On The Horizon

James Arnold, Chief Liaison and Policy Diversion Control Division

National Conference Pharmaceutical and Chemical Diversion

Dallas, Texas December 13, 2017

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LEGAL DISCLAIMER The following presentation was accompanied by an oral presentation on December 13, 2017, and does not purport to establish legal standards that are not contained in statutes, regulations, or other competent law. Statements contained in this presentation that are not embodied in the law are not binding on DEA. Summaries of statutory and regulatory provisions that are summarized in this presentation do not purport to state the full extent of the statutory and regulatory requirements of the cited statutes and regulations. I have no financial relationships to disclose.

New EMS Law

Protecting Patient Access to Emergency Medications Act of 2017 PL 115-83 November 17, 2017.

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New EMS Law

• A DEA registration will be required

• Standing Orders will be allowed

• Option for a single registration in each state 4

New EMS Law • The EMS may use the

registration of a Hospital/Clinic

• No registrations as a Distributor

• Recordkeeping

• Storage 5

States with Limits CII • District of Columbia 7 Day Supply (emergency situation) • Florida 72-hour Supply (oral prescription) • Hawaii 30 Day Supply • Illinois 30 Day Supply: CII

(Some exceptions under certain conditions)

• Indiana 7 Day Supply (initial prescription) 7 Day Supply (for minors)

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States with Limits CII

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Kansas 30 Day Supply (Substances to treat obesity) Kentucky 3 Day Supply (acute pain with exceptions) Louisiana 10 Day Supply: CII-III (Prescribers not licensed in Louisiana) Maine 30 Day Supply (chronic pain) 7 Day Supply (acute pain)

States with Limits CII

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Massachusetts 7 Day Supply (unless more in indicated) 7 Day Supply (all opioids for minors) Massachusetts 30 Day Supply: CII-III 60 Day Supply (Dextroamphetemine) Missouri 30 Day Supply: CII 90 Day (If medical reason given) New Hampshire 34 Day Supply: CII 60 Day Supply (ADD/ADHD)

States with Limits CII

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New Jersey First prescription: 5 Day Supply New York 30 Day Supply 7 Day Supply (initial prescription) North Carolina 5 Day Supply (acute pain) Ohio 7 Day Supply 5 Day Supply (for minors) Oregon 7 Day Supply (initial prescription) 7 Day Supply (for minors)

States with Limits CII

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Pennsylvania 7 Day Supply (for minors) 7 Day Supply (emergency department and urgent care centers) Rhode Island 20 Doses for opioids (initial prescription) No more than 30 morphine MME/day South Carolina 31 Day Supply (Except Transdermal patches) 90 Day Supply: CIII-V

States with Limits CII

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Tennessee 30 Day Supply of Opioids and Benzodiazepines Texas 90 Day Supply (multiple prescriptions) Utah 30 Day Supply: CII Vermont 90 Day Supply 72 MME (first prescription for minors) 350 MME – 7 Day limit (acute pain, first prescription)

States with Limits CII

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Virginia Limitations on Number of Days 7 Day Supply (acute pain) 14 Day Supply (surgical procedures) (Some exceptions) Washington 7 Day Supply (initial prescription) 3 Day Supply (dentist) West Virginia 72 Hour Supply 30 Day Supply: Hydrocodone

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34

30

31 32

36

35

33

2

39

40

44

47 48

44 49

49

49

Completed PDACs

* Repeated State

October 31, 2017

FL

WA

UT

OR

CA NV

ID

MT

AZ

WY

CO

NM

ND

SD

TX 4

NE

KS

OK

MN

IA

MO

AR

LA

MI

WI

IL IN 6

KY

TN

MS AL GA 3

OH 1

WV VA

NC

SC

PA

NY

MA

ME

DC

MD

NJ

RI

DE

12B

12A

21

20 19

7

11

10

17

9

14

8

16 15

CT 18 29 37

22

23

25

26

24

28

27

5

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FY-2018 PDACs

49 STATES (incl. the D.C./Caribbean (PR)) 99 PDAC CONFERENCES

30

31

36

35

38

2

40

41

39

13

42 43

51

44

49

48

47 46

VT NH

32 33

52

AK

HI

45 PR

53

53

50

50

FY-2011FY-201629-Pittsburgh, PA 12/10-11/15 19630-Jackson, MS 1/9-10/16 18531-Charleston, WV 2/27-28/16 24532-Wilmington, DE 3/19-20/16 11133-Towson, MD 4/17-4/18/16 44234-Little Rock, AR 6/11-12-/16 21635-Minneapolis/St. Paul, MN 7/8-9/16 15136-Hilton Head, SC 8/15-16/16 15737-Camp Hill, PA 8/27/16 8438-New Brunswick, NJ 9/18-19/16 304 FY-2016 Total Attendance 2,091FY-201739-Fargo, ND 10/2/16 6840-Washington, DC 11-19-20/16 41441-Buffalo, NY 12/9-10/16 23942-Honolulu, HI 1/22-23/17 11443-Anchorage, AK 2/10/2017 6144-Witchita, KS 3/11-12/17 10945-San Juan, PR 3/26-27/2017 52246-Omaha, NE 6/4/17 3747-Des Moines, IA 7/16/2017 4948-Missoula, MT 8/5/17 2549-Casper, WY 8/13/17 9450-Hartford, CT (RI) 9/24-25/2017 60 FY-2017 Total Attendance 1,792FY-201851-Sioux Falls, SD 10/1/2017 5452-Boise, ID 10/22-23/2017 71 Total Attendance To Date 13,226

Completed PDACs Attendance

Thank You

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