Several of New Jersey’s professional licensing Boards recently adopted new controlled dangerous substance prescription requirements. Prescribers should be aware of the changes to avoid running afoul of the new regulations.
Citing “abuse of prescription drugs [which] has reached epidemic proportions nationwide,” several New Jersey professional licensing Boards have concurrently adopted, first on an emergency basis, and now permanently, rules establishing “special requirements when prescribing a Schedule II controlled dangerous substance for pain or any opioid drug; for the treatment of chronic pain; and the prescribing of opioid drugs for the treatment of acute pain.”
In general, the new rules prohibit a practitioner from issuing an initial prescription for an opioid drug in a quantity exceeding a five-day supply and require the prescription to be for the lowest effective dose of an immediate-releasing opioid drug. The new rules further provide that a licensee shall not issue an initial prescription for an opioid drug that is for an extended-release or long-acting opioid. The professional Boards issuing the new rules include the State Board of Dentistry, the State Board of Medical Examiners, the State Board of Nursing, and the State Board of Optometrists.
The new rules also specify the actions a licensee must perform when prescribing, dispensing, or administering any controlled dangerous substances. For example, it directs licensees to take a thorough medical history of the patient that reflects the nature, frequency, and severity of any pain; the patient’s history of substance use or abuse; and the patient’s experience with non-opioid medication and non-pharmacological pain management approaches.
The new rules require the licensee to conduct an examination appropriate to the practitioner’s specialty (including an assessment of physical and psychological function, and an evaluation of underlying or coexisting diseases or conditions). They also require a practitioner to access and consider relevant Prescription Monitoring Program information. Practitioners must also develop a specific treatment plan which takes into account pain management. In addition, the new requirements mandate that the practitioner prepare a patient record that reflects the history, the findings on examination, any relevant PMP data, the treatment plan, the complete name of the controlled dangerous substance, the dosage, strength, and quantity of the controlled dangerous substance, and the instructions as to frequency of use.
Other requirements include, entering into a proposed pain management agreement with a patient when issuing the third prescription for a Schedule II controlled dangerous substance for pain or any opioid drug, limiting Schedule II controlled dangerous substances in a quantity not to exceed a 30-day supply (to be at the lowest effective dose as determined by the directed dosage and frequency of dosage). Practitioners must also abide by the specific requirements when prescribing controlled dangerous substances for chronic pain.
The new changes also added definitions for terms such as “acute pain,” “chronic pain,” “initial prescription,” “licensee,” and “palliative care.”
If you have any questions about the new controlled substance prescribing regulations or have other health law questions please contact our office.