Policies associated with prescribing controlled substances

Key Federal Mandates

DEA Registration: Any practitioner who prescribes controlled substances must have a valid DEA registration number, which must appear on the prescription.

Legitimate Medical Purpose: The core rule is that a prescription must be "issued for a legitimate medical purpose by an individual practitioner acting in the usual course of professional practice."

Prescription Requirements: Strict rules govern the content, security, and method of transmission (e.g., electronic prescribing, or EPCS is widely used but requires specific software authentication).

2. 🏛️ State-Level Regulatory Controls

State governments often implement stricter policies to address local needs, particularly related to the opioid crisis.

Prescription Drug Monitoring Programs (PDMPs)

The PDMP is a state-run electronic database that tracks all controlled substance prescriptions dispensed to patients.

Mandatory Use: Most states mandate that prescribers (or their authorized delegates) review the PDMP:

Before issuing an initial prescription for an opioid or other high-risk controlled substance.

Periodically (e.g., every 30 days or 90 days) for patients on continuous therapy.

Goal: To identify and prevent "doctor shopping" (a patient obtaining prescriptions from multiple providers) and to alert providers to potential dangerous drug combinations (e.g., opioids and benzodiazepines).

Sample Answer

Policies associated with prescribing controlled substances are a complex and stringent blend of federal law, state regulations, and professional clinical standards designed to ensure legitimate medical access while preventing abuse, misuse, and diversion.

1. 📜 Federal Law (Controlled Substances Act - CSA)

The foundation of controlled substance policy in the US is the Controlled Substances Act (CSA), enforced by the Drug Enforcement Administration (DEA).

Drug Scheduling

Controlled substances are classified into five Schedules based on their accepted medical use and potential for abuse and dependence: