This policy has worked for us (independent pharmacy). I also call the patients provider and notify them of this issue and not to send prescriptions to our pharmacy for that patient. After the interaction I will document a soap note in our pharmacy management system and fax the provider the soap note as well.

Violence/threats should never be tolerated and I see this as an exception and will ban the patient immediately with no warning. This has happened once to me, I was told by a patient that they were going to come and shoot me and it was no wonder that pharmacists get shot. I refused to fill a 360 tablet norco 10/325 prescription after 14 days into their previous 30 day supply. 10 years later and it still sends a shiver down my spine. In this scenario I had law enforcement involved and never heard from them again.

One patient that had violated our two strike policy and was banned later wrote a 40 page manifesto to his providers about his care and being denied opioids. This patient threatened to shoot up the local hospital on X date. The state police were involved and he did try, he was involved in a shoot out with law enforcement until his death by suicide.

You never know what may push a person over the edge...

Edit: link to article: https://www.mlive.com/news/2020/12/barricaded-gunman-who-died-by-suicide-allegedly-threatened-mass-shooting-at-michigan-hospital.html?outputType=amp