AN ACT RELATING TO FOOD AND DRUGS -- UNIFