What Is Prescription Drug Fraud?

What is prescription drug fraud?


Prescription drug fraud is the illegal procurement of a controlled substance use for medication. This form of fraud can occur in hospitals, pharmacies, and other medical facilities where such drugs are prescribed, stored, and/or legally distributed.

Prescription drug fraud can encompass a wide variety of specific acts, including (but not limited to) the theft of prescription drug pads; package theft (for diverting the shipment of a controlled substance for personal use or gain); stealing prescription drugs directly from another person, such as family, friends, colleagues, or even strangers; or clinical theft, where a healthcare worker (doctor, nurse, or other staff member) takes a controlled substance not prescribed to them either to sell or for personal use.

Why is prescription drug fraud such a serious crime?


The seriousness of prescription drug fraud is notable because it is indicative of the scale of the opioid crisis in the United States. It is reported that 128 people die every day from an opioid overdose.

Between 1999 and 2018, deaths associated with drug overdoses grew four times over (nearly 450,000 people!) and approximately 70% of 2018’s deaths could be connected to an opioid.

Experts from the Centers for Disease Control suggest that this increase in use, addiction and death from opioids in the United States can be associated with what is now considered a culture that over-prescribed opioids, beginning in the late 90s, which led to an increase in the number of heroin-related deaths in the early 2010s, and finally, the prevalence of fentanyl use, abuse, and death, starting around 2013.

The effects of the abuse of prescription medication in the United States are a strain on families, first responders, hospitals and health systems, and state and federal courts. There is not only an emotional toll, but also a significant financial toll that can be attributed to the opioid crisis.

Remember: It is illegal to be in the possession of a controlled substance that is not prescribed to you.

Even possessing a small amount of a controlled substance can lead to criminal charges, potentially hefty fines, and even prison. Law enforcement and prosecutors are taking extra measures in order to combat the effects of the opioid crisis.

According to BlueCross BlueShield, the greatest contributor to prescription drug fraud is related to actions associated with drug-seeking behavior, with other forms of fraud including ID theft, forged prescriptions, and seeking drug therapy on false pretenses.

Speaking of insurance providers, it should be noted that these organizations, like law enforcement and prosecutors, are also taking extra measures in order to combat the opioid crisis.

Plan officials take note of unusual activities, both of patients and providers, such as an inordinately high volume of prescriptions being filled or administered. This can lead to pharmacy audits and other actions that could very well lead to criminal charges, fine, jail time, and even the loss of licensing for medical professionals participating in such fraud.

Acts associated with prescription drug fraud can include:


Doctor shopping or visiting multiple pharmacies, which is the act of procuring controlled substances either from multiple providers or the act of seeking out less ethical providers


Mail theft (in an attempt to divert prescription drugs for personal or financial gain)


Stealing directly from manufacturers


Stealing from pharmaceutical sales


Clinical theft of drugs


Theft of prescription pads


Illegally procuring drugs from pharmacy staff

Criminal charges associated with these acts can include:


Fraud — the falsification of information (including hospital or pharmacy records) can bring with it hefty fines and potentially multi-year prison sentences


Possession and distribution — punishment varies, depending on the amount of the controlled substance and the prosecution’s ability to prove intent to distribute, but even possessing small amounts of an illegally obtained licit drug can bring with it harsh punishments, including fines and prison


Theft — Theft, including that of items like prescription drug pads or other forms, can, depending on the level of crime you’re being charged with, can lead to fines and as many as five years in prison

I’ve been accused of prescription drug fraud. What should I do?


If you or someone you care about has been accused of prescription drug fraud, we recommend you seek legal counsel immediately.

Choosing the right attorney for the charges being brought against you is crucial in protecting your freedom.

When looking for the right legal representation, ask yourself:


Do they have experience in this sphere of law?


Do they have a record of success in protecting client freedoms?


Are there online reviews reflective of this success and the value of their services?


Is their billing structure clear and concise?


Do they treat their team with respect?


Even if they’re a large enough firm to treat many clients, do they make you feel like you’re their top priority?

The Law Offices of Robert J. DeGroot has the experience and proven record of protecting citizens accused of crimes related to prescription drug fraud.

Want to support your counsel in creating the best outcome for your case?

We recommend you always follow these steps:


Do not speak to anyone without consulting your attorney first — Remember, anything you say can and will be used against you!


Avoid social media (and any form of media!) — Again, this information can be used against you or put a spotlight on your case that might make more desirable outcomes harder to achieve or more difficult to find unbiased jurors.


Be totally honest and open with your attorney
— Working with a criminal defense attorney requires you to be open, honest, and transparent. The last thing in the world we want to be during this process is surprised. Our job isn’t to judge, it’s to represent, counsel, and protect. The more open you are, the better we can be at our job!


Provide all files, documents, or other tangible information to your lawyer — The prosecutor and their team will be gathering evidence, testimony, and other information in order to establish a narrative that proves guilt beyond a reasonable doubt. It’s our role as criminal defense attorneys to create a strong counter-narrative that sews doubt — and protects your innocence.


Heed their advice — Enduring a criminal prosecution is a stressful experience and you might be tempted to say or do something that, while seems appropriate for the moment, could actually jeopardize your attorney’s ability to defend you in the way they feel is best for your situation. When you’ve been charged with a crime, the rules change. Your behavior should, too. And a great criminal defense attorney will help show you how.

Have you or a loved one been charged with a crime
related to prescription drug fraud?


Call the Law Offices of Robert J. DeGroot today
for your confidential consultation!