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North Carolina and Texas Sign Legislation to Make Naloxone More Accessible to Patients


New legislation in North Carolina and Texas make naloxone, the opioid overdose reversal drug, more accessible to patients. North Carolina Governor Pat McCrory signed Senate Bill (SB) 734 into law on June 20, 2016, which authorizes the state health director to prescribe an opioid antagonist using a statewide standing order.

Under the former law, only a practitioner was authorized to prescribe an opioid antagonist pursuant to a standing order. SB 734 became effective the same day, according to the North Carolina Health and Human Services press release.
 
Beginning August 1, 2016, pharmacists in Texas will be authorized to dispense naloxone to patients under a standing order. The legislation will require pharmacists to complete a one-hour course accredited by the Accreditation Council for Pharmacy Education and in coordination with the Texas Pharmacy Association, according to a press release.

SB 1462 states an authorized prescriber may prescribe an opioid antagonist through a standing order. Medical doctors have unlimited, independent prescribing authority in every state. NABP’s 2016 Survey of Pharmacy Law states that pharmacists in Texas may perform specific acts relating to drug therapy management under written protocol from a practitioner including implementing or modifying therapy.


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Delaware Law Requires ID to Buy Certain Cough Medicines


A new Delaware law restricts the sale of over-the-counter (OTC) medicines containing dextromethorphan (DXM) to those aged 18 and older.

Intended to reduce abuse of the cough suppressant among teens, the law requires an ID to be presented at the point of purchase.

Delaware is the 12th state to impose a DXM restriction, reports Drug Store News.


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New Hampshire Pharmacies May Establish Drug Take-Back Programs Under New Law


Retail pharmacies in New Hampshire are authorized to establish pharmaceutical drug take-back programs if their program meets certain federal requirements.

House Bill (HB) 1490 was signed into law by Governor Maggie Hassan and is effective August 6, 2016. Under HB 1490, a registered pharmacy may establish a drug take-back program to collect controlled and non-controlled pharmaceutical drugs.

New Hampshire RSA 318-E:1 defines “pharmaceutical drug” as a prescription or OTC drug, including controlled drugs.


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Alaska Regulates Sale of Dextromethorphan Products to Adults, Requires Prescription for Persons Under 18 Years of Age.


The sale of products containing dextromethorphan in Alaska is restricted to individuals 18 years of age or older under a new law. House Bill 125 states products containing dextromethorphan may be sold if the person is under 18 years of age and has a prescription for the product from a licensed practitioner.

Alaska is the 11th state to restrict the sale of products containing dextromethorphan to adults and to require a prescription from a practitioner for individuals younger than 18 years, reports the American Pharmacists Association.


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Pharmacies in West Virginia Will Be Allowed to Dispense Opioid Antagonists Pursuant to Protocol Under New Law.


Pharmacies in West Virginia will be able to dispense naloxone, the opioid overdose reversal drug, pursuant to a protocol beginning June 10, 2016. Under the new law, a pharmacist or pharmacy intern is authorized to dispense an opioid antagonist pursuant to a protocol.
 
The law states the West Virginia Board of Pharmacy is required to develop a protocol requiring patient counseling, educational materials, and documentation of distribution in the West Virginia Controlled Substances Monitoring Program database. In addition, the Board is required to revise existing reporting requirements, provide limited liability to pharmacists and pharmacy interns, and reorganize existing code language.
 
West Virginia codes to be amended and reenacted include Chapter 16, Article 46, Section 3; Chapter 16, Article 46, Section 5; and Chapter 16, Article 46, Section 6. The law also adds a new section: Chapter 16, Article 46, Section 3a. Senate Bill 431 was signed into law by Governor Earl Ray Tomblin in March 2016 and takes effect June 10, 2016.


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Pharmacists in New Jersey Would Be Able to Dispense Certain Contraceptives Under Proposed Law.


Pharmacists in New Jersey would be able to dispense self-administered hormonal contraceptives pursuant to a standing order under a proposed New Jersey bill. Senate Bill 1073/2060 would require the New Jersey State Board of Pharmacy and Board of Medical Examiners to jointly develop procedures and protocols.
 
