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Prescription Drug Time and Dosage Limit Laws

Prescription Drug Time and Dosage Limit Laws The United States is in the midst of an unprecedented epidemic of Prescription drug overdose Nearly 44,000 people died of drug overdoses in 2013, and just over half of these deaths (22,767) were caused by overdoses involving Prescription The vast majority of Prescription drug overdose deaths in 2013 (16,235) involved a Prescription opioid pain reliever (OPR), which is a drug derived from the opium poppy or synthetic versions of it such as oxycodone, hydrocodone, or The Prescription drug overdose epidemic has not affected all states equally, thus overdose death rates vary widely among states. States have the primary responsibility to regulate and enforce Prescription drug practice.

Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, ... to the pharmacy to be entered on or attached to the prescription form the medical reason for requiring the larger supply. The supply limitations provided in this …

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Transcription of Prescription Drug Time and Dosage Limit Laws

1 Prescription Drug Time and Dosage Limit Laws The United States is in the midst of an unprecedented epidemic of Prescription drug overdose Nearly 44,000 people died of drug overdoses in 2013, and just over half of these deaths (22,767) were caused by overdoses involving Prescription The vast majority of Prescription drug overdose deaths in 2013 (16,235) involved a Prescription opioid pain reliever (OPR), which is a drug derived from the opium poppy or synthetic versions of it such as oxycodone, hydrocodone, or The Prescription drug overdose epidemic has not affected all states equally, thus overdose death rates vary widely among states. States have the primary responsibility to regulate and enforce Prescription drug practice.

2 Although state laws are commonly used to prevent injuries and their benefits have been demonstrated for a variety of injury types,4 there is little information on the effectiveness of state statutes and regulations designed to prevent Prescription drug abuse and diversion. This menu is a first step in assessing laws on Prescription drug time and Dosage limits by creating an inventory of state legal strategies in this domain. Introduction To combat the Prescription drug overdose epidemic, many states have enacted laws that set time or Dosage limits on the prescribing or dispensing of controlled substances. 1 For the purpose of this document, overdose death refers to death resulting from either intentional or accidental overdose, which could be caused by a patient being given the wrong drug, taking the wrong drug in error, or taking too much of a drug inadvertently.

3 2 Centers for Disease Control and Prevention, Wide-ranging Online Data for Epidemiologic Research (WONDER) Database (2013) 3 Id. 4 Julie Gilchrist, Richard A. Schieber & David A. Sleet, Legislative and Regulatory Strategies to Reduce Childhood Injuries, 10 UNINTENTIONAL INJURIES IN CHILDHOOD 111, 111 30 (2000). A law is included in this resource if it limits Prescription drug quantity by time (hours or days supply) or amount of drug ( Dosage units or number of pills).5 Time or Dosage Limit laws concerning benefit plans such as general assistance programs for the elderly (Medicare) or Medicaid programs were Time or Dosage Limit laws p articular to certain facilities, ( , long-term care facilities, community-based care facilities, hospices, home healthcare facilities, nursing facilities, hospitals, and emergency departments) were excluded from this Laws relating specifically to certain kinds of patients, ( , outpatients, discharged patients, and in-p atients) were also excluded.

4 Laws regarding payments of claims or reimbursement restrictions of benefit plans are not direct Prescription drug limits and were therefore excluded from this Laws pertaining to treatment of narcotic addiction, drug samples, maintenance drugs, emergency drug kits, multiple-drug single-dosing containers, and collaborative drug therapy management with authorized pharmacists were also excluded. Laws requiring time or Dosage limits were included for physicians (doctors of medicine and doctors of osteopathic medicine) and pharmacists but not for other professions. Forty-seven states9 and the Di strict of Columbia have laws that set time or Dosage limits for controlled substances.

