California 2019 2019-2020 Regular Session

California Assembly Bill AB888 Amended / Bill

Filed 03/21/2019

                    Amended IN  Assembly  March 21, 2019 CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 888Introduced by Assembly Member LowFebruary 20, 2019 An act to amend Section 11454 11158.1 of the Health and Safety Code, relating to controlled substances. LEGISLATIVE COUNSEL'S DIGESTAB 888, as amended, Low. Controlled substances. Opioid prescriptions: information: nonpharmacological treatments for pain.Existing law requires a prescriber, with certain exceptions, before directly dispensing or issuing for a minor the first prescription for a controlled substance containing an opioid in a single course of treatment, to discuss specified information with the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment.This bill would extend that requirement for the prescriber by applying it to any patient, not only a minor, under those circumstances. The bill would also require the prescriber to discuss the availability of nonpharmacological treatments for pain, as defined.Existing law makes an exception to the requirement for the prescriber in the case of a patient who is being treated for a diagnosis of chronic intractable pain, as specified.This bill would remove that exception and would instead make an exception in the case of a patient who is currently receiving hospice care.The bill would require the prescriber, after discussing the information, to offer a referral for a provider of nonpharmacological treatments for pain, and to obtain informed written consent from the patient, a minor patients parent or guardian, or another authorized adult, as specified.Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires a health benefit plan issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined.This bill would make legislative findings and declarations relating to addiction associated with overreliance on prescription medication for pain management, and providing that nonpharmacological treatments for pain should be considered during the next update to the states essential health benefits benchmark plan.Existing law, the Uniform Controlled Substances Act, classifies certain substances as controlled substances and prohibits or otherwise limits the possession or sale of those substances.Existing law imposes specified duties relating to the regulation and control of controlled substances upon the Department of Justice. Existing law authorizes the Attorney General to employ persons and expend funds, as specified, for this purpose.This bill would make technical, nonsubstantive changes to those provisions.Digest Key Vote: MAJORITY  Appropriation: NO  Fiscal Committee: NOYES  Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) The opioid crisis has devastated communities within California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.(b) A growing body of research indicates that certain nonpharmacological therapies are proven to be equally effective to treat certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.(c) To this end, awareness of, and access to, nonpharmacological treatments for pain are vitally important to the states efforts to combat the opioid crisis, and that coverage of these treatments should be considered during the next update to the states essential health benefit benchmark plan pursuant to Section 156.111 of Title 45 of the Code of Federal Regulations.SEC. 2. Section 11158.1 of the Health and Safety Code is amended to read:11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:(1) The risks of addiction and overdose associated with the use of opioids.(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.(4) The availability of nonpharmacological treatments for pain.(4)(5) Any other information required by law.(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.(2) Offer a referral for a provider of nonpharmacological treatments for pain.(b)(c) This section does not apply in any of the following circumstances:(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.(c)(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.SECTION 1.Section 11454 of the Health and Safety Code is amended to read:11454.The Attorney General and the agents appointed by the Attorney General, when authorized to do so by the Attorney General, may expend those sums as the Attorney General deems necessary in the purchase of controlled substances for evidence and in the employment of operators to obtain evidence.The sums so expended shall be repaid to the officer making the expenditures upon claims approved by the Attorney General and subject to postaudit by the Department of Finance. The claims when approved shall be paid out of the funds appropriated or made available by law for the support or use of the Department of Justice.

 Amended IN  Assembly  March 21, 2019 CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 888Introduced by Assembly Member LowFebruary 20, 2019 An act to amend Section 11454 11158.1 of the Health and Safety Code, relating to controlled substances. LEGISLATIVE COUNSEL'S DIGESTAB 888, as amended, Low. Controlled substances. Opioid prescriptions: information: nonpharmacological treatments for pain.Existing law requires a prescriber, with certain exceptions, before directly dispensing or issuing for a minor the first prescription for a controlled substance containing an opioid in a single course of treatment, to discuss specified information with the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment.This bill would extend that requirement for the prescriber by applying it to any patient, not only a minor, under those circumstances. The bill would also require the prescriber to discuss the availability of nonpharmacological treatments for pain, as defined.Existing law makes an exception to the requirement for the prescriber in the case of a patient who is being treated for a diagnosis of chronic intractable pain, as specified.This bill would remove that exception and would instead make an exception in the case of a patient who is currently receiving hospice care.The bill would require the prescriber, after discussing the information, to offer a referral for a provider of nonpharmacological treatments for pain, and to obtain informed written consent from the patient, a minor patients parent or guardian, or another authorized adult, as specified.Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires a health benefit plan issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined.This bill would make legislative findings and declarations relating to addiction associated with overreliance on prescription medication for pain management, and providing that nonpharmacological treatments for pain should be considered during the next update to the states essential health benefits benchmark plan.Existing law, the Uniform Controlled Substances Act, classifies certain substances as controlled substances and prohibits or otherwise limits the possession or sale of those substances.Existing law imposes specified duties relating to the regulation and control of controlled substances upon the Department of Justice. Existing law authorizes the Attorney General to employ persons and expend funds, as specified, for this purpose.This bill would make technical, nonsubstantive changes to those provisions.Digest Key Vote: MAJORITY  Appropriation: NO  Fiscal Committee: NOYES  Local Program: NO 

 Amended IN  Assembly  March 21, 2019

Amended IN  Assembly  March 21, 2019

 CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION

Assembly Bill No. 888

Introduced by Assembly Member LowFebruary 20, 2019

Introduced by Assembly Member Low
February 20, 2019

 An act to amend Section 11454 11158.1 of the Health and Safety Code, relating to controlled substances. 