Under the proposed law, the standardized procedures and protocols would require a patient to use a self-screening tool to identify patient risk factors for the use of self-administered hormonal contraceptives, based on the current US Medical Eligibility Criteria for Contraceptive Use developed by the Centers for Disease Control and Prevention.
 
The standardized procedures and protocols would also require a pharmacist, upon furnishing a contraceptive to a patient or upon determining that a contraceptive is not recommended, to refer the patient to the patient’s primary care provider or to an appropriate and nearby medical clinic.
 
To date, the bill, sponsored by Senators Shirley K. Turner and Joseph F. Vitale, has been referred to the Senate Budget and Appropriations Committee.


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Pharmacists in New Jersey Would Be Able to Dispense Certain Contraceptives Under Proposed Law


Pharmacists in New Jersey would be able to dispense self-administered hormonal contraceptives pursuant to a standing order under a proposed New Jersey bill. Senate Bill 1073/2060 would require the New Jersey State Board of Pharmacy and Board of Medical Examiners to jointly develop procedures and protocols.
 
Under the proposed law, the standardized procedures and protocols would require a patient to use a self-screening tool to identify patient risk factors for the use of self-administered hormonal contraceptives, based on the current US Medical Eligibility Criteria for Contraceptive Use developed by the Centers for Disease Control and Prevention.
 
The standardized procedures and protocols would also require a pharmacist, upon furnishing a contraceptive to a patient or upon determining that a contraceptive is not recommended, to refer the patient to the patient’s primary care provider or to an appropriate and nearby medical clinic.
 
To date, the bill, sponsored by Senators Shirley K. Turner and Joseph F. Vitale, has been referred to the Senate Budget and Appropriations Committee.


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Naloxone Available in Some Pennsylvania Pharmacies Under Statewide Standing Order


Pennsylvania has among the highest rates of opioid-related abuse and overdose, according to this recent press release. In October 2015, Pennsylvania Physician General Rachel Levine, MD, signed astanding order that authorized pharmacists to dispense the overdose reversal drug naloxone to people who are at risk of experiencing an opioid-related overdose. Under the standing order, ACME Markets has made naloxone available at 10 ACME Markets pharmacies, a subsidiary of Albertsons, throughout Delaware County, PA.

Source: http://www.nabp.net/news/naloxone-available-in-some-pennsylvania-pharmacies-under-statewide-standing-order?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NabpNewsroom+%28NABP+Newsroom%29


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Maine to Require Providers Use E-Prescribing and Check Prescription Monitoring Data for Opioids, Benzodiazepine; Law Includes New Limits for Opioid Prescribing.


Maine to Require Providers Use E-Prescribing and Check Prescription Monitoring Data for Opioids, Benzodiazepine; Law Includes New Limits for Opioid Prescribing.

Prescribers and dispensers in Maine will be required to check prescription monitoring information when prescribing and dispensing a benzodiazepine or an opioid medication under “An Act To Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program” signed into law by Governor Paul LePage on April 19, 2016.

Under the law, a person who violates this rule commits a civil violation for which a $250 fine per incident may be adjudged.

Specifically, a dispenser must check prescription monitoring information prior to dispensing a benzodiazepine or an opioid medication to a person under any of the following circumstances:

a. the person is not a resident of Maine;
b. the prescription is from a prescriber with an address outside of Maine;
c. the person is paying cash when the person has prescription insurance on file; or
d. the person has not had a prescription for a benzodiazepine or an opioid medication in the previous 12-month period according to the pharmacy prescription record.
 
Further, the law (SP 671-LD 1646) establishes opioid medication prescribing limits. Prescribers may not prescribe to a patient any combination of opioid medication in an aggregate amount in excess of 100 morphine milligram equivalents of opioid medication per day.

In addition, prescribers may not prescribe within a seven-day period more than a seven-day supply of an opioid medication to a patient under treatment for acute pain, and prescribers may not prescribe within a 30-day period more than a 30-day supply of an opioid medication to a patient under treatment for chronic pain.

Prescribers will also need to complete three hours of continuing education every two years on the prescription of opioid medication as a condition of prescribing opioid medication. The law also requires all opioid medication to be prescribed electronically by July 1, 2017. Certain sections of the law are effective January 1, 2017.