5 Time Limitations One main category of Prescription drug Limit laws sets forth time limits (hours or days supply) to the supply of Prescription drugs. These time Limit laws can be further classified by their applicability to certain drugs, certain populations or certain situations. Time Limits Applicable to Certain Drugs or Types of Prescriptions A few states10 have laws setting time limits for all prescriptions or all controlled substances. For example, Florida law states Pharmacists may order the medicinal drug products set forth in each rule subject to the following terms and limitations: .. (3) In any case of dispensing hereunder, the amount or 5 In this menu, the first effective dates of the specific provisions referenced are cited as [legal citation] (eff.)

6 [year]). Where dates were either not provided within the laws or were unclear due to multiple revisions, this fact is cited as [legal citation] (eff. date unclear, [estimated year]). 6 Laws related to specific assistance programs like mental health programs, state employees programs, or workers compensation programs were excluded. 7 Laws related to pain management clinics were included in the scope of research. 8 See, , 016-06-22 ARK. CODE R. (eff. 2005) (direct Prescription drug Limit ); but see, , 1 TEX. (eff. 2012) (indirect Prescription drug Limit ). 9 Alabama, Arizona, arkansas , California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

7 10 Five states. See, , FLA. ADMIN. CODE r. (eff. 1986); LA. ADMIN. CODE tit. 46, pt. XLV, 6506 ( ); MO. ANN. STAT. (eff. 1987); EDUC. LAW 6807 (McKinney eff. date unclear); CODE 44-53-360 (eff. date unclear). 2 | Pagequantity of drug dispensed shall not exceed a [thirty-four]-day supply or standard course of treatment unless subject to the specific limitations in this Twenty-three states12 and the District of Columbia13 have laws setting time limits for specific schedules of Prescription drugs. For example, Missouri statute provides for day supply limits: The quantity of Schedule II controlled substances prescribed or dispensed at any one time shall be limited to a thirty-day supply.

8 The quantity of Schedule III, IV or V controlled substances prescribed or dispensed at any one time shall be limited to a ninety-day supply .. The supply limitations provided in this subsection may be increased up to three months if the physician describes on the Prescription form or indicates via telephone, fax, or electronic communication to the pharmacy to be entered on or attached to the Prescription form the medical reason for requiring the larger supply. The supply limitations provided in this subsection shall not apply if the Prescription is dispensed directly to a member of the United States armed forces serving outside the United South Carolina has day supply limits for specific scheduled controlled substances.

9 Its law requires that [p]rescriptions for controlled substances listed in Schedules III, IV, and V shall not be issued for more than a thirty-one day supply of the substance. 15 California law provides for hour supply limits for Schedule II drugs dispensed by the prescriber. Its law states A practitioner .. may dispense directly to an ultimate user a controlled substance classified in Schedule II in an amount not to exceed a [seventy-two]-hour supply for the patient in accordance with directions for use given by the dispensing practitioner only where the patient is not expected to require any additional amount of the controlled substance beyond the [seventy-two] 11 FLA.

10 ADMIN. CODE r. (eff. 1986). 12 See, , & SAFETY CODE 11158 (eff. date unclear, 1976 1980); COLO. REV. STAT. ANN. 18-18-414 (eff. 1992); 24 DEL. ADMIN. CODE (eff. 2009); FLA. STAT. ANN. (eff. 2009); IDAHO ADMIN. CODE r. (eff. 2012); 720 ILL. COMP. STAT. 570/312 (eff. date unclear); IOWA ADMIN. CODE r. (124) (eff. 2009); KY. REV. STAT. (eff. 2012); LA. ADMIN. CODE. tit . 46, pt. LIII, 2745 (eff. 2008); 105 MASS. CODE REGS (eff. 1998); 30-20-3001 MISS. CODE R. XIX (eff. 2012); MO. ANN. STAT. (eff. 1987); NEV. ADMIN. CODE (eff. 2007); REV. STAT. 318-B:9 (eff. 1983); STAT. ANN. 45 (eff. 2010); CODE R. (eff. 2002); COMP.


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