California Dental Practice Act: 2 Hour Course

Prescriptions and the Law






Prescriptions can only be written by the dentist. An individual practitioner, acting in the usual course of their professional practice, can issue a prescription for a controlled substance only as part of dental treatment.

Examples of non-legal prescriptions:

        • A prescription that is issued not in the usual course of professional treatment.
        • Prescribing, administering, dispensing, or furnishing a controlled substance to or for any person or animal not under the dentist’s treatment.
        • False or fictitious prescriptions in any respect.
        • Prescribing, administering, or furnishing a controlled substance for one's self.

Controlled Substances

Schedule material provided by: U.S. Department of Justice, Drug Enforcement Administration
Schedule I               

  • The drug or other substance has a high potential for abuse.
  • The drug or other substance has no currently accepted medical use in treatment in the United States.
  • There is a lack of accepted safety for use of the drug or other substance under medical supervision.
  • Some Schedule I substances are heroin, LSD, marijuana, and methaqualone.

Schedule II

  • The drug or other substance has a high potential for abuse.
  • The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions.
  • Abuse of the drug or other substance may lead to severe psychological or physical dependence.
  • Schedule II substances include morphine, PCP, cocaine, methadone, and methamphetamine. Requires triplicate prescription.

Schedule III

  • The drug or other substance has a potential for abuse less than the drugs or other substances in Schedules I and II.
  • The drug or other substance has a currently accepted medical use in treatment in the United States.
  • Abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence.
  • Anabolic steroids, codeine and hydrocodone with aspirin or Tylenol, and some barbiturates are Schedule III substances.

Schedule IV

  • The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule III.
  • The drug or other substance has a currently accepted medical use in treatment in the United States.
  • Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule III.
  • Included in Schedule IV are Darvon, Talwin, Equanil, Valium and Xanax.

Schedule V

  • The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule IV.
  • The drug or other substance has a currently accepted medical use in treatment in the United States.
  • Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule IV.
  • Over-the-counter cough medicines with codeine are classified in Schedule V.

Prescribing and SB 151
 

The prescribing of controlled substances changed with the passage of SB 151, which became effective on January 1, 2005.

Prescription: A written, oral, or electronically transmitted order from a prescriber to a pharmacy or pharmacist.

Cures: All information pertaining to the prescribing of Schedule II controlled substances is maintained in the Department of Justice Controlled Substance Utilization Review and Evaluation System (CURES).

All written prescriptions for Schedules II-V controlled substances must be on a new, tamper-resistant form. Dentists can obtain the forms from a security vendor approved by the Board of Pharmacy and the Department of Justice.
For a list of approved vendors, visit the state Bureau of Narcotic Enforcement at http://ag.ca.gov/bne/security_printer_list.php.

Administering Schedule II Drugs

The administration of Schedule II controlled substances does not have to be reported to CURES, BUT dentists who prescribe or administer a Schedule II controlled substance must maintain a record of the transaction that includes all of the following:

  • Name and address of patient.
  • Date of transaction.
  • Character, including name, strength, and quantity Schedule II controlled substance involved.
  • The pathology and purpose for which the Schedule II controlled substance is prescribed.

Recording this information in the patient’s chart is sufficient. You are not required to maintain a separate log.

Drug Dispensing

Dispensing is providing a controlled substance in a container to the patient for later use.  Dispensing Schedule II and Schedule III drugs must be reported monthly to CURES.

  • Store the controlled substances in a locked cabinet or drawer.
  • Maintain a log.
  • Prior to dispensing, offer to give a written prescription to the patient that the patient may elect to have filled by any pharmacy.  The patient must be given the option to obtain the medication at a pharmacy.
  • Child-proof containers are now required for dispensing.

Dispensing prescribers must report those substances dispensed to the CURES program on a monthly basis, including the following information for each prescription filled:

Diversion Program Guidelines

The Legislature and the Dental Board of California (DBC) established a diversion program for licensed dental professionals who may be impaired by the abuse of dangerous drugs or alcohol. The program's aim is to treat licensed dental professionals  who  are  so  afflicted  and  allow  them  to  return  to  the  practice  of dentistry in a manner that will not endanger the public health and safety of the citizens of California.
 The diversion program was established in part as a voluntary alternative approach to traditional disciplinary actions. The DBC has established criteria for acceptance, denial, or termination of licentiates into the diversion program. An individual may enter the program either by:

  • Voluntarily request or
  • Board requirement as a condition of a licentiate’s disciplinary probation.

If a licensed dental professional is determined to be abusing drugs or alcohol the Board:

  • Could revoke their license with refusal to enter a diversion program.
  • Can force the individual into a diversion program.
  • Has the option to offer a diversion program as part of a rehabilitative package.
  • Must offer the diversion program to all licensed individuals with a drug/alcohol problem.

Conditions

If a licensed dental professional is currently under investigation by the Board for any violations of the Dental Practice Act or other violations, they may request entry into the diversion program by contacting the board’s Diversion Program Manager. Prior to authorizing a licentiate to enter in the diversion program, the diversion program manager may require the individual to execute a statement of understanding. This states that the licentiate understands that their violation of the Dental Practice Act or other statutes, that would otherwise be the basis for discipline, may still be investigated and the subject of disciplinary action.

Neither the acceptance nor participation in the diversion program will preclude the Board from investigating, or continuing to investigate, disciplinary action against any licentiate for any unprofessional conduct committed before, during, or after participation in the diversion program.

Upon committee determination that a licentiate has been rehabilitated and the diversion  program  is  completed,  the  committee  shall  purge  and  destroy  all records pertaining to the licentiate's participation in a diversion program. Except if a licentiate is non-compliant with the program agreement, Committee records pertaining to the treatment of a licentiate in a program are kept confidential and are not subject to discovery or subpoena.

Continue on to Mandated Reporting: Abuse, Violence and Neglect