Controlled Substances: Scheduling, Prescribing, Dispensing, Monitoring, and Reporting
Controlled-substance questions combine federal scheduling with Michigan monitoring. Know schedule distinctions, refill limits, reporting duties, and red flags.
Federal framework
- CI has no accepted medical use; CII has high abuse potential; CIII–V have decreasing potential. Michigan adopts federal schedules but may add state controls.
- CII: no refills; emergency oral orders require a written or electronic follow-up within 7 days; partial fills are limited.
- CIII–V: maximum five refills within six months; partial fills are allowed under federal rules.
- DEA Form 222 or CSOS for Schedule I and II procurement; biennial inventory; records for 2 years; theft or loss reported on DEA Form 106.
Michigan MAPS
- Dispensers report controlled-substance dispensing to the Michigan Automated Prescription System, generally by the next business day.
- Prescribers must check MAPS in specified circumstances; pharmacists use MAPS to resolve red flags and document corresponding responsibility.
- Review patient history, prescriber pattern, cash payment, early refills, distance traveled, and overlapping opioids or benzodiazepines.
Worked example
A patient requests an early oxycodone refill, pays cash, and lives 90 minutes away. The prescription is valid on its face. Check MAPS, verify with the prescriber, and document. If red flags remain unresolved, do not dispense. A technically valid prescription does not eliminate corresponding responsibility.
Traps
- Refilling a CII.
- Reporting to MAPS on the wrong schedule.
- Ignoring cash-pay red flags.
- Assuming a prescriber’s DEA number validates medical purpose.