Chapter 14 Legal and Regulatory Issues in Pain Management

Question 1

The federal Controlled Substances Act (CSA)

Answer 1

is the principal drug control law in the United States. The CSA prohibits the nonmedical use of controlled substances and establishes criminal penalties for their illicit possession, manufacture,
and distribution, while at the same time recognizing that
they have a useful and legitimate medical purpose, that they are necessary for public health, and that their medical
availability must be ensured

Question 2

Controlled Substances Schedules for Opioid Analgesics - Schedule I

Answer 2

Schedule I controlled substances (e.g., heroin, LSD, and marijuana) have no currently accepted medical use, no accepted safety for use under medical
supervision, and a high potential for abuse, and are available only for scientific research.

Question 3

Controlled Substances Schedules for Opioid Analgesics - Schedule II

Answer 3

drugs have the highest potential for abuse, and include such opioids as codeine, fentanyl, hydromorphone, meperidine, methadone, morphine, and oxycodone
Prescriptions for Schedule II medications must be written
and may not be refilled

Question 4

Controlled Substances Schedules for Opioid Analgesics - Schedule III

Answer 4

drugs have a lower abuse potential than Schedule II drugs, and include opioids such as dihydrocodeine and hydrocodone- or codeine-combinations with aspirin or acetaminophen. buprenorphine

Question 5

Controlled Substances Schedules for Opioid Analgesics - Schedule IV

Answer 5

drugs have a lower abuse potential relative to drugs in

Schedule III, and include opioids such as dextropropoxyphene, propoxyphene and pentazocine.

Question 6

Controlled Substances Schedules for Opioid Analgesics - Schedule V

Answer 6

drugs have a low abuse potential compared to drugs in

Question 7

Drug Enforcement Administration (DEA)

Answer 7

is the primary federal agency responsible for enforcing the CSA and, thus, has regulatory authority over controlled substances

Question 8

prescriptions for Schedule II controlled substances in medical emergencies
under specific circumstances

Answer 8

Federal law allows oral or faxed (but not electronic) transmission

Question 9

Under the CSA it is unlawful to prescribe opioids (i.e., methadone and buprenorphine) to treat

Answer 9

addiction, which requires separate registration by the federal government as an opioid treatment program (OTP) for the purpose of maintenance or
detoxification of opioid addiction