As July 1st comes around, so does a few changes to opioid and controlled substance dispensing in the state of Minnesota. The Board of Pharmacy has implemented some new rules and regulations for controlled substances and opioid medications and I will highlight the biggest changes for the community setting. There is no grandfathering of prescriptions.
1. Filling limitations:
a. Any opioid or narcotic pain reliever schedule II through IV must be filled within 30 days of the date the prescription was written or issued, or the prescription is no longer valid.
b. For prescribers that issue schedule II opioids as “90 day prescriptions” via issuing three seperate prescriptions on the same day, each prescription is a “new” prescription and must be filled within 30 days of the written date of the prescriptions. Other controlled substances are not affected by this change (such as ADHD medications)
c. For any opioid or narcotic pain reliever schedule III through IV, any subsequent refill must be within 30 days of the previous refill/fill or all remaining refills/fills are invalid. These medications can still have 5 refills within 6 months.
2. Day Supply Limitations:
a. When an opioid or narcotic pain reliever is being prescribed for acute pain (except for dental pain), the days supply must not exceed 7 days for an adult and must not exceed 5 days anyone under the age of 18 years old.
b. Acute pain does not include pain associated with cancer, palliative care, hospice, or end-of-life pain.
c. For dental pain, including wisdom teeth extraction, any prescription for opioids or narcotic pain relievers schedule II through IV, the days supply cannot exceed 4 days.
d. However, if in the clinical judgement of the practitioner and pharmacist, the acute pain requires more than the maximum amount of days supplied (listed in 2.a and 2.b), the practitioner can write a prescription for an opioid or narcotic pain reliever schedule II through IV for the appropriate quantity and days supplied.
3. ID requirements:
a. For allschedule II through IV prescriptions (not just opioids and narcotic pain relievers), the purchaser of the prescription, which does not have to be who the prescription was written for, must present a valid form of photographic identification, unless the person buying the prescription is known to the seller.
4. Emergency Fills:
a. Pharmacists can dispense up to a 30 day supply of medication (or the original prescribed amount whichever is less), even if there are no refills remaining, so long as;
i. Patient has consistently filled the medication at the pharmacy
ii. Pharmacist is unable to contact prescriber or another provider of care for the patient
iii. Drug is essential to treating chronic condition or life-saving that not dispensing the medication could result in harm
iv. Drug is not controlled, unlesscontrolled drug has been prescribed to treat seizure disorder, then a 72 hour supply can be dispensed.
b. Only oneemergency refill can be supplied for a patient in any 12 month period
c. Pharmacist must notify prescriber/provider within 72 hours of emergency refill