Prescribing Controlled Substances
- Rivka Lebrett
- Feb 2
- 4 min read
Controlled substances are widely prescribed, especially for ADHD treatment and pain relief. We all know someone who takes or has taken these medications, and so it isn't unusual to be asked to help out a family member or friend when a prescription falls short.
It's important to handle the prescription of these controlled substances responsibly and to understand the legal frameworks governing them.
In this blog we share all the relevant information you need to feel competent prescribing controlled drugs, including hot-off-the-press, regulations which will be implemented next month.
Laws & Regulations Governing Narcotic Drugs
Firstly, in Israel, Controlled drugs are known legally as Dangerous Drugs (סַּמִּים הַמְסֻכָּנִים).
General medical prescriptions are defined and regulated by 'The Physicians Ordinance and the Physicians Regulations (Issuing Prescriptions), 1981' (פְּקוּדַת הָרוֹפְאִים וְתַקָּנוֹת הָרוֹפְאִים (מַתַּן מִרְשָׁם), הַתַּשְׁמ״א–1981) whereas controlled substances are governed by the Dangerous Drugs Ordinance,5733, 1973 (פְּקוּדַת הַסַּמִּים הַמְסֻכָּנִים , הַתַּשְׁל״ג–1973), and the Dangerous Drugs Regulations, 5740, 1979 (תַקָּנוֹת הַסַּמִּים הַמְסֻכָּנִים, הַתַּשׁ״ם–1979)
The Dangerous Drugs Ordinance 1973, is the primary legislation. It forms the legal backbone of controlled substance regulation in Israel. It defines what constitutes a “dangerous drug,” establishes the government’s legal authority to regulate these substances, and outlines the relevant criminal offences.
The Dangerous Drugs Regulations 5740, 1979, are the secondary legislation issued under the authority of the Ordinance. While the Ordinance establishes the legal framework, the Regulations deal with the practical implementation of the law.
They set out the operational details, including how prescriptions must be written, record-keeping requirements, pharmacy logbook rules, storage and inventory management standards, and reporting obligations.
Which drugs are considered 'dangerous drugs'?
Below are some of the most commonly prescribed controlled (dangerous) medications in Israel.
Amphetamine
Amobarbital
Codeine
Hydrocodone
Methadone
Methamphetamine
Methylphenidate
Morphine
Oxycodone
Pentobarbital
Phenobarbital
Pethidine (Meperidine)
Buprenorphine
Fentanyl
Cannabis
LSD
Cocaine
A full and detailed list of classified “dangerous drugs” can be found at the end of the Dangerous Drugs Ordinance 1973 above.
Breaking News: Regulation of Dangerous Drugs is changing from March 2026!
In response to rising misuse of opioid medications, the Knesset Health Committee approved new regulations in 2025 aimed at strengthening oversight and reducing misuse of dangerous drugs.
Up until now, controlled substances were tracked through manual paper logbooks in individual pharmacies. In practice, a private paper prescription for morphine could be written by any doctor and then used across different pharmacies, without a shared system to detect excessive dispensing.
This is all about to change. On March 3, 2026, new reforms will be in place, with a one-year transition period for healthcare institutions to complete implementation.
The reforms include:
Electronic Prescriptions
Opioid medications will be issued exclusively via electronic prescriptions to enhance supervision and reduce fraud. Manual prescriptions will be permitted only in exceptional circumstances.
Computerized Pharmacy Systems
Pharmacies will transition to a fully computerized system for managing medications classified as dangerous drugs. This will replace the current manual logbooks and improve monitoring, efficiency, and inventory control.
Prevention of Duplicate Dispensing
Pharmacists will be able to view a patient’s previous opioid dispensations, including those from private prescriptions and private pharmacies, helping prevent duplicate dispensing.
Mandatory Reporting to Health Funds (Kupot)
Pharmacies will report opioid dispensing through the computerized interface directly to the health funds. This information will automatically update the patient’s medical record, allowing family physicians to oversee and coordinate medication management more effectively.
Added perk included in the new regulations:
To reduce the need for frequent pharmacy visits, the regulations also include relief for individuals with ADHD: prescriptions for ADHD medications may now be dispensed in quantities sufficient for two months, instead of the previous one-month limit.
How to write a private narcotic prescription:
Although paper prescriptions of controlled substances may soon become largely obsolete, I’ll outline the requirements anyway (because... this is Israel, and you just never know!).
Additional Important Points
The prescription is valid for 14 days only. Medications cannot be dispensed from an older prescription.
The original prescription must be presented at the pharmacy. A photocopy or fax will not be accepted. The original remains at the pharmacy. If the prescription is issued through a health fund (Kupah), the physician should provide one additional signed copy. Each prescription can be used only once.
If there are corrections or deletions on the prescription, the physician must sign next to the correction.
As a rule, medication may be dispensed for 10 days of treatment only. A one-month supply may be dispensed only if the physician writes why e.g: “For long-term treatment of ADHD, the patient is under follow-up.” Writing only the diagnosis is not sufficient. Medication cannot be dispensed for a period longer than one month.
If a one-month supply was dispensed, an additional supply can be provided only after 30 days, not earlier. If only 10 days were dispensed, an additional supply can be provided only after 10 days, and so on.
The pharmacist may request ID from both the patient and the person collecting the medication.
Further details can be found in the most recent Ministry of Health document addressing the dispensing of prescriptions for dangerous drugs:
Final Thoughts
'Dangerous drugs' are part of life, helping many to cope and function better. We welcome the new regulations which will reduce misuse and make our society safer.
We hope this blog gave you some clarity as you practice in Israel! B'Hatzlacha!
