New Jersey is continuing its fight against prescription drug abuse by placing additional requirements on providers. Last month Governor Christie signed into law a bill that requires prescribers to discuss the risks of abuse when prescribing Schedule II opioid drugs to minors. The prescriber must discuss such risks with either an emancipated minor or the parents or guardians on a non-emancipated minor. The law defines a "minor" as a person under the age of 18. This requirement applies to health care prescribers when writing a script for "an opioid drug which is a schedule II controlled and dangerous substance." Based on the wording of the law, the new requirements will apply when a minor is prescribed a drug that is both an opioid and a schedule II controlled and dangerous substance. Examples of such drugs include but are not limited to: Fentanyl; morphine; Demerol; Dilaudid; and combination drugs like Endocet and Percocet.
Specifically, the prescriber must explain the "risks of developing a physical or psychological dependence" on the medication and provide an option for alternative treatments if available, and if the prescriber deems such alternative treatments to be appropriate. This discussion must be documented in the patient's medical record. The new law does not list any specific penalties for failure to comply with the discussion requirement, but non-compliance could result in a finding by a judge or jury that the physician fell below the standard of care. In other words, if a physician prescribes a Schedule II opioid to a minor patient and the patient later becomes addicted to opioids and sues the physician for malpractice then the physician's failure to have or document the conversation required under this law could be used as a basis for finding the physician negligent. Although not prevalent at the moment, the medical community is likely to see an increase in suits against providers based on opioid dependence. Following this law will help providers guard against such future legal trends.
Prescribers writing these medications for patients receiving hospice care form a licensed hospice are exempt from the new law's requirements. The law took effect immediately, so providers should already be having this conversation with their patients and documenting it in the medical record.