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10/20/2015 South Carolina Registrants >16,000 Practitioners >3,000 Mid‐Level (NP & PA) >1,100 Pharmacies >450 Hospitals/Clinics 17 Narcotic Treatment Programs 3 Teaching Institutions 3 Collectors* What is a Registrant? Registrant – any person or entity that is given a DEA certificate of registration, which authorizes the person or entity to handle controlled substances in a particular activity (i.e. manufacturer, distributor, dispensing, prescribing, administer, etc..). Every person or entity that handles controlled substances must be registered with DEA or be exempt by regulation from registration. Renewal fee - $731 for a 3 year period. 1 10/20/2015 Practitioner’s Responsibilities • To know the role in protecting one’s DEA registration and business; become familiar with the regulations that guide the accountability of controlled substances; and recognize the various methods of diversion used to illegally obtain controlled substances and understand the reasons people seek prescriptions drugs. Top Drugs of Abuse Oxycodone products – (OxyContin ®, Roxicodone ®, Percocet ® ) Hydrocodone products – (Lorcet ®, Lortab ®, Vicodin ® ) Methadone Fentanyl Alprazolam (Xanax ®) Valium® Florence AOR Pee Dee 2 10/20/2015 Charleston AOR Lowcountry Columbia AOR Midlands Greenville AOR Upstate 3 10/20/2015 Methods of Diversion Practitioners / Pharmacists Pharmacy / Other Theft Illegal distribution Armed robbery Self abuse Burglary (Night Break-ins) Trading drugs for sex In Transit Loss (Hijacking) Smurfing Employee pilferage Patients Hospitals Practitioners’ offices Drug rings Nursing homes Doctor-shopping Retail pharmacies Forged / fraudulent / altered Manufacturing / distribution facilities prescriptions Internet availability The Medicine Cabinet /obituaries Pain Clinics Prescription Fraud • Fraudulent prescriptions • Highly organized • Use real physician name and DEA Reg. Number • Contact information false or “fake office” • (change locations often to avoid detection) • Prescription printing services utilized • Not required to ask questions or verify info printed • Stolen Prescriptions • Forged • “Smurfed” to a large number of different pharmacies Know Your Employees/Co‐workers Registrants should not employ an employee who has access to controlled substances: 1. Any person who has been convicted of a felony offense related to controlled substance; 2. Any person who has been denied a DEA registration; 3. Any person who has had a DEA registration revoked; 4. Any person who has surrendered a DEA registration for cause. Code of Federal Regulations 1301.76(a) 4 10/20/2015 Civil Fine Issues DATA Waived physician exceeded authorized patient limit; authorized for 30 or 100; Failure to maintain complete and accurate records; or maintain CS records for two years; Failure to conduct biennial inventory; Registrant improperly used DEA registration to obtain and dispense controlled substances. Administrative & Civil Actions 63 Investigations Completed 18 Letters of Admonition 11 Memorandums of Agreement 11 Voluntary Surrenders $800,000 in Civil Fines Fiscal Year 2015 DEA Alerts FENTANYL – the abuse of fentanyl is surging throughout the US. ‐ reported overdose deaths 5 10/20/2015 Internet Resources DEA Diversion Control Program www.DEAdiversion.usdoj.gov Practitioner’s Manual An Informational Outline of the Controlled Substances Act Code of Federal Regulations Part 1300 to End Contact Information Amie Hickerson, Diversion Investigator tel: 803-253-3441 fax: 803-253-3163 email: [email protected] 6