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INTRODUCTION

243 CMR Section 2.07:

All licensees are not allowed to self-prescribe any substance in Schedules II-IV and licensees are only allowed to prescribe a Schedule II substance to a family member in an emergency situation. A family member includes the following:

  • Spouse (or equivalent)

  • Parent

  • Child

  • Sibling

  • In-laws

  • Step-relations

If a licensee does prescribe a controlled substance to a family member, they must maintain a medical record for that family member.

Licensees are also not allowed to prescribe anabolic steroids to a patient for athletic performance enhancement, and they cannot prescribe a Schedule II substance for its anorectic or loss of appetite effect.

If a prescriber plans on prescribing an extended-release hydrocodone prescription they must do the following:

  • Review the patient for risk factors, substance abuse history, current medications, and check the patient's history in the Prescription Monitoring Program.

  • Discuss the benefits and risks with the patient.

  • Have a pain management treatment agreement with the patient that will involve drug screening, pill counts, and safe disposal.

  • Provide a Letter of Medical Necessity to the Board.

  • Keep documentation of all the above activities in the patient's medical record.

Prescribing Practices Guidelines:

Physicians are not allowed to self-prescribe any substance in Schedules II-IV and are only allowed to prescribe a Schedule II substance to a family member in an emergency situation. When writing a prescription, a physician must make sure they are practicing within their scope of medicine and must perform basic health care practices with a patient such as taking a medical history and doing a physical/mental examination on the patient.

Physicians will only be able to prescribe if they fulfill certain requirements. They must have an active Massachusetts license to practice and register with the DEA to prescribe Schedule II-V prescriptions. To prescribe Schedule II-VI substances they must have a Massachusetts Controlled Substance Registration (MCSR) number. If a physician chooses to participate in and run a narcotic treatment program they must separately register with the DEA, be licensed by the Massachusetts Department of Public Health, and receive a DEA waiver for opioid treatment outside of a treatment program. If a physician wishes to prescribe buprenorphine for opioid addiction the physician must obtain a waiver from the U.S Department of Health and Human

Services, Substance Abuse and Mental Health Services Administration (SAMHSA). The physician is also not allowed to delegate the task of prescribing buprenorphine for opioid addiction to non-physicians. Under this waiver, physicians are only allowed to treat up to 30 patients in the first year, after one year a physician can request to treat up to 100 patients.

Advanced Practice Registered Nurses (APRN), Physician Assistants (PA) and Pharmacists may issue prescriptions under the supervision of a physician. For pharmacists in particular, they must enter into a collaborative practice ...

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