Safe Prescribing Discussion Paper

Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.

The DEA is the federal agency charged with controlling access and distribution of potentially harmful chemical substances. In fact, the agency’s task has been synonymous with managing access to controlled substances that either have the potential for abuse for addiction. With regards to PMHNP, the DEA’s function is to ensure that the concerned nursing personnel meet the set criteria for safe prescription of controlled substances. This occurs through two expectations on the nurses. The first expectation is that the nurse must use professional knowledge to determine that the controlled substance is necessary and there is no safer alternative chemical agent that would meet the same conditions. The second condition is that a validly written prescription should be presented for the controlled substance with all key elements presented as determined by the DEA. Although the DEA is the major agency concerned with the two responsibilities, they would typically delegate these responsibilities to other government agencies capable of providing policing services (Drug Enforcement Administration, 2010).Safe Prescribing Discussion Paper

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Explain your responsibilities when having a DEA number.

All nursing personnel who seek to prescribe or handle prescription services are expected to have a DEA number. The number is a distinctive identifier with each nurse assigned a unique number. The number is a certification that the medical personnel is permitted to prescribe controlled substances. In fact, the DEA would simply use the number to determine the validity of each prescription. As such, it can be construed that the number allows the agency to regulate controlled substances use within the medical environment. For the medical personnel, the DEA number ensures that they are able to take responsibility for their prescription activities and that all the controlled substances they handle are used responsibly (Drug Enforcement Administration, 2010). In this respect, the responsibility of any medical personnel with a DEA number is to ensure that controlled substances are used safely and responsibly.

Explain how you apply for a DEA number in Arizona.

Any medical personnel who anticipates to engage in prescription activities, particularly those handling controlled substances that have a high potential for causing harm, must have a DEA number. Applying for the number in the State of Arizona follows a specific procedure that can be summarized in three steps. The first step entails holding a current and active practicing license for the State of Arizona. The license would allow me to offer professional medical services within the state, although the services must be within the scope specified in the license to include offering prescription services. The second step is to acquire a permit to handle controlled substances. The permit acts as evidence that the individual has not engaged in any criminal activity using controlled substances. The final step is to approach the federal DEA registration office within the state and present the valid practice license while applying for the DEA number. It is important to note that the number is only valid for three years with the application process repeated every three years (CompHealth, 2018).

Explain Arizona’s requirements for a safe prescribing and prescription monitoring program.

The Arizona State Board of Pharmacy (2018) presents the conditions for safe prescription and prescription monitoring program, noting that this is necessary to protect the welfare, safety and health of Arizona residents. The board presents four conditions that medical personnel must meet to be part of the program. The first condition is that medical personnel must register for the program and pay the necessary license and permit fees. The second condition is the capacity to navigate the program to view the patients’ medical reports. The third condition is to understand the report generated by the program. The final condition is to view prescriptions filled using the DEA number. Other than the four mentioned conditions, the board also specifies that all medical personnel who are part of the program can only prescribe controlled prescription medication when providing professional medical services and to meet valid healthcare needs that would not be met by other safer chemical substances. The board also explains that all prescriptions must be used under the supervision and direction of medical personnel (Arizona State Board of Pharmacy, 2018). Safe Prescribing Discussion Paper

Explain your responsibility as a PMHNP to follow these requirements.

As a PMHNP, I am expected to observe the requirements presented by the Arizona State Board of Pharmacy. In fact, I am legally and ethically expected to follow the requirements as part of professional practice. Ethically, I am expected to present my patients with the best possible medical care, to include only prescribing controlled substances when absolutely necessary and when permitted. Also, the prescription must be responsible and used under close supervision. Legally, the law governing medical practice is clear that the prescription must be done responsibly, to imply that it should only be used when necessary. I am aware that failing to follow these requirements could have serious consequences that include my practice license being withdrawn, cancelled or suspended, fines and prison terms. As such, it is incumbent upon me as a PMHNP to follow these responsibilities.

Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

Table 1. Schedule II-V drug levels (Source: Drug Enforcement Administration, 2018)

Schedule drug levels Examples of drugs
II Methamphetamine, Amphetamine, Fentanyl, Oxycodone, Meperidine, Methadone, and Hydromorphone.
III Ketamine, Phendimetrazine, and Benzphetamine.
IV Triazolam, Temazepam, Midazolam, Lorazepam, Diazepam, Clorazepate, Clonazepam, Carisoprodol, and Alprazolam.
V Codeine, Ezogabine and Phenergan
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