You might have heard this statement: “Having a DEA registration is a privilege, not a right.” What you are less likely to hear is this: “When your personal DEA registration is used to order controlled substances, you are personally responsible for everything that happens with those drugs.” I would amend the first line to state: “Having a DEA practitioner registration is a privilege that comes with responsibility and can lead to significant personal risk when used to order controlled substances for activities that go beyond individual personal practice.”
When your personal DEA registration is used beyond its intended scope, problems can add up quickly, leading to serious consequences.
Here are three situations I’ve seen.
- A veterinarian ordering controlled substances while working as a medical director at a corporate-owned hospital was terminated without warning. All the controlled substances remaining in the hospital’s inventory had been ordered using the veterinarian’s personal DEA practitioner registration. Corporate leadership illegally took possession of the inventory after the DVM’s termination and allowed the drugs to be administered to patients. Legal counsel and law enforcement helped the veterinarian regain possession.
- A veterinarian provided part-time relief services at an animal shelter. The shelter owner had asked the doctor to use their DEA registration to order controlled substances so that operations could continue after the medical director suddenly left. The DVM agreed to do it just once. A falling-out occurred shortly afterward, and the shelter owner fired the relief veterinarian and continued using the doctor’s DEA registration, unbeknownst to the DVM. Months later, the U.S. Drug Enforcement Administration discovered during a routine inspection that all the controlled substances on-site belonged to the former relief veterinarian, who had never been an actual employee and had not been physically present for a while. The DVM was held responsible for abandoning a controlled substance inventory, a severe violation. Legal experts helped sort out the matter. The veterinarian avoided jail time and a six-digit fine.
- A newly graduated veterinarian who recently obtained a DEA registration worked one to two days a week at a clinic while searching for a full-time practice position. The clinic owner asked the doctor to order controlled substances using their personal DEA registration “on an interim basis” because the DEA registrant of record had left. The graduate agreed. During our conversation, I learned that over seven months had passed and that no new registrant of record had been hired. The young DVM asked the owner to provide copies of the drug invoices and to stop using the DVM’s registration. The owner refused and locked the veterinarian out of the clinic. Legal counsel and law enforcement were engaged to return the controlled substance inventory to the doctor.
Here Today, Gone Tomorrow
Employee turnover has escalated over the years as corporations and private groups merge and acquire veterinary practices. Many of the departures involve veterinarian DEA registrants who had been ordering and maintaining a controlled substance inventory on behalf of their hospitals. They then transitioned out, and a new DEA registrant moved in.
You might ask, “Mergers and acquisitions take place all the time, so why does it matter?” The big deal involves the DEA registrant of record.
A controlled substance inventory isn’t automatically rolled into a practice sale or merger. Attorneys handling a sale on behalf of either party should ensure that any remaining controlled drugs and all supplier accounts are transferred and updated correctly.
From a business standpoint, who legally owns the hospital, organization or corporation doesn’t matter. In the DEA’s eyes, the controlled drugs are legally owned by the individual or entity whose registration number was used on the order. Who paid the invoices doesn’t matter. The privilege of holding a DEA registration comes with responsibilities that must be adhered to.
Among the countless veterinarians I’ve had the pleasure to meet or work alongside, never once has someone said they “preferred” using their personal DEA registration to order controlled drugs on behalf of a large hospital or organization. Veterinarians who end up in situations like the ones I described earlier almost always say, “There was no other option” or “Without me, they would have been forced to close the practice.”
If you’re thinking, “That’s just an excuse,” you’re wrong. It’s an unfortunate fact in veterinary medicine and a sad truth for many practitioners.
The Risk
I’ll sound like a broken record when driving home this point: If you are a licensed veterinarian with an individual DEA practitioner registration and you use it to order controlled substances on behalf of a facility or organization, you must understand all the risks. The DEA doesn’t show empathy or award a consolation prize if you make decisions based only on what you think is in the best interest of patients. In the DEA’s eyes, you are ultimately the responsible party for everything that happens with a controlled substance inventory. You must consider the stakes and ask the right questions.
The Right Questions
If you are considering allowing your personal DEA registration to be used to order controlled drugs on behalf of a practice, organization or another operation for which you are not the primary owner or decision maker, stop and do your due diligence. Ask these questions:
- Why was I asked to take on the responsibility?
- Why did the former DEA registrant leave?
- How well do I know the owners and key stakeholders?
- What is the state of controlled substance compliance here? Have there been any thefts or significant losses? How often are the logs and inventory reconciled? Do physical security controls exist?
- Does the facility or organization encompass multiple locations or provide ambulatory services?
- What vetting, onboarding and education are in place for employees who prescribe or have access to controlled substances?
- What is my decision-making authority?
- What is my employment status?
- How will I be compensated for the use of my personal DEA registration?
The Reward
The veterinary professionals I know well are inherently kind and trustworthy. They live to help and understand personal and professional sacrifice.
In the three examples I provided, none of the veterinarians asked for or received anything in exchange for allowing their personal DEA registrations to be used to order controlled drugs. They took on significant personal and professional risks for nothing in return. Being a great veterinarian with good intentions does not equate to protection and ideal outcomes in such cases.
If someone asks you to use your personal DEA registration to order controlled substances on behalf of a practice or organization, ask yourself this: Is the risk worth the reward?
PERSONAL THOUGHTS
Federal regulations, while well-intended, can create more confusion than clarity. Compound them with state regulations, which vary significantly, and local ordinances in certain areas, and you will have a disaster ready to occur.
As someone immersed in regulations 24/7, I think the piling on results in veterinary professionals misunderstanding the laws they must adhere to. I’ve seen countless busy veterinarians become so defeated by regulatory confusion that they push everything aside to focus on their patients.
In a perfect system, veterinary facilities employing multiple veterinarians and using a shared controlled substance inventory would qualify for an institutional DEA registration. Veterinary medical schools and teaching hospitals typically operate under one. An institutional DEA registration is pretty much unheard of in veterinary practices.
The law seems stacked against veterinarians. It isn’t fair or logical in some respects. Unfortunately, none of that changes the requirements.