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What is a Forensic Pharmacist?
Peter D. Anderson, Pharm.D., R.Ph., DABFE, FASCP, FACFE
Forensic Pharmacist
Fellow, American College of Forensic Examiners
Diplomate, American Board of Forensic Examiners
Associate Member, Association of Certified Fraud Examiners
P.O. Box 252
Boston MA 02124-0003
617-769-9955
Fax 617-769-9956
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Pharmacy is the science of medications. Forensic means the application of science to legal issues. Despite the common misconception, the word "forensic" does not mean death. Therefore, forensic pharmacy is the application of medication sciences to legal issues. Forensic pharmacists engage in professional work relating to litigation, the regulatory process, or the criminal justice system. Forensic pharmacists may testify in court, engage in regulatory activities, consult for lawyers or law enforcement officials, or perform other medico-legal related work. Forensic pharmacists are involved with administrative hearings and civil and criminal trials. A few pharmacists are full-time forensic pharmacists who work for the government (e.g. Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), state regulatory agencies, etc.) or work as forensic toxicologists. Most forensic pharmacists are part-time consultants while working full-time in community pharmacies or hospitals, conducting research, teaching, or clinical consulting. These part-time forensic pharmacists may consult for lawyers, law enforcement, or serve on drug testing crews for athletic teams.
Issues Concerning Forensic Pharmacists
-prescription forgery
-pharmacologic euthanasia
-screening and testing for drugs of abuse
-professional malpractice
-medication errors
-adverse drug reactions (including drug interactions)
-drug impaired driving
-drug induced violence
-product tampering
-quackery, health care fraud & scientific fraud
-patient confidentiality
-patient consent
-poisoning
-effect of psychoactive medications on competency to stand trial
-pain equilibration (assessing the magnitude of pain in an individual by analyzing analgesic medications)
-appropriate use of chemical restraints
-psychopharmacological effects as a mitigating factor in criminal activity (may result in a reduced sentence)
-risk management
Examples of Activities of Forensic Pharmacists
-analyzing an adverse drug reaction for causation
-instructing police officers to be "drug recognition experts"
-serving as a technical officer on the drug testing crew at the Olympics
-testifying in a murder trial where the defendant claims that the medication caused
him/her to engage in violence
-serving as a Consumer Safety Officer for the Food and Drug Administration
-employment as a Diversion Investigator or Special Agent for the Drug Enforcement Administration
-serving as an agent, investigator, or inspector for a state narcotics agency, state health department, or Board of Pharmacy
-working as a criminalist for a police department
-employment as a security manager for a chain drug store
-providing pharmaceutical services at a prison
-serving as a toxicologist for the medical examiner's office
-appointment as Special Agent for the Federal Bureau of Investigation
-reviewing a workman's compensation claim that has issues relating to pharmacotherapy
-interpretation of drug levels
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Reading List of Forensic Pharmacy Related Topics
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Rynn KO, Graf SE, Paloucek FP. Selective Prescribing in Suicdal Patients: A Little Thought Can Decrease the Risk of Future Morbidity and Mortality. Annals of Pharmacotherapy 1997; 31: 924-5.
Fish RM. Understanding the Information in Medical Records. The Forensic Examiner 1998; 7 (11 &12): 18-22.
Fraser GL, Davis TD. The pharmacist as expert witness. Am J Hosp Pharm 1990; 47: 2082-5.
Dudley AD, Allen T. Chaos to Order: Using Statistical Graphics to Detect Medicaid Fraud. The White Paper 1998; 12 (3): 23-25 40-41.
Ferner RE. Forensic Pharmacology: Medicines, Mayhem, and Malpractice. Oxford University Press, New York 1996.
Brick. Drugs, The Brain and Behavior: The Pharmacology of Abuse and Dependence. Haworth Medical Press, Inc.,Binghamton NY.
Fischer DJ. Suicide: a primer for investigators. The Forensic Examiner 1998; 7 (1 & 2): 35-38.
Lipman JJ. Recent forensic pharmacological developments in drug abuse: the growth and problems of speedballing. The Forensic Examiner 1997; 6 (7 & 8); 9-13.
Pounder DJ. The nightmare of postmortem drug changes. Wecht CH, editor. Legal Medicine 1993 163-191.
Ferguson L. Medical Malpractice. Castle CE, editor. Advanced Civil Forensic Investigations. Lawyers and Judges Publishing Co. Tucson 1997.
McNichol A. Handwriting Analysis: Putting It To Work for You. Contemporary Books. Chicago 1997.
(contains information on how drugs can affect the handwriting of a person)
Kirby-Hall K. Castle GE, editor. Medical Records Investigation. Advanced Forensic Civil Investigations. Lawyers and Judges Publishing Co. Tucson 1997.
O'Donnell J. Adverse Drug Reactions. Legal Medicine 1994. Butterworth Legal Publishers
Boussairi A, Dupeyron JP, et al. Urine benzodiazepines screening of involuntarily drugged and robbed or raped patients. Clinical Toxicology 34 (6); 1997 721-724.
Garriott JC, editor Medicolegal Aspects of Alcohol. Lawyers & Judges Publishing Co Tucson 1996.
Kennedy DL, Graham DJ. The Clinical Impact of Adverse Event Reporting. A MedWatch Continuing Education Article by the Food and Drug Administration October 1996.
