Recognizing Nontherapeutic Dispensing or ("Pill Mill" Activity)


NABP's Red Flag Video - This video discusses some of the red flags associated with nontherapeutic dispensing in pharmacies, and highlights the warning signs pharmacists should look for when deciding whether or not to dispense.

TSBP's Red Flag Checklist For Pharmacies - This PDF list gives a detailed overview of the most common warning signs that consumers, prescribers, and/or pharmacies may be involved in nontherapeutic dispensing.

Fraudulent Prescription Forms

Rule 291.29 - This rule explains that a pharmacist’s professional responsibility includes looking  for certain patterns (i.e., “red flags”) that are relevant to preventing the non-therapeutic dispensing of controlled substances.

Under section 481.0761(j) of the Texas Controlled Substances Act, if a pharmacist suspects that a patient is attempting to obtain controlled substances for non-therapeutic purposes (i.e., the pharmacist cannot resolve the “red flags” presented), the pharmacist must access Texas Prescription Monitoring Program for information on the patient.

TSBP’s Pill Mill Video Series
The following videos examine the “red flags” associated with nontherapeutic prescriptions – specific warning signs that mark a prescription as potentially nontherapeutic. A pharmacist has a corresponding responsibility to dispense only prescriptions that are issued for a legitimate medical purpose.  The Board provides this video series to assist pharmacists in recognizing and taking appropriate action in light of nontherapeutic prescription flags. 

Abuse and Misuse of Prescription Drugs