Home Forums Discussions General Discussion e-scribing controlled substances

Is anyone able to e-prescribe controlled substances yet? What are the steps? I'm in Arizona.

Someone can correct me if I'm wrong, but as I remember the DEA is insistent on a second form of biometric identification to be able to do this.. maybe iris scanning or something.... so I have not heard of any successful system. I'd be glad to be corrected, as it is incredibly dumb that we can't e-prescribe a medication that can be phoned in.

Agreed..As far as I know one can legally prescibe Schedules II-V electronically. Pharmacies are about 60% on board but the various vendors, ie. Amazing Charts etc. have to get their software in some sort of complance. Whatever that means. Biometrics? Added passwords?

I always thought it was:

Something you know: password
Something you are: iris scan
Something you possess: USB key

Absolutely stupid

I can't help but think of:

Something old, something new
Something borrowed, something blue

There are so many positive reasons for ease of use, efficiency and security, it makes absolutely no sense to not escribe narcotics and stimulants, etc.

My understanding is you have to have password and then either a biometric or a usb key - I have not actually heard of any e scrip program being compliant and it being used. I agree with Bert - it makes no sense that we cannot send e scrips because I think anyone can set their fax to broadcast a fake number and fax them to the pharmacy of their choice.

This is strange because we've received class III & IV's for e-rx but we can't write for them (or accept the request). Yet you can call it in. It makes so very little sense and so much extra work.

Amazing that the DEA thinks the fax is secure enough for a signed schedule III, but that an e-script is not. It would be so easy for a patient to send a false fax with a photoshopped script

I should have kept track, because I say this is the stupidest thing I have ever heard all the time. Then have a top 10. But, this has to be closest to the stupid.

On Class III and even Class II drugs wouldn't an ePrescribe with a six to eight letter password with all the fancy characters be secure enough. The password would need to match the name at the signature field or even have to add your DEA number which would not show on the preview. Only for narcotics, etc. The pharmacist would report mismatched passwords. For any error, there is a $1,000 fine, which doesn't break the bank but is substantial enough for PCPs. So, if you give out your password, you are asking for trouble.

Wouldn't this give a much better paper trail than a fax or call?

Typical government policy: incredibly, unbelievably stupid.

What is the incentive for government to become more efficient? I can't think of one. And if there is one, why are we in so much debt?

Do you guys want to see DEA bureaucrats begging on the street corners? State attorney general office staffs shredded to the bone?

1. Nothing, 2. I know the answer, but I am not posting it here,

3 & 4, I don't quite understand your questions.

Sometimes I print the ERx to Updox, then in the edit window, sign it, and fax it to pharmacy. Pretty convoluted -- alternative is printing to a printer, signing it and faxing to pharmacy.

A "consultant" advised me to put a multifunction printer in every exam room. Major horse laugh. I have so much electronic gear now I think I will go nuts -- especially since I'm the one who has to maintain it, because my practice doesn't generate enough income to hire a real IT person.

This divide between DEA and prescribing docs is getting pretty old, and very discouraging.

AS a pain doc, I'll explain it as I understand the law. It depends a great deal on what state you're in. ( not state of mind ) When there are federal and state laws relating to a particular act or crime, the more stringent law supersedes. Example, if Georgia law says it is illegal to throw and hit someone with a peach and federal law says they don't mind, the Georgia law trumps the federal law. If your state doesn't like Class II, III, or IV being e-prescribed, it doesn't matter what federal DEA says.
All of you by now should realize what a complete waste of brain-power it is to apply logic to a federal or state government problem. Lord knows they don't.
In conclusion, learn the laws in place were you sit, practice according to those laws, get your work done, then go fishing.
PS- watch out for flying peaches!
Nate

Ah yes, the DEA and the rest of the gubbermint security apparatus. The people who made Edward Snowden famous.

They haven't figured out yet that anyone with a word processor and a fax board on their computer can send out ... oh, about a million ... phony narc Rxs to every pharmacy in the country. So nerd-obsessing over 2 factor authentication for eRXs is just so very absurd.

Our tax dollars at work.

I will go one step further and probably start a fury. Why don't we feed the homeless and get out of the war business before we worry about diversion of 60 oxycodones.

I get calls all the time about this mother or that mother selling their kids' Concerta. My feeling is I diagnose the problem, and I then treat the problem. I couldn't careless who takes or sells the medication.

I guess when the parent sells the drug, it helps the child's ADHD as their grades go from Cs to As. And, I have yet to have a parent accuse the other when they still live under the same roof.

Perhaps... the number of nonmedical users over 12 yo was 6.1 million in 2011. The number of new intiates was 6400 per day. From CMS.

Maybe we should get out of the 'nation building' business. Look at the chaos in Egypt today: if not our fault, largely made worse by us.

My latest DEA experience was this:

My daughter is going to start chemistry in high school, and thinks it will be boring, based on her middle school exposure. I thought I'd show here some "cool" chemistry, like the reduction/oxidation reaction in the thermite reaction, or the creation of aluminum hex iodide with the formation of clouds of purple smoke and flames. Very cool nerd stuff. So, I went online to get some aluminum powder and iodine crystals.

Guess what? The DEA now has a "list one" (not schedule 1) of chemicals that could potentially be used to make methamphetamine, and iodine is now supposedly restricted in some occult way. So the chemical supply house I have used would not sell it to me. However, e-bay had no such issues and I could get it easily. Hydrochloric acid is also on this list( that you can get in gallon jugs at any paint supply store), as is sulphuric acid that is freely available in any battery supply. But, I guess chemistry is not really their strong suit. Nor is intelligence.

I guess if we just have an infinite number of rules, no one will ever do any stupid or self distructive actions ever again.

Making drugs with Sulfuric acid seems to be about the least harmful thing someone might do with it... crazy stories.

I think they need to watch "Breaking Bad."