BILL ANALYSIS                                                                                                                                                                                                    



          Subject matter was not heard in Assembly policy committee this  
          legislative
          Session, should be noted in the last paragraph of the background  
          section of the 
          CSA analysis.  Language will vary depending on the circumstance.
           AB 2018
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 2018 (Thomson)
          As Amended August 18, 2000
          Majority vote
           
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          |ASSEMBLY:  |     |(May 30, 2000)  |SENATE: |27-0 |(August 31,    |
          |           |     |                |        |     |2000)          |
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                    (vote not relevant)

          Original Committee Reference:    HEALTH  
           
          SUMMARY  :  Revises existing prescription requirements for  
          Schedule II controlled substances by permitting practitioners to  
          receive more than 100 triplicate prescription blanks in a 30 day  
          period, permitting triplicate prescriptions to be typewritten by  
          the physician or his or her employee, and permitting  
          practitioners to fax or mail corrections of triplicate  
          prescriptions to the pharmacist.  

           The Senate amendments  deleted the Assembly version of this bill,  
          and instead permit:

          1)A practitioner to orally, electronically, or in writing  
            request triplicate prescription blanks in an amount larger  
            than 100 forms, and repeal provisions of law prohibiting the  
            Department of Justice (DOJ) from issuing more than 100  
            triplicate prescription blanks to a practitioner during any  
            30-day period.

          2)Triplicate prescription forms to be either typewritten or  
            handwritten by the physician or his or her employee, as long  
            as the signature of the prescriber is handwritten on each  
            prescription form.

          3)A pharmacist to fill a Schedule II controlled substance  
            containing an error or errors, if the pharmacist notifies the  
            prescriber of the error or errors and the prescriber approves  
            any correction.  Require the prescriber to fax or mail a  








          Subject matter was not heard in Assembly policy committee this  
          legislative
          Session, should be noted in the last paragraph of the background  
          section of the 
          CSA analysis.  Language will vary depending on the circumstance.
           AB 2018
                                                                  Page  2

            correction to the pharmacist within seven days of the  
            prescription being dispensed.

           EXISTING LAW  :

          1)Prohibits any person from furnishing any dangerous drug or  
            device except upon the prescription of a physician, dentist,  
            podiatrist, optometrist or veterinarian.

          2)Establishes the California Uniform Controlled Substances Act,  
            which lists controlled substances in five schedules, with  
            Schedule I containing substances with the highest restrictions  
            (generally illegal), and Schedule V the least restrictive.   
            Schedule II substances are generally the most dangerous  
            substances that can still be legally prescribed (e.g.,  
            morphine, Demerol, and Percodan).

          3)Requires each prescription for a controlled substance  
            classified in Schedule II to be wholly written in ink or  
            indelible pencil in the handwriting of the prescriber upon an  
            official prescription form, in triplicate, issued by DOJ.   
            Requires the original and duplicate of the prescription to be  
            delivered to the pharmacist filling the prescription.   
            Requires the duplicate to be retained by the pharmacist, and  
            the original to be transmitted to DOJ at the end of the month  
            in which the prescription was filled.

          4)Requires triplicate prescription blanks to be issued by DOJ in  
            serially numbered groups of not more than 100 forms each. 

          5)Establishes the CURES Pilot Project within DOJ for the  
            electronic monitoring of the prescribing and dispensing of  
            Schedule II controlled substance in order to assist law  
            enforcement and regulatory agencies in their efforts to  
            control the diversion and resultant abuse of Schedule II  
            controlled substances.  The CURES Pilot Project was  
            established on July 1, 1997, and is required to be  
            administered concurrently with the existing triplicate  
            prescription process to examine the comparative efficiencies  
            between the two systems.








          Subject matter was not heard in Assembly policy committee this  
          legislative
          Session, should be noted in the last paragraph of the background  
          section of the 
          CSA analysis.  Language will vary depending on the circumstance.
           AB 2018
                                                                  Page  3


           AS PASSED BY THE ASSEMBLY  , this bill repealed, on January 1,  
          2003, the requirement that Schedule II controlled substances be  
          written on an official prescription form issued by DOJ, and  
          repealed the sunset date of CURES Pilot Project within DOJ,  
          thereby making this program permanent.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :  According to the author, triplicate prescriptions are  
          an administrative hassle for prescribers and can result in  
          inadequate relief for patients in pain.  The author states that  
          for patients, pain management is frequently reported to be poor,  
          and the author argues that triplicates interfere with the  
          patient-physician relationship.  The author states that  
          researchers have found that multiple copy prescription programs  
          result in prescribers substituting drugs that do not require a  
          triplicate for those that do.  The author further asserts that  
          many physicians do not have the full range of tools necessary to  
          treat patients with severe pain because they do not have  
          triplicate forms.  According to the author, only 40,333 of the  
          74,518 California-licensed physicians with Schedule II  
          privileges had triplicates issued to them.  

          The author's office states that this bill would reduce some of  
          the administrative hassles involved in writing triplicate  
          prescriptions for Schedule II substances.  This bill lifts the  
          cap on the number of triplicate prescription blanks that can be  
          issued to a physician, which the author argues is too low for  
          physicians who specialize in pain management or treatment of  
          cancer patients.  This bill also permits a physician with a busy  
          practice and/or illegible handwriting to either type the  
          triplicate prescription or have an employee type or write the  
          prescription, as long as the physician signs the prescription.   
          Finally, the author states that this bill allows a pharmacist to  
          fill a triplicate prescription that contains an error if the  
          physician approves any correction and faxes or mails a corrected  
          prescription within seven days.

           








          Subject matter was not heard in Assembly policy committee this  
          legislative
          Session, should be noted in the last paragraph of the background  
          section of the 
          CSA analysis.  Language will vary depending on the circumstance.
          AB 2018
                                                                  Page  4

          Analysis Prepared by  :  Vincent D. Marchand / HEALTH / (916)  
          319-2097                                               


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