Physicians and other prescribers now have better guidance on how to navigate new Drug Enforcement Agency (DEA) regulations related to prescribing controlled substances in long-term care. The American Geriatric Society, in collaboration with the American Medical Directors Association and the American Medical Association, has developed a “Tip Sheet for Prescribing Controlled Substances in Long Term Care.” The guide was developed to help practitioners comply with current law and to provide for more expeditious dispensing of controlled substances to long-term care patients.
Federal regulations require prescriptions for Schedule II controlled substances to be made in writing and signed by a DEA-registered practitioner. If the prescribing physician determines that the situation is an emergency, a pharmacist may dispense a Schedule II drug after receiving oral authorization directly from the physician. If the physician calls in an emergency prescription, the prescribing physician must still follow up with a written prescription within seven days of the verbal order.
The tip sheet explains that under current law a prescriber must write the prescription himself. Further, it suggests ways in which prescribers can expedite the filling of controlled substance prescriptions. These include always carrying a prescription pad that meets state requirements, knowing legal requirements for a controlled substance prescription, writing a prescription at a facility that has a fax machine and faxing the prescription to the provider pharmacy, purchasing a home fax for after hours or weekend calls, and—in emergency situations when faxing is not an option and a prescription pad is unavailable—calling the pharmacist directly with the order in addition to giving the information to the nurse.
The guide also urges practitioners to reach out to local hospital staff so that patients who require controlled substances are discharged with a hard copy prescription for a few days’ worth of their needed medication. The prescription should specify the drug, but also say “or formulary equivalent.”
The recommendations contained in the tip sheet should alleviate some of the problems associated with dispensing controlled substances given the DEA stringent regulations. It is recommended that long-term care providers make a copy of the tip sheet available to their practitioners for review. Click here for a copy of the tip sheet.