To prescribe, dispense, or administer controlled substances, the prescriber must be licensed in the State of West Virginia and comply with all applicable state and federal regulations. The Practitioner’s Manual of the U.S. Drug Enforcement Administration provides specific regulations governing the medical use of controlled substances (DEA, 2006 [most recent]). Prescribers must register with and use the West Virginia Controlled Substances Monitoring Program established in West Virginia Code Chapter 60A, Article 9.
Prescription Drug Monitoring Programs (PDMPs)
Clinicians should request a report of a patient’s medication history from the state’s PDMP before prescribing opioids. PDMPs track controlled substances prescribed by authorized practitioners and dispensed by pharmacies. PDMP programs employ electronic data transfer systems, under which prescription information is transmitted from the dispensing pharmacy to a state agency, which collates and analyzes the information. PDMPs assist in patient care, provide early-warning signs of drug epidemics, and help to detecting drug diversion and insurance fraud.
The Government Accountability Office (GAO) concluded that such programs have the potential to help law enforcement and regulatory agencies rapidly identify and investigate activities that may involve illegal prescribing, dispensing, or consumption of controlled substances. PDMPs also can help to prevent prescription drug misuse, overdose, and diversion by allowing clinicians to determine whether a patient is receiving prescriptions for controlled substances from other clinicians, as well as whether the patient has filled or refilled an order for an opioid the clinician has prescribed (FSMB, 2017).
West Virginia’s Prescription Drug Monitoring Program, the Controlled Substance Automated Prescription Program (CSAPP), was established in 1995 by the State Board of Pharmacy for the monitoring of Schedule II–IV Controlled Substances. The goal of CSAPP is to provide prescribers and dispensers with access to information that will help them make better prescribing decisions and positively impact West Virginia’s drug problem. Furthermore, CSAPP can help to identify patients who may benefit from a substance abuse referral (CSAPP, 2018).
When Drug Diversion Is Suspected
If a healthcare professional suspects that drug diversion has occurred, he or she must document the suspicion and make a report to the following agencies:
Local law enforcement and local fraud alert networks
- DEA (theft or loss of controlled substances) on the DEA Office of Diversion Control website.
- HHS-OIG National Hotline (800 HHS-TIPS, or 800 447 8477) or
TTY 800 377 4950 or
Other resources for information and assistance (SAMHSA, 2016a) include:
- Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 800 662-HELP (4357) or TDD 800 487 4889 (for hearing impaired)
- Behavioral Health Treatment Locator: https://findtreatment.samhsa.gov to search by address, city, or zip code
- Buprenorphine Treatment Physician Locator: http://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator
- State Substance Abuse Agencies: https://findtreatment.samhsa.gov/TreatmentLocator/faces/about.jspx
- Center for Behavioral Health Statistics and Quality (CBHSQ) http://www.samhsa.gov/data
- SAMHSA Publications: http://store.samhsa.gov1; 877-SAMHSA (877 726 4727)
- Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/drugoverdose/epidemic
Drug Take-Back Programs
Combating prescription drug abuse necessitates the proper disposal of unused, unneeded, or expired medications. Patients must have a secure and convenient way to dispose of controlled substances. The Drug Enforcement Agency has strict regulations for drug take-back programs, including National Prescription Drug Take Back Days. Healthcare providers should encourage patients to use such take-back disposal services when available.
If no take-back program is available, patients should be warned to take precautions that help prevent environmental impact and drug diversion, including mixing pharmaceuticals with undesirable substances such as coffee grounds or cat litter; sealing them in a bag, empty can, or other nonleaking container; and removing all personal information (name, phone number, prescription number) from product packaging and labels (FDA, 2018).
The 14th National Take Back Day, which took place October 28, 2017, collected 912,305 pounds (456 tons) of prescription drugs nationwide. In West Virginia 5,473 pounds of prescription drugs were collected (DEA, 2018b).
DEA is committed to the citizens of West Virginia. This [Take Back] program allows citizens to empty their medicine cabinets of unwanted or expired medications with no questions asked. DEA will then dispose of these medications in a safe manner.
DEA Assistant Special Agent in Charge
U.S. Attorney’s Office, 2018