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Controlled Substance Requirements

​Prescribing Controlled Substances

Prior to administering or prescribing controlled substances in Kentucky, you must have the following:

  1. An active Kentucky dental license;
  2. A DEA registration number specific for Kentucky (if you practice in more than one state or administer controlled substances in multiple locations within Kentucky, you may be required to register for additional DEA numbers); and   
  3. An active KASPER account.

Dentists licensed in Kentucky may ONLY administer and prescribe controlled substances:

  1. For the evaluation or treatment for a condition of the oral cavity, maxillofacial area, or the adjacent and associated structures and their impact on the human body KRS 313.010(11); and
  2. As outlined in the Dental practices and prescription writing regulation 201 KAR 8:540.                         

**Dentists may not dispense (package and label) controlled substances for use by the patient outside of an office setting.


Kentucky All Schedule Prescription Electronic Reporting (KASPER)

KASPER is the Commonwealth's mandatory prescription monitoring program. It is designed to assist practitioners and pharmacists with patient care while also providing an investigative tool for law enforcement and regulatory agencies. Dentists authorized to administer and prescribe controlled substances in Kentucky must have a KASPER account and use it to query any patients being prescribed schedule II or III controlled substances. KASPER registration and information is available at https://chfs.ky.gov/agencies/os/oig/dai/deppb/Pages/kasper.aspx.


Dentists Play a Critical Role

Opioid abuse is a serious public health issue with more than 47,600 deaths due to opioids in 2017, the highest year on record. Nearly half of all opioid overdose deaths involve a prescription opioid. Dentists should consider if non-pharmacologic and non-opioid therapy is preferred, especially if screening determines patient's increase of harm or misuse is greater than benefit (see examples below).

Substance use disorder - history of drug misuse, overdose, family history of SUD

Medical Conditions – sleep apnea, pregnancy, older age

Mental Health Conditions – depression, anxiety, schizophrenia

Other prescriptions (Use KASPER) – benzodiazepines, muscle relaxants, hypnotics or other narcotics 

All patients should be educated on safe use of medication, risk factors of use, appropriately storing medication, disposal methods and risks while operating heavy machinery.

Helpful Resources

Phone Numbers

DEA Louisville Office: 502-582-5905

DEA London Office: 571-362-7052

KY Board of Dentistry: 502-429-7280

KY Dental Association: 502-489-9121

KASPER/Drug Enforcement Branch/OIG: 502-564-7985

Documents

Opioid Consent Form.pdf

White Paper - Opioid Prescribing.pdf

DEA Contact Information.pdf

DEA Registration Information.pdf

Opioid Risk Tool.pdf

Opioid Patient Counseling Guide.pdf

Websites

Law Enforcement Disposal Locations: https://odcp.ky.gov/Pages/Prescription-Drug-Disposal-Locations.aspx

DEA Take Back Day: https://takebackday.dea.gov/

Patient Disposal Guidelines: https://www.fda.gov/consumers/consumer-updates/where-and-how-dispose-unused-medicines

Dentist Disposal Guidelines: https://www.deadiversion.usdoj.gov/21cfr/cfr/1317/subpart_a.htm

Find Help Now: https://findhelpnowky.org/

Behavioral Health Treatment Locator: https://findtreatment.samhsa.gov/

KY Drug and Alcohol Abuse Facility Locators: https://drugabuse.com/usa/drug-abuse/kentucky/

KY Office of Drug Control Policy Resource Page: https://odcp.ky.gov/Pages/Treatment-Resources.aspx


Frequently Asked Questions

Q: I have a DEA but rarely write for controlled substances. Am I still required to obtain a KASPER account?
A: Yes. All Kentucky licensed dentists with an active Kentucky DEA registration must register and maintain a KASPER account regardless of whether you plan to use such authority. If you are unable to conform to the controlled substance prescribing regulation you may want to retire your DEA number by calling DEA Registration Support at 571-362-6905. 

 Q: I am a Kentucky licensed dentist; however, I practice in Colorado and my DEA is registered to my office in Colorado. Do I need to maintain a KASPER account?

A: No. Only dentists who are licensed to practice in Kentucky and have a Kentucky DEA registration are required to maintain a KASPER account. A Kentucky specific DEA number is required to prescribe or dispense controlled substances in Kentucky because DEA registrations are state specific. If you return to practice in Kentucky and transfer your DEA to a Kentucky address or create a new Kentucky DEA registration, you are required to register with KASPER at that time.   

Q: I'm a licensed Kentucky dentist, however I am in the military. Do I still need to register?
A: Yes. If you have a Kentucky dental license and a Kentucky DEA registration, regardless of whether you are a military dentist, you should maintain a KASPER account.  

Q: I don't have a computer in my office, what do I do?
A: It is required by law that each office must have one computer with internet capabilities to access the KASPER website and run KASPER reports.

Q: I have not had access to my KASPER account and I keep getting emails about needing to get a new KOG account. What is KOG?

A: KASPER moved to a new secure portal site, Kentucky Online Gateway (KOG) in May 2019. You will need to create an account at https://kog.chfs.ky.gov.  Once you are logged in, search (by the letter K) for the Kentucky All Scheduled Prescription Electronic Reporting and click the Enroll/Launch to go the Account Request Onboarding Screen. You will be required to put in your old KASPER user name and password to link to your old account. Please call the KASPER Help Desk 502-564-2703 if you do not remember your old KASPER credentials. Do NOT create a new account!  

Q: When am I required to run a KASPER?

A: Prior to the initial prescribing or administration of a schedule II or III controlled substance the dentist shall obtain and review a KASPER for the 12 months preceding the patient encounter. You may review any exception to this rule in the KBD prescribing and dispensing regulation posted here https://apps.legislature.ky.gov/law/kar/201/008/540.pdf   

Q: How often do I have to run a KASPER report to update a previous report?
A: If the course of treatment extends beyond 3 months and additional controlled substances are required, the dentist shall obtain a new KASPER report.  

Q: Am I required to inform the patient that a KASPER report will be generated?
A: No.

Q: I don't have time to request KASPER reports, can someone else in my office do this for me?

A:  Yes. You may delegate office employees to request KASPER patient reports on your behalf by logging onto your KASPER account and clicking the Manage Delegate button in the Administration tab. The delegate should follow the instructions in the email generated and obtain their own account. Do NOT share your KOG login id or password.   

Q: Are dentists required to keep the KASPER report in the patient record?
A: It is not a requirement, however, it is recommended for documentation purposes. Additionally, if the patient is seen in the office more than one time during a three month period, the same KASPER report can be used.

Q: Am I required to complete any continuing education regarding controlled substances?
A: Dentists with controlled substance prescriptive authority are required to complete three hours of continuing education that relates to the use of the electronic monitoring system (KASPER), pain management or addiction disorders, or any combination of the three, during every two year license renewal cycle. 

Q: Can an associate dentist write a refill for a patient if the associate dentist that treated the patient is not present?
A: Yes, provided the partner or associate performs an exam on the patient prior to prescribing the controlled substance. Additionally, if the KASPER is older than three months, an updated KASPER would need to be obtained.

Q: I heard there was a 3 day limit on pain pills now but my patient is in severe pain from major surgery and needs more. Should I just make the patient do without?
A: In 2017, HB333 limited prescribing to a three day supply or less for pain as an acute medical condition with exceptions. If in your professional judgement, you believe more than a three day supply of a schedule II or III controlled substance is medically necessary document in the record the condition and lack of alternative treatment options which justifies the deviation of the three day limit.  https://apps.legislature.ky.gov/law/kar/201/008/540.pdf

Q: If I run a KASPER report on a patient and I feel that the patient may be abusing drugs, what should I do?
A: Speak to the patient in private. Explain to them that you have concerns about their health and welfare as a result of the information that was generated on the KASPER. You have the right to refuse to prescribe them a controlled substance. If you feel threatened or believe they are doctor shopping, you may contact a local law enforcement agency or refer them to treatment recovery at https://findhelpnowky.org/

Q: Can I KASPER potential employees to make sure they are not on drugs prior to hiring?

A: No. You may only KASPER for the purpose of providing medical treatment to a bona fide current or prospective patient.

                                                                               

Updated 02/28/2020