How many controlled substances can you name?

I was at work the other night, and a mom brought in a prescription for one of her kids from an area hospital. Apparently, the kid had just been released from the hospital after breaking multiple bones in a car accident. As a result, she was getting the usual sorts of meds you'd see in this situation - Lovenox (for clot prevention), high-end pain medications (Oxycontin, etc.), Senna (for the constipation caused by the pain meds), and there was also a script for Diazepam (Valium) - likely for muscle spasms and/or anxiety.

We had 2 different doctors writing these scripts. One doctor wrote for the Oxycontin and immediate-release oxycodone - and he did a great job making those scripts fillable. He signed his name, printed his name, *and* added his DEA number to the script. *tosses confetti* Thank you for doing a wonderful job, doctor, and making my life easier!

The other scripts were written by what turned out to be a resident, after I did some research. So far as I could tell, he didn't have a DEA number, which meant that I couldn't fill the script for Diazepam. I called the hospital - they didn't have a DEA number on record, but they gave me his pager number. I paged him twice, but - of course - by this time it was getting later in the evening, so he didn't respond.

The mom ended up getting a different doctor in the department on the phone, and handed me her cell phone. Usually, I'm not a fan of talking on patient cell phones, but I just wanted to get this handled and get Mom on her way. Here's about how that conversation went ...

Me: So would you be okay with my using you as the authorizing doctor for the Diazepam?
MD: Why?
Me: Because you have a valid DEA number.
MD: You don't need a DEA number for Diazepam.
Me: Yes, you do. It's a controlled substance.
MD: Are you sure? (No, doc, I just am bothering you after 8pm because I wanted to check with what you thought.)
Me: Yes, it's a benzodiazepine. All of those are controlled. I believe they're Schedule IV. (I then quickly look it up in my computer to confirm.) Yes, sir, it's a Schedule IV drug, and I need a doctor with a DEA number to write for this drug.
MD: Yeah, fine, I'll authorize it.

And, from there, he gave me his DEA number - even though he couldn't really remember it and only gave me the two letters and 6 of the numbers. Still, he was in my computer system, so I was able to look it (and him) up.

I guess my question is regarding how much doctors learn about controlled substances in school - or was this doctor (who I don't know personally) just older and perhaps more out of touch with what drugs are controlled? I know that I had to take a law exam, which covers this sort of material, in order to become licensed as a pharmacist. This is something that I figured doctors would know.

Are there some odd-ball controlled substances? Absolutely! Pseudoephedrine-products, for one. Lyrica (Pregabalin) is another one since a similar drug (Gabapantin / Neurontin) is not controlled. But I figured that it was common knowledge among doctors that benzodiazepines were all controlled drugs. Am I missing something here?

First post! (for me)

This is my first post here, so I figure I should probably introduce myself. I'm Abby's sister, Dr. Liz ... except, I'm a Doctor of Pharmacy, versus being a medical doctor. I work in the retail setting (at a store I'm going to be referring to as Rx's R Us ... and, of course, all patient names and identifying information will be changed for patient privacy reasons), and I graduated from college a few years ago. I've been working in pharmacy, though, for a half-dozen years or so by now, though, so I definitely have plenty of stories to share. I generally won't bore you with old stories, but if something interesting happens at work, I'll definitely pass it along.

And, it just so happens that I have a story about a "special" patient of mine to pass along.

Last night, a patient calls in a refill for her Diazepam 10mg. Directions: 1 tablet three times daily. She received 90 pills 10 days ago. I flag it as being too soon to fill, and call the patient to tell them that I will not have it ready for them that evening. The doctor's office is closed, so I can't check about getting an early refill.

But, wait, it gets better.

The patient proceeds to tell me that she talked to the nurse, and the nurse said that she was going to call in a new script with the right directions. And what directions were these, you might ask? 30mg of Diazepam three times daily. Because the patient was in so much pain, that's how the doctor told her to take it. (my mental response: riiiiiiiiiiiiiight)

I tell the patient that I don't have any way to get ahold of the doctor, but they're willing to try if they'd like to do so. I say that I cannot fill the prescription until I hear back from the doctor giving me new directions and/or an authorization to fill the medication early.

This morning, I call over to the doctor's office - they do a lot of orthopedic stuff and deal with a lot of patients in pain, but I'm pretty sure that the nurse will not be confirming the patient's story.

RPh: Patient Susie Smith --

Nurse: *audible sigh*

RPh: I take it you talked to her this morning?

Nurse: Last night, actually. She called to have the doctor call in a new presciption for her Valium (brand name for Diazepam), saying that she's had to take more of the medication because of her pain. I told her last night that the doctor was already gone when she called in, so it would have to wait until today. He won't be in until after lunch since he's in surgery this morning.

The nurse said she'd call back once she talked to the doctor about the patient, but I didn't hear anything back before I left work this afternoon.

And, to top things off, the patient finally realized that I wasn't going to fill her RX without doctor authorization (which didn't appear to be forthcoming), so she had the prescription filled at a different pharmacy. I told the other RPh about the too soon issue, but it's their problem now ...