The Drug Enforcement Administration has issued a clarification of requirements for prescribing schedule II controlled substances—those controlled substances that have the highest potential for abuse that also have an approved medical use.

The essential requirement is that medical practitioners, including veterinarians, prescribe schedule II controlled substances for a legitimate medical purpose, such as the treatment of pain, in the usual course of professional practice.

Also, practitioners may not authorize refills of schedule II controlled substances or write multiple prescriptions on the same day with instructions to fill on different dates. Practitioners must exercise the utmost care in determining whether to see a patient each time they issue a prescription for a schedule II controlled substance or whether seeing the patient at less frequent intervals is consistent with sound medical practice.

In instances when a practitioner who regularly sees such a patient does not see the patient, the practitioner may mail the prescription to the patient or the pharmacy. Practitioners may fax a prescription to a pharmacy to facilitate filling if the pharmacist reviews the original written, signed prescription before dispensing the drug.

Practitioners must ensure that their prescribing of controlled substances occurs in a manner consistent with effective controls against diversion and misuse, taking into account the nature of the drug.

Some states impose limits on the amount of a schedule II controlled substance that a practitioner may prescribe. These limitations apply in addition to the requirements of federal law.