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105 CMR SECTION 700

Definitions

Narcotic Drug: Derivative, salt or compound of opium, opiate or coca leaves. Opium poppy or poppy straw are also considered narcotic drugs.

Non-self-administering: personally, taking or applying a controlled substance as directed by a practitioner with more than minimal assistance by program staff.

Opiate: Any substance with addiction-forming or addiction-sustaining liability similar to morphine.

700.003: Registrations for Specific Activities

  • Certified nurse practitioners, psychiatric nurse specialists, certified registered nurse anesthetist, or physician assistants can issue prescriptions for Schedules II-VI but must meet certain requirements which include:

    • Registration in the Department's Prescription Monitoring and Drug Control Program

    • Written prescriptions must be within the scope of practice of the prescriber

    • The person writing the prescription must identify their name and title to pharmacist and provide their registration number, work address, phone number, and name of the supervising physician.

The Department allows the administration of epinephrine, naloxone*, opioid antagonists, atropine, pralidoxime chloride or other nerve agent antidotes by:

  • First responders

  • Public employees or volunteers of an agency or municipality that functions in emergency preparedness and response

  • Authorized employee or volunteer to a facility or program which services include the administration of the above medications

*On August 2018, Chapter 208, "An Act for Prevention and Access to Appropriate Care and Treatment of Addiction", allows pharmacies to dispense opioid antagonists without a prescription to any person at-risk of experiencing an opioid-related overdose. Thus, all pharmacies must maintain a constant supply of naloxone rescue kits and there is no limit to the amount of naloxone that may be dispensed to an individual as a pharmacy may dispense naloxone to a patient-specific prescription or via a statewide standing order.

The administration of the above medications requires a prescription from a prescriber; however, first responders are allowed to administer these medications under the Statewide Treatment Protocols. In addition to this, the epinephrine and nerve agent antidote must be packaged in a prefilled, automatic injection device that allows for self-administration and the naloxone and opioid antagonists must be in the original package. The Department also requires a designated qualified, licensed practitioner who will be responsible for creating and enforcing protocols for correct administration of epinephrine, naloxone, and other opioid antagonist. Part of the protocol should include proper training of administration of these medications such as the following:

  • Risk reduction procedures

  • Opioid overdose symptom recognition

  • Proper use of auto-injectors for epinephrine and nerve agent antidotes

  • Measures to notify proper emergency medical services

School districts or private schools are allowed to register with the department to administer controlled substances. Employees of community programs are also allowed to administer or assist in administration of controlled substances to non-self-administering persons if they meet the following requirements:

  • Registered with the department

    • Administration must be done ...

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