Tennessee § 53-11-308 - Prescription requirements.

§ 53-11-308. Prescription requirements.

Except when dispensed directly by a health care prescriber other than a pharmacy to an ultimate user, no controlled substance in Schedule II may be dispensed without the electronic prescription of a health care prescriber, unless authorized by § 63-1-160. To the extent federal law does not permit an electronic prescription, a written prescription from a health care prescriber is required. In emergency situations, Schedule II drugs may be dispensed upon oral prescription of a health care prescriber, reduced promptly to writing or to electronic form, as appropriate, and filed by the pharmacy. Prescriptions shall be retained in conformity with the requirements of § 53-11-306. No prescription for a Schedule II substance may be refilled. Except when dispensed directly by a practitioner other than a pharmacy to an ultimate user, a controlled substance included in Schedule III or IV that is a prescription drug shall not be dispensed without a written or oral prescription of a practitioner. The prescription shall not be filled or refilled more than six (6) months after the date of the written or oral prescription or be refilled more than five (5) times, unless renewed by the practitioner. A controlled substance included in Schedule V shall not be distributed or dispensed other than for a medical purpose. No prescription for any opioids or benzodiazepines may be dispensed in quantities greater than a thirty-day supply. If a prescriber dispenses any opioids, benzodiazepines, barbiturates, or carisoprodol, then the prescriber shall submit the transaction to the controlled substances monitoring database operated under chapter 10, part 3 of this title. Any prescribers of opioids, benzodiazepines, barbiturates or carisoprodol, either alone, concurrently, or sequentially with any other opioids, benzodiazepines, barbiturates, or carisoprodol to patients who are in chronic, long-term drug therapy for ninety (90) days or longer shall consider mandatory urine drug testing. This subsection (g) shall not supercede any rules promulgated by the commissioner for urine drug testing by registered pain management clinics. Prior to prescribing more than a three-day supply of an opioid or an opioid dosage that exceeds a total of a one hundred eighty (180) morphine milligram equivalent dose to a woman of childbearing age, a prescriber shall: Advise the patient of the risk associated with opioid use during pregnancy; Counsel the patient on appropriate and effective forms of birth control; and Offer information about the availability of free or reduced cost birth control to the patient. As used in this subsection (h) “a woman of childbearing age” means any woman between the ages of fifteen (15) and forty-four (44). This subsection (h) does not apply if: The prescriber has previously taken all actions required by subdivision (h)(1) with respect to the patient within the past three (3) months; or The prescriber reasonably believes that the patient is not capable of becoming pregnant. If the patient is under eighteen (18) years of age, the physician may satisfy this subsection (h) by advising, counseling, and providing information to the parent or guardian instead of the patient. This subdivision (h)(4) does not prohibit a physician from advising, counseling, and providing information directly to the patient if not otherwise prohibited by law. The department of health shall develop and publish guidance to assist prescribers of opioids in complying with this subsection (h). Acts 1971, ch. 163, § 24; T.C.A., § 52-1431; Acts 2013, ch. 430, § 4; 2018, ch. 883, § 2; 2018, ch. 901, § 1. Compiler's Notes. The controlled substances schedules, referred to in this section, appear in title 39, ch. 17, part 4. Acts 2013, ch. 430, § 1 provided that the act, which added subsections (e)-(g), shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.” Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5) , in order to promulgate any rules required by the act. Acts 2018, ch. 883, § 10 provided that the commissioner of health is authorized to promulgate rules to effectuate the purposes of the act. All rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5. Amendments. The 2013 amendment added (e)-(g). The 2018 amendment by ch. 883, effective January 1, 2019, in (a), substituted “health care prescriber” for “practitioner” preceding “other” and “electronic prescription of a health care prescriber, unless authorized by § 63-1-160 . To the extent federal law does not permit an electronic prescription, a written prescription from a health care prescriber is required” for “written prescription of a practitioner” at the end; in (b), substituted “health care prescriber” for “practitioner” following “prescription of a”, inserted “or to electronic form, as appropriate,” and substituted “§ 53-11-306 ” for “§ 53-11-305 ”. The 2018 amendment by ch. 901, effective July 1, 2018, added (h). Effective Dates. Acts 2013, ch. 430, § 16. October 1, 2013; provided, that, for the purpose of promulgating rules and regulations, the act took effect May 16, 2013. Acts 2018, ch. 883, § 12. January 1, 2019; provided that for rulemaking purposes the act took effect May 3, 2018. Acts 2018, ch. 901, § 3. July 1, 2018. Cross-References. Substitution of drugs in filling prescriptions prohibited, § 39-17-421 . Cited: State v. Dominy, 6 S.W.3d 472, 1999 Tenn. LEXIS 571 (Tenn. 1999); State v. Robinson, 139 S.W.3d 661, 2004 Tenn. Crim. App. LEXIS 82 (Tenn. Crim. App. 2004).