Author: Dr. Clarissa G. Noureddine, DVM, MS, MS
A new change in reporting requirements for controlled substances (Schedule II-V) takes effect today. Although the change will not impact our ability at Lawndale to prescribe needed controlled drugs for our patients, it will change how we dispense certain drugs.
Controlled substances can be addictive and they hold the potential for abuse. As we have all seen in the news the ‘opioid epidemic’ is a public health crisis. It has been reported that more than 900 people die every week from opioid-related overdoses (1). Controlled substances have regulatory requirements surrounding all aspects of the drugs – from acquisition all the way through dispensing and disposal. The Controlled Substances Act (CSA) categorizes controlled drugs into one of five schedules. According to the Drug Enforcement Administration (DEA) website the categorization is “…based upon the substance’s medical use, potential for abuse, and safety or dependence liability.”(2) Here is a summary of the different schedule definitions for controlled substances according to the US Department of Justice DEA website (3):
- Schedule I: “Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.” [Examples: Heroin, marijuana, LSD, peyote]
- Schedule II/IIN: “Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence”. [Examples: Morphine, codeine, hydrocodone, hydromorphone, fentanyl, methadone, amphetamine, methamphetamine]
- Schedule III/IIIN: “Substances in this schedule have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.” [Examples: Buprenorphine, Tylenol with codeine (codeine not more than 90 mg per dosage unit), ketamine, anabolic steroids]
- Schedule IV: “Substances in this schedule have a low potential for abuse relative to substances in Schedule III.” [Examples: Tramadol, diazepam, alprazolam, midazolam]
- Schedule V: “Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.” [Examples: Cough preparations containing no more than 200 mg codeine per 100 mL or per 100 grams.]
The North Carolina Controlled Substance Reporting System (CSRS) is a tool used for the collection of information regarding controlled substance prescriptions that have been dispensed, and this information is made available to prescribers and dispensers. According to the North Carolina Department of Health and Human Services (NCDHHS) website, the CSRS “…is used as a clinical tool to improve patient care and safety while avoiding potential drug interactions and identifying individuals that may be in need of referral to substance use disorder services” (4).
So what is the change that will be impacting how we dispense certain drugs? Basically, the reporting requirements have increased for Schedule II-V drugs (and the time allowed for reporting is in a much shorter timeframe). Now, any dispenser of controlled substances (Schedule II-V) must report dispensations greater than a 48-hour supply to the CSRS by the end of the next business day following the date the drug was dispensed. These rigorous reporting requirements are meant to protect human public health and decrease the potential for abuse of controlled drugs. Lawndale Veterinary Hospital recognizes the importance of taking steps to decrease the potential for human drug abuse and dependence. Given the rigorous reporting requirements and the fact that a pharmacy is better equipped to handle this reporting, Lawndale Veterinary Hospital will be writing prescriptions for these controlled substances instead of dispensing them. It will still be easy and convenient to have your prescriptions filled through our online pharmacy partner – Vets First Choice. Here is the link for Vets First Choice, and you can always find the link on our webpage.
If you have any questions regarding your individual pet(s), don’t hesitate to give us a call!
- Felter, C. The U.S. Opioid Epidemic. Council on Foreign Relations. (2019)
- Controlled Substances Act DEA Website
- US Department of Justice Schedules
- North Carolina Department of Health and Human Services (NCDHHS) CSRS