Controlled Substances, MAPS, and Professional Practice Standards
Domain 4: Controlled Substances, MAPS, and Professional Practice Standards
This domain tests safe prescribing and professional conduct: Michigan controlled-substance licensing, the Michigan Automated Prescription System (MAPS), opioid limits, and standards such as informed consent, records, and reporting.
Core rules
- A dentist who prescribes controlled substances needs both a DEA registration and a Michigan controlled-substance license; state and federal registration are separate.
- Prescribers must register with MAPS and query it before prescribing a controlled substance in the circumstances the statute requires-generally before an initial prescription and at required intervals for continuing therapy.
- Schedule II drugs cannot be refilled; schedules III–V have refill limits. Michigan limits initial opioid prescriptions for acute pain to a 7-day supply, subject to statutory exceptions.
- Document the indication, dose, quantity, MAPS review, and rationale. Offer opioid safety information and consider naloxone when risk factors are present.
- Professional standards include informed consent, accurate records, infection control, scope-of-practice compliance, and reporting impaired or unethical conduct as required.
Worked example
A patient with acute pulpitis requests 30 days of oxycodone. The dentist confirms the diagnosis, checks MAPS, finds no recent opioids, and prescribes a 7-day supply with instructions to use NSAIDs first. The MAPS query and the 7-day limit are documented. Prescribing 30 days without a query or exception would violate Michigan requirements.
Traps
- Relying on DEA registration alone; Michigan also requires a state controlled-substance license.
- Refilling a Schedule II prescription.
- Skipping MAPS because the patient is "known."
- Prescribing to self or family outside the rules.
- Treating documentation as optional.