Connecticut Seal

General Assembly

File No. 223

    February Session, 2018

Substitute Senate Bill No. 431

Senate, April 4, 2018

The Committee on General Law reported through SEN. LEONE of the 27th Dist. and SEN. WITKOS of the 8th Dist., Chairpersons of the Committee on the part of the Senate, that the substitute bill ought to pass.

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 Section 21a-252 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2018):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) (1) A prescribing practitioner, as defined in section 20-14c, shall not, except in an emergency, prescribe, dispense or administer controlled substances in schedules II to IV, inclusive, to a member of his or her immediate family. For purposes of this section, "immediate family member" means 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 prescribing practitioner and shall not include an animal in the residence. In an emergency, a prescribing practitioner may prescribe, dispense or administer not more than a seventy-two-hour supply of such controlled substances to an immediate family member only when there is no other qualified prescribing practitioner available.

(2) A prescribing practitioner who prescribes, dispenses or administers any controlled substance to a member of his or her immediate family pursuant to subdivision (1) of this subsection shall perform an assessment for the care and treatment of the patient, medically evaluate the patient's need for such controlled substance and document such assessment and need in the normal course of his or her business. The prescribing practitioner shall document the emergency that gave rise to the prescription, dispensing or administering of such controlled substance to the immediate family member.

(k) A prescribing practitioner, as defined in section 20-14c, shall not, except in an emergency, prescribe, dispense or administer controlled substances in schedules II to IV, inclusive, for his or her own use. In an emergency, a prescribing practitioner may prescribe, dispense or administer not more than a seventy-two-hour emergency supply of such controlled substances for self-use only when there is no other qualified prescribing practitioner 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 recordkeeping 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 subsection (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 Legislative Commissioners:

In Section 1, Subsecs. (j)(1) and (k), "in" was inserted before "schedules II to IV" for accuracy, and in Subsec. (j)(1), the definition for "immediate family member" was redrafted for consistency with standard drafting conventions.

GL

Joint Favorable Subst.

 

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.


OFA Fiscal Note

State Impact: None

Municipal Impact: None

Explanation

This bill makes various changes to the prescription drug abuse statutes and allows the Commissioner of the Department of Consumer Protection to adopt regulations which results in no fiscal impact to the state because the department has the expertise to implement the regulations.

The Out Years

State Impact: None

Municipal Impact: None

OLR Bill Analysis

sSB 431

AN ACT CONCERNING CHANGES TO PRESCRIPTION DRUG ABUSE STATUTES.

SUMMARY

This bill generally prohibits prescribing practitioners from prescribing, dispensing, or administering schedule II to IV controlled substances to themselves or immediate family members, except in emergencies. If there is an emergency, the prescriber may provide up to a 72-hour supply of the controlled substance, but only if no other qualified prescriber is available.

The bill also authorizes prescribing practitioners and pharmacists authorized to prescribe naloxone to enter into an agreement to distribute opioid antagonists to certain entities, including community health organizations and law enforcement agencies (see BACKGROUND). The practitioners and pharmacists must provide training to those individuals who will distribute or administer opioid antagonists under such an agreement. The bill authorizes the consumer protection commissioner to adopt implementing regulations.

EFFECTIVE DATE: July 1, 2018

PROVISION OF CONTROLLED SUBSTANCES

Prohibition

Under the bill, prescribing practitioners generally may not prescribe, dispense, or administer schedule II to IV controlled substances to themselves or immediate family members. An “immediate family member” is a spouse; parent; child; sibling; parent-in-law; son- or daughter-in-law; brother- or sister-in-law; step-parent, -child, or -sibling; or other relative residing with the prescriber. Animals living with the prescriber are not considered immediate family members.

Exception

In an emergency, the bill allows prescribers to prescribe, dispense, or administer up to a 72-hour supply of a schedule II to IV controlled substance to themselves or immediate family members, but only if there is no other qualified prescriber available. If prescribing, dispensing, or administering to a family member, the prescriber must (1) perform an assessment for the patient's care and treatment; (2) medically evaluate the patient's need for the controlled substance; and (3) document the emergency, assessment, and patient's need in the normal course of his or her business.

OPIOID ANTAGONIST PROGRAM

Agreement

The bill authorizes prescribers and pharmacists authorized to prescribe naloxone to enter into an agreement with a law enforcement agency, emergency medical service provider, government agency, or community health organization (“agencies”) concerning the distribution and administration of opioid antagonists. The agreement must address the agencies' opioid antagonist storage, handling, labeling, recalls, and recordkeeping.

Training

The prescribers and pharmacists must provide training to the individuals who will distribute or administer opioid antagonists under an agreement. Additionally, the bill requires individuals who will distribute or administer opioid antagonists to receive training before doing so (presumably, this requirement applies to individuals to whom the agencies distribute opioid antagonists).

Liability Immunity

Under the bill, prescribers and pharmacists who enter into an agreement as permitted by the bill cannot, as a result of an agency's administration or dispensing of an opioid antagonist, be (1) held liable for damages in a civil action or (2) subjected to administrative or criminal prosecution.

BACKGROUND

Opioid Antagonists

An “opioid antagonist” is naloxone hydrochloride (e.g., Narcan) or any other similarly acting and equally safe drug that the federal Food and Drug Administration approved for treating a drug overdose (CGS 17a-714a).

Pharmacists Authorized to Prescribe Opioid Antagonists

Licensed pharmacists may prescribe opioid antagonists if they (1) have been trained and certified by a program approved by the consumer protection commissioner and (2) act in good faith (CGS 20-633c).

Prescribing Practitioners

The following health providers may prescribe medication within the scope of their practice: physicians, dentists, podiatrists, optometrists, physician assistants, advanced practice registered nurses, nurse-midwives, and veterinarians (CGS 20-14c).

COMMITTEE ACTION

General Law Committee

Joint Favorable Substitute

Yea

17

Nay

0

(03/20/2018)

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