LIMITING PRESCRIPTIONS FOR

CONTROLLED SUBSTANCES

Senate Bill 274 (S-2) as passed by the Senate

Sponsor:  Sen. Marty Knollenberg

House Committee:  Health Policy

Senate Committee:  Health Policy

Complete to 9-25-17

SUMMARY:

Senate Bill 274 would amend the Public Health Code to allow a pharmacist to fill partially in increments a prescription for a Schedule 2 controlled substance in certain situations.  It would also limit the supply of an opioid a prescriber could prescribe to a patient being treated for acute pain, beginning July 1, 2018.  The bill would take effect 90 days after enactment.  (MCL 333.7333 and proposed 333.7333b)

Specifically, the bill would state that a pharmacist may partially fill in increments a prescription for a Schedule 2 controlled substance in any of the following three instances:

·         The pharmacist is unable to supply the full quantity of the controlled substance prescribed or the patient requests a smaller quantity of the controlled substance than was prescribed. A prescription that was partially filled under this section must not be filled more than 30 days after the prescription was issued.

·         The prescription was filled upon the oral prescription of a practitioner.  The pharmacist who fills this prescription must record the quantity dispensed and maintain that documentation. A prescription partially filled under this section must not be filled more than 72 hours after the first partial filling.

·         The prescription is for a terminally ill patient whose terminal illness is documented by the pharmacist as required by the Michigan Board of Pharmacy or its designated or established authority. A prescription partially filled under this section must not be filled more than 60 days after the prescription was issued.

Currently under the Code, a prescription may only be filled partially under the third instance—in the case of a terminally ill patient.

The bill would also create a new section of the Code which would provide that a prescriber treating a patient for acute pain may not prescribe more than a seven-day supply of an opioid within a seven-day period.

Acute pain as used in that section would mean pain that is the normal, physiological response to a noxious chemical or a thermal or mechanical stimulus and is typically associated with invasive procedures, trauma, and disease and usually lasts for a limited amount of time.

BACKGROUND:

According to the bill sponsor, the bill is intended to reduce the number of unused opioids in medical cabinets and on the streets.  It is hoped that limiting an initial opioid prescription when treating a patient for acute pain would lessen the likelihood that the patient would develop a dependence on that opioid.

FISCAL IMPACT:

Senate Bill 274 would not have any significant fiscal impacts on any units of state or local government.

                                                                                        Legislative Analyst:   Jenny McInerney

                                                                                                Fiscal Analyst:   Marcus Coffin

■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their deliberations, and does not constitute an official statement of legislative intent.