The Drug Enforcement Administration (DEA) announced internal policy changes that will now recognize nurses who work in long-term care facilities as agents of physicians who prescribe certain medications regulated under the Controlled Substances Act. Oral prescriptions for some painkillers and anti-anxiety medications may now be phoned in by long-term care nurses with authorization from a physician.
Published in the Federal Register, the policy reiterates DEA’s definition of an agency relationship as it pertains to a practitioner and those duties that can be delegated to another individual. The notice expands upon DEA’s expectations for establishing agency through a series of recommendations, including establishing written agreements between practitioners and nurses who wish to establish an agency relationship. Once an agency relationship is established, a nurse at a long-term care facility acting as the agent of a prescribing practitioner may communicate to a pharmacy prescription orders for Schedule C-III, C-IV, and C-V medications.
“By allowing the long-term care nurse to serve as an agent of the prescribing physician, orders for C-III through C-V controlled medications can be communicated to the pharmacy in a more efficient and timely manner,” said Albert Barber, president-elect of the American Society of Consultant Pharmacists (ASCP). “Patients will now be at a much lower risk of encountering delays for medications to alleviate their pain.”
This update follows a change in DEA enforcement policy within the last 18 months, which led to increased enforcement activities in long-term care facilities.
The Quality Care Coalition for Patients in Pain study “How U.S. DEA Rules Harm Patients in Nursing Facilities” (PDF)