Connecticut Seal

General Assembly

 

Raised Bill No. 431

February Session, 2018

 

LCO No. 2050

 

*02050_______GL_*

Referred to Committee on GENERAL LAW

 

Introduced by:

 

(GL)

 

AN ACT CONCERNING CHANGES TO PRESCRIPTION DRUG ABUSE STATUTES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 21a-252 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2018):

(a) A physician, in good faith and in the course of the physician's professional practice only, may prescribe, administer and dispense controlled substances, or may cause the same to be administered by a physician assistant, nurse or intern under the physician's direction and supervision, for demonstrable physical or mental disorders but not for drug dependence except in accordance with state and federal laws and regulations adopted thereunder. Notwithstanding the provisions of this subsection the Department of Consumer Protection may approve protocols allowing the dispensing of take-home doses of methadone, by a registered nurse or licensed practical nurse, to outpatients in duly licensed substance abuse treatment facilities. Such dispensing shall be done pursuant to the order of a licensed prescribing practitioner and using computerized dispensing equipment into which bulk supplies of methadone are dispensed by a pharmacist. The quantity of methadone dispensed by such nurse shall not exceed at any one time that amount allowed under federal or state statutes or regulations governing the treatment of drug dependent patients. The Department of Consumer Protection shall conduct inspections of such treatment facilities to ensure that the computerized dispensing equipment and related dispensing procedures documented in the approved protocols are adhered to.

(b) A dentist, in good faith and in the course of the dentist's professional practice only, may prescribe, administer or dispense controlled substances, or may cause the same to be administered by a nurse under the dentist's direction and supervision, to the extent permitted by the federal Controlled Substances Act, federal food and drug laws and state laws and regulations relating to dentistry.

(c) A podiatrist, in good faith and in the course of the podiatrist's professional practice only, may prescribe, administer and dispense controlled substances in schedules II, III, IV or V, or may cause the same to be administered by a nurse under the podiatrist's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to podiatry.

(d) A veterinarian, in good faith in the course of the veterinarian's professional practice only, and not for use by a human being, may prescribe, administer and dispense controlled substances, and may cause them to be administered by an assistant or orderly under the veterinarian's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to veterinary medicine.

(e) An advanced practice registered nurse licensed pursuant to section 20-94a, in good faith and in the course of such nurse's professional practice only, may prescribe, dispense, and administer controlled substances in schedule II, III, IV or V, or may cause the same to be administered by a registered nurse or licensed practical nurse under the advanced practice registered nurse's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to advanced nursing practice.

(f) A nurse-midwife licensed under chapter 377, in good faith and in the course of the nurse-midwife's professional practice only, may prescribe, dispense, and administer controlled substances in schedules II, III, IV and V, or may cause the same to be administered by a registered nurse or licensed practical nurse under the nurse-midwife's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws.

(g) A physician assistant licensed pursuant to section 20-12b, in good faith and in the course of the physician assistant's professional practice only, may prescribe, dispense, and administer controlled substances in schedule II, III, IV or V, or may cause the same to be administered by an advanced practice registered nurse, registered nurse, or licensed practical nurse who is acting under a physician's direction, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to physician assistant practice.

(h) An optometrist authorized to practice advanced optometrical care, in good faith and in the course of the optometrist's professional practice only and who is duly authorized by section 20-127, may prescribe, administer or dispense controlled substances in schedule II, III, IV or V to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to optometry.

(i) Any person who has obtained directly from a physician, dentist, podiatrist, optometrist, veterinarian, physician assistant, advanced practice registered nurse or nurse-midwife any controlled substance for self-administration or administration to a patient during the absence of such physician, dentist, podiatrist, optometrist, veterinarian, physician assistant, advanced practice registered nurse or nurse-midwife shall return to such physician, dentist, podiatrist, optometrist, veterinarian, physician assistant, advanced practice registered nurse or nurse-midwife any unused portion of such controlled substance, when it is no longer required by the person or the patient, or may surrender such controlled substance to the Commissioner of Consumer Protection for proper disposition.

(j) A licensed practitioner shall not, except in an emergency, prescribe or dispense controlled substances schedules II to IV, inclusive, to a member of their immediate family. For purposes of this section, an immediate family member is defined as a spouse, parent, child, sibling, parent-in-law, son or daughter-in-law, brother or sister-in-law, step-parent, step-child, step-sibling, or other relative residing in the same residence as the practitioner. In emergency settings or isolated settings where there is no other qualified physician available, a licensed practitioner shall limit prescriptions to only the amount necessary for a family member and until another licensed practitioner becomes available. A licensed practitioner shall have a bona fide patient relationship with any immediate family member for whom the practitioner prescribes a controlled substance.

(k) A licensed practitioner shall not, except in an emergency, prescribe or dispense controlled substances schedules II to IV, inclusive, for their own use. In emergency settings or isolated settings where there is no other qualified practitioner available, the practitioner should limit prescriptions to only the amount necessary until another licensed practitioner becomes available.

Sec. 2. (NEW) (Effective July 1, 2018) (a) For purposes of this section:

(1) "Opioid antagonist" shall have the meaning set forth in section 17a-714a of the general statutes.

(2) "Prescribing practitioner" shall have the meaning set forth in section 20-14c of the general statutes.

(3) "Pharmacist" shall have the meaning set forth in section 20-609a of the general statutes.

(b) A prescribing practitioner or a pharmacist certified to prescribe naloxone pursuant to section 20-633c of the general statutes may enter into an agreement with a law enforcement agency, emergency medical service provider, government agency or community health organization related to the distribution and administration of an opioid antagonist for the reversal of an opioid overdose. The prescribing practitioner or pharmacist shall provide training to persons who will distribute or administer the opioid antagonist pursuant to the terms of the agreement. Persons other than the prescribing practitioner or pharmacist shall receive training in the distribution or administration of opioid antagonists prior to distributing or administering an opioid antagonist. The agreement shall address the storage, handling, labeling, recalls and record keeping of opioid antagonists by the law enforcement agency, emergency medical service provider, government agency or community health organization which is party to the agreement.

(c) A prescribing practitioner or pharmacist who enters into an agreement pursuant to section (b) of this section shall not be liable for damages in a civil action or subject to administrative or criminal prosecution for the administration or dispensing of an opioid antagonist by such law enforcement agency, emergency medical service provider, government agency or community health organization.

(d) The Commissioner of Consumer Protection may adopt regulations, in accordance with the provisions of chapter 54 of the general statutes, to implement the provisions of this section.

This act shall take effect as follows and shall amend the following sections:

Section 1

July 1, 2018

21a-252

Sec. 2

July 1, 2018

New section

Statement of Purpose:

To prohibit prescribers from prescribing controlled substances for themselves and their family members and to create mechanisms for the distribution of naloxone by certain nonprescribers.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]