____________________________ Responsibilities and Requirements of Prescribing Schedule II Opioid Drugs
example, Schedule I drugs are considered the most dangerous class of drugs with a high potential for abuse and potentially severe psychological and/or physical dependence. STATE-SPECIFIC LAWS AND RULES Most states have established laws and rules governing the prescribing and dispensing of opioid analgesics. It is each prescriber’s responsibility to have knowledge of and adhere to the laws and rules of the state in which he or she prescribes. CONCLUSION Opioid analgesic medications can bring substantial relief to patients suffering from pain. However, the inappropriate use, abuse, and diversion of prescription drugs in America, particularly prescription opioids, has increased dramatically in recent years and has been identified as a national public health epidemic. A set of clinical tools, guidelines, and recom- mendations are now available for prescribers who treat patients with opioids. By implementing these tools, the clinician can effectively address issues related to the clinical management of opioid prescribing, opioid risk management, regulations sur- rounding the prescribing of opioids, and problematic opioid use by patients. In doing so, healthcare professionals are more likely to achieve a balance between the benefits and risks of opioid prescribing, optimize patient attainment of therapeutic goals, and avoid the risk to patient outcome, public health, and viability of their own practice imposed by deficits in knowledge.
subdivision (c), to consult the patient activ- ity report from the CURES database the first time the health care practitioner pre- scribes, orders, administers, or furnishes a controlled substance to a patient, the health care practitioner shall consult the patient activity report from the CURES database to review the patient’s controlled substance history before subsequently prescribing a Schedule II, Schedule III, or Schedule IV controlled substance to the patient and at least once every six months thereafter if the prescriber renews the prescription and the substance remains part of the treatment of the patient. (iii) A health care practitioner who did not directly access the CURES database to per- form the required review of the controlled substance use report shall document in the patient’s medical record that they reviewed the CURES database generated report within 24 hours of the controlled substance prescription that was provided to them by another authorized user of the CURES database. (B) For purposes of this paragraph, “first time” means the initial occurrence in which a health care practitioner, in their role as a health care practitioner, intends to prescribe, order, admin- ister, or furnish a Schedule II, Schedule III, or Schedule IV controlled substance to a patient and has not previously prescribed a controlled substance to the patient. (2) A health care practitioner shall review a patient’s controlled substance history that has been obtained from the CURES database no earlier than 24 hours, or the previous business day, before the health care practitioner prescribes, orders, administers, or fur- nishes a Schedule II, Schedule III, or Schedule IV controlled substance to the patient. (b) The duty to consult the CURES database, as described in subdivision (a), does not apply to veterinarians or pharmacists. (c) The duty to consult the CURES database, as described in subdivision (a), does not apply to a health care practitioner in any of the following circumstances: (1) If a health care practitioner prescribes, orders, or furnishes a controlled substance to be administered to a patient in any of the following facilities or during a transfer between any of the following facilities, or for use while on facility premises: (A) A licensed clinic, as described in Chapter 1 (commencing with Section 1200) of Division 2.
APPENDIX: LAWS AND REGULATIONS IN CALIFORNIA
HEALTH AND SAFETY CODE DIVISION 10. UNIFORM CONTROLLED SUBSTANCES ACT CHAPTER 4. Prescriptions ARTICLE 1. Requirements of Prescriptions
§11165.4. (a) (1) (A) (i) A health care practitioner authorized to prescribe, order, administer, or furnish a controlled sub- stance shall consult the patient activity report or information from the patient activity report obtained from the CURES database to review a patient’s controlled substance history for the past 12 months before prescribing a Schedule II, Schedule III, or Schedule IV controlled substance to the patient for the first time and at least once every six months thereafter if the prescriber renews the prescription and the substance remains part of the treatment of the patient. (ii) If a health care practitioner authorized to
prescribe, order, administer, or furnish a controlled substance is not required, pursuant to an exemption described in
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