G ove r n men t Re lat ions
substance containing an opioid (regardless
of whether the dosage is modified during
that course of treatment):
• Assess whether the minor has taken or
is currently taking prescription drugs for
treatment of a substance use disorder.
• Discuss with the minor and the minor’s
parent, guardian or authorized adult all
of the following:
1. The risks of addiction and overdose
associated with the controlled
substance.
2. The increases risk of addiction to
controlled substances for individuals
suffering from mental or substance
use disorders.
3. The dangers of taking a controlled
substance containing an opioid with
benzodiazepines, alcohol or other
central nervous system depressants.
5. The signature of the minor’s parent,
guardian or authorized adult and
date of signing.
6. The prescriber must retain the form
in the patient’s record.
Prescribers, with some exceptions, may
not prescribe to minors more than a
seven-day supply of a controlled
substance containing an opioid. If it is
an authorized adult (not parent or
guardian) signing the consent form, the
prescriber may not prescribe more than
a 72-hour supply to the minor.
Prescribers may prescribe more than a
seven-day supply to a minor if either of
the following applies:
• Obtain written consent for the
prescription from the minor’s parent,
guardian or authorized adult. The
prescriber should obtain the consent
using forms created by the Bureau of
Professional and Occupational Affairs
and made available to all prescribers.
The form must contain all of the
following:
1. The brand name or generic name
and quantity of the controlled
substance containing an opioid being
prescribed and the amount of the
initial dose.
2. A statement indicating that a
controlled substance is a drug or
other substance that the U.S. Drug
Enforcement Agency has identified
as having a potential for abuse.
3. A statement certifying that the
prescriber engaged discussed risks
with the patient.
4. The number of refills authorized by
the prescription.
10
MAY/JU NE 2017 | P EN N S YLVA N IA D EN TA L J O UR N A L
1. In the prescriber’s professional
clinical judgment, more than a
seven-day supply of a controlled
substance containing an opioid is
required to stabilize the minor’s
acute medical condition. If this is the
case, the prescriber must document
the condition and indicate the
reason why a non-opioid alternative
is not appropriate.
2. For management of pain associated
with cancer, use in palliative or
hospice care, or management of
chronic pain not associated with
cancer