CARA and partialling opioids

[ZakMeister]

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Just wondering if any of you has yet implemented the good practice of partially a CII opioid for a patient who probably doesn't need the full quantity? The law doesn't say anything about 72 hrs time frame so do you tell them to come back to get the rest within that time or they have to get a new rx?




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[zelman]

Just wondering if any of you has yet implemented the good practice of partially a CII opioid for a patient who probably doesn't need the full quantity? The law doesn't say anything about 72 hrs time frame so do you tell them to come back to get the rest within that time or they have to get a new rx?




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[Digsbe]

Actually the law does talk about the 72 hour limit very strictly and explicitly... Also, partially filling a CII is not "a good practice" as the only reason to really do it is if you don't have the full quantity in stock. If the patient doesn't pick it up by the 72 hr limit they cant get the rest of the quantity and will need a new prescription. The only patients the 72 hr limit doesn't apply to are hospice or LTC patients.

 

[ldiot]

Asking questions like this is pointless, state law may be more stringent than federal.

 

[owlegrad]

Is anyone else curious what CARA means? Google would seem to indicate it is a pharmaceutical company but what would that have to do with 'partialling'?

 

[ZakMeister]

Is anyone else curious what CARA means? Google would seem to indicate it is a pharmaceutical company but what would that have to do with 'partialling'?

Comprehensive Addiction and Recovery Act. Looks like Obama has failed to make an impression on the fight against Opioid abuse lol


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[Dred Pirate]

Comprehensive Addiction and Recovery Act. Looks like Obama has failed to make an impression on the fight against Opioid abuse lol


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pretty sure the president doesn't make people addicts.

But why do you say"good practice" when it is essentially illegal - you CANNOT partial a C2 - even if the patient wants (other than a few cases)

 

[ZakMeister]

pretty sure the president doesn't make people addicts.

But why do you say"good practice" when it is essentially illegal - you CANNOT partial a C2 - even if the patient wants (other than a few cases)

According to the new law, you CAN. Please look it up.


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[ZakMeister]

pretty sure the president doesn't make people addicts.

But why do you say"good practice" when it is essentially illegal - you CANNOT partial a C2 - even if the patient wants (other than a few cases)

https://www.congress.gov/bill/114th-congress/senate-bill/524/text


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[zelman]

According to the new law, you CAN. Please look it up.


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Really? In what states?

SEC. 702. PARTIAL FILLS OF SCHEDULE II CONTROLLED SUBSTANCES.

(a) In General.--Section 309 of the Controlled Substances Act (21
U.S.C. 829) is amended by adding at the end the following:
``(f) Partial Fills of Schedule II Controlled Substances.--
``(1) Partial fills.--A prescription for a controlled
substance in schedule II may be partially filled if--
``(A) it is not prohibited by State law;

 

[ldiot]

This isn't allowed in most states as far as I'm aware... if I did a partial quantity I'd tell them they they will lose the remaining quantity and I cannot guarantee that their doctor will write them another script.

 

[ZakMeister]

Really? In what states?

I double checked with our State board and they are working on it. But yes, looks like most states do not allow it. My bad!


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[Sine Cura]

If a patient "probably" doesn't need the full quantity, why is the quack writing for so many?

 

[zelman]

If a patient "probably" doesn't need the full quantity, why is the quack writing for so many?

Because "probably" isn't "certainly" and they may not be very available to write a second prescription. Everyone who has wisdom teeth removed is warned about dry sockets because they can make pain during recovery more severe and prolonged. The typical painkiller prescription is written as though this will happen, but often it doesn't.

 

[zelman]

I double checked with our State board and they are working on it. But yes, looks like most states do not allow it. My bad!


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I'm pretty confident that no states allow it. Does anyone have an example of a state that does?

 

[CetiAlphaFive]

I'm pretty confident that no states allow it. Does anyone have an example of a state that does?

Mine.

 

[zelman]

Mine.

Mystery solved.


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[Niosh]

Mine.

Which state is yours?

 

[Deja]

California 😛

 

[radio frequency]

I'm pretty confident that no states allow it. Does anyone have an example of a state that does?

I'm licensed in multiple states and don't recall this being specified by any of the states' pharmacy laws. It was all from the DEA.

 

[zelman]

I'm licensed in multiple states and don't recall this being specified by any of the states' pharmacy laws. It was all from the DEA.

Many states have a controlled substance act that is the same as the the federal CSA with a few tweaks. When I was about to take my Hawaii MPJE I hadn't read their controlled substance laws so 5 minutes before the exam I flipped through them and said "this looks like federal, I'll assume it's the same." I passed.