The Drug Enforcement Administration (DEA) has issued new guidance addressing a longstanding challenge for physicians who administer controlled substances through intrathecal pumps.
Federal law generally requires a pharmacy to dispense a controlled substance directly to the patient or a member of the patient’s household. This has created practical and safety concerns for intrathecal medications, which are often best delivered directly to the physician who will administer them.
Under the new guidance, a patient may execute a power of attorney (POA), consistent with state law, authorizing the administering physician to act as the patient’s agent solely for purposes of accepting delivery of the prescribed medication. A DEA-registered pharmacy may then deliver the patient-specific controlled substance directly to the physician for administration in a healthcare setting.
For physicians treating patients with intrathecal pumps, this provides an additional pathway for directly receiving medications when direct delivery is appropriate for sterility, quality-control, or other reasons.
Physicians using this pathway should be aware that:
- The medication must be prescribed for and administered only to the named patient. It cannot become office stock.
- Patient-specific medication received under a POA must be kept separate from controlled substances held under the physician’s DEA registration.
- Physicians remain responsible for appropriate prescribing, security, and diversion controls.
- DEA recommends retaining the POA for at least two years after the last delivery or administration, unless state law requires longer.
- State laws and regulations still apply.
Importantly, the POA pathway is optional, not a requirement. DEA describes it as an additional method intended to support safer and more practical handling of patient-specific controlled substances, including medications used in intrathecal drug delivery.
Microsoft Copilot was used to assist with the drafting of this material. The content was reviewed and approved by NANS staff.