© Gary Inglese

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Dental Defense - Illinois Department of Financial and Professional Regulations Defense - Dental-Legal Issues - Dental Risk Management - Dental Contracts and Business Issues - Dental Office Transitions

To avoid those situations, however, dentists should take care when ordering controlled substances and keeping them in the office.  There are several agencies that monitor the sale and purchases of controlled substance, but you must take the primary responsibility for monitoring your purchases, inventory and dispersal of drugs.

Regardless of what a pharmaceutical sales representative tells you, know that you may refuse controlled substance samples if they are offered to you.  If accepted, you will be required to sign for them and provide your state license number and Drug Enforcement Administration (DEA) number.  It is part of the control mechanism.

Once the drugs are in your office, you must account for controlled substances by maintaining an accurate inventory and securing the drugs.  When the substances are dispensed, appropriate notations must be placed in the patient’s record, and these notations must correspond with the inventory log.  If a staff member performs these tasks, the dentist should periodically check to make sure that the staff member is not stealing the controlled substance for his or her own use.  The controlled substances were ordered under your license number.  You are required to make sure that these substances are secure. 

Drug wholesalers are strictly regulated and must keep accurate records, too.  Because orders frequently cross state boundaries, violations can involve federal law.  Fraudulent orders are easily tracked and, over the long term, usually detected.  Wholesalers always cooperate with the authorities.

Pharmaceutical sales representatives rarely call on dentists because dentists do not usually prescribe the products they promote. Dentists usually write prescriptions for antibiotics and mild to moderate pain relievers- everyone knows that.  So whom do you think will be fooled by a fraudulent order?

Once prescriptions reach the neighborhood pharmacy, they are subject to similar controls.

Most pharmacies are computerized and it is easy to run patient profiles.  As I noted in a previous column, pharmacy practices are closely regulated and pharmacists will cooperate with the Illinois Department of Financial and Professional Regulations and DEA investigators because IDFPR and DEA also regulate the pharmacy and the pharmacist.  Self-prescribing is a violations of state regulations.  If you are ill, visit your physician who will write a prescription for you.  Besides, the prescribed medications are probably beyond the scope of your dental license. Over time, abusers are always caught- sometimes turned in by a frustrated family member of a loyal staff member who can no longer bear to witness the abuser’s self-destruction.

Vold D.D.S., J.D., Michael. (2004, September/October). Control the controlled substances in your practice.  CDS Review, 28.   

The controlled substances you keep in your practice can be tremendously beneficial to the patients who truly need them.  The danger, however, of keeping controlled substances and drug samples in the office is that they can land in the hands of drug-seeking patients and members of the dental team (including the dentist) who may be addicted to such substances.

Substance abuse, left untreated, will destroy your life, your practice and your family.  Substance abuse frequently leads to criminal acts and allegations of malpractice.

Whether it is you, a friend or an associate, seek help- the earlier, the better.  Organized dentistry and many hospitals have programs to treat addicted professionals.  It is better to voluntarily seek help than to be caught and forced into treatment.  Authorities frequently take your efforts into consideration and reduce a penalty if you have already begun treatment.

Control the controlled substances in your practice.