As a dentist, you may at times need to write prescriptions for medications or need to use drugs that are classified as controlled substances under US law. If you are prescribing or using controlled substances in your dental practice, you should ensure that you are following the stipulated State Laws and DEA regulations on the use of these substances. Failure to follow these laws can lead to arrest and arraignment in court. Though adhering to some of the laws and regulations on the use of controlled substances just requires the use of common sense, there are other laws that you or the employees in your dental practice may not know about.
DEA compliance consultant Nick Oberheiden shares IMPORTANT REGULATIONS set by the DEA that you should remember when handling controlled substances in your dental practice:
1. Maintain a valid license showing that you have the authority to administer, sell or prescribe controlled substances through your practice.
2. You should only write prescriptions for current and valid patients in your clinic. Additionally, any prescriptions you give should only be for dental purposes.
3. When buying drugs to use within your practice (in-office use), you should ensure that the request order clearly states that they are “For In-Office Use”. The drug order form should not be labelled as prescription or have an Rx label. If you fill the drug order form incorrectly, you may run afoul with DEA diversion agents.
4. Once you receive the first order of prescription drugs for sedating your patients, you should ensure that you confirm the exact contents in your order by taking a physical inventory. You should ensure that you carry out a physical count of all the drugs at your disposal at least once every two years.
5. You should ensure that you keep an accurate record of every dose (every tablet or drop) that you either add or subtract from your existing inventory. Ensure that you record your inventory in a ledger or record that cannot easily be manipulated. This means avoiding certain ways of keeping records that can be easily changed such as spreadsheets.
6. You should ensure that controlled substances are kept locked safely away. Only specific employees should have access to the area where the drugs are stored.
7. You should also ensure that any visiting dental practitioner who issues prescriptions (Including electronic scripts) or handles the controlled substances under your care have your written authorization to do so. If any other party handles the drugs at your disposal, they will be acting as your designated agent. Note that for any individual to act as your designated agent, they must have your express written permission to act on your behalf.
8. Before administering controlled substances on a patient or writing a prescription, ensure that you carefully check the drug history of the patient.
9. You should also ensure that employees who communicate your patient’s prescriptions to pharmacies are your designated agents. This means that you should provide these employees with written authorization to act as your representative when dealing with pharmacies and drug stores.
10. You should always report any significant loss of controlled substances from your pharmacy to the DEA.
11. Whenever there are any waste drugs in your practice, you should ensure that they are rendered unusable. This means maintaining quality waste disposal mechanisms. Ensure that you keep an accurate record of any waste drugs from your practice. Before dumping the waste, ascertain the contents of the waste in the presence of a witness who should then collaborate that the contents of the waste are accurate by signing the waste inventory sheet.
12. Ensure that you keep a comprehensive record of all the drugs that you handle for at least 2 years. Some of the records to maintain include purchase receipts, inventories, administration logs, fully filled 222 forms as well as designated agent screening and authorization forms.