Controlled substances: clinics.

Existing law, the Pharmacy Law, provides for the licensure and regulation of pharmacists by the California State Board of Pharmacy and makes a violation of the act a crime. Under existing law, specified clinics, including surgical clinics, may purchase drugs at wholesale for administration or dispensing to the clinic's patients. Existing law requires these clinics to maintain certain records and to obtain a license from the board. Existing law prohibits specified substances from being dispensed by a nonprofit or free clinic, as defined. This bill would authorize a practitioner authorized to prescribe a narcotic drug at a nonprofit or free clinic, as specified, to dispense the narcotic drug from clinic supply for the purpose of relieving acute withdrawal symptoms while arrangements are being made for referral for treatment, as described, and would require the clinic dispensing the narcotic to be subject to specified reporting, labeling, and recordkeeping requirements. The bill would require clinics with a supply of narcotic drugs being dispensed pursuant to these provisions to establish policies or procedures for dispensing the narcotics, as specified. Because the bill would specify additional requirements under the Pharmacy Law, a violation of which would be a crime, it would impose a state-mandated local program. Existing law classifies certain controlled substances into designated schedules. Existing law prohibits a controlled substance classified in Schedule II from being dispensed without a prescription, except when dispensed directly to the user in an amount not to exceed a 72-hour supply for the patient when the patient is not expected to require any additional amount of the controlled substance beyond the 72 hours. This bill would additionally authorize a practitioner to directly dispense no more than a 3-day supply of a Schedule II controlled substance to be dispensed to the ultimate user at one time for the purpose of initiating maintenance treatment or detoxification treatment, as specified. Existing law requires the State Department of Health Care Services to regulate and license narcotic treatment programs, including in the use of narcotic replacement therapy and medication-assisted treatment. Existing regulation specifies certain requirements and considerations for a patient to be eligible for treatment at a licensed narcotic treatment program, such as a medical evaluation conducted by the program, laboratory tests for disease, and minimum monthly participation in counseling, among others. Existing regulation also imposes specified criteria to be considered before a patient is eligible for take-home doses of medication. This bill would require the department to amend specified regulations regarding narcotic treatment programs to comply with federal regulations pertaining to dispensing of narcotic drugs for maintenance treatment or detoxification treatment. The bill would require the department to adopt these regulations by April 30, 2029. Existing law authorizes the use of specific medications for use in narcotic replacement therapy and medication-assisted treatment by licensed narcotic treatment programs, including Levo-alpha-acetylmethadol (LAAM) . Existing law states the intent of the Legislature that take-home doses of narcotic replacement therapy medications are to be provided if the patient is clearly adhering to the requirements of the program and if daily attendance at a clinic would be incompatible with gainful employment, education, responsible homemaking, and retirement or medical disability, or as otherwise specified. This bill would remove LAAM from the list of authorized medications for use in narcotic replacement therapy and medication-assisted treatment by licensed narcotic treatment programs and would make conforming changes. The bill would remove from the statement of the Legislature's intent the requirement that daily attendance at a clinic would be incompatible with gainful employment, education, responsible homemaking, and retirement or medical disability. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. This bill would declare that it is to take effect immediately as an urgency statute.