Changes in Law Relative to 90-Day Supplies of Opiates

Effective April 1, there are new limits in the amount of opiate pills that can be dispensed from a single prescription to a 90-day supply. In addition, opiate prescriptions that are unused after 30 days are invalid. This change was brought about with passage of Senate Bill (SB) 319, the mid-biennium review legislation regarding opiates that was passed during the last General Assembly and signed into law by Governor John Kasich on January 4. SB 319, sponsored by Senator John Eklund (R- Geauga County), enacts additional reforms to strengthen oversight by the State of Ohio Board of Pharmacy (SOBP) to encourage responsible treatment and prevent overdoses.

• The prescription is one of multiple prescriptions for the drug issued by a single prescriber to the patient on a single day.
• When combined, the prescriptions do not authorize the patient to receive an amount that exceeds a ninety-day supply of the drug, as determined according to the prescriptions’ directions for use of the drug.
• The prescriber has provided written instructions on the prescription indicating the earliest date on which the prescription may be filled.
• Not more than fourteen days have elapsed since the earliest date on which the prescription may be filled.

So, if you have always given the patient 3 scripts for a 30-day supply each and identified the fill date on each, you will continue to be able to do that, just no more than a total of 90 days. You will need to be specific on the fill date.

• Allows facilities that regularly interact with high-risk individuals (for example, homeless shelters, halfway houses, schools, and drug treatment centers) to have onsite access to naloxone, an overdose antidote that can save lives,
• Allocates $500,000 in state money for local government first responders to purchase and carry naloxone,
• Requires Ohio’s 42,000 pharmacy technicians to register with the SOBP. Over the past three years, pharmacy technicians have accounted for more than one-third of all drug theft cases investigated by the SOBP, and the lack of a registration process makes it too easy for a technician who is fired for theft to find new employment with another pharmacy.
• Requires that suboxone treatment facilities that treat 30 or more patients be licensed by the SOBP unless the facility is a licensed hospital or is already certified by the state. Physician ownership of office-based opiate treatment clinics along with mandatory background checks for the owners and employees of these facilities are also required.
• Gives oversight authority to the pharmacy board when sole proprietors — doctors, dentists, veterinarians, and others — distribute controlled substances to their patients. An exemption in current Ohio law allows sole proprietors to distribute controlled substances to their patients without any oversight from the SOBP. In 2015, exempted prescribers purchased more than 6.5 million doses of controlled substances – including more than 3 million doses of opiates.
• Allows for-profit methadone clinics to open and waives the requirement that providers be certified in Ohio for two years prior to becoming a methadone clinic. The number of methadone clinics in Ohio is insufficient and some people travel hours each day to get methadone, a recognized medical treatment for addiction.
• Provides civil immunity to first responders and other authorized to administer naloxone, which reverses opioid overdoses.

The new law is the latest attempt to address Ohio’s addiction crisis. Despite investing almost $1 billion a year to fight drug abuse and addiction, accidental overdoses claimed 3,050 lives in Ohio in 2015, up 20.5% over 2014. The number of prescription opiate doses has declined and accidental overdose deaths attributed to opioids have also begun to decline slightly in recent years, but deaths attributable to heroin, fentanyl, cocaine, and benzodiazepines have been climbing.