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A BILL TO BE ENTITLED
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AN ACT
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relating to the prescribing of opioids. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter C, Chapter 481, Health and Safety |
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Code, is amended by adding Section 481.07635 to read as follows: |
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Sec. 481.07635. PRESCRIPTIONS OF OPIOIDS. (a) In this |
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section, "acute pain" means pain with abrupt onset that is caused by |
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an injury or other process that is not ongoing. |
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(b) For the initial treatment of acute pain, a prescriber |
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may not issue a prescription for an opioid in an amount that exceeds |
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a seven-day supply. |
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(c) On issuance of an initial opioid prescription under |
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Subsection (b) for a patient who is a minor, a prescriber shall |
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discuss with the patient and the patient's parent, conservator, or |
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guardian, or other person authorized to consent to the minor's |
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medical treatment: |
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(1) the risk of addiction and overdose associated with |
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the use of opioid prescription drugs; |
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(2) the danger of taking the drug with |
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benzodiazepines, alcohol, or other central nervous system |
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depressants; and |
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(3) the reasons why the prescription is necessary for |
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the patient. |
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(d) Notwithstanding Subsection (b), if, in the professional |
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medical judgment of a prescriber, more than a seven-day supply of an |
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opioid is required to treat the patient's acute pain or is necessary |
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for chronic pain management, for the treatment of pain associated |
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with a cancer diagnosis, or for palliative care, the practitioner |
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may issue a prescription for the quantity of the opioid needed to |
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treat the patient's pain. The prescriber shall document in the |
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patient's medical record: |
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(1) the specific medical condition that necessitated |
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greater than a seven-day supply of an opioid; and |
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(2) that in the prescriber's medical opinion, an |
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alternative non-opioid treatment was not appropriate to address the |
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medical condition. |
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(e) Subsection (b) does not apply to opioids prescribed to |
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treat substance abuse or opioid dependence. |
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(f) Before issuing any prescription for an opioid, a |
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prescriber shall: |
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(1) inform the patient that the patient has the option |
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of filling the prescription in a lesser quantity than that |
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prescribed; and |
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(2) inform the patient of the risks associated with |
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the opioid prescribed. |
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(g) At the request of the patient, a dispenser may dispense |
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an opioid in a quantity lower than the quantity listed on the |
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prescription. The dispenser may later fill the remaining quantity |
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of the prescription at the request of the patient. |
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(h) If the dispenser partially fills a prescription at the |
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request of a patient under Subsection (g), the dispenser shall |
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accurately record the amount dispensed in providing information to |
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the board. If the dispenser has access to the patient's electronic |
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health record, the dispenser shall also note the partial filling of |
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the prescription not later than the seventh day after the date the |
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opioid is dispensed. |
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(i) This section does not apply to a prescriber or dispenser |
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who is a veterinarian. |
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SECTION 2. Section 481.003(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) The director may adopt rules to administer and enforce |
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this chapter, other than Sections 481.073, 481.074, 481.075, |
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481.076, 481.0761, 481.0762, 481.0763, 481.07635, 481.0764, |
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481.0765, and 481.0766. The board may adopt rules to administer |
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Sections 481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, |
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481.0763, 481.07635, 481.0764, 481.0765, and 481.0766. |
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SECTION 3. Section 554.051(a-1), Occupations Code, is |
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amended to read as follows: |
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(a-1) The board may adopt rules to administer Sections |
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481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, 481.0763, |
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481.07635, 481.0764, 481.0765, and 481.0766, Health and Safety |
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Code. |
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SECTION 4. Section 565.003, Occupations Code, is amended to |
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read as follows: |
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Sec. 565.003. ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING |
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APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless |
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compliance would violate the pharmacy or drug statutes or rules in |
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the state in which the pharmacy is located, the board may discipline |
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an applicant for or the holder of a nonresident pharmacy license if |
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the board finds that the applicant or license holder has failed to |
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comply with: |
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(1) Section 481.073, 481.074, [or] 481.075, 481.076, |
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481.0761, 481.0762, 481.0763, 481.07635, 481.0764, 481.0765, or |
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481.0766, Health and Safety Code; |
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(2) Texas substitution requirements regarding: |
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(A) the practitioner's directions concerning |
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generic substitution; |
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(B) the patient's right to refuse generic |
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substitution; or |
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(C) notification to the patient of the patient's |
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right to refuse substitution; |
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(3) any board rule relating to providing drug |
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information to the patient or the patient's agent in written form or |
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by telephone; or |
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(4) any board rule adopted under Section 554.051(a) |
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and determined by the board to be applicable under Section |
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554.051(b). |
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SECTION 5. Section 481.07635, Health and Safety Code, as |
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added by this Act, applies only to a prescription issued on or after |
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the effective date of this Act. A prescription issued before the |
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effective date of this Act is governed by the law in effect on the |
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date the prescription is issued, and the former law is continued in |
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effect for that purpose. |
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SECTION 6. This Act takes effect September 1, 2019. |