10.19.03.07

.07 Prescriptions.

A. Provisions governing the issuance, filling, and filing of prescriptions pursuant to Criminal Law Article, §§5-501—5-505, Annotated Code of Maryland, are set forth generally in those sections and specifically by the sections of this regulation.

B. Persons Entitled to Issue Prescriptions (21 CFR §1306.03).

(1) A prescription for a controlled dangerous substance may be issued only by an individual practitioner who is:

(a) Authorized to prescribe controlled dangerous substances in the State of Maryland, in which the practitioner is licensed to practice the practitioner's profession; and

(b) Either registered or exempted from registration pursuant to 21 CFR §1301.22(c) and 21 CFR §1301.23.

(2) A prescription issued by an individual practitioner may be communicated to a pharmacist by an employee or agent of the individual practitioner.

C. Purpose of Issue of Prescription (21 CFR §1306.04).

(1) A prescription for a controlled dangerous substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of the individual practitioner's professional practice. The responsibility for the proper prescribing and dispensing of controlled dangerous substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription. An order purporting to be a prescription issued not in the usual course of professional treatment or in legitimate and authorized research is not a prescription within the meaning and intent of the Maryland Controlled Dangerous Substances Act Criminal Law Article, §§5-501—5-505, Annotated Code of Maryland, and the person knowingly filling such a purported prescription, as well as the person issuing it, shall be subject to the penalties provided for violations of the provisions of law relating to controlled dangerous substances.

(2) A prescription may not be issued in order for an individual practitioner to obtain controlled dangerous substances for supplying the individual practitioner for the purpose of general dispensing to patients.

(3) A prescription may not be issued for the dispensing of narcotic drugs listed in any schedule for detoxification treatment or maintenance treatment.

D. Manner of Issuance of Prescriptions (21 CFR §1306.05).

(1) All prescriptions for controlled dangerous substances shall be dated as of, and signed on, the day when issued and shall bear the full name and address of the patient, the drug name, strength, dosage form, quantity prescribed, directions for use, and the name, address, and registration number of the practitioner. A practitioner may sign a prescription in the same manner as the practitioner would sign a check or legal document (for example, J.H. Smith or John H. Smith). When an oral order is not permitted, prescriptions shall be written with ink, indelible pencil, typewriter, or computer and shall be manually signed by the practitioner. The prescriptions may be prepared by a secretary or agent for the signature of a practitioner, but the prescribing practitioner is responsible in case the prescription does not conform in all essential respects to the law and regulations. A corresponding liability rests upon the pharmacist who fills a prescription not prepared in the form prescribed by these regulations.

(2) An individual practitioner exempted from registration under 21 CFR §1301.22(c) shall include on all prescriptions issued by the individual practitioner the registration number of the hospital or other institution and the special internal code number assigned to the individual practitioner by the hospital or other institution, as provided in 21 CFR §1301.22(c), instead of the registration number of the practitioner required by this regulation. Each written prescription shall have the name of the individual practitioner stamped, typed, or handprinted on it, as well as the signature of the individual practitioner.

(3) An official exempted from registration under 21 CFR §1301.23 shall include on all prescriptions issued by the practitioner the branch of service or agency (for example—"U.S. Army" or "Public Health Service") and the practitioner's service identification number, instead of the registration number of the practitioner required by this section. The service identification number for a Public Health Service employee is the practitioner's Social Security identification number. Each prescription shall have the name of the officer stamped, typed, or handprinted on it, as well as the signature of the officer.

E. Persons Entitled to Fill Prescriptions. A prescription for controlled dangerous substances may only be filled by a pharmacist acting in the usual course of the pharmacist's professional practice and either registered individually or employed in a registered pharmacy or registered institutional practitioner.

F. Administering or Dispensing of Narcotic Drugs (21 CFR §1306.07).

(1) The administering or dispensing directly, but not prescribing, of narcotic drugs listed in any schedule to a narcotic drug dependent individual for "detoxification treatment" or "maintenance treatment" as defined in 21 U.S.C. §802 shall be deemed to be within the meaning of the term "in the course of his professional practice of research" as provided in 21 U.S.C. §828(e) and 21 U.S.C. §802(21), if the practitioner is separately registered with the United States Attorney General as required by 21 U.S.C. §823(g) and complies with the regulatory standards for treatment qualification, security, records, and unsupervised use of drugs pursuant to the federal Act.

(2) A physician who is not specifically registered to conduct a narcotic treatment program may administer, but may not prescribe, narcotic drugs to an individual for the purpose of relieving acute withdrawal symptoms if necessary while arrangements are being made for referral for treatment. More than one day's medication may not be administered to the individual, or for the individual's use, at one time. This emergency treatment may not be carried out for more than 3 days and may not be renewed or extended.

(3) A physician or authorized hospital staff may administer or dispense narcotic drugs:

(a) In a hospital to maintain or detoxify an individual as an incidental adjunct to medical or surgical treatment of conditions other than addiction; or

(b) To an individual with intractable pain in which no relief or cure is possible or none has been found after reasonable efforts.