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Vermont News: Prescribing Schedule II Drugs
Published in the December 2007 Vermont Board of Pharmacy Newsletter
The purpose of the memorandum is to answer some questions and clarify a few issues that have recently been brought to the Board’s attention. Topics covered include the Board’s rules and other Vermont laws covering Schedule II, “valid” prescriptions, and tamper-resistant prescription pads.
Re: Schedule II Prescriptions
The Board of Pharmacy has received numerous inquiries as to what Vermont law allows when issuing Schedule II prescriptions. We would like to address several issues where there appears to be confusion.
I. “Do not fill until (specific date)”
A prescriber is allowed to write a prescription, with the current date, with a statement “do not fill until . . .” as long as that date is within 10 days of the date written (to be in compliance with the requirement that Schedule II must be filled within 10 days of the date written). If a prescriber wants to issue a Schedule II prescription between patient visits, a prescriber is allowed to mail the prescription to the patient or directly to the pharmacy.
II. Quantity Prescribed
Vermont law does not limit the quantity of Schedule II prescriptions to a specific number of days supplied. Confusion may exist because some surrounding states (ie, New Hampshire) limit Schedule II pre¬scriptions to a 30-day supply. Vermont, however, follows the federal Drug Enforcement Administration’s (DEA) guidelines with regard to quantity prescribed. There is nothing prohibiting a prescriber from issuing a Schedule II prescription for a 90-day supply as long as that individual practitioner determines, based on sound medical judg¬ment, and in accordance with established medical standards, that it is appropriate to issue this quantity.
III. Electronic Transmission of Schedule II prescriptions
Facsimile transmitting of Schedule II prescriptions is not permitted except for a resident of a long-term care facility, a hospice patient, or a compounded prescription for direct administration to a patient by parenteral, intravenous, intramuscular, or subcutaneous means, or in an emergency situation. See Board of Pharmacy Rule 19.3.1.4 or 21 CFR 1306.11 (DEA regulations) for complete guidelines.
The Board of Pharmacy is in the process of rewriting its rules and intends to amend the 10-day Schedule II validity provision to 30 days. The Board, however, also found that Title 18 VSA §4215 prohibits dispensing after 14 days of the date written. This will require a legislative change and may delay the process. The Board’s goal is to amend both provisions so that they are in agreement.
The Board of Pharmacy is not opposed to DEA’s rule that allows practitioners to provide an individual patient with multiple prescriptions for a specific Schedule II controlled substance, written on the same date to be filled sequentially. The Board agrees with the rule, which became effective December 19, 2007; however, until the rule and statutes are ammended it is not allowed by Vermont law.
