Yes, we should have more guidance on what to do after we suspect there is a problem. It appears to me that we have the option of declining (avoiding the word "refused" ) to fill the prescription, but we should handle it delicately and not in front of the other customers waiting in line. We should have some documentation to be ready for the inevitable complaint, including what we said to the customer, why we declined the prescription and how we approached the customer. One recent story: A prescription for 360 Hydrocodone/APAP 10/325 was dropped off at the front counter, typed by the technician and given to me to fill. After looking at the directions and Rx history, it occcured to me that this patient was taking 12 of these a day, every day, and was also coming in a little early on top of that. I went to Fact & Comparisons and printed out the dosage information, which showed the maximum dosage of 6 per day. I discreetly asked to speak with the customer and she came to a side window. I showed her the dosage information and asked if she was really taking 12 a day, which was twice the maximum dosage according to my accredited reference. She asked for the prescription back, which I gave back to her. I FAX'd the doctor about this incident and asked for diagnosis codes for this patient and a valid reason why she was taking twice the maximum dosage. I never heard back from that doctor. Perhaps I should file a complaint on the doctor? Another quick story. When I was a young pharmacist, I had a chance to get involved with a community project to help with the problem of drug addiction called the "Chemical People Project". I met a middle aged lady who had back pain and had gotten addicted to pain meds. She confessed to getting jobs anywhere she could to get access to pain meds: hospitals, Dr.'s offices, etc. She still has back pain but is no longer abusing pain meds. She speaks to women's groups to help prevent other women from falling into the pain abuse trap. One thing resonated with me: She went back to her Pharmacist and said " Joe, why didn't you say something?" Of course, we all know why he didn't say anything. It's risky: the patient will become angry and file a complaint and we are often considered guilty of mistreating a customer unless we can prove otherwise. In these cases, you have the need to have proper documentation: including a lack of willingness from the physician to give you a diagnosis code(s), your demeanor while speaking with the customer (it might be good idea to have a technician with you to verify how you treated the customer), a history of abuse (different doctors and pharmacies), excessive dosage, excessive early fills, filled on cash, specified manufacturer as well as other things mentioned in the film. It would be good to have a file on this patient handy, so that when the store director or division manager approaches you about a complaint, you will be ready. Remember when speaking to upper management to be professional and not be emotional. If you are angry to them, they are likely to believe that you were angry to the customer. Approach the manager as a friend and tell him or her that you are glad that they are interested in this patient and then kindly show them your documentation. A reasonable person would agree with your decision. An unreasonable supervisor who demands that you fill this prescription in spite of your concerns and documentation deserves a complaint be filed on them. You have that right and obligation to pursue a complaint on the supervisor, and as a whistle blower are protected by law from retaliation by the employer.