LEGISLATIVE COUNSEL'S DIGEST

## LEGISLATIVE COUNSEL'S DIGEST

AB 888, as amended, Low. Controlled substances. Opioid prescriptions: information: nonpharmacological treatments for pain.

Existing law requires a prescriber, with certain exceptions, before directly dispensing or issuing for a minor the first prescription for a controlled substance containing an opioid in a single course of treatment, to discuss specified information with the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment.This bill would extend that requirement for the prescriber by applying it to any patient, not only a minor, under those circumstances. The bill would also require the prescriber to discuss the availability of nonpharmacological treatments for pain, as defined.Existing law makes an exception to the requirement for the prescriber in the case of a patient who is being treated for a diagnosis of chronic intractable pain, as specified.This bill would remove that exception and would instead make an exception in the case of a patient who is currently receiving hospice care.The bill would require the prescriber, after discussing the information, to offer a referral for a provider of nonpharmacological treatments for pain, and to obtain informed written consent from the patient, a minor patients parent or guardian, or another authorized adult, as specified.Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires a health benefit plan issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined.This bill would make legislative findings and declarations relating to addiction associated with overreliance on prescription medication for pain management, and providing that nonpharmacological treatments for pain should be considered during the next update to the states essential health benefits benchmark plan.Existing law, the Uniform Controlled Substances Act, classifies certain substances as controlled substances and prohibits or otherwise limits the possession or sale of those substances.Existing law imposes specified duties relating to the regulation and control of controlled substances upon the Department of Justice. Existing law authorizes the Attorney General to employ persons and expend funds, as specified, for this purpose.This bill would make technical, nonsubstantive changes to those provisions.

Existing law requires a prescriber, with certain exceptions, before directly dispensing or issuing for a minor the first prescription for a controlled substance containing an opioid in a single course of treatment, to discuss specified information with the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment.

This bill would extend that requirement for the prescriber by applying it to any patient, not only a minor, under those circumstances. The bill would also require the prescriber to discuss the availability of nonpharmacological treatments for pain, as defined.

Existing law makes an exception to the requirement for the prescriber in the case of a patient who is being treated for a diagnosis of chronic intractable pain, as specified.

This bill would remove that exception and would instead make an exception in the case of a patient who is currently receiving hospice care.

The bill would require the prescriber, after discussing the information, to offer a referral for a provider of nonpharmacological treatments for pain, and to obtain informed written consent from the patient, a minor patients parent or guardian, or another authorized adult, as specified.

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires a health benefit plan issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined.

This bill would make legislative findings and declarations relating to addiction associated with overreliance on prescription medication for pain management, and providing that nonpharmacological treatments for pain should be considered during the next update to the states essential health benefits benchmark plan.

Existing law, the Uniform Controlled Substances Act, classifies certain substances as controlled substances and prohibits or otherwise limits the possession or sale of those substances.



Existing law imposes specified duties relating to the regulation and control of controlled substances upon the Department of Justice. Existing law authorizes the Attorney General to employ persons and expend funds, as specified, for this purpose.



This bill would make technical, nonsubstantive changes to those provisions.



## Digest Key

## Bill Text

The people of the State of California do enact as follows:SECTION 1. The Legislature finds and declares all of the following:(a) The opioid crisis has devastated communities within California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.(b) A growing body of research indicates that certain nonpharmacological therapies are proven to be equally effective to treat certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.(c) To this end, awareness of, and access to, nonpharmacological treatments for pain are vitally important to the states efforts to combat the opioid crisis, and that coverage of these treatments should be considered during the next update to the states essential health benefit benchmark plan pursuant to Section 156.111 of Title 45 of the Code of Federal Regulations.SEC. 2. Section 11158.1 of the Health and Safety Code is amended to read:11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:(1) The risks of addiction and overdose associated with the use of opioids.(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.(4) The availability of nonpharmacological treatments for pain.(4)(5) Any other information required by law.(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.(2) Offer a referral for a provider of nonpharmacological treatments for pain.(b)(c) This section does not apply in any of the following circumstances:(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.(c)(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.SECTION 1.Section 11454 of the Health and Safety Code is amended to read:11454.The Attorney General and the agents appointed by the Attorney General, when authorized to do so by the Attorney General, may expend those sums as the Attorney General deems necessary in the purchase of controlled substances for evidence and in the employment of operators to obtain evidence.The sums so expended shall be repaid to the officer making the expenditures upon claims approved by the Attorney General and subject to postaudit by the Department of Finance. The claims when approved shall be paid out of the funds appropriated or made available by law for the support or use of the Department of Justice.

