Michigan: Controlled Substance Legislation UPDATE

In December of 2017, Michigan’s Lt. Governor Brian Calley signed  a comprehensive 10-bill package to address Michigan’s opioid epidemic, substance abuse and drug diversion problems. The multi-faceted package addresses various education initiatives from school aged children to patient informed consent and also covers acute pain prescriptions, MAPS and a variety of other topics impacting the prescribing of controlled substances in Michigan.

A brief overview and effective dates are summarized below. We have also included a handful of additional resources for reference.

Michigan Timeline Source: Michigan State Medical Society 

Public Act 246 of 2017: Requires disclosure of opioid information to minors, their parents, and patients.

In summary, before issuing a new prescription for a controlled substance containing an opioid to a minor, the following information should be provided:

  • Discuss with the minor and the minor's parent or guardian the potential risks of addiction and overdose associated with the controlled substance.
  • Discuss the increased risk of addiction to a controlled substance to an individual suffering from both mental and substance abuse disorders.
  • Discuss the danger of taking a controlled substance containing an opioid with benzodiazepine, alcohol, or another central nervous system depressant.
  • Discuss any other information in the patient counseling information section of the label for the prescription.
  • The signature of the minor's parent or guardian to consent to the minor's
  • treatment is required on a "start talking consent form", which is to be filed
  • in the minor’s medical record.

Before issuing a new prescription for a controlled substance, the following information shall be provided to patients:

  • The dangers of opioid addiction.
  • How to properly dispose of an expired, unused, or unwanted controlled substance.
  • That the delivery of a controlled substance is a felony under Michigan Law.
  • If the patient is pregnant or is a female of reproductive age, the short and long- term effects of exposing a fetus to an opioid, including but not limited to neonatal abstinence syndrome.

Effective Date: June 1, 2018

Templates are available for download for both adults and minors.

Start Talking Consent Form: For Use With Minors

Opioid Start Talking Form (Available in English, Spanish and Arabic)

 

Public Act 247 of 2017: Requires a prescriber to be in a bona-fide prescriber-patient relationship before prescribing a controlled substance listed in Schedule 2-5.

Original Effective Date: March 31, 2018.

New Effective Date March 31, 2019 (or upon the promulgation of rules), providing the Department of Licensing and Regulatory Affairs with adequate time to develop administrative rules without impacting patient continuum of care.

Important Note: The legislation defines a bona fide prescriber-patient relationship as treatment or a counseling relationship between a prescriber and a patient in which both of the following are present:

  • The prescriber has reviewed the patient's medical or clinical records and completed a full assessment of the patient's medical history and current medical condition, including a relevant medical evaluation of the patient conducted in person or via telehealth.
  • The prescriber has created and maintained records of the patient's condition in accordance with medically accepted standards.

Public Acts 248 and 249 of 2017: Before prescribing or dispensing a controlled substance to a patient, licensed prescribers are required to be registered with MAPS and, prescribers and dispensers are required to check, and review MAPS reports before providing a controlled substance to a patient in a quantity that exceeds a 3-day supply.

Effective Date: June 1, 2018

Michigan Automated Prescription System (MAPS) information can be found here

 

Public Act 250 of 2017: Requires health professionals that treat a patient for an opioid-related overdose to provide that patient with information regarding Substance Use Disorder Services (SUDs).

Effective Date: March 27, 2018

A county by county guide for Michigan Public Health Resources can be found here

Medication Assisted Treatment Information can be found here

Public Act 251 of 2017: Requires that for acute pain a prescriber not prescribe the patient more than a 7-day supply of an opioid within a 7-day period.

Effective Date: July 1, 2018

Important Note: Public Act 251 of 2017 defines acute pain as pain that is the normal, predicted physiological response to a noxious chemical or mechanical stimulus and is typically associated with invasive procedures, trauma, and disease, and usually lasts for a limited amount of time.

Additional Information: Effective, March 27, 2018, a pharmacist, consistent with federal law and regulations on the partial filling of a controlled substance included in Schedule 2, may partially fill in increments, a prescription for a Controlled Substance included in Schedule 2.

Public Act 252 of 2017: Before dispensing or prescribing a Controlled Substance at a Substance Use Disorder (SUD) program, a prescriber shall obtain and review a MAPS report on the patient.

Effective Date: March 27, 2018

Michigan Automated Prescription System (MAPS) information can be found here

Public Act 253 of 2017: Codifies medically necessary treatment for opioid abuse for Medicaid patients, amending the Social Welfare Act to allow an eligible individual access to medically necessary treatment for opioid abuse.

Effective Date: March 27, 2018

Public Act 254 of 2017: Requires that by July 1, 2018, Michigan’s PDOAC to have developed or adopted for Michigan’s Department of Education (MDE), recommendations for the instruction of pupils regarding the dangers of prescription opioid abuse.

Public Act 255 of 2017 – Requires that by July 1, 2019, Michigan's Department of Education (MDE) to make available to school districts a model program of instruction on the dangers of prescription opioid drug abuse, developed or adopted by PDOAC. Beginning in the 2019-2020 School Year, MDE shall ensure that the state model of academic standards for health education includes instruction on prescription opioid drug abuse, including at minimum the PDOAC recommendations.

 

ADDITIONAL RESOURCES:

Prescribing Checklist for Controlled Substances

University of Michigan’s Health Lab: Michigan's New Opioid Rules Explained

Opioid Alert: Opioid Legislation FAQs

Opioid Alert: Update April 2018

Opioid Law FAQ

The Michigan State Medical Society provides a summary overview. Available for download here

AffirmHealth State-by-State Opioid Prescribing Guidelines

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Cover Photo Source: Michigan Data Summary LARA

 

The information presented on or through this website is made available solely for general information purposes and is not intended to substitute for professional, medical or legal advice. We do not warrant the accuracy, completeness, or usefulness of this information. Any reliance you place on such information is strictly at your own risk. We disclaim all liability and responsibility arising from any reliance placed on such materials.

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