II. Types: Class I (Schedule I Controlled Substance)
- High abuse potential
- No accepted medical use
- Examples
III. Types: Class II (Schedule II Controlled Substance)
- High abuse potential
- Severe dependence liability
- Examples
IV. Types: Class III (Schedule III Controlled Substance)
- Moderate dependence liability
- Examples
- Tylenol with Codeine (Tylenol #3)
- Hydrocodone (e.g. Vicodin) - will be moved to Class II in 2014
V. Types: Class IV (Schedule IV Controlled Substance)
- Limited dependence liability
- Examples
- Benzodiazepines (e.g. Xanax, Ativan, Valium, Klonopin)
- Propoxyphene (e.g. Darvocet)
- Phentermine
VI. Types: Class V (Schedule V Controlled Substance)
- Limited abuse potential
- Examples
VII. Protocol: Schedule II Narcotic Prescriptions (DEA regulations, States may have additional rules)
-
Electronic Prescription of controlled substances
- Will be required in Medicare Part D by 2021, and many states are also implementing requirements
- E-Presciptions reduce the risk of controlled substance diversion and abuse
- Requires 2 factor authentication
- Pharmacy must receive an original signed prescription before dispensing
- Prescription may not be changed by pharmacist on contacting provider for clarification
- Exceptions in which alternative to original prescription is acceptable
- Fax is sufficient in long term care patients, Hospice patients, or ParenteralNarcotics
- Limited quantity emergency prescriptions may be phoned to pharmacy
- Require that pharmacy receive original signed prescription within 7 days
- Prescription may cover up to 90 day supply
- Total of 90 day supply may be split over multiple prescriptions (e.g. 1 month each)
- Each prescription must have the date today (not post-dated) and an earliest fill date
- Partial filling of prescription is allowed for terminally ill and long-term care patients
- References
- (2020) Prescr Lett 27(1): 4
- (2008) Prescr Letter 15(1):1
- FDA Rule: Issuance of Multiple Prescriptions for Schedule II Controlled Substances