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DEA recognizes LTC nurses as agents of prescribers

The Drug Enforcement Agency (DEA) has changed its policy and now recognizes long-term-care (LTC) nurses as agents of prescribers of Schedule C-III through C-V medications, according to a Federal Register notice released today.

In the Federal Register notice, a DEA policy statement outlines the proper roles of agents — including but not limited to LTC nurses — and a practitioner when there is no employer-employee relationship. In addition, the notice provides guidance about the differences between prescription requirements for Schedule II and Schedule III through V medications, defines what constitutes an agent, summarizes the requirements of a prescription, and covers the rules associated with faxing prescriptions for controlled substances.

The American Society of Consultant Pharmacists (ASCP) has advocated for many years to change DEA policies for patients in LTC facilities who encountered delays in access to prescribed medications that were subject to regulation under the Controlled Substances Act. “We commend the DEA for clearing the way for improved quality care for patients,” said ASCP President-Elect Albert Barber, PharmD, CGP, FASCP, in a press release.

“By allowing the long-term-care nurse to serve as an agent of the prescribing physician, orders for C-III through C-V controlled medications can be communicated to the pharmacy in a more efficient and timely manner. Patients will now be at a much lower risk of encountering delays for medications to alleviate their pain,” Barber continued.

In the July issue of Drug Topics (Regulatory & Legal, “1995 DEA letter surfaces”), Ned Milenkovich, PharmD, JD, pointed out that the DEA had previously allowed LTC nurses to give verbal orders, according to a 1995 letter addressed to the Missouri Department of Health. However, in a Federal Register notice in April 2001, DEA would “not recognize an ‘agency’ relationship between a prescribing practitioner and an LTC nurse.”

Today’s announcement reverses the 2001 DEA decision. The Federal Register notice of October 6, 2010, can be accessed at controlled substances and authorized agents.

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