Prescription Writing/ Regulations

Prescription Writing

• A sample prescription example includes patient name, address, date, drug name, strength, quantity, and sig dosing directions.
• Common abbreviations in prescription writing include disp=daily, stat=immediately, qd=every day, po=by mouth, bid=twice daily, tid=thrice daily, qid=4 times a day, ac=before meals, pc=after meals, and sig=directions for use.
• Common conversions in prescription writing include 1 gram = 15.4 grains, 1 gr = 60 mg, and 1 fluid ounce = 30 ml.

Prescription Error Responsibility

• Licensed prescribers, pharmacists, staff administering medication, and employing institutions can be held responsible for prescription errors.

Controlled Substances

• The DEA's primary focus is preventing diversion of controlled substances to the illicit market.
• Schedule I controlled substances have high abuse potential and no approved medical use.
• Schedule II controlled substances have accepted medical use, high abuse potential, and severe dependence.
• Examples of Schedule II drugs include oxycodone, hydrocodone, morphine, codeine, and cocaine.
• Schedule III controlled substances have lower abuse potential and less dependence compared to Schedule II.
• Examples of Schedule III drugs include codeine with Tylenol #3.
• Schedule IV controlled substances have lower abuse potential and less dependence compared to Schedule III.
• Examples of Schedule IV drugs include benzodiazepines like alprazolam and triazolam.
• Schedule V controlled substances have lower abuse potential and less dependence compared to Schedule IV.
• Examples of Schedule V drugs include cough medicines with codeine.

Prescription Writing for Controlled Substances

• Schedule II prescriptions require written, electronic, or emergency authorization, and have no refills or a 90-day supply for chronic pain.
• Schedule III and IV prescriptions can be written, faxed, or oral, and have a 5-refill limit within 6 months.
• Schedule V prescriptions can be dispensed or refilled within 1 year from the date of issuance.

Prescribing Controlled Substances Risk Management

• Be aware of drug-seeking behavior, such as late-day or near-weekend appointments, claims of allergy or lack of efficacy, and requests for specific drugs or higher doses.
• Be cautious when prescribing for oneself, family, or friends, and maintain accurate records.
• Patients with a known history of dependence or addiction require special care.

National Drug Overdose Trends

• National trends show changing patterns of drug overdose, with fentanyl being a major concern.
• There is intense public and government interest in monitoring programs, drug schedule changes, and new rules and regulations.

National Response to Opioid Crisis

• Professional organizations, state boards, the ADA, and dental education institutions are involved in the response.
• State legislatures and federal agencies like the FDA and insurance companies are also responding.
• Prescription Management Programs aim to detect diversion, abuse, and misuse of controlled substances.

Minnesota Prescription Monitoring Program

• The program monitors Schedule II-V drugs, protects patient health information, and allows queries and access to data.
• Options for addressing misuse include no obligation, refusing to prescribe, or offering support resources.

Opioid Misuse, Abuse, and Overdose in Dentistry

• Recognize the importance of governing state and federal agencies, writing valid prescriptions, and understanding Controlled Substance Schedules.
• Be aware of national and state narcotic abuse trends and initiatives addressing the opioid crisis.