(A) For purposes of this rule:
(3) "Personally furnish" means the distribution of drugs by a prescriber to the prescriber's patients for use outside the prescriber's practice setting.
(4) "Protracted basis" means a period in excess of twelve continuous weeks.
(5) "Reported drugs" means all the drugs listed in rule 4729-37-02 of the Administrative Code that are required to be reported to the drug database established and maintained pursuant to section 4729.75 of the Revised Code, including:
(a) Controlled substances in schedules II, III, IV, and V, and
(b) All dangerous drug products containing tramadol.
(B) If a physician assistant believes or has reason to believe that a patient may be abusing or diverting drugs, the physician assistant shall use sound clinical judgment in determining whether or not the reported drug should be prescribed to the patient under the circumstances.
(1) To assist in this determination, the physician assistant shall access OARRS and document receipt and assessment of the information received if the patient exhibits the following signs of drug abuse or diversion:
(a) Selling prescription drugs;
(b) Forging or altering a prescription;
(c) Stealing or borrowing reported drugs;
(d) Increasing the dosage of reported drugs in amounts that exceed the prescribed amount;
(e) Having a drug screen result that is inconsistent with the treatment plan or refusing to participate in a drug screen;
(f) Having been arrested, convicted or received diversion, or intervention in lieu of conviction for a drug related offense while under the physician's care;
(g) Receiving reported drugs from multiple prescribers, without clinical basis; or
(h) Having a family member, friend, law enforcement officer, or health care professional express concern related to the patient's use of illegal or reported drugs.
(2) Other signs of possible abuse or diversion which may necessitate accessing OARRS include, but are not limited to the following:
(a) A known history of chemical abuse or dependency;
(b) Appearing impaired or overly sedated during an office visit or exam;
(c) Requesting reported drugs by specific name, street name, color, or identifying marks;
(d) Frequently requesting early refills of reported drugs;
(e) Frequently losing prescriptions for reported drugs;
(f) A history of illegal drug use;
(g) Sharing reported drugs with another person; or
(h) Recurring emergency department visits to obtain reported drugs.
(C) A physician assistant prescribing reported drugs to treat a patient on a protracted basis shall, at a minimum, document receipt and assessment of an OARRS report in the following circumstances:
(1) Once the physician assistant has reason to believe that the treatment will be required on a protracted basis; and
(2) At least once annually, thereafter.
(D) A physician assistant shall document receipt and assessment of all OARRS reports in the patient record.
(1) Initial reports requested in compliance with this rule shall cover a time period of at least one year;
(2) Subsequent reports requested in compliance with this rule shall, at a minimum, cover the period from the date of the last report to present.
(E) In the event an OARRS report is not available prior to writing a prescription for a reported drug or personally furnishing the reported drug, the physician assistant shall document in the patient record why the OARRS report was not available.