Update on New Legislation AB 1753 – Controlled Substance Prescriptions

by Arutyun “Harry” Sarkissian, PharmD. and Janice Hoffman, PharmD., EdD, APh, BCGP, FASCP

Introduction by Flora Y. Bessey, Pharm.D., BCGP

Dr. Harry Sarkissian brings us an enlightening summary of AB 1753, which addresses controlled substances and the efforts of the California legislature to increase security and decrease fraud and theft of controlled substances. This bill is very specific about PAPER prescriptions, and applies some very strict guidelines about how these scripts need to be written.

As we all know, much of the correspondence between our facilities and our pharmacies is via FAX, or scan and FAX/email. The paper that must be used now will show a large “VOID” across the prescription when the FAX/scan is received by the pharmacy. This is an effort to prevent copies of prescriptions being used to generate fraudulent paper prescriptions that could then be filled at any pharmacy. However, there is well-founded concern that some pharmacists would be reluctant to fill a prescription that is marked “VOID!” We may be able to mitigate this with appropriate training of our bench pharmacists, but it is certainly a consideration.

There is also the consideration of “continuance” letters the pharmacy is presently sending to prescribers as a reminder that an updated prescription is required for ongoing therapy.  This is almost exclusively being done via fax. Usually the prescriber will sign the fax, and resend. With the new law, unless the fax arrives and is printed on the “special” paper, the continuance-letter script that the prescriber resends will not be valid. The California state officials have not ironed out how this will be managed or what is required.  Simply put, the DEA has one set of requirements, the board of pharmacy another, the state a third set. How this will all play out is unclear, as this all went into effect only a few weeks ago.

There is also mention of a grace period until July 1, 2019 for prescribers to get the correct prescribing pads.  

It is important to note that if a prescriber utilizes e-prescribing, this bill has little to no effect upon their practice. Yet another reason for our prescribers to take advantage of today’s technology to better serve our patient population!  Click here to see my article on e-prescribing.

I advise you meet with your consultant pharmacist.  Understand what your pharmacy provider is going to require of you to avoid any “slow down” in the system/process.  Also very important to note: a “slowdown” could result in poor outcomes with regards to patient pain, as well as safety.

Update on New Legislation AB 1753 – Controlled Substance Prescriptions

by Arutyun “Harry” Sarkissian, PharmD. and Janice Hoffman, PharmD., EdD, APh, BCGP, FASCP

AB 1753: The purpose of this bill is to increase security and decrease fraud and theft of controlled substances.

Key notable points of AB 1753 are:

  • All paper prescriptions for controlled substances are required to be on prescription pads containing a serial number sequence approved by the Department of Justice (DOJ). 

  • These prescription pads need to be printed by DOJ approved printers. 

  • This extra security precaution will be used in addition to Controlled Substance Utilization Review and Evaluation System (CURES).

  • AB 1753 does not mention a grace period to allow for adaptation of the new regulations and requires all prescriptions written on or after January 1, 2019 to be on the prescription pads containing DOJ approved serial numbers.

  • Although AB 1753 does not include a grandfathered timeframe, the California Board of Pharmacy has acknowledged that patients may still present prescriptions written on pads prior to January 1, 2019 and advised California Licensed pharmacists to use professional judgement and act as they see most appropriate for the patient and public health.  The Enforcement Committee will not take action against pharmacists using their best professional judgment until July 1, 2019.

The Medical Board of California has developed an information page which lists and addresses all the requirements of a prescription pad in a detailed format.

The Medical Board of California has also released a memo to all prescribing physicians addressing these changes that have taken place on January 1, 2019.

AB 1753 can be found and review in completion on the California legislative Information web site:

About Arutyun “Harry” Sarkissian, PharmD.
Dr. Sarkissian received his Bachelor’s Degree in biology from California State University, Northridge (CSUN) in 2013. When he graduated from CSUN, he ended a 10-year career in banking and decided to follow his dream of becoming a pharmacist. Dr Sarkissian received his Doctorate in Pharmacy from Western University of Health Sciences in 2018. He is currently a PGY1 geriatrics resident at Western University. He looks forward to expanding his knowledge and skills, hoping to pass these down to future pharmacists.