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Exceptions to Ohio’s Mandatory Electronic Prescribing Requirements

May 4, 2023  821  821   

In light of recent drug shortages, the State of Ohio Board of Pharmacy has provided some important reminders on federal and state laws related to controlled substances. Please see the information below about the prescriber’s ability to issue verbal orders in emergency situations. The Board of Pharmacy has provided the same information to pharmacists for their awareness. 

Emergency Dispensing of Schedule II Controlled Substances Upon Verbal Order

In the case of an emergency situation, federal regulations permit a pharmacist to dispense a controlled substance listed in Schedule II upon receiving verbal authorization from a prescribing individual practitioner, provided that:

1) The quantity prescribed and dispensed is limited to the amount adequate to treat the patient during the emergency period (dispensing beyond the emergency period must be pursuant to a paper or electronic prescription signed by the prescribing individual practitioner);

(2) The prescription shall be immediately reduced to writing by the pharmacist and shall contain all information required in § 1306.05, except for the signature of the prescribing individual practitioner;

3)  If the prescribing individual practitioner is not known to the pharmacist, the pharmacist must make a reasonable effort to determine that the verbal authorization came from a registered individual practitioner, which may include a callback to the prescribing individual practitioner using the practitioner’s phone number as listed in the telephone directory and/or other good faith efforts to insure the practitioner’s identity; and

(4) Within 7 days after authorizing an emergency oral prescription, the prescribing individual practitioner shall cause a written prescription for the emergency quantity prescribed to be delivered to the dispensing pharmacist. In addition to conforming to the requirements of § 1306.05, the prescription shall have written on its face “Authorization for Emergency Dispensing,” and the date of the oral order. The paper prescription may be delivered to the pharmacist in person or by mail, but if delivered by mail it must be postmarked within the 7-day period. Upon receipt, the dispensing pharmacist must attach this paper prescription to the oral emergency prescription that had earlier been reduced to writing. For electronic prescriptions, the pharmacist must annotate the record of the electronic prescription with the original authorization and date of the oral order. The pharmacist must notify the nearest office of the Administration if the prescribing individual practitioner fails to deliver a written prescription to the pharmacist; failure of the pharmacist to do so shall void the authority conferred by this paragraph to dispense without a written prescription of a prescribing individual practitioner.

5) Central fill pharmacies shall not be authorized under this paragraph to prepare prescriptions for a controlled substance listed in Schedule II upon receiving an oral authorization from a retail pharmacist or an individual practitioner.

For the purposes of authorizing an oral prescription of a controlled substance listed in Schedule II of the Federal Controlled Substances Act, the term emergency situation means those situations in which the prescribing practitioner determines:

(1) That immediate administration of the controlled substance is necessary, for proper treatment of the intended ultimate user; and

(2) That no appropriate alternative treatment is available, including administration of a drug which is not a controlled substance under Schedule II of the Act, and

(3) That it is not reasonably possible for the prescribing practitioner to provide a written prescription to be presented to the person dispensing the substance, prior to the dispensing.

State law (3719.05) also permits a Schedule II controlled substance to be dispensed upon a verbal prescription in emergency situations as provided in the federal drug abuse control laws (i.e., the process outlined above).