CONNECTICUT - DRUGS

January 1, 2008

State laws and regulations that affect your medical practice

1. What is a controlled substance?

Controlled drugs are those drugs which contain any quantity of a substance which has been designated as subject to the federal Controlled Substances Act or which has been designated as a depressant or stimulant drug pursuant to federal food and drug laws, or which has been designated by the Commissioner of Consumer Protection as having a stimulant, depressant or hallucinogenic effect upon the higher functions of the central nervous system and as having a tendency to promote abuse or psychological or physiological dependence, or both. Such controlled drugs are classifiable as amphetamine-type, barbiturate-type, cannabis-type, cocaine-type, hallucinogenic, morphine-type and other stimulant and depressant drugs. Specifically excluded from controlled drugs and controlled substances are alcohol, nicotine and caffeine.

C.G.S.A. § 21a-240

(a) Any of the following opiates, including their isomers, esters, ethers, salts and salts of isomers, esters and esthers, unless specifically excepted:

(1) Acetylalpha-methylfentanyl;

(2) Acetylmethadol;

(3) Allylprodine;

(4) Alphacetylmethadol (except Levo-alphacetylmethadol or LAAM);

(5) Alphameprodine;

(6) Alphamethadol;

(7) Alpha-methylfentanyl;

(8) Alphamethylthiofentanyl;

(9) Benzethidine;

(10) Benzylfentanyl;

(11) Betacetylmethadol;

(12) Beta-hydroxy-fentanyl;

(13) Beta-hydroxy-3-methylfentanyl;

(14) Betameprodine;

(15) Betamethadol;

(16) Betaprodine;

(17) Clonitazene;

(18) Dextromoramide;

(19) Diampromide;

(20) Diethylthiambutene;

(21) Difenoxin;

(22) Dimenoxadol;

(23) Dimepheptanol;

(24) Dimethylthiambutene;

(25) Dioxaphetyl Butyrate;

(26) Dipipanone;

(27) Ethylmethlthiambutene;

(28) Etonitazene;

(29) Etoxeridine;

(30) Furethidine;

(31) Hydroxypethidine;

(32) Ketobemidone;

(33) Levomoramide;

(34) Levophenacylmorphan;

(35) 3-methylfentanyl;

(36) 3-methylthiofentanyl;

(37) Morpheridine;

(38) Noracymethadol;

(39) Norlevorphanol;

(40) Normethadone;

(41) Norpipanone;

(42) Para-fluorofentanyl;

(43) Phenadoxone;

(44) Phenampromide;

(45) Phenomorphan;

(46) Phenoperidine;

(47) Piritramide;

(48) Proheptazine;

(49) Properidine;

(50) Propiram;

(51) Racemoramide;

(52) Thenylfentanyl;

(53) Thiofentanyl;

(54) Tilidine

(55) Trimeperidine

(b) Any of the following opium derivatives, their salts, isomers and salts of isomers, unless specifically excepted:

(1) Acetorphine;

(2) Acetyldihydrocodeine;

(3) Benzylmorphine;

(4) Codeine methylbromide;

(5) Codeine-N-oxide;

(6) Cyprenorphine;

(7) Desomorphine;

(8) Dihydromorphine;

(9) Drotebanol;

(10) Etorphine, except hydrochloride salts

(11) Heroin;

(12) Hydromorphinol;

(13) Methyldesorphine;

(14) Methyldihydromorphine;

(15) Morphine methylbromide;

(16) Morphine methylsulfonate;

(17) Morphine-N-oxide;

(18) Myrophine;

(19) Nicocodeine;

(20) Nicomorphine;

(21) Normorphine;

(22) Pholcodine;

(23) Thebacon.

( c ) Any material, compound, mixture or preparation which contains their salts, isomers and salts of isomers, unless specifically excepted, within the specific chemical designation:

(1) 4-bromo-2,5-dimethoxyamphetamine; or 4-bromo-2,5-DMA;

(2) 2,5-dimethoxyamphetamine; or 2,5-DMA

(3) 2,5-Dimethoxy-4-ethylamphetamone or DOET;

(4) 3,4-Methylenedioxy-N-ethylamphetamine;

(5) 1-methl-4-phenyl-4-propionoxypiperidine; or MPPP;

(6) 3,4-methylenedioxymethamphetamine; or MDMA;

(7) 4-methoxyamphetamine; or PMA;

(8) 5-methoxy-3,4-methylenedioxy-amphetamine;

(9) 5-methoxy-nn-diisopropyltryptamine (5-methoxy-dipt);

(10) 4-methyl-2,5-dimethoxyamphetamine; or DOM; or STP

(11) 3,4-methylenedioxy amphetamine; or MDA

(12) 3,4,5-trimethoxy amphetamine;

(13) benzylpiperazine or BZP;

(14) Bufotenine or Mappine;

(15) Alphaethyltryptamine;

(16) Diethyltrptamine or DET:

(17) Dimethyltiyptamine or DMT;

(18) Ibogaine;

(19) Lysergic acid diethylamide;

(20) Marihuana;

(21) Mescaline;

(22) Parahexyl or Synhexyl;

(23) Peyote, meaning all parts of the plants;

(24) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine; or PEPAP;

(25) N-ethyl-3-piperidyl benzilate;

(26) N-methl-3-piperidyl benzilate;

(27) Psilocybin;

(28) Psilocyn;

(29) Tetrahydrocannabinols except Dronabinol (synthetic) in sesame oil and encapsulated in a soft gelatin capsule in a United States food and drug administration approved product;

(30) Ethylamine analog of phencyclidine, Cyclohexamine or PCE;

(31) 4-Bromo-2,5-dimethoxyphenethylamine;

(32) Pyrrolidine analog of phencyclidine, PCP or PHP;

(33) 1-[1-(2-thienyl)cyclohexyl]pyrrolidine;

(34) Thiophene analog of phencyclidine, TPCP or TCP;

(35) Tiletamine or 2-(ethylamino)-2-(2-thienyl)-cyclohexanone;

(36) Trifluoromethylphenylpiperazine or TFMPP.

(d) Any material, compound, mixture or preparation which contains any quantity of the following substances having a depressed effect on the central nervous system, their salts, isomers and salts of isomers unless specifically excepted:

(1) Gamma-hydroxy butyric acid, except if contained in a drug product for which an application has been approved under section 505 of the federal food, drug and cosmetic act;

(2) Gamma-butyrolactone;

(3) Mecloqualone;

(4) Methaqualone; or

(5) Zolazepam

(e) Unless specifically excepted or unless listed in another schedule, any material, compound, mixture or preparation which contains any quantity of the following substances having a stimulant effect on the central nervous system, including its salts, isomers and salts of isomers:

(1) Aminorex;

(2) 4-Methylaminorex;

(3) Cathinone;

(4) Fenethylline;

(5) Methcathinone;

(6) N-ethylamphetamine;

(7) N,N-Dimethylamhetamine

CT ADC § 21a-243-7

3. Does Connecticut permit electronic prescribing systems?

Each health care provider licensed in Connecticut with prescriptive authority may generate prescriptions in Connecticut utilizing an electronic prescribing system.

C.G.S.A. § 191-25b

4. Who has prescriptive authority in Connecticut?

(a) A physician, in good faith and in the course of the physician's professional practice only, may prescribe, administer and dispense controlled substances, or may cause the same to be administered by a physician assistant, nurse or intern under the physician's direction and supervision, for demonstrable physical or mental disorders but not for drug dependence except in accordance with state and federal laws. The Department of Consumer protection may approve protocols allowing the dispensing of take-home doses of methadone, by a registered nurse or licensed practical nurse, to outpatients in duly licensed substance abuse treatment facilities and in compliance with all relevant regulations.

(b) A dentist, in good faith and in the course of the dentist's professional practice only, may prescribe, administer or dispense controlled substances, or may cause the same to be administered by a nurse under the dentist's direction and supervision, to the extent permitted by the federal Controlled Substances Act, federal food and drug laws and state laws and regulations relating to dentistry.

( c ) A podiatrist, in good faith and in the course of the podiatrist's professional practice only, may prescribe, administer and dispense controlled substances in schedules II, III, IV or V, or may cause the same to be administered by a nurse under the podiatrist's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to podiatry.

(d) An advanced practice registered nurse, in good faith and in the course of such nurse's professional practice only, may prescribe, dispense and administer controlled substances in schedule II, III, IV or V, or may cause the same to be administered by a registered nurse or licensed practical nurse under the advanced practice registered nurse's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to advanced nursing practice.

(e) A licensed nurse-midwife, in good faith and in the course of the nurse-midwife's professional practice only, may prescribe, dispense, and administer controlled substances in schedules II, III, IV and V, or may cause the same to be administered by a registered nurse or licensed practical nurse under the nurse-midwife's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws.

(f) A licensed physician assistant, in good faith and in the course of the physician assistant's professional practice only, may prescribe, dispense, and administer controlled substances in schedule II, III, IV or V, or may cause the same to be administered by an advanced practice registered nurse, registered nurse, or licensed practical nurse who is acting under a physician's direction, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to physician assistant practice.

(g) An optometrist authorized to practice advanced optometrical care, in good faith and in the course of the optometrist's professional practice only and who is duly authorized may prescribe, administer or dispense controlled substances in schedule II, III, IV or V to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to optometry.

C.G.S.A. § 21a-252

4. Are answers provided on an electronic questionnaire sufficient for the prescription of controlled substances?

No. In the absence of a documented patient evaluation that includes a physical examination, any request for a controlled substance issued solely on the results of answers to an electronic questionnaire shall be considered to be issued outside the context of a valid practitioner-patient relationship and not be a valid prescription.

C.G.S.A. § 20-613a

Copyright Kern Augustine Conroy and Schoppmann, P.C. Used with permission.