Task Force report : narcotics and drug abuse annotations and consultants' papers.
- United States. Task Force on Narcotics and Drug Abuse.
- Date:
- [1967]
Licence: Public Domain Mark
Credit: Task Force report : narcotics and drug abuse annotations and consultants' papers. Source: Wellcome Collection.
109/172 (page 99)
![production of such drugs is likely to be a more significant factor in their introduction to illicit channels of distribu- tion than it is in the case of “depressant or stimulant drugs” having significant medical use.** Drugs having significant medical use are more likely to be introduced into illicit channels by way of diversions from legitimate sources than by way of illicit production. Even where there is illicit production of such drugs, diversions from legitimate sources presumably will be significant enough that controls over precursors will not be particularly sig- nificant in controlling the illicit traffic. Where, however, a drug has no significant medical use in the United States, it is more likely that controls over precursors will be significant in controlling the illicit traffic. The recommendation also requires a showing by the FDA of some actual use of the precursor in illicit produc- tion of the “depressant or stimulant drug.” The purpose of this requirement is to insure that there is some need for control of the precursor. PRACTITIONERS’ EXEMPTION FROM RECORD-KEEPING RE- QUIREMENTS It must be recognized that the exemption from the recordkeeping and inspection provisions of the Federal amendments of practitioners who do not regularly engage in dispensing “depressant or stimulant drugs’’ to patients for a fee leaves‘a gap in the regulatory scheme. Ideally, a system of interrelated recordkeeping should make every link in the chain of distribution accountable for drugs coming in and for drugs going out. The exemption was justified in Congress on the ground that there had in the past been only a small number of drug violations by practitioners.?°° Although it should be noted that recordkeeping and inspection reuirements might uncover or furnish leads to violations that now are undiscovered, when the exemption is viewed in light of the known number of violations the gap in the regula- tory scheme may be viewed as more apparent than real. In addition, elimination of the exemption would extend the recordkeeping requirements to large numbers of per- sons. In the House debate on H.R. 2 Congressman Jar- man of Oklahoma, a member of the committee which re- ported on the bill, stated that there were 230,000 phy- sicians, 84,000 dentists and 15,000 veterinarians in the United States.2°° For these reasons it is believed that the politically difficult task of repealing the exemption should not be attempted at this time. But if the number of violations by practitioners should show signs of in- crease, repeal of the exemption should be considered. Existing State law on the subject is not uniform. The Model State Barbiturate Act requires recordkeeping of practitioners.”*° However, two jurisdictions which have based their legislation on the act have exempted prac- titioners from recordkeeping.*4* The Model State Drug Abuse Control Act,!” the recent legislation in Virginia ** and the proposed legislation in New Jersey 74 contain the 99 require some recordkeeping of practitioners.2 The 1965 New York law, amended in 1966, is one of these.2*® In the interests of uniformity with the Federal act it is rec- ommended that the exemption be included in a model State act. However, the large number of States which require some recordkeeping of practitioners suggests that particular States may not desire to include it. PRESCRIPTION LIMITATIONS It is recommended that the limitations on the life of prescriptions and on refilling prescriptions in the 1965 amendments should be retained. The amendments limit the life of a prescription for a “depressant or stimulant drug” to a maximum of 6 months from the date of issue and provide that no prescription for such a drug can be refilled more than five times or more than 6 months after it was issued. The prescriber may, however, renew the prescription after five refills or 6 months.?27 These limitations were designed to eliminate open- ended prescriptions under which a person could con- tinue to obtain a dangerous drug long after his medical need for it had ceased or without the benefit of medical judgment as to whether a medical need continued.”4* It was believed that open-ended prescriptions facilitated addicts and habitual users in obtaining drugs and may have provided an opportunity for some persons to become dependent.”?® On the other hand, the Federal limitations do not necessarily prevent a person who without the knowledge of his physician is addicted or otherwise dependent from obtaining drugs. A person may, if a pharmacist will fill it, have a prescription refilled five times in a short period and then obtain another prescription either from the same or another physician. This abuse could be curbed somewhat by a requirement that a prescription must designate a minimum time which must elapse between refills.22° Moreover, the amendments permit oral prescriptions and oral refills if they are promptly reduced to writing by the pharmacist. Oral prescription permit persons to impersonate physicians and_ obtain drugs without a practitioner’s approval. A requirement that the practitioner must follow up an oral prescription by a confirming written prescription within a designated period, as exists in some States, might limit this practice somewhat. A requirement that a pharmacist must con- firm an oral prescription by telephoning the physician might have more effect. Finally, the abuses of oral prescriptions are eliminated by prohibiting them. It is not believed that the Federal limitations should be changed at this time. Limitation on prescriptions would seem to be a matter predominantly for State action, because it involves restrictions on both practitioner and pharmacist. Before any additional Federal restric- tions are enacted it should appear that there is substantial abuse despite the existing Federal provision. While limitations like those in the Federal law should exemption contained in the Federal amendments. On be included in a mode] State act, it 1s not believed that 27 Such drugs may also be unlawfully imported into the United States. Com- 213 Va. Code Ann., § 54-446.5(c) re oes BAe Mar. 14, 1966). missioner Goddard of the FDA has stated that LSD is being unlawfully imported into the United States. New York Times, May 23, 1966, p. 31, cols. 7 and 8. See also Levin, “LSD in New York: a reporter’s inside look,” part 5, New York Post, June 10, 1966, p. 46. See note 78 supra. 209111 Congressional Record 4304, col. 3, 89th Cong., Ist sess. (House) (daily ed. Mar. 9, 1965). Commissioner Larrick reported these same figures in his testi- mony before the House Commerce Committee. Hearings at 100. 210 See note 149 supra. °11 See note 150 supra. 218 Model State Drug Abuse Control Act, § 7(e) (3). 14 NiJ. Assembly No. 548, § 2(g) (3) 215 See note 151 esa 216 See notes 110 and 151 supra. 217 Food, Drug, and Cosmetic Act, § 511, 21 U.S.C. § 360a(e). 218 House Report at 9-10, 111 Congressional Record 4299, col. 1, 89th Cong., lst sess. (remarks of Representative Springer of Illinois) (House) (daily re Mar. 9, 1965); Testimony of Dr. John Griffith, Director, Oklahoma Mental Healt Planning Committee, Hearings at 307-08, 310, 311. 219 See the authorities cited in the preceding note. , ; 220 Recommended in Fort, “‘The problem of barbiturates in the United States of America,’ 16 Bulletin on Narcotics, No. 1, 17, 30 (January-March 1964).](https://iiif.wellcomecollection.org/image/b32179911_0109.jp2/full/800%2C/0/default.jpg)