The people of the State of California do enact as follows:

## The people of the State of California do enact as follows:

SECTION 1. The Legislature finds and declares all of the following:(a) The opioid crisis has devastated communities within California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.(b) A growing body of research indicates that certain nonpharmacological therapies are proven to be equally effective to treat certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.(c) To this end, awareness of, and access to, nonpharmacological treatments for pain are vitally important to the states efforts to combat the opioid crisis, and that coverage of these treatments should be considered during the next update to the states essential health benefit benchmark plan pursuant to Section 156.111 of Title 45 of the Code of Federal Regulations.

SECTION 1. The Legislature finds and declares all of the following:(a) The opioid crisis has devastated communities within California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.(b) A growing body of research indicates that certain nonpharmacological therapies are proven to be equally effective to treat certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.(c) To this end, awareness of, and access to, nonpharmacological treatments for pain are vitally important to the states efforts to combat the opioid crisis, and that coverage of these treatments should be considered during the next update to the states essential health benefit benchmark plan pursuant to Section 156.111 of Title 45 of the Code of Federal Regulations.

SECTION 1. The Legislature finds and declares all of the following:

### SECTION 1.

(a) The opioid crisis has devastated communities within California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.

(b) A growing body of research indicates that certain nonpharmacological therapies are proven to be equally effective to treat certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.

(c) To this end, awareness of, and access to, nonpharmacological treatments for pain are vitally important to the states efforts to combat the opioid crisis, and that coverage of these treatments should be considered during the next update to the states essential health benefit benchmark plan pursuant to Section 156.111 of Title 45 of the Code of Federal Regulations.

SEC. 2. Section 11158.1 of the Health and Safety Code is amended to read:11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:(1) The risks of addiction and overdose associated with the use of opioids.(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.(4) The availability of nonpharmacological treatments for pain.(4)(5) Any other information required by law.(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.(2) Offer a referral for a provider of nonpharmacological treatments for pain.(b)(c) This section does not apply in any of the following circumstances:(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.(c)(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.

SEC. 2. Section 11158.1 of the Health and Safety Code is amended to read:

### SEC. 2.

11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:(1) The risks of addiction and overdose associated with the use of opioids.(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.(4) The availability of nonpharmacological treatments for pain.(4)(5) Any other information required by law.(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.(2) Offer a referral for a provider of nonpharmacological treatments for pain.(b)(c) This section does not apply in any of the following circumstances:(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.(c)(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.

11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:(1) The risks of addiction and overdose associated with the use of opioids.(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.(4) The availability of nonpharmacological treatments for pain.(4)(5) Any other information required by law.(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.(2) Offer a referral for a provider of nonpharmacological treatments for pain.(b)(c) This section does not apply in any of the following circumstances:(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.(c)(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.

11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:(1) The risks of addiction and overdose associated with the use of opioids.(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.(4) The availability of nonpharmacological treatments for pain.(4)(5) Any other information required by law.(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.(2) Offer a referral for a provider of nonpharmacological treatments for pain.(b)(c) This section does not apply in any of the following circumstances:(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.(c)(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.



11158.1. (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or for a diagnosis of chronic intractable pain as used in Section 124960 of this code and Section 2241.5 of the Business and Professions Code, except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minors parent or guardian, or another adult authorized to consent to the minors medical treatment treatment, before directly dispensing or issuing for a minor to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:

(1) The risks of addiction and overdose associated with the use of opioids.

(2) The increased risk of addiction to an opioid to for an individual who is suffering from both mental and substance abuse disorders.

(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.

(4) The availability of nonpharmacological treatments for pain.

(4)



(5) Any other information required by law.

(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:

(1) Obtain informed written consent from the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, which shall be placed in the patients medical record and shall contain all of the following:

(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.

(B) A statement certifying that the prescriber discussed with the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment, the information required by subdivision (a).

(C) A space for the signature of the patient, a minor patients parent or guardian, or another adult authorized to consent to the minor patients medical treatment.

(2) Offer a referral for a provider of nonpharmacological treatments for pain.

(b)



(c) This section does not apply in any of the following circumstances:

(1) If the minors patients treatment includes emergency services and care as defined in Section 1317.1.

(2) If the minors patients treatment is associated with or incident to with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.

(3) If, in the prescribers professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the minors patients health or safety, or in violation of the minors patients legal rights regarding confidentiality.

(d) For purposes of this section, nonpharmacological treatments for pain include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.

(c)



(e) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.





The Attorney General and the agents appointed by the Attorney General, when authorized to do so by the Attorney General, may expend those sums as the Attorney General deems necessary in the purchase of controlled substances for evidence and in the employment of operators to obtain evidence.



The sums so expended shall be repaid to the officer making the expenditures upon claims approved by the Attorney General and subject to postaudit by the Department of Finance. The claims when approved shall be paid out of the funds appropriated or made available by law for the support or use of the Department of Justice.