Controlled Substances Health Science Pharmacy Technician Virginia Parker

Stair Step Schedules for Controlled Substances Schedule I – most addictive, highest potential for abuse. Considered to have no medical purpose. Most restrictive regulation. Schedule II – highly addictive but having medical purpose. Still highly controlled. Schedule III – moderate chance of abuse Schedule IV – moderate chance of abuse, less than III Schedule V – minimal chance of abuse, least controlled.

Labeling The letter C and the correct Roman Numeral to indicate controlled substance level

Securing Controlled Substances II’s must be in a locked area accessible by pharmacist in pharmacy or by licensed personnel in patient care areas. Each removal of substances for dispensing requires a signature and records of dispensing must be kept. Exact counts of II’s are required at all times. Inventory is periodically done to ensure no drugs are missing (once monthly by licensed pharmacist in hospital, bi-annual retail).

Schedule I No medical use – cannot be ordered by local pharmacy. Only contained in research labs Examples: Crack cocaine LSD Ecstasy Heroin

Schedule II Must have written prescription for these drugs – cannot call in to pharmacy unless dire emergency. Script must have patient name, prescriber signature & DEA – cannot be added by pharmacy. Emergency rules are: Must be no way MD can write script and is absolutely necessary to treat pt./no other drug would be adequate. Only amount needed to treat pt. during emergency Written script must be provided within 7 days, DEA is notified if script is not received

Schedule II NO REFILLS !!! – New script every time. Partial fill must be complete within 72 hours. Scripts for II’s must be filed in a manner that makes easily retrievable – usually separate or if with other schedules III-V, the III-V must be marked w/ red letter 1” C.

Schedule II Must be ordered on DEA Form 222 – triplicate form that must be typed or filled out in non-erasable ink, signed by authorized person. One copy stays with ordering entity, one copy to distributor and one copy to DEA. Receiving invoice and form 222 are compared for each order received and then records are kept x 7 years by federal law.

Examples of Schedule II Morphine Demerol - meperidine Oxycontin Cocaine Dilaudid Ritalin Amphetamines

Schedule III, IV May be called in or faxed in to pharmacy. May be refilled up to 5 times in 6 months Ordered on regular invoice. Records kept x 7 years. Examples III: Hydrocodone (Vicodin, Lortab); Marinol, Anabolic Steroids Examples IV: Xanax, Ativan

Schedule V Least controlled – varies depending on state often need only signature on log book, be 18 years of age and show ID to obtain these medications or may be script. May be called “exempt narcotics.” Pharmacist dispenses! Often cough syrups such as promethazine & codeine (Phenergan/Codeine) or Lomotil (diphenoxylate/atropine) for diarrhea with minimal habit forming substances.

What if there is a theft of controlled substances? Report to local law enforcement and DEA Must also be reported to State Board of Pharmacy

Calculating the DEA Number Every prescriber is given a number that identifies them for ordering controlled substances. First letter is A, B, M then second letter is first letter of prescriber’s last name. Then 7 digits To Verify: Add 1+3+5. Add 2+4+6 then multiply x 2. Add together above two sums. Last digit of sum will be 7th digit of DEA number.

Verify the following DEA Numbers AM2468975 for Dr. Samantha Malone BC 1357943 for Dr. Jean Calloway MC1234363 for Dr. Thomas Taylor AB1234563 for Dr. Joseph Brown