PrescriptionPadAs emergency physicians, we are experts in pain control. We frequently write opiate prescriptions for patients being discharged home. Unfortunately, an occasional patient tries to forge my prescription. At times, I get a call from pharmacy for prescriptions that were suspiciously written. For instance several years ago, I had someone try to forge 100 tablets of “Mophine”.

Trick of the Trade

When writing opiate prescriptions, you might consider developing a system. Some people dispense these medications in increments of 10’s. Some choose increments of 10, but starting with 8 (8, 18, 28, or 38 tablets). In fact, I have heard of one attending use only prime numbers!

I used to write “Do not drive while taking medications” on the prescriptions, and so when prescriptions didn’t have this additional recommendation, I knew that I did not write them. I’m unfortunately not as consistent doing this and so now it’s not a helpful screening approach for me.

What system have you used or heard of?


Michelle Lin, MD
ALiEM Editor-in-Chief
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg San Francisco General. Founder of ALiEM @aliemteam #PostitPearls
Michelle Lin, MD