Leikin JB, Paloucek FP, editors. Poisoning & Toxicology Handbook 1996 American Pharmaceutical Association, Washington, D.C.
(a reference book)
Holtorf K. Ur-Ine Trouble 1997 Vandalay Press. Scottsdale. AZ
Vaughan D. The Challenger Launch Decision 1996 University of Chicago Press, Chicago
(I know this book seems irrelevant to forensic pharmacy or any aspect of pharmacy. Ms. Vough, in her book introduces a new field the sociology of errors. This can be applied to adverse drug reactions and medication errors.)
Caplan YM. The toxicologist: part pharmacist, part detective. Tomorrow's Pharmacist Nov/Dec 1987 pg 4&5.
(at the time Dr. Caplan was Chief Toxicologist for Office of Chief Medical Examiner in Maryland and President of the American Academy of Forensic Sciences)
Caley CF. The pharmacotherapy of human aggression: a review. Journal of Pharmacy Practice IX (2) 1996 pg 133-143.
Brody R. Witnesses for hire: pharmacists take the stand. American Druggist Nov 1992 pg 44-49.
Kintz P, editor. Drug Testing in Hair. CRC Press. New York 1996.
Moch JW, Borja A, O'Donnell J. Pharmacy Law: Litigating Pharmaceutical Cases. Lawyers & Judges Publishing Company 1995.
Lynn NJ, Kaumm RE. Avoiding liability problems. American Pharmacy NS35 (12):14 Dec 1995 pg 14-24.
Fink JL. Liability and the changing role of pharmacists. American Pharmacy NS34 (12):14 Dec 1995 pg 34-35.
Ambrose PJ. Doping control in sports- a perspective from the 1996 Olympic games. American Journal of Health-System Pharmacy 54(9) May 1997 pg 1053-1057.
Hollinger MA. Rohypnol: The date rape drug. The Forensic Examiner 6 (3&4) Mar/Apr 1997 pg 15-17.
Longhorn Pharmaceutical Association. Streetwise 2: What Every Pharmacist Should Know
O'Donnell JT, Lamb KV, Matthiesen V. Appropriate use of chemical and physical restraints with elderly nursing home residents. Journal of Pharmacy Practice IX (2): 1996 pg 144-146.
LeBlang TR. Malpractice claims must show causation. American Druggist May 1997 pg 56-57.
Gibler B, Hayes G, et al. Forensic psychiatric pharmacy practice at Atascadero state hospital. Journal of Pharmacy Practice IX (4) pg 222-228.
Culmo CT. Pharmacists in state government: the regulatory perspective. Journal of Pharmacy Practice IX (4) pg 276-280.
McCarthy R. Pharmacist heads up DEA task force. American Druggist July 1987 pg 90-93.
Shiffman MA. Off-label use of drugs and devices. The Forensic Examiner 1997; 6 (1&2): 18-19.
Eskridge KD and Guthrie SK. Clinical issues associated with urine testing of substances of abuse. Pharmacotherapy May/June 1997; 17(3): 497-510.
Special Thanks to Tom English and the American Pharmaceutical Association for featuring this web site
"Forensic Pharmacy Has a Cyberspace Trailblazer"
The article is in the Spring 1998 issue of the Pharmacy Student 28 (2): 15 & 25.
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Special Alert:
Do your part as a citizen. Write a letter to the FDA protesting a new policy which interferes with the data collection on adverse drug reactions.
For More Information or To See A Sample Letter Click Here
For information on consultations, seminars, or presentations by Dr. Anderson visit his home page
Peter Anderson
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Forensic Pharmacy Related Links
Pharmacy Associations
The Institute for Safe Medication Practices
American Society of Health System Pharmacists
American College of Clinical Pharmacy
American Pharmaceutical Association
American Society of Consultant Pharmacists
Kappa Psi Pharmaceutical Fraternity International Home Page
Forensic Associations
American College of Forensic Examiners
Forensic Science Society
Forensic Toxicologist Certification Board, Inc.
Society of Forensic Toxicologists
Association of Certified Fraud Examiners
The International Association of Forensic Toxicologists
The American Academy of Experts in Traumatic Stress
Government Agencies
Drug Enforcement Administration
Food and Drug Administration
Office of the Chief Medical Examiner of Massachusetts
Drug Testing
Sensor Technologies FAQ Page
drug testing in sports
Legal issues and cases for drug testing
International Journal of Drug Testing
Professional Liability
A Malpractice Case with Forensic Pharmacist Involvement
Current Trends in Pharmaceutical Liability
Pharmaceutical Care and OBRA 90
Toxicology
Virginia DFS/Forensic Toxicology Papers
MedWeb: Toxicology
Florida Poison Information Center -Jacksonville
Health Care Fraud
QuackWatch Home Page
National Council Against Health Fraud, Inc.
Other
A Murder Case with Forensic Pharmacist Involvement
PSYCHOLOGY of VIOLENT CRIMES
Future Synthetic Drugs of Abuse
Forensic Kiosk
Forensic Science Web Page
Linda's Pharmacy Page
BROWNson's pharmacy links
Planet Link Web Directory: Health and Medical
Grier's Pharmacy Page
Luis G. Pareras, M.D.
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Keep visiting this site!
I will be adding links and expanding the reading list. Please submit any suggestions for links or reading material.
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