OAR 851-056-0026
Rules Relating to Controlled Substances
(1)
In the administration, distribution, storage, prescribing, and dispensing of controlled substances, APRNs shall comply with all applicable requirements in the Code of Federal Regulations (CFR), Title 21, and state law, including but not limited to, ORS Chapter 430 (Mental Health) and 475 and OAR chapter 415 and 855.(2)
Nurse practitioners and clinical nurse specialists shall not dispense a controlled substance without current dispensing authority. Distribution of prepackaged, complimentary drug samples is not considered dispensing (ORS 689.005 (Definitions)(9)).(3)
APRNs who have authority from the Drug Enforcement Administration (DEA) to prescribe controlled substances must verify evidence of such with their prescriptive authority renewal application. A nurse with prescriptive authority may choose to decline DEA certification and must verify so in writing.(4)
Storage and inventory of controlled substances:(a)
Samples or quantities of controlled substances shall be stored in a securely locked cabinet on the premises of the APRNs practice location.(b)
APRNs who receive samples or quantities of controlled substances shall be responsible for the security, inventory, and disposal of these drugs.(c)
APRNs shall maintain inventory records of controlled substances that they receive or distribute for a period of three years. The records shall include:(A)
Drug name, amount received, date received, drug expiration date;(B)
Drug name, amount distributed, date distributed, to whom distributed;(C)
Drug name and the date and place where it was returned for destruction.(d)
Controlled substances that are expired, deteriorated, or unwanted shall be returned to a DEA registered disposal site or disposal system or law enforcement authorities. This does not include controlled substances which are properly wasted at the facility where they were to be administered. In this context, “properly wasted” means that on-site destruction of a controlled substance in conformance with applicable state and federal law. APRNs shall not personally destroy controlled substances.(e)
Controlled substances must be transported in a secured, locked container.(f)
Client records shall state the distribution of controlled substance samples.(g)
Theft of controlled substances shall be immediately reported upon discovery to the DEA and to any other required authorities.(h)
APRNs who receive controlled substances shall cooperate with the Board in their inspection of records and physical inventory of controlled substances. Inventory of all controlled substances shall be taken by the prescriber responsible for their receipt and storage every year on the same date as the biennial inventory required by 21 CFR 1304.13.(i)
If requested by the Board, any APRN who receives controlled substances shall submit a copy of inventory records from the preceding two years for review.(5)
Prescribing controlled substances:(a)
APRNs shall only prescribe the controlled substances from Schedules II–V, at the level provided for on their DEA certificate.(b)
Nurse Practitioners who treat opioid addiction must demonstrate that they meet federal requirements and obtain a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA). To qualify for such a waiver, nurse practitioners must:(A)
Hold a current DEA registration with an identification number that specifically authorizes him or her to engage in medication assisted treatment of opioid addiction;(B)
Hold current Nurse Practitioner Certification in Oregon;(C)
Hold current Prescriptive Authority (NP-PP designation on licensure);(D)
Complete all SAMHSA required training related to the treatment and management of opioid addiction;(E)
Comply with all federal and state regulations applicable to controlled substances.(6)
Intractable or chronic pain management:(a)
APRNs may prescribe or administer controlled substances to a person in the course of their treatment for a diagnosed condition causing pain.(b)
The diagnosis and treatment of intractable or chronic pain requires documentation of the following:(A)
A recent diagnosis of the condition (if acute or unstable), or past diagnosis (if chronic and stable) causing pain, by one or more licensed practitioners specializing in the treatment of the body area, system, or organ perceived as the source of pain; and(B)
A written material risks notice specific to the patient’s condition and treatment; and(C)
A consultation and review of the pain treatment plan where clinically indicated if the patient shows limited or no improvement.(c)
APRNs must have a complete discussion with the patient or person authorized to make health care decisions for the patient regarding the diagnosis, as well as the risk, benefits, alternatives, side effects, and potential for addiction and withdrawal of the controlled substance, along with any other applicable precautions. These discussions must be documented in the patient record. Documentation must include a plan for period review of patient response and follow-up.(d)
APRNs shall document patient use of controlled substances for chronic or intractable pain, including history and assessment to rule out substance abuse. Evidence of patient addiction or abuse requires referral and/or transfer of care for further diagnosis and treatment.
Source:
Rule 851-056-0026 — Rules Relating to Controlled Substances, https://secure.sos.state.or.us/oard/view.action?ruleNumber=851-056-0026.