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PRINTER'S NO. 2297
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1712
Session of
2017
INTRODUCED BY NEILSON, READSHAW, SANTORA, TAYLOR, DRISCOLL,
PASHINSKI, O'BRIEN, McNEILL, A. HARRIS, DONATUCCI, W. KELLER
AND KAUFER, AUGUST 16, 2017
REFERRED TO COMMITTEE ON HEALTH, AUGUST 16, 2017
AN ACT
Amending Title 35 (Health and Safety) of the Pennsylvania
Consolidated Statutes, in prescribing opioids to minors,
providing for prescribing opioids to individuals and further
providing for definitions, for prohibition and for procedure.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The heading of Chapter 52A of Title 35 of the
Pennsylvania Consolidated Statutes is amended to read:
CHAPTER 52A
PRESCRIBING OPIOIDS TO [MINORS] INDIVIDUALS
Section 2. The definition of "medical emergency" in section
52A01 of Title 35 is amended and the section is amended by
adding definitions to read:
§ 52A01. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
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"Conservative care management." An approach to treating back
pain, neck pain and related spinal conditions utilizing
nonpharmacological and nonsurgical treatment options.
"Conservative care management specialist." A medical
professional that administers conservative care management
treatment that is either licensed by the State Board of Medicine
or the State Board of Chiropractic.
* * *
"Medical emergency." A situation which, in a prescriber's
good faith professional judgment, creates an immediate threat of
serious risk to the life or physical health of [a minor] an
individual.
* * *
Section 3. Sections 52A03 and 52A04 of Title 35 are amended
to read:
§ 52A03. Prohibition.
(a) Proscription.--A prescriber may not do any of the
following:
(1) Prescribe to [a minor] an individual a controlled
substance containing an opioid unless the prescriber complies
with section 52A04 (relating to procedure).
(2) Except as set forth in subsection (b) and subject to
section 52A04(c)(1), prescribe to [a minor] an individual
more than a seven-day supply of a controlled substance
containing an opioid.
(b) Exception.--Notwithstanding subsection (a)(1), a
prescriber may prescribe to [a minor] an individual more than a
seven-day supply of a controlled substance containing an opioid
if any of the following apply:
(1) In the professional medical judgment of the
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prescriber, more than a seven-day supply of a controlled
substance containing an opioid is required to stabilize the
[minor's] individual's acute medical condition. In order for
this paragraph to apply, the prescriber must:
(i) document the acute medical condition in the
[minor's] individual's record with the prescriber; and
(ii) indicate the reason why a non-opioid
alternative is not appropriate to address the acute
medical condition.
(2) The prescription is for:
(i) management of pain associated with cancer;
(ii) use in palliative or hospice care; or
(iii) management of chronic pain not associated with
cancer.
§ 52A04. Procedure.
(a) Requirements.--Except as set forth in subsection (b),
before issuing [a minor] an individual the first prescription in
a single course of treatment for a controlled substance
containing an opioid, regardless of whether the dosage is
modified during that course of treatment, a prescriber shall do
all of the following:
(1) Assess whether the [minor] individual has taken or
is currently taking prescription drugs for treatment of a
substance use disorder.
(1.1) Assess whether or not the individual has completed
a 12-week conservative care management treatment regimen
administered by a doctor of chiropractic or other licensed
physical medicine and rehabilitation professional. The
following shall apply:
(i) If it is determined that the individual has not
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completed a 12-week conservative care management
treatment regimen, the prescriber shall refer the
individual to a conservative care management treatment
specialist to complete a 12-week conservative care
management treatment regimen before issuing a
prescription.
(ii) If the individual has completed a 12-week
conservative care management treatment regimen, the
prescriber shall consult with the individual's
conservative care management treatment specialist as soon
as practicable to determine if a prescription should be
issued. The reasons provided by the conservative care
management treatment specialist as to why a prescription
should be issued shall be documented by the prescriber.
(2) Discuss with the [minor and] individual or, if the
individual is a minor, with the minor's parent or guardian or
with an authorized adult, all of the following:
(i) The risks of addiction and overdose associated
with the controlled substance containing an opioid.
(ii) The increased risk of addiction to controlled
substances to individuals suffering from mental or
substance use disorders.
(iii) The dangers of taking a controlled substance
containing an opioid with benzodiazepines, alcohol or
other central nervous system depressants.
(iv) Other information in the patient counseling
information section of the labeling for controlled
substances containing an opioid required under 21 C.F.R.
201.57(c)(18) (relating to specific requirements on
content and format of labeling for human prescription
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drug and biological products described in § 201.56(b)(1))
deemed necessary by the prescriber.
(3) Obtain written consent for the prescription from the
[minor's] individual or, if the individual is a minor, from
the minor's parent or guardian or from an authorized adult.
The prescriber shall record the consent on the form under
section 52A02(b)(1) (relating to administration). The
following apply:
(i) The form must contain all of the following:
(A) The brand name or generic name and quantity
of the controlled substance containing an opioid
being prescribed and the amount of the initial dose.
(B) A statement indicating that a controlled
substance is a drug or other substance that the
United States Drug Enforcement Administration has
identified as having a potential for abuse.
(C) A statement certifying that the prescriber
engaged in the discussion under paragraph (2).
(D) The number of refills authorized by the
prescription under section 52A03(b) (relating to
prohibition).
(E) The signature of the [minor's] individual
or, if the individual is a minor, the signature of
the parent or guardian or of an authorized adult, and
the date of signing.
(ii) The form shall be maintained in the [minor's]
individual's record with the prescriber.
(b) Exception.--Subsection (a) does not apply if the
[minor's] individual's treatment with a controlled substance
containing an opioid meets any of the following criteria:
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(1) The treatment is associated with or incident to a
medical emergency as documented in the [minor's] individual's
medical record.
(2) In the prescriber's professional judgment, complying
with subsection (a) with respect to the [minor's]
individual's treatment would be detrimental to the [minor's]
individual's health or safety. The prescriber shall document
in the [minor's] individual's medical record the factor or
factors which the prescriber believed constituted cause for
not fulfilling the requirements of subsection (a).
(3) A conservative care management specialist recommends
to the prescriber the issuance of a prescription for an
individual under subsection (a)(1.1)(ii).
(c) Limited prescription.--If the individual who signs the
consent form under subsection (a)(3) is an authorized adult, the
prescriber:
(1) may prescribe not more than a single, 72-hour
supply; and
(2) shall indicate on the prescription the quantity that
is to be dispensed pursuant to the prescription.
Section 4. This act shall take effect in 180 days.
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