By reversing the policy prohibiting facsimile transmission of controlled-substance prescriptions, the U.S. Drug Enforcement Administration (DEA) has recognized the increased use of this technology. DEA reversed the previous policy through a combination of amending existing regulations and adding new regulations. The effective date of the new regulations is May 19, 1994, the date of publication in the Federal Register.
In recognition of DEA's expectation that registrants achieve "strict compliance" with its regulations, this column will review applicable state laws. Pharmacists may find that facsimile transmission of controlled-substance prescriptions is still prohibited by state law. They may also find in state law specific requirements on issues such as placing fax numbers on prescriptions and the type of facsimile paper used.
THE DEA REGULATIONS:
As expected, the regulation of facsimile prescriptions for Schedule II controlled substances is substantially more rigorous than that for Schedules III through V. While the regulations permit a pharmacy to receive a facsimile prescription for a Schedule II controlled substance, the original written Rx must be presented and verified against the facsimile prescription prior to dispensing. Additionally, the original prescription must be maintained as previously required. Following is the amended regulation, with new language emphasized in bold print.
"A pharmacist may dispense directly a controlled substance in Schedule II, which is a prescription drug as determined by the Federal Food, Drug, & Cosmetic Act, only pursuant to a written prescription signed by the practitioner.... A prescription for a Schedule II controlled substance may be transmitted by the practitioner's agent to a pharmacy via facsimile equipment, provided the original written, signed prescription is presented to the pharmacist for review prior to the actual dispensing of the controlled substance.... The original prescription shall be maintained...."
However, two exceptions to the requirement that the prescription be presented and verified prior to dispensing are included in the new regulations. The first exception is a prescription for home infusion/intravenous pain therapy.
"A prescription ... written for a Schedule II narcotic substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion may be transmitted by the practitioner or the practitioner's agent to the home infusion pharmacy by facsimile. The facsimile serves as the original written prescription. …