Just saw this: DEA loosens nursing home painkiller rules | wisconsinrapidstribune.com | Wisconsin Rapids Daily Tribune

The Drug Enforcement Administration has announced it will allow nurses to dispense controlled painkillers to nursing home patients if the patient's doctor electronically transmits a prescription to a pharmacist.

The announcement comes after complaints made by nursing homes in recent weeks, including homes in Wisconsin, that a recent DEA crackdown on narcotics has led to delays that threaten the welfare of patients in pain.

The DEA said it is simply enforcing a 40-year-old law that requires pharmacies to wait for prescriptions signed by physicians before dispensing potent painkillers such as Perocet and morphine to patients at long-term care facilities.

Nursing homes have said the enforcement of such rules is not only new, it changes years of practice in which the government informally allowed nurses to take orders from doctors over the phone, or from medical charts, and then pass them along to pharmacies, as is done in hospitals.

Since last year, the DEA has tried to crack down on nurse shortcuts and has taken action against pharmacies in Ohio, Michigan, Wisconsin and Virginia that the agency accused of dispensing painkillers without having prescriptions in hand, according to the New York Times.

Sen. Herb Kohl, D-Wisconsin, chairman of the Senate Special Committee on Aging, held a hearing on the practice Wednesday. The interim rule, released Thursday, doesn't really change the way nursing homes are treated by the DEA, but could make it easier to for nurses to get doctor prescriptions to pharmacies.

Susan Ernst, director of nursing at the Portage County Health Care Center, said the tougher enforcement has caused a lot of extra steps for nurses and staff members. No patients at the care center have suffered thus far because of the changes, she said, but the prospect does exist.

If a patient's pain level changed and the doctor or pharmacist wasn't available, nurses at the care center used to be able to access medication from an emergency box, and then notify the pharmacy after receiving a telephone order from a doctor.

That's not the case anymore. Now, nurses must call the pharmacist with a signed doctor's prescription before they can open the box. Under the newest rule, a doctor can electronically send that prescription to the pharmacist, but a script still will be needed before the nurse can open the box.

"We can't go in (the box) without it. And there could be a delay, if we can't get a hold of the doctor to get a hold of the pharmacist, especially in the evenings, or on weekends or holidays," Ernst said.

The stricter enforcement also has slowed things down at the Marshfield Care Center, Director of Nursing Barbara Robinson said.

She said the best way to fix the problem would be for the DEA to allow doctors to write longer painkiller prescriptions for nursing home patients. Currently, nurses have to contact doctors every month for refills of such medication.

"If someone has been in a nursing for a long time, and we know they are going to be on that Fentanyl patch for six months, it would be nice if we could even get a two-month supply at a time," she said.