Prescribing Controlled Substances
Practitioners in Kentucky are required to conform to all state and federal rules regarding the prescribing of controlled substances. For licensed optometrists, this includes the Federal Controlled Substances Act, the Kentucky Controlled Substances Act, the Kentucky Optometry Practice Act, and all related regulations. Remember, it is your responsibility to be aware of the requirements contained in the relevant statutes and regulations. Below you will find information and links to help you meet this responsibility.
Authority to Handle Controlled Substances
An optometrist’s authority to handle controlled substances is granted in KRS 320.240 and clarified in 201 KAR 5:130. Optometrists who are both diagnostically and therapeutically certified are authorized to prescribe controlled substances, meaning issue a prescription to be filled by a pharmacist. Optometrists are not authorized to:
1. Procure or purchase controlled substances for office use;
2. Administer (or apply a controlled substance to the body of a patient) directly from office stock; nor
3. Dispense (or package and give to a patient for home use) controlled substances.
Prior to prescribing a controlled substance in Kentucky, optometrists must have:
1. An active license from the Kentucky Board of Optometric Examiners.
2. A current and valid DEA registration certificate.
DEA numbers are state specific. If you practice in multiple states, you may be required to purchase additional DEA registrations.
3. An active KASPER account.
Pursuant to KRS 218A.202 (2), if you have an active DEA number, you must have an active KASPER account, even if you never issue a prescription.
4. A certified electronic prescribing application that meets the requirements of 21 C.F.R. pt. 1311.
Optometrists licensed in Kentucky may prescribe controlled substances:
1. Only for a legitimate medical purpose in the usual course of professional practice KRS 218A.170 (6);
2. For the examination or treatment for a condition of the eye and its appendages KRS 320.240 (13);
3. Within the statutory prescribing limits defined in KRS 320.240 (13);
a. Schedule II (other than hydrocodone combination products): MAY NOT PRESCRIBE
b. Schedule II hydrocodone combination products (KRS 218A.010): 72-hour supply with no refills
c. Schedules III-V: 72 -hour supply with no refill
4. As outlined in the Kentucky Board of Optometric Examiners prescribing regulation 201 KAR 5:130;
5. Via a certified electronic prescribing application or in compliance with KRS 218A.182 and 902 KAR 55.130. (See Kentucky EPCS Mandate Details for more information);
6. In compliance with KRS 218A.180 and 902 KAR Chapter 55 (including 902 KAR 55:105 for paper prescriptions); and
7. In compliance with all other state and federal laws.
Continuing Education Requirements
Optometrists with a DEA registration are required to obtain at least 2 CEU per year relating to KASPER, pain management, or addiction disorders as part of their total CE requirements (201 KAR 5:030). A free CE series on Protecting and Promoting Patient and Public Health may be found online at UK CECentral.
Optometrists Play a Critical Role in Injury Prevention
Drug misuse and abuse is a serious public health issue. Nearly half of all opioid overdose deaths involve a prescription opioid. Optometrists should consider whether non-pharmacologic or non-opioid therapies are preferred, especially if screening determines the risk of controlled substance harm or misuse is greater than the potential therapeutic benefits. See examples below:
Substance use disorder (SUD) – history of drug misuse, overdose, family history;
Medical Conditions – sleep apnea, pregnancy, older age;
Mental Health Conditions – depression, anxiety, schizophrenia; and
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. Below you will find additional resources to assist in screening patients and complying with Board regulations.
KASPER Query Guidelines
KY Controlled Substances by Schedule II-V
Opioid Risk Tool
Written Consent for Treatment
Patient Counseling Guide on Opioid Analgesics (English)
Patient Counseling Guide on Opioid Analgesics (Spanish)
Patient Medicine Disposal Guide
Request a DEA or make modifications (change address/name)
DEA Registration FAQ
KY DEA Contact Information
Behavioral Health Treatment Locator: https://findtreatment.samhsa.gov/
DEA Take Back Day: https://takebackday.dea.gov/
DEA Drug Disposal Information: https://www.deadiversion.usdoj.gov/drug_disposal/index.html
Find Help Now: https://findhelpnowky.org/
KY Board of Optometric Examiners: Kentucky Board of Optometric Examiners
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/Resources/Pages/Treatment-and-Recovery-Resources.aspx
Law Enforcement Disposal Locations: https://odcp.ky.gov/Pages/Prescription-Drug-Disposal-Locations.aspx
DEA Louisville/Lexington Office: 502-582-5905
DEA London Office: 502-862-4500
Drug Enforcement & Professional Practice Branch: 502-564-7985
KASPER Technical Support: 502-564-2703
KY Board of Optometric Examiners: 859-246-2744
KY DEA Registration Specialist: 502-830-3962
KY Optometric Association: -875-3516