10 Tips for Prescribing Controlled Substances

When prescribing controlled substances for patients in long-term care settings, doctors should use these tips to assure the right drug in the right dose gets to the right patient—and avoid problems with the U.S. Drug Enforcement Administration—suggests a coalition of physician groups.

The coalition consists of physicians, medical directors, and others practicing in skilled nursing and other long-term care settings:

• American Medical Directors Association
• American Medical Association
• American Academy of Family Physicians
• The American Geriatrics Society
• The American Academy of Hospice and Palliative Medicine

The groups say they are concerned because the DEA recently instituted changes in long-standing prescribing practices that have resulted in delayed drug delivery to their patients.

"These changes forced on us have delayed dispensing of controlled substances to long term care facility residents who urgently need them," says Meenakshi Patel, MD, director of geriatrics at Miami Valley Hospital in Dayton, OHI and an AMDA member who helped develop the tip sheet.

Cecil Wilson, MD, president of the AMA, says the organizations want to change the interpretation of the rules, however, "revising laws and regulations can be a long and complex process and physicians must ensure their patients' current health needs are addressed."

"Currently DEA interpretation of the existing regulation means that patients are going without needed pain relief. This simply should not be happening," added Cheryl Phillips, MD, AGS board chair. "We believe it's essential that practitioners have information about complying with the DEA regulations and so we worked collaboratively to develop this tip sheet. The group said the tips should help physicians who prescribe controlled substances for patients in long-term care facilities avoid running afoul of DEA rules and deal with aggressive enforcement actions by DEA agent."