86R11598 JSC-F
By: West S.B. No. 813
A BILL TO BE ENTITLED
AN ACT
relating to the prescribing of opioids.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter C, Chapter 481, Health and Safety
Code, is amended by adding Section 481.07635 to read as follows:
Sec. 481.07635. PRESCRIPTIONS OF OPIOIDS. (a) In this
section, "acute pain" means pain with abrupt onset that is caused by
an injury or other process that is not ongoing.
(b) For the initial treatment of acute pain, a prescriber
may not issue a prescription for an opioid in an amount that exceeds
a seven-day supply.
(c) On issuance of an initial opioid prescription under
Subsection (b) for a patient who is a minor, a prescriber shall
discuss with the patient and the patient's parent, conservator, or
guardian, or other person authorized to consent to the minor's
medical treatment:
(1) the risk of addiction and overdose associated with
the use of opioid prescription drugs;
(2) the danger of taking the drug with
benzodiazepines, alcohol, or other central nervous system
depressants; and
(3) the reasons why the prescription is necessary for
the patient.
(d) Notwithstanding Subsection (b), if, in the professional
medical judgment of a prescriber, more than a seven-day supply of an
opioid is required to treat the patient's acute pain or is necessary
for chronic pain management, for the treatment of pain associated
with a cancer diagnosis, or for palliative care, the practitioner
may issue a prescription for the quantity of the opioid needed to
treat the patient's pain. The prescriber shall document in the
patient's medical record:
(1) the specific medical condition that necessitated
greater than a seven-day supply of an opioid; and
(2) that in the prescriber's medical opinion, an
alternative non-opioid treatment was not appropriate to address the
medical condition.
(e) Subsection (b) does not apply to opioids prescribed to
treat substance abuse or opioid dependence.
(f) Before issuing any prescription for an opioid, a
prescriber shall:
(1) inform the patient that the patient has the option
of filling the prescription in a lesser quantity than that
prescribed; and
(2) inform the patient of the risks associated with
the opioid prescribed.
(g) At the request of the patient, a dispenser may dispense
an opioid in a quantity lower than the quantity listed on the
prescription. The dispenser may later fill the remaining quantity
of the prescription at the request of the patient.
(h) If the dispenser partially fills a prescription at the
request of a patient under Subsection (g), the dispenser shall
accurately record the amount dispensed in providing information to
the board. If the dispenser has access to the patient's electronic
health record, the dispenser shall also note the partial filling of
the prescription not later than the seventh day after the date the
opioid is dispensed.
(i) This section does not apply to a prescriber or dispenser
who is a veterinarian.
SECTION 2. Section 481.003(a), Health and Safety Code, is
amended to read as follows:
(a) The director may adopt rules to administer and enforce
this chapter, other than Sections 481.073, 481.074, 481.075,
481.076, 481.0761, 481.0762, 481.0763, 481.07635, 481.0764,
481.0765, and 481.0766. The board may adopt rules to administer
Sections 481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762,
481.0763, 481.07635, 481.0764, 481.0765, and 481.0766.
SECTION 3. Section 554.051(a-1), Occupations Code, is
amended to read as follows:
(a-1) The board may adopt rules to administer Sections
481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, 481.0763,
481.07635, 481.0764, 481.0765, and 481.0766, Health and Safety
Code.
SECTION 4. Section 565.003, Occupations Code, is amended to
read as follows:
Sec. 565.003. ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING
APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless
compliance would violate the pharmacy or drug statutes or rules in
the state in which the pharmacy is located, the board may discipline
an applicant for or the holder of a nonresident pharmacy license if
the board finds that the applicant or license holder has failed to
comply with:
(1) Section 481.073, 481.074, [or] 481.075, 481.076,
481.0761, 481.0762, 481.0763, 481.07635, 481.0764, 481.0765, or
481.0766, Health and Safety Code;
(2) Texas substitution requirements regarding:
(A) the practitioner's directions concerning
generic substitution;
(B) the patient's right to refuse generic
substitution; or
(C) notification to the patient of the patient's
right to refuse substitution;
(3) any board rule relating to providing drug
information to the patient or the patient's agent in written form or
by telephone; or
(4) any board rule adopted under Section 554.051(a)
and determined by the board to be applicable under Section
554.051(b).
SECTION 5. Section 481.07635, Health and Safety Code, as
added by this Act, applies only to a prescription issued on or after
the effective date of this Act. A prescription issued before the
effective date of this Act is governed by the law in effect on the
date the prescription is issued, and the former law is continued in
effect for that purpose.
SECTION 6. This Act takes effect September 1, 2019.