Representative Douglas R. Welton proposes the following substitute bill:




Chief Sponsor: Douglas R. Welton

Senate Sponsor: Jen Plumb


8     General Description:
9          This bill creates certain requirements for the dispensing of opioids.
10     Highlighted Provisions:
11          This bill:
12          ▸     requires a pharmacist who dispenses opioids to a patient to:
13               •     provide patient counseling on the use and availability of opioid antagonists; and
14               •     offer an opioid antagonist to the patient or the patient's representative for certain
15     opiate prescriptions;
16          ▸     requires a health care provider who prescribes opioids to include a prescription for
17     an opioid antagonist under certain circumstances; and
18          ▸     implements these requirements on January 1, 2024.
19     Money Appropriated in this Bill:
20          None
21     Other Special Clauses:
22          None
23     Utah Code Sections Affected:
24     AMENDS:
25          58-37-7, as last amended by Laws of Utah 2018, Chapter 145

26          58-37-19, as enacted by Laws of Utah 2019, Chapter 130

28     Be it enacted by the Legislature of the state of Utah:
29          Section 1. Section 58-37-7 is amended to read:
30          58-37-7. Labeling and packaging controlled substance -- Informational pamphlet
31     for opiates - Naloxone education and offer to dispense.
32          (1) A person licensed pursuant to this act may not distribute a controlled substance
33     unless it is packaged and labeled in compliance with the requirements of Section 305 of the
34     Federal Comprehensive Drug Abuse Prevention and Control Act of 1970.
35          (2) No person except a pharmacist for the purpose of filling a prescription shall alter,
36     deface, or remove any label affixed by the manufacturer.
37          (3) Whenever a [pharmacist] pharmacy sells or dispenses any controlled substance on a
38     prescription issued by a practitioner, the [pharmacist] pharmacy shall affix to the container in
39     which the substance is sold or dispensed:
40          (a) a label showing the:
41          (i) pharmacy name and address;
42          (ii) serial number; and
43          (iii) date of initial filling;
44          (b) the prescription number, the name of the patient, or if the patient is an animal, the
45     name of the owner of the animal and the species of the animal;
46          (c) the name of the practitioner by whom the prescription was written;
47          (d) any directions stated on the prescription; and
48          (e) any directions required by rules and regulations promulgated by the department.
49          (4) Whenever a [pharmacist] pharmacy sells or dispenses a Schedule II or Schedule III
50     controlled substance that is an opiate, [a pharmacist] the pharmacy shall:
51          (a) affix a warning to the container or the lid for the container in which the substance is
52     sold or dispensed that contains the following text:
53          [(a)] (i) "Caution: Opioid. Risk of overdose and addiction"; or
54          [(b)] (ii) any other language that is approved by the Department of Health[.] and
55     Human Services;
56          (b) beginning January 1, 2024:

57          (i) offer to counsel the patient or the patient's representative on the use and availability
58     of an opioid antagonist as defined in Section 26-55-102; and
59          (ii) offer to dispense an opioid antagonist as defined in Section 26-55-102 to the patient
60     or the patient's representative, under a prescription from a practitioner or under Section
61     26-55-105, if the patient:
62          (A) receives a single prescription for 50 morphine milligram equivalents or more per
63     day, calculated in accordance with guidelines developed by the United States Centers for
64     Disease Control and Prevention;
65          (B) is being dispensed an opioid and the pharmacy dispensed a benzodiazepine to the
66     patient in the previous 30 day period; or
67          (C) is being dispensed a benzodiazepine and the pharmacy dispensed an opioid to the
68     patient in the previous 30 day period.
69          (5) (a) A [pharmacist] pharmacy who sells or dispenses a Schedule II or Schedule III
70     controlled substance that is an opiate shall, if available from the Department of Health and
71     Human Services, prominently display at the point of sale the informational pamphlet developed
72     by the Department of Health and Human Services under Section 26-55-109.
73          (b) The board and the Department of Health and Human Services shall encourage
74     [pharmacists] pharmacies to use the informational pamphlet to engage in patient counseling
75     regarding the risks associated with taking opiates.
76          (c) The requirement in Subsection (5)(a) does not apply to a [pharmacist if the
77     pharmacist] pharmacy if the pharmacy is unable to obtain the informational pamphlet from the
78     Department of Health and Human Services for any reason.
79          (6) A person may not alter the face or remove any label so long as any of the original
80     contents remain.
81          (7) (a) An individual to whom or for whose use any controlled substance has been
82     prescribed, sold, or dispensed by a practitioner and the owner of any animal for which any
83     controlled substance has been prescribed, sold, or dispensed by a veterinarian may lawfully
84     possess it only in the container in which it was delivered to the individual by the person selling
85     or dispensing it.
86          (b) It is a defense to a prosecution under this subsection that the person being
87     prosecuted produces in court a valid prescription for the controlled substance or the original

88     container with the label attached.
89          Section 2. Section 58-37-19 is amended to read:
90          58-37-19. Opiate prescription consultation -- Prescription for opioid antagonist
91     required.
92          (1) As used in this section:
93          [(a) "Hospice" means the same as that term is defined in Section 26-21-2.]
94          [(b)] (a) "Initial opiate prescription" means a prescription for an opiate to a patient
95     who:
96          (i) has never previously been issued a prescription for an opiate; or
97          (ii) was previously issued a prescription for an opiate, but the date on which the current
98     prescription is being issued is more than one year after the date on which an opiate was
99     previously prescribed or administered to the patient.
100          (b) "Opioid antagonist" means the same as that term is defined in Section 26-55-102.
101          (c) "Prescriber" means an individual authorized to prescribe a controlled substance
102     under this chapter.
103          (2) Except as provided in Subsection (3), a prescriber may not issue an initial opiate
104     prescription without discussing with the patient, or the patient's parent or guardian if the patient
105     is under 18 years of age and is not an emancipated minor:
106          (a) the risks of addiction and overdose associated with opiate drugs;
107          (b) the dangers of taking opiates with alcohol, benzodiazepines, and other central
108     nervous system depressants;
109          (c) the reasons why the prescription is necessary;
110          (d) alternative treatments that may be available; and
111          (e) other risks associated with the use of the drugs being prescribed.
112          (3) [This section] Subsection (2) does not apply to a prescription for:
113          (a) a patient who is currently in active treatment for cancer;
114          (b) a patient who is receiving hospice care from a licensed hospice as defined in
115     Section 26-21-2; or
116          (c) a medication that is being prescribed to a patient for the treatment of the patient's
117     substance abuse or opiate dependence.
118          (4) (a) Beginning January 1, 2024, a prescriber shall prescribe or dispense an opioid

119     antagonist to a patient if the patient receives an initial opiate prescription for:
120          (i) 50 morphine milligram equivalents or more per day, calculated in accordance with
121     guidelines developed by the United States Centers for Disease Control and Prevention; or
122          (ii) any opiate if the practitioner is also prescribing a benzodiazepine to the patient.
123          (b) Subsection (4)(a) does not apply if the initial opiate prescription:
124          (i) is administered directly to an ultimate user by a licensed practitioner; or
125          (ii) is for a three-day supply or less.
126          (c) This Subsection (4) does not require a patient to purchase or obtain an opioid
127     antagonist as a condition of receiving the patient's initial opiate prescription.