To prescribe, dispense, or administer controlled substances, the prescriber must be licensed in the State of Delaware 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). Prescribers who hold an active Controlled Substances Registration (CSR) must register with the Delaware Prescription Monitoring Program established in the Delaware Prescription Monitoring Act (16 Del. C.§ 4798).
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. PDMPs assist in patient care, provide early-warning signs of drug epidemics, and help to detecting drug diversion and insurance fraud.
Delaware’s Prescription Drug Monitoring Program, known as Prescription Monitoring Program (PMP) authorizes the Office of Controlled Substances to establish, maintain, and monitor the PMP for the purpose of reducing the misuse of controlled substances in Delaware and promoting improvements in patient care and professional practice standards.
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
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 (ONDCP, 2013). 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, 2011).
According to the U.S. Drug Enforcement Agency, the most recent National Prescription Drug Take-Back Day on September 27, 2014, in Delaware collected 4,707 pounds of unwanted, unused, and expired prescription drugs from citizens (DEA, 2014). The previous National Prescription Drug Take-Back events have removed over 2,411 tons of prescription drugs from homes nationwide (DEA, 2014).