cases where someone with the job and authority to stop someone from breaking the rules and is choosing not to. Prescription pads are just these wildly insecure things where once the pad is stolen (which is relatively easy to do), it seems like the system is designed to just blindly trust them. I know that has changed a bit in the modern world, but even that it was once like that seems weird.
Well, all it takes for you to drive a metric ton of metal at 120 KM/h in public is somebody signing a document claiming you know how to drive.
The only thing preventing you from creating poisonous gases from two cheap supermarket cleaning products is your own desire.
Sure, but if I want to get a driver's license, I can't just walk up to the DMV with a document on the right letterhead and get a license. There's actually a whole process involving a test.
The fact that a pharmacy requires a prescription on a certain kind of pad from a doctor means that that's supposed to be a security measure. It's supposed to stop someone from getting a prescription that they just scribbled on a random piece of paper they found. But, in terms of security, it's just about the weakest form of security I can imagine.
It's basically the equivalent of this:
In theory. In practice, an employee could skip all steps and pretend you concluded the test.
Similarly, a pharmacy expects that you went through a long process with a doctor diagnosing and ordering the medicine.
Yes, they could break the rules.
While following the rules, they could just accept whatever you wrote onto the paper.
See the difference? In one case the security model is reasonable so that it takes an employee cheating / breaking the rules for a bad result. In the other case the security model sucks so an undesirable outcome is possible even if all the security checks are followed.
You can, at least once. But if you wanted to do it regularly, it'd be easiest to just apply for a job there.
There are quite a few special requirements that need to be met for narcotics to be dispensed. Can they be ignored? Yup! Also, there should be some numbers run first and in many states an online check is required as well.