Prescribing, Controlled Substances, and Prescription Monitoring
Prescribing authority and Indiana systems
A dentist may prescribe within the scope of dental practice. Controlled substances require an Indiana controlled-substance registration in addition to a DEA registration. Prescriptions must be issued for a legitimate dental purpose after an appropriate evaluation. Schedule II substances cannot be refilled; prescription elements and electronic-prescribing rules must be followed. Indiana uses INSPECT, the state prescription monitoring program; dentists should check it as required before prescribing controlled substances, especially opioids, and document the review.
Opioids and documentation
Indiana limits opioid prescribing for acute dental pain, with exceptions for defined situations. The record should show the diagnosis, procedure, non-opioid alternatives considered, quantity, instructions, and any INSPECT findings. Do not prescribe to family, friends, or self outside proper care, and do not sign blank or pre-signed prescriptions.
Worked example
After an extraction, a dentist plans 20 oxycodone tablets for a patient already receiving opioids from another prescriber. A required INSPECT check shows the active opioid. The dentist should reconsider the combination, consider non-opioid analgesia, and document the rationale or referral. Ignoring the query is not defensible because the risk of duplication and diversion is known.
Traps that cost marks
Assuming a DEA number alone satisfies Indiana registration. Treating INSPECT as optional for every opioid. Delegating the decision to prescribe to an assistant. Failing to document the medical necessity for the quantity.