2023 Tennessee Code › Title 53 - FOOD, DRUGS AND COSMETICS (§§ 53-1-101 — 53-15-103) › Chapter 11 - NARCOTIC DRUGS AND DRUG CONTROL (§§ 53-11-201 — 53-11-452) › Part 3 - REGULATIONS AND REGISTRATION (§§ 53-11-301 — 53-11-314) › Section 53-11-308 - Prescription requirements

(a)
Except when dispensed directly by a health care prescriber other than a pharmacy to an ultimate user, no controlled substance in Schedule II may be dispensed without the electronic prescription of a health care prescriber, unless authorized by §
63-1-160
. To the extent federal law does not permit an electronic prescription, a written prescription from a health care prescriber is required.
(b)
In emergency situations, Schedule II drugs may be dispensed upon oral prescription of a health care prescriber, reduced promptly to writing or to electronic form, as appropriate, and filed by the pharmacy. Prescriptions shall be retained in conformity with the requirements of §
53-11-306
. No prescription for a Schedule II substance may be refilled.
(c)
Except when dispensed directly by a practitioner other than a pharmacy to an ultimate user, a controlled substance included in Schedule III or IV that is a prescription drug shall not be dispensed without a written or oral prescription of a practitioner. The prescription shall not be filled or refilled more than six (6) months after the date of the written or oral prescription or be refilled more than five (5) times, unless renewed by the practitioner.
(d)
A controlled substance included in Schedule V shall not be distributed or dispensed other than for a medical purpose.
(e)
No prescription for any opioids or benzodiazepines may be dispensed in quantities greater than a thirty-day supply.
(f)
If a prescriber dispenses any opioids, benzodiazepines, barbiturates, or carisoprodol, then the prescriber shall submit the transaction to the controlled substances monitoring database operated under chapter 10, part 3 of this title.
(g)
Any prescribers of opioids, benzodiazepines, barbiturates or carisoprodol, either alone, concurrently, or sequentially with any other opioids, benzodiazepines, barbiturates, or carisoprodol to patients who are in chronic, long-term drug therapy for ninety (90) days or longer shall consider mandatory urine drug testing. This subsection (g) shall not supercede any rules promulgated by the commissioner for urine drug testing by registered pain management clinics.
(h)
(1)
Prior to prescribing more than a three-day supply of an opioid or an opioid dosage that exceeds a total of a one hundred eighty (180) morphine milligram equivalent dose to a woman of childbearing age, a prescriber shall:
(A)
Advise the patient of the risk associated with opioid use during pregnancy;
(B)
Counsel the patient on appropriate and effective forms of birth control; and
(C)
Offer information about the availability of free or reduced cost birth control to the patient.
(2)
As used in this subsection (h), "a woman of childbearing age" means any woman between the ages of fifteen (15) and forty-four (44).
(3)
This subsection (h) does not apply if:
(A)
The prescriber has previously taken all actions required by subdivision (h)(1) with respect to the patient within the past three (3) months; or
(B)
The prescriber reasonably believes that the patient is not capable of becoming pregnant.
(4)
If the patient is under eighteen (18) years of age, the physician may satisfy this subsection (h) by advising, counseling, and providing information to the parent or guardian instead of the patient. This subdivision (h)(4) does not prohibit a physician from advising, counseling, and providing information directly to the patient if not otherwise prohibited by law.
(5)
The department of health shall develop and publish guidance to assist prescribers of opioids in complying with this subsection (h).
(i)
(1)
Notwithstanding another law, and except as otherwise provided in subdivision (i)(2), when prescribing an opioid to a patient, a healthcare prescriber shall offer a prescription for an opioid antagonist, or another drug approved by the United States food and drug administration for the complete or partial reversal of an opioid overdose event, to the patient when one (1) or more of the following conditions are present in accordance with the federal centers for disease control and prevention opioid-prescribing guidelines setting forth treatment of a known or suspected opioid overdose:
(A)
The healthcare provider prescribes more than a three-day supply of an opioid medication; and
(B)
(i)
The healthcare provider prescribes an opioid medication concurrently with a prescription by the same provider for benzodiazepine; or
(ii)
The patient presents with an increased risk for overdose, including a history of overdose, a history of substance use disorder, or being at risk for returning to a high dose of opioid medication to which the patient is no longer tolerant.
(2)
Subdivision (i)(1) does not apply to:
(A)
An opioid prescription that is written as part of a patient's palliative care treatment. As used in this subdivision (i)(2)(A), "palliative care" has the same meaning as defined in §
63-1-164
; or
(B)
An opioid prescription that is written by a licensed veterinarian, as defined in §
63-12-103
.
Amended by 2022 Tenn. Acts, ch. 1061, s 1, eff. 7/1/2022.
Amended by 2018 Tenn. Acts, ch. 883, s 2, eff. 1/1/2019.
Amended by 2013 Tenn. Acts, ch. 430, s 4, eff. 5/16/2013.
Acts 1971, ch. 163, § 24; T.C.A., § 52-1431.