In 2010, the US Drug Enforcement Administration (DEA) legalized the use of Electronic Prescriptions for Controlled Substances (EPCS) to help deter the rising prescription drug abuse problem in the United States.
EPCS technology is helping address the issue of stolen prescriptions by requiring prescriber authentication, heightened security standards and actively auditing the EPCS platforms. The DEA Title 21 CFR provides EPCS guidance.
What is a Controlled Substance Prescription?
Any prescription drug that has the potential for abuse or dependence is a controlled substance. The Controlled Substance Act (CSA) regulates these drugs. Controlled substances are divided into five categories called schedules.
The following is a quick breakdown of each schedule, refer to the controlled substance schedule for further details and examples of drug types. The potential of abuse decreases as we move from Schedule I to IV.
Schedule I Controlled Substances
These substances currently have no accepted medical use in the United States, they lack safety even with medical supervision and have high abuse potential.
Schedule II/IIN Controlled Substances (2/2N)
These substances have a high abuse potential and may lead to severe psychological or physical dependence.
Schedule III/IIIN Controlled Substances (3/3N)
These substances have less abuse potential than Schedule I or II substances and can lead to low to moderate physical dependence or high psychological dependence.
Schedule IV Controlled Substances
These substances have a low abuse potential relative to substances in Schedule III.
Schedule V Controlled Substances
These substances have a low abuse potential relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.
What is Electronic Prescribing Controlled Substances (EPCS)?
Electronic prescriptions for controlled substances or EPCS is a technology solution designed to address the prescription drug abuse problem in the United States.
The rule “Electronic Prescriptions for Controlled Substances,” allows clinicians to write and transmit controlled substance prescriptions electronically. In addition, the rule permits pharmacies to receive, dispense and archive electronic prescriptions.
What are the Provider’s Responsibilities with Controlled Substances?
DEA Title 21 places a large amount of responsibility on the provider for the prescription of controlled substances. A provider must register with the DEA and receive a DEA number to prescribe controlled substances.
Providers must also maintain sole possession of any two-factor authentication tokens and cannot share passwords with anyone. Practitioner responsibilities are the same when prescribing electronically as they are with oral or paper prescriptions.
What Are EHR Technology Responsibilities?
DEA Title 21 requires the technology (EHR or other) to be a certified product by a third-party auditor or certification body. Being adequately certified ensures proper creating, signing, and refilling of controlled substance prescriptions.
The technology must allow prescribers to access identity verification as well as two-factor authentication meeting national criteria. The technology must link the provider to a minimum of one DEA registration number and ensure only they are signing prescriptions.
State Participation Today?
Though the road to adaptation took several years, all 50 states have made Electronic prescribing of controlled substances, including opioids, legal. Vermont became the final state to adopt EPCS on September 15, 2015. Before that date, many states allowed Schedule III-IV drugs to be e-prescribed but held back on Schedule II drugs. Presently, all drug schedules in all 50 states are allowed to be e-prescribed.
