1. Controlled Substances
Health Science
Pharmacy Technician
Virginia Parker

2. 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.

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

4. 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).

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

6. 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

7. 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.

8. 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.

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

10. 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

11. 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.

12. 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

13. 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
Add then multiply x 2.
Add together above two sums.
Last digit of sum will be 7th digit of DEA number.

14. Verify the following DEA Numbers
AM for Dr. Samantha Malone
BC for Dr. Jean Calloway
MC for Dr. Thomas Taylor
AB for Dr. Joseph Brown