Reading 13

Question 1

When can we used a faxed C-II prescription as an original?

Answer 1

• injectable narcotic for immediate administration
• resident of a LTCF
• narcotic for a patient enrolled in a hospice care program

Question 2

True or false: you can ALWAYS use the fax for a CIII-V as an original.

Answer 2

true

Question 3

Can C-IIs be transferred from one pharmacy to another via phone?

Answer 3

no; federal law only permits III-V to be transferred (only one time unless pharmacies share a real-time online database)

Question 4

Are you allowed to transfer a controlled substance before it has been filled?

Answer 4

no; patient would need to get a new prescription if they wanted to do that

Question 5

What must be included when recording a controlled transfer?

Answer 5

• issue date of original prescription (not needed if electronic transfer)
• original number of refills authorized on original prescription (not needed if electronic transfer)
• original dispense date
• number of valid refills left and date(s) and locations of previous refill(s)
• pharmacy name, address, DEA number, prescription number from which the prescription was transferred
• name of transferring pharmacist
• pharmacy name, address, DEA number, and prescription number from which the prescription was originally filled

Question 6

Define “detoxification”.

Answer 6

dispensing a narcotic drug in decreasing doses to bring a patient to a drug-free state

Question 7

Define “maintenance” in regards to controlled substance abuse.

Answer 7

maintaining the patient on a stable dose of a narcotic drug and is treatment of greater than 180 days

Question 8

What are narcotic drugs based on?

Answer 8

opium, opiates, or their derivatives; poppy straw and concentrate; coca leaves, cocaine, ecgonine, and their derivatives; and any compound, mixture, or preparation containing any quantity of a product already listed

Question 9

Generally, can detoxification or maintenance treatments be issued for all controlled substances?

Answer 9

no; only CIII-V narcotics approved by the FDA specifically for these treatments

Question 10

Can NTP/OTP registrants prescribe narcotics for maintenance or detox?

Answer 10

no; can only administer or dispense directly

Question 11

How are practitioners allowed to administer a maintenance or detox narcotic from their office?

Answer 11

“narcotic drugs to an addict for a maximum of three days for the purpose of relieving acute withdrawal symptoms while arrangements are being made for referral to treatment”

Question 12

What is the caveat for administering maintenance or detoxification narcotics to a patient in the hospital?

Answer 12

the patient must be hospitalized due to an issue outside of addiction

Question 13

What is special about office-based treatment programs (OBTPs)?

Answer 13

practitioners can “administer or dispense, including prescribe, any schedule III, IV, or V narcotic drug approved by the FDA specifically for use in maintenance and detoxification treatment”

Question 14

What act basically created OBTPs?

Answer 14

Drug Addiction and Treatment Act of 2000 (DATA 2000)

Question 15

What do the DEA numbers for detox/maintenance OBTPs start with?

Answer 15

X (MUST be added to any prescriptions for this purpose)

Question 16

True or false: practitioners without their own X DEA number can practice under another’s via a collaborative practice arrangement.

Answer 16

false

Question 17

What are the only two drugs approved for maintenance and detox under the FDCA or section 351 of the Public Health Service Act?

Answer 17

buprenorphine and buprenorphine/naloxone combinations

Question 18

Those treating these patients generally can treat __ patients in the first year of becoming a DATA waived practitioner

Answer 18

30; if board-certified, can treat up to 100 patients right away

Question 19

The 275 patient maximum for maintenance/detox prescribers went into effect with what legislation?

Answer 19

CARA

Question 20

True or false: a pharmacist can legally deliver Suboxone tablets to a physician’s office for administration.

Answer 20

false; must be administered by injection or implant no later than 14 days after receiving the product from the pharmacy

Question 21

What DEA form must be sent to reverse distributors to destroy a controlled substance?

Answer 21

DEA Form 41

Question 22

What DEA form are reverse distributors required to send to pharmacies if they are destroying a CI or CII?

Answer 22

222

Question 23

Distributions by a retail pharmacy cannot exceed 5 percent of all controlled substances distributed and dispensed by the pharmacy. If it does, the pharmacy must obtain a distributor registration. However, distributions made to an automated dispensing system in a ________ does not count towards the 5 percent.

Answer 23

Long Term Care Facility (LTCF)

Question 24

What are the 4 ways to dispose of controlled substances?

Answer 24

1. on-site destruction (“wasting”)
2. reverse distributor
3. send back to distributor/warehouse/manufacturer (only in the case of recall or return)
4. request DEA assistance

Question 25

If there is a theft or significant loss of controlled substances, what two entities should be notified?

Answer 25

DEA and BoP

Question 26

What should be considered to determine whether or not a controlled substance loss is truly *significant*?

Answer 26

* The actual **quantity** of controlled substances lost in relation to the type of business. * The **specific substances** lost. * Whether the loss can be associated with access to controlled substances by **specific individuals** or whether the loss can be attributed to **unique activities** that may take place involving controlled substances. * A **pattern of losses over a specific time period**, whether the losses appear to be random, and the results of efforts taken to resolve the losses. * Whether the specific controlled substances are **likely candidates for diversion**. * **Local trends** and other indicators of the diversion potential of the missing controlled substance

Question 27

What DEA Form is filed out to report controlled substance theft or significant loss?

Answer 27

106