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AB-2741 Prescription drugs: opioid medications: minors.(2017-2018)

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Date Published: 04/03/2018 04:00 AM
AB2741:v98#DOCUMENT

Revised  April 18, 2018
Amended  IN  Assembly  April 02, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 2741


Introduced by Assembly Member Burke
(Coauthors: Assembly Members Dahle and Cunningham)

February 16, 2018


An act to add Article 10.8 (commencing with Section 745) to Chapter 1 of Division 2 of the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


AB 2741, as amended, Burke. Prescription drugs: opioid medications: minors.
Existing law provides for the licensure and regulation of health care practitioners by various boards and requires prescription drugs to be ordered and dispensed in accordance with the Pharmacy Law. Existing law makes repeated acts of clearly excessive prescribing or administering of drugs or treatment unprofessional conduct for certain health care practitioners.
This bill would require a prescriber, as defined, to comply with specified conditions when prescribing opioid medication to a minor, including not prescribing more than a 5-day supply of an opioid medication to that minor except in specified instances. This bill would prohibit a prescriber, as defined, from prescribing more than a 5-day supply of opioid medication to a minor unless the prescription is for specified uses. The bill would also require a prescriber to take certain steps before prescribing a minor a course of treatment with opioid medication, including discussing opioid risks and obtaining specified written consent, except in specified instances. The bill would make a violation of the bill’s provisions unprofessional conduct and would subject the prescriber to discipline by the board charged with regulating his or her license. The provisions of the bill requiring the prescriber to assess the minor’s substance abuse history, whether the minor has or is taking prescription drugs for treatment of a substance use disorder, discuss opioid risks, and obtain written consent would not be implemented apply until the development of a consent form by the Medical Board of California.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Article 10.8 (commencing with Section 745) is added to Chapter 1 of Division 2 of the Business and Professions Code, to read:
Article  10.8. Opioid Medication For Minors

745.
 (a) For purposes of this article, section, the following definitions apply:
(1) “Opioid medication” means an opioid analgesic drug product, including, but not limited to, an abuse-deterrent opioid analgesic drug product.
(2) “Prescriber” means a person licensed, certified, registered, or otherwise subject to regulation pursuant to this division, or an initiative act referred to in this division, who is authorized to prescribe opioid medication.
(b) A prescriber authorized to prescribe a Schedule II controlled substance shall comply with this section when prescribing opioid medication to a minor.
(c) A prescriber shall not prescribe more than a five-day supply of opioid medication to a minor unless the prescription is for any of the following:
(1) Management of pain associated with cancer.
(2) Use in palliative or hospice care.
(3) Management of chronic pain not associated with cancer.
(4) Treatment of a substance use disorder.
(d) Except as provided in the case of a prescription for a use listed in subdivision (b), (c), before prescribing a minor a course of treatment with opioid medication, 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 has taken or is currently taking prescription drugs for treatment of a substance use disorder.
(2) Discuss with the minor and the minor’s parent or guardian, or other authorized adult, all of the following:
(A) The risks of addiction and overdose associated with opioid medication.
(B) The increased risk of addiction to opioid medication to individuals suffering from mental or substance abuse disorders.
(C) The dangers of taking opioid medication with benzodiazepines, alcohol, or other central nervous system depressants.
(D) Any other information deemed necessary by the prescriber.
(3) Obtain written consent consent, on the form created pursuant to subdivision (e), for the prescription from the minor’s parent or guardian, or authorized adult. The prescriber shall maintain the consent form in the minor’s record.
(e) (1)The Medical Board of California, by January 1, 2020, shall create a standardized consent form to be used for purposes of this section. The board shall notify its licensees of the availability of the consent form and make it accessible on its member Internet Web site. The consent form shall contain all of the following:

(A)

(1) The brand name or generic name and quantity of the opioid medication being prescribed and the amount of the initial dose.

(B)

(2) A statement indicating that opioid medication is a drug or other substance that the United States Drug Enforcement Administration has identified as having a potential for abuse.

(C)

(3) A statement certifying that the prescriber engaged in the discussion described in subdivision (d).

(D)

(4) The signature of the minor’s parent or guardian, or authorized adult, and the date of signing.

(2)The prescriber shall maintain a consent form completed under this section in the minor’s record.

(f) Subdivision (b) does (c) and paragraph (3) of subdivision (d) shall not apply if the minor’s treatment with opioid medication meets either of the following criteria:
(1) The treatment is associated with, or incident to, a medical emergency as documented in the minor’s medical record.
(2) In the prescriber’s professional judgment, complying with subdivision (b) (c) or with paragraph (3) of subdivision (d), respectively, with respect to the minor’s treatment would be detrimental to the minor’s health or safety. The prescriber shall document in the minor’s medical record the factor or factors which the prescriber believed constituted cause for not fulfilling the requirements of subdivision (b). (c) or paragraph (3) of subdivision (d).
(g) A violation of this article section constitutes unprofessional conduct and grounds for disciplinary action by the prescriber’s licensing board. Each licensing board established under this division, or under an initiative act referred to in this division, shall be charged with enforcing this article section as it pertains to that board’s prescribers.
(h) Subdivision (d) shall not be implemented apply until the Medical Board of California has created the standardized consent form described in subdivision (e).

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REVISIONS:
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