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Altered Prescriptions: Charges and Sentencing Guidelines

Altered Prescriptions: Charges and Sentencing Guidelines

Prescription drug abuse has become an epidemic in the United States. According to the Centers for Disease Control and Prevention, overdose deaths involving prescription opioids have quadrupled since 1999 [1]. One of the ways people obtain prescription drugs for misuse is through altered prescriptions. This article will examine what constitutes an altered prescription, typical charges and penalties, and sentencing guidelines.

What is an Altered Prescription?

An altered prescription is when someone changes a legitimate prescription to try to obtain more of a controlled substance than was prescribed [2]. This includes changing the quantity, strength, or number of refills. Some common ways prescriptions are altered include:

• Changing the quantity – For example, changing a prescription for 30 pills to 130 pills
• Changing the strength – Changing a prescription for 5mg oxycodone to 15mg oxycodone
• Adding refills – Adding additional refills not authorized by the prescriber
• Creating a completely fake prescription

Pharmacists are trained to look for signs of alteration and have a corresponding responsibility to ensure prescriptions are legitimate before dispensing controlled substances [3]. However, sometimes altered prescriptions do get filled, contributing to diversion and misuse.

Charges for Altered Prescriptions

There are a range of state and federal charges that can result from altering a prescription. Exact laws and penalties vary by state, but some potential charges include:

• Obtaining a controlled substance by fraud or deception – This may be charged if someone alters a prescription to obtain more pills than prescribed. Penalties vary but may include fines and 1+ years in prison [4].
• Forgery – Forging a prescription carries penalties similar to other types of forgery, which is typically a felony. Prison time may range from 6 months to 10+ years depending on the circumstances [5].
• Identity theft – If someone uses another person’s identity to alter a prescription, they may also face identity theft charges .

In addition to criminal charges, those who alter prescriptions may face professional discipline if they are a healthcare provider. This can include license suspension or revocation [3].

Federal Sentencing Guidelines

If someone is convicted of federal charges related to an altered prescription, sentencing will occur based on the Federal Sentencing Guidelines . The guidelines provide recommended sentencing ranges based on the offense level and criminal history category. Some key factors in determining the offense level for altered prescription charges include:

• The type and quantity of the controlled substance – More dangerous substances like fentanyl or large quantities increase the offense level .
• Role in the offense – Those who alter their own prescriptions may receive lower offense levels than large-scale organizers or leaders .
• Acceptance of responsibility – Pleading guilty and accepting responsibility generally reduces the offense level .

First-time offenders often receive sentences on the lower end of the guideline range. However, the final sentence depends on the judge’s discretion .

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2024-03-21

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State Sentencing Guidelines

If convicted of state charges, sentencing will occur based on that state’s laws and sentencing guidelines. Some states like Florida and Kansas have sentencing guidelines similar to the federal system. Other states give judges more discretion without formal guidelines. Sentencing enhancement laws, like “drug-free zone” laws that increase penalties for drug crimes near schools or parks, may also apply in some states .

Defenses and Mitigating Factors

Those facing charges related to altered prescriptions have several potential defenses and mitigating factors that may reduce or dismiss charges [3]:

• Lack of intent – If someone can show the alterations were unintentional, charges may be dismissed or reduced.
• Duress – Someone who altered a prescription under threat may argue they acted under duress.
• Addiction – Courts may show leniency to those who altered prescriptions due to untreated addiction and order rehabilitation.
• Mental illness – Similar to addiction, mental illness may provide grounds for more lenient sentencing and treatment.

Those facing charges should consult with an experienced criminal defense attorney to explore potential defenses and mitigating factors in their specific case.

Preventing Altered Prescriptions

To help combat prescription misuse, states have implemented prescription drug monitoring programs that allow prescribers and pharmacists to track controlled substance prescriptions. This allows them to identify potential “doctor shopping” or altered prescriptions . Additional strategies include :

• Tighter regulation and monitoring of pain clinics and pill mills
• Wider use of tamper-resistant prescription forms
• Patient education about safely using and storing medications
• Proper medication disposal programs

A multifaceted public health and law enforcement approach is needed to address the complex factors contributing to prescription misuse. While those who alter prescriptions should face appropriate charges, sentencing should also emphasize rehabilitation and addiction treatment when relevant. A balance of consequences and compassion is important in reducing harm at both the individual and societal levels.

References

[1] https://www.cdc.gov/drugoverdose/data/prescribing/overview.html
[2] https://www.deadiversion.usdoj.gov/faq/prescriptions_faq.htm
[3] https://www.deadiversion.usdoj.gov/pubs/manuals/pharm2/pharm_content.htm
[4] https://codes.findlaw.com/tx/health-and-safety-code/health-safety-sect-481-129.html
[5] https://criminal.findlaw.com/criminal-charges/forgery.html
https://www.findlaw.com/criminal/criminal-charges/identity-theft.html
https://www.ussc.gov/guidelines/2018-guidelines-manual
https://www.ussc.gov/guidelines/2018-guidelines-manual/annotated-2018-chapter-2-d
https://www.ussc.gov/guidelines/2018-guidelines-manual/annotated-2018-chapter-3
https://www.ussc.gov/sites/default/files/pdf/research-and-publications/research-projects-and-surveys/miscellaneous/15-year-study/chap4.pdf
https://www.flsenate.gov/Laws/Statutes/2011/921.0022
http://www.sentencing.ks.gov/docs/default-source/default-document-library/sentencing-grid-7-1-20.pdf
https://www.ojp.gov/pdffiles1/nij/247350.pdf
https://www.cdc.gov/drugoverdose/pdmp/states.html
https://www.cms.gov/files/document/drugdiversion022316pdf