14 Sep 23

DEA Narcotic Review for Physicians

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DEA Narcotic Review for Physicians

Physicians who prescribe controlled substances face increased scrutiny from the Drug Enforcement Administration (DEA). The DEA has authority to regulate the manufacture, distribution, and dispensing of controlled substances. This includes conducting audits and reviews of physicians’ prescribing practices.

Some key things for physicians to know about DEA narcotic review:

Registration Requirements

Physicians must register with the DEA to prescribe controlled substances. Registration needs to be renewed every 3 years. The DEA has authority to deny, revoke, or suspend a physician’s registration if they determine the physician has acted outside the ‘public interest’.

Prescription Monitoring

The DEA monitors controlled substance prescriptions through state Prescription Drug Monitoring Programs (PDMPs). PDMPs track prescriptions for scheduled drugs. The DEA uses PDMP data to identify high-risk prescribing patterns that may warrant further review.

Audits and Investigations

The DEA conducts routine audits of physicians’ controlled substance prescribing as part of their Diversion Control Program. Audits examine prescription records and patient files. The DEA also conducts investigations when potential violations are identified. Violations can result in criminal prosecution or administrative penalties.

Areas of Concern

Some prescribing patterns that may raise red flags for the DEA include:

  • Excessively high doses or quantities
  • Prescribing without a legitimate medical purpose
  • Prescribing to patients exhibiting signs of misuse or diversion
  • Not properly documenting justification for prescriptions

Best Practices

To avoid DEA scrutiny, physicians should:

  • Document medical necessity for prescriptions
  • Check state PDMP data
  • Monitor patients for signs of misuse/diversion
  • Secure prescription pads and DEA registration
  • Properly dispose of unused medications

While the DEA plays an important role in preventing diversion, physicians also need to balance this with ensuring appropriate access for patients with legitimate medical needs. Careful documentation and diligence can help physicians avoid issues while providing compassionate care.


  1. U.S. DOJ DEA Diversion Control Division: Practitioner’s Manual