There are times that dentists need to write legitimate prescriptions for controlled substances. Some controlled substances may also need to be administered in the dental office. If you are prescribing or administering these medications, you must follow DEA and applicable state laws. Some of these laws are just common sense, but others may not be known to dentists or their employees. Unfortunately, ignorance is no excuse. Compliance with state and federal rules and laws is a must.
Here are a few regulations:
- Maintain proper registration (authority) to administer, dispense, or prescribe controlled substances.
- Only write prescriptions that are patient of record and then only for legitimate dental purposes.
- Controlled prescription drugs purchased for ‘in-office’ use should be properly ordered and labeled “for in-office use” and should not be ordered as a prescription, or contain a Rx number, unless you want to meet a DEA diversion agent.
- When you first receive your supply of controlled prescription drugs for sedation purposes you are required to record a physical inventory count of your drugs. Repeat at least every two years.
- Keep an accurate drug administration log to track every dose (every drop, every tablet) that is added or subtracted from your inventory. Keep it up to date. Avoid using spreadsheets or other records that can be easily manipulated.
- Keep all controlled prescription drugs locked up and allow only specific employees to have access.
- Ensure any practitioners or employees who physically handle or administer drugs from your drug inventory and those who prepare prescriptions (including e-scripts) have your written authorization to do so. Those persons are called designated agents. Designated agents are required to have your express, written authorization.
- Access patient drug histories prior to dispensing or prescribing controlled prescription drugs.
- Ensure any employees who communicate your prescriptions with pharmacies are designated agents as described above.
- Significant loss of drugs from the office supply must be reported to the DEA
- Waste drugs must be rendered unusable, so make sure you have a suitable means for waste disposal. Maintain records of your waste and always waste in the presence of a witness (both people should sign off on the waste).
- Maintain all drug records including administration logs, inventories, purchase receipts, completed 222 forms, designated agent screening and authorization form, and such for at least 2 years.
When dentists get in trouble for disuse/misuse of controlled substances they often get in trouble with the DEA and their state dental board, which tends to make these situations extra stressful.
There is no need to be afraid of using controlled prescription drugs legitimately but do take time to learn the rules and regulations and periodically evaluation your practice for compliance with controlled substance rules and regulations. Implement corrective actions as necessary. You don’t have to ‘do’ compliance alone. Build your team of experts to advise and support you, so you can protect your practice, and spend more time doing what you love.
What’s interesting is I love supporting dentists with their compliance efforts and I’m good at it. I’ll bet you love doing dentistry and that you’re good at it. Would it make sense for use to partner up?
Let’s schedule time to talk through what this might look like. Click on the link below and we’ll find time to make it happen.
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Be well. Do good. Be blessed.
About the Author
A former Law Enforcement Officer/ Dental Board investigator, Duane Tinker is the CEO of Dental Compliance Specialists. Mr. Tinker provides compliance consulting, auditing and training services for dentists and Dental Service Organizations on compliance risks including OSHA, HIPAA, Dental Board rules/ regulations, state radiology rules, DEA and state drug regulations, and Medicaid. Mr. Tinker is a frequent speaker for dental societies and study clubs. He also hosts a podcast called Talking with the Toothcop. Mr. Tinker can be reached by calling (817) 755-0035 or through his company’s website DentalCompliance.com.