Controlled Drugs

Question 1

Prior to the establishment of the DEA how were drugs of abuse (e.g., opioids) regulated?

Answer 1

Before the 1970s, there were very little, if any, laws on the use and control of many drugs, so many dangerous drugs were sold without any control

Question 2

Substances are placed in their respective DEA schedules based on what three criteria?

Answer 2

Whether they have a currently accepted medical use in treatment in the US
Their relative abuse potential
Likelihood of causing dependence when abused

Question 3

What are the criteria that make drugs schedule I?

Answer 3

Drugs or other substances with high potential for abuse
Have no currently accepted medical use in treatment
Lack of accepted safety for use of the drug or other substance under medical supervision

Question 4

What are the criteria that make drugs schedule II?

Answer 4

Drug or other substances has high potential for abuse
Has currently accepted medical use in treatment in the US with severe restrictions
Abuse of drug or other substances may lead to severe physiological or physical dependence

Question 5

What are the criteria that make drugs schedule III?

Answer 5

Drug or substance has a potential for abuse less than those in schedules I and II
Drug or substance has currently accepted medical use in the US
Abuse of drug or substance may lead to moderate or low physical dependence or high physiological dependence

Question 6

What are the criteria that make drugs schedule IV?

Answer 6

Drug or other substance has a low potential for abuse relative to those in schedule III
Drug or substance has currently accepted medical use in treatment in the US
Abuse of may lead to limited physical dependence or physiological dependence relative to schedule III drug

Question 7

What are the criteria that make drugs schedule V?

Answer 7

Drug or other substance has a low potential for abuse relative to schedule IV drugs
Drug or substance has currently accepted medical use
Abuse of drug or substance may lead to limited physical dependence or physiological dependence relative to schedule IV drugs

Question 8

What is the DEA schedule for alprazolam (Xanax)?

Answer 8

4

Question 9

What is the DEA schedule for anabolic steroids such as boldenone (Equipoise)?

Answer 9

3

Question 10

What is the DEA schedule for buprenorphine?

Answer 10

3

Question 11

What is the DEA schedule for butorphanol?

Answer 11

4

Question 12

What is the DEA schedule for codeine with acetaminophen?

Answer 12

3

Question 13

What is the DEA schedule for diazepam (Valium)?

Answer 13

4

Question 14

What is the DEA schedule for diphenoxylate (Lomotil)?

Answer 14

5

Question 15

What is the DEA schedule for euthanasia solutions with phenobarbital?

Answer 15

2

Question 16

What is the DEA schedule for fentanyl?

Answer 16

2

Question 17

What is the DEA schedule for hydrocodone with acetaminophen or homatropine?

Answer 17

2

Question 18

What is the DEA schedule for hydromorphone?

Answer 18

2

Question 19

What is the DEA schedule for ketamine?

Answer 19

3

Question 20

What is the DEA schedule for marijuana (cannabis)?

Answer 20

1

Question 21

What is the DEA schedule for midazolam (Versed)?

Answer 21

4

Question 22

What is the DEA schedule for morphine?

Answer 22

2

Question 23

What is the DEA schedule for tiletamine/zolazepam (Telazol)?

Answer 23

3

Question 24

What is the DEA schedule for tramadol (Ultram)?

Answer 24

4

Question 25

How do schedule II substances differ from other schedules relative to whether refills are allowed? If not, what is an alternative to provide the drug for patients beyond the initial prescription?

Answer 25

No refills allowed You can write a maximum of 3 one month prescriptions (not to be post-dated) Can enter the correct fate on prescription and then write “Do not fill before mm/dd/yyyy”

Question 26

How do schedule II substances differ from other schedules relative to whether telephoned or faxed prescriptions are acceptable. How does this differ in an emergency and what additional steps must be taken as follow-up? ?

Answer 26

Can be phoned in for an emergency, but a written prescription must follow within 7 days with “Authorization for Emergency dispensing” written on it

Question 27

What entity typically oversees a Prescription Monitoring Program and what is/are the purpose(s) of the program?

Answer 27

The state oversees this program This is aimed at finding patients and doctors that abuse the prescriptions Every time you write a prescription, it must be entered on the website The biggest intent is looking at an individual patient’s prescriptions You can see the date the prescription was filled and what the drug was to see if there is a potential for abuse

Question 28

What is a DEA form 222 used for and where do practitioners obtain them?

Answer 28

A DEA 222 form is used for the procurement of controlled drugs It is used to obtain drug from the distributor

Question 29

What are the requirements for storing controlled drugs in a clinic?

Answer 29

Must be stored in a double locked, secured container Box must be secured to an immovable object License holder should have possession of storage box keys There should be no label on the outside

Question 30

What additional requirement is needed to store carfentanil?

Answer 30

It must be stored in a safe or steel cabinet equivalent to a US government class V security container

Question 31

What logs need to be kept for use and dispensing of controlled drugs within a practice?

Answer 31

Authorized users signature log Unopened container log Opened container log

Question 32

How are expired controlled drugs dealt with?

Answer 32

All expired and unused controlled substances must be turned over to a Reverse Distributor licensed by the DEA If you have expired controlled substances, mark them accordingly and store them in the controlled substances cabinet until they can be relinquished to the reverse distributor You will get a receipt and it should be recorded in your drug logs and should be kept for 2 years with order packing slips/invoices

Question 33

How long are prescriptions for controlled drugs good for and how does this compare to prescriptions for other medications?

Answer 33

``` Controlled drug prescriptions are only good for six months if Schedule 3-5. Schedule 2 is good for 1 month Other prescriptions (refills) are good for one year ```