NEW TENNESSEE LAW LIMITS OPIOID AND BENZODIAZEPINE DISPENSING

On or after October 1, 2013, "no prescription for any opioids or benzodiazepines may be dispensed by a Tennessee licensed pharmacy (including out-of-state Tennessee licensed pharmacies mailing into Tennessee) in quantities greater than a thirty (30) day supply."

What law is this? Public Chapter 430 (also called the "Addison Sharp Prescription Regulatory Act") enacted by the Tennessee General Assembly during the 2013 session made changes to requirements for prescribing, dispensing, and use of controlled substances in Tennessee. This legislation was brought at the request of the Knoxville Chief of Police in an attempt to curb drug abuse in Tennessee. This new limitation on dispensing was included in the Act to decrease the amount of drugs available at any one time in Tennessee.

What drugs are affected by the law? The law does not specify a list of drugs and no regulatory entity has issued such a list. This means that the pharmacist must use professional judgment. TPA notes that the intent of the law is for the limitation to apply to any drug pharmacologically classified by the FDA as an opioid or benzodiazepine.

What are the penalties for violation of this law? This new requirement was added to the existing Narcotic Drugs and Drug Control law found in TCA Title 53, Section 11, Part 3, specifically § TCA 53-11-308. No change was made in the penalty for violation of existing provisions in § TCA 53-11-308. The penalty for a violation of this section continues to be a Class D felony with significant fines depending on the Schedule of the drug.

Are prescribers limited in the number of days supply they are permitted to prescribe? NO. This new law places no limits on quantities of opioids or benzodiazepines that can be prescribed. However, if a prescriber is also dispensing, the dispensing limitations of a 30 day supply do apply.

What happens to the remainder of a prescription written for more than a 30 day supply? Pharmacists may treat each 30 day supply dispensed as partial fills and may dispense remaining quantities of drugs on prescriptions written for drugs in Schedules III, IV and V in quantities in excess of a 30 day supply up to the total quantity originally prescribed in accordance with current laws and rules. For prescriptions for Schedule II drugs being dispensed by community pharmacies, pharmacists may adjust the quantities of the original prescriptions only per state and federal law and in accordance with current Tennessee Board of Pharmacy policy, but new prescriptions will be required for any remaining quantities in excess of a 30 day supply for the original Schedule II prescription.

Does this mean the patient must get a new prescription for any opioid or benzodiazepine every 30 days? NO. Patients can have prescriptions refilled in accordance with current laws and rules regarding refills of controlled substance prescriptions depending on the Schedule of the drug. Prescriptions for Schedule II drugs will continue to NOT be refillable.

What if I have questions? The provisions of this law are enforced by the Tennessee Board of Pharmacy. The Board's September 2013 newsletter contains additional information regarding this law. After reviewing the Board newsletter, if you have further questions, please contact the Board of Pharmacy. There are additional provisions to this law, such as the requirement for the Tennessee Commissioner of Health to develop recommended treatment guidelines for prescribing of opioids, benzodiazepines , barbiturates and carisoprodol by January 1, 2014.