Maybe I can help a little. As an invasive/ non-invasive pain physician, I'm kindof familiar with the rules and regs of narcotic prescriptions. Importantly you can not apply the same standards and laws to all situations in all locations.
Eg. whenever federal, state, or local laws are different for one geographic location, the more strenuous law is the one the one that is followed. It trumps other laws so to speak. State law can sometimes supersede federal.
There are also various laws that treat DEA class III meds and class II meds differently. Some allow faxing some don't, some require real physical signiture and some don't. Some allow faxing of class II meds if followed by original physical script within a certain time frame.
As far as mail order meds, it depends on where you are sending it from and where your sending it to. Each location may be governed by a different law.
My personal habits are: Never allow refills of any sort on class IIs, must physically see a patient to write a class II RX, urine drug test everyone randomly, get urine drug tests when things appear odd. If I want a urine test and they can't pee,then no Rx until they come back and give me a urine sample.
Please everyone remember, our DEA registration doesn't just allow us to write for controlled meds,it also REQUIRES us to suspect, investigate, and take measures to avoid narcotic diversion. Paper work rules and headaches are a small price to pay to keep a 9 yr old from ODing on a prescribed narcotic.
Check the fed/state/ local laws were you practice.
Nate
