Prescription pads are among the most sensitive items physicians have access to. In the wrong hands, prescription pads facilitate access to substances that would be illicit in another context: often strong opiates or other narcotics. Prescription pads fetch a high price on the black market and contribute to drug abuse.

Keeping prescription pads locked away until they are needed will help ensure that they aren't stolen, but security is never perfect, so prescribers should take every precaution they can in order to make sure their pads stay in the right hands.

Doctors trying to keep their pads secure and to comply with state and federal regulations need to know a few different methods to keep prescription pads from being used fraudulently. 

State and federal regulations
Federal guidelines state that prescription pads should have at least three separate industry-recognized security features as set forth in the Medicaid Tamper Resistant Prescription Law. At the very least, prescriptions should have features that are designed to prevent:

  • Unauthorized copying of prescriptions – blank or filled, such as a hidden "VOID" mark that only appears when the document is copied or scanned
  • Erasing or modifying the information written on a pad, such as paper that reacts to chemical attempts to alter the prescription
  • Counterfeiting, such as fluorescent fibers in the paper that glow under UV light yet are difficult to print upon

In addition to this, many states such as California and Florida have their own specific guidelines to regulate prescribers in those states, ranging in direction and depth. Georgia only requires that prescriptions be embossed with the Georgia State Board of Pharmacy logo. However, Delaware mandates that prescription paper is perforated in a precise pattern and printed with a particular watermark, and only by printers licensed to do business in the state.

Depending on the jurisdiction, prescribers have to follow a wide range of different regulations, and as such, it's important that printers are able to understand and follow all of those rules to ensure compliance with state and federal law.

Above and beyond
Following legal guidelines for prescription pad document security is the first step in ensuring that documents are tamper proof, but there are additional security features that can go into a document to go the extra mile in making sure that pads aren't vulnerable to forgery and tampering.

Here are some other security features that managed print services can implement to increase document security:

  • Microprinting: printing words or a series of dots at an incredibly small point size. The characters appear as a solid line to the naked eye, but can be seen when magnified. It's very difficult to reproduce this effect, so forged prescriptions would only be able to show the solid line
  • Heat-sensitive marker: printing a symbol with thermochromic ink, which changes color with the temperature and makes it easy to detect the genuine article by just touching or rubbing the symbol
  • Watermarks: the gold standard for document security, holding the prescription at an angle reveals an additional image. The printing process used to create watermarks is hard to emulate.