Controlled Substances: Scheduling, Prescribing, Dispensing, and Reporting
Federal backbone
Know the CSA schedules and their practical consequences. Schedule II: no refills, written/qualifying electronic prescriptions, and strict recordkeeping. Schedule III–V: limited refills within a defined window (verify the current federal rule, which changed for some schedules). DEA registration is required to dispense, and separate registration is needed per location. The PDMP is central: Alaska requires reporting of dispensed controlled substances, and pharmacists must review the PDMP in defined circumstances.
Alaska overlay
Alaska schedules mirror federal schedules with state additions; verify state-specific scheduling. Prescription monitoring, theft/loss reporting (DEA Form 106), and biennial inventory are recurring exam points. The trap: assuming a Schedule II prescription may be partially filled freely-federal rules restrict partial filling to specific exceptions.
Traps
(1) Refilling a CII. (2) Missing the DEA registration/location rule. (3) Forgetting PDMP review and reporting duties. (4) Confusing theft/loss reporting with the biennial inventory. (5) Assuming an out-of-state prescriber's DEA number is always acceptable-verify Alaska rules.
Rule of thumb
For any CS question, run the checklist: schedule → valid prescription elements → refill authority → PDMP → records/reporting.
Worked example
A patient presents a CII for a 90-day supply with two refills. CII cannot be refilled; the pharmacist may dispense only the authorized quantity consistent with federal and Alaska limits and must not honor refills.