Many of your patients seek treatment by you for some type of pain, whether related to an injury or some other form of illness. As a physician who dispenses medicine at the point of care, controlled substances are certain type of medication you may want to have on hand.
There are special requirements for dispensing controlled substances that are different than dispensing non-controlled substances. Becoming equipped to dispense narcotics or other medications labeled as controlled begins long before the medicine arrives in your office ready for dispensing.
Below are some things you need to do to ensure you are completely equipped to dispense controlled substances.
Know Your State and DEA Requirements
You can dispense schedule II through V class of drugs only and you must follow all Drug Enforcement Administration rules strictly.
Every few years you must register with the Drug Enforcement Administration (DEA) to dispense controlled substances.
You must be licensed by your State’s Board of Pharmacy. Once approved, you must follow their prescribing regulations.
Register for Drug Monitoring
Governments have established programs called the prescription drug monitoring program to help physicians verify whether or not a patient has been listed as an abuser of certain drugs. This monitoring system has been a terrific way to prevent patients from doctor shopping.
Programs today are becoming more advanced to make communications between doctors easier. Some patients visit many different doctors, one for each problem they have. It is dire that you know what these other doctors are prescribing to avoid any overdose or interactions between medications.
Know the Limits of Prescriptions
Refills are prohibited for some scheduled medications under DEA regulations. You must know which ones can automatically refill and which ones require a new office visit. Some medications can have refills but no more than five. It is up to you to check with the DEA to determine the refill requirements for each medicine you prescribe.
You will also need to follow the strict guidelines set forth for expiration dates of controlled substances.
There may be times when your patients need immediate assistance. You can dispense controlled substances in these urgent situations. However, you must be able to prove it was an emergency and that no other form of treatment was available.
Believe it or not, there are conditions under which you can dispense a controlled substance without a prescription. The specific details are outlined in the regulation handbook.
Proper Record Keeping
One of the most important regulations in dispensing drugs is to keep good records. You must document everything about your prescription and dispensing practices include who is receiving the drugs, why they are receiving them and why they are necessary.
You must keep all documentation on prescribed controlled substances for at least two years. Schedule I and II records must be kept separately from all other medications. And Schedule III through V should be kept separately. All must be easy to access and readily available.
Storage of Controlled Substances
Regulations require physicians to store controlled substances in locked cabinets that are sturdy and not easily broken into. They must also meet the temperature and light requirements of the medications, so they do not degrade while in storage.
Some schedules of medicine require being stored in steel storage containers that are comparable to a Government Class V security container.
Security of Controlled Substances
Once medication is in its proper storage container, you must follow additional rules for security of that container. Some of these rules include stored in a safe location within the building; the building itself must be locked and secure; there is control over the public accessing the building; and you have access to police help if needed. Having an alarm system is also a regulation set forth to protect controlled substances.
Hire the Right Personnel
Your staff must meet certain requirements if they are going to be handling controlled substances. In fact, you may want all staff to meet the guidelines established if you are going to prescribe controlled substances.
These guidelines say staff should not have a prior conviction related to controlled substances. Also, if they have had a DEA license denied or revoked, you should avoid hiring them. You do not want to create a working environment with the possibility of trouble.
Proper Disposal of Controlled Substances
The DEA has regulations for how you can dispose of medications. They even have scheduled days where you can return the medication to them.
If you do not return the medicine to the DEA, you must return them to an agency that has been approved by the DEA to accept unused or expired medicines. The DEA has given these facilities the title of Reverse Distributors.
You must be able to properly inventory the medicines in your possession. In-office dispensing software programs are the best way to help you do this. They come equipped with tracking programs that do all the work for you.
These software programs can even alert you to when you are running low on a medication and can automatically send a reorder to the in-office dispensing company.
This is the best way to make sure you can account for every single controlled substance in your office and the ones that have been prescribed.
Labeling and Packaging
Controlled substances must be contained in secure packaging to avoid contamination of the medicine. Packaging much also be child-resistant to avoid any potential accidents. Controlled substances labels must be detailed and list the patient’s name, address; phone number and reason for use.
They must also list potential hazards, warnings and the prescribing doctor’s name.
In-office dispensing programs come equipped to meet the regulations required for labeling and packaging. The software is set up to print all required information on every label.
In addition, in-office dispensing programs use repackaging and prepackaging companies that exceed the recommendations set for by the Government and State.
Connecting with the right in-office dispensing company should be your first step when setting up a controlled substance program.