From the Research
In Virginia, the rules for dispensing controlled substances vary by schedule, with Schedule II medications limited to a 30-day supply and Schedule III-V medications allowed up to a 90-day supply with a valid prescription. This distinction is made to balance patient access to needed medications with appropriate controls for substances with higher abuse potential, as outlined in the Virginia Board of Pharmacy and Drug Control Act regulations 1. Schedule II medications, such as oxycodone, fentanyl, and Adderall, have stricter limits due to their higher risk profile, while medications like tramadol, testosterone, or certain anti-anxiety medications in lower schedules can be dispensed for longer periods.
When dispensing controlled substances, it is essential to:
- Verify the prescription's validity
- Check the state's Prescription Monitoring Program
- Ensure compliance with both state law and DEA regulations
- Be aware of insurance plans that may further restrict quantities regardless of legal maximums
The most recent study on the topic, published in 2023, found that prescription drug monitoring program (PDMP) use mandates are not associated with the number of prescriptions filled or the total amount reimbursed in US dollars for stimulants among Medicaid enrollees 1. However, this study does not directly address the rules for dispensing controlled substances in Virginia.
Key factors associated with individuals receiving potentially inappropriate concurrent controlled substance prescriptions include:
- Having prescriptions for opioids
- Being ≥18 years of age
- Utilizing controlled substance prescriptions for >30 days
- Utilizing greater than one controlled substance prescription
- Having a multiple provider episode
- Traveling >25 miles to obtain controlled substance prescriptions 2
It is crucial to consider these factors when dispensing controlled substances to minimize the risk of abuse and ensure patient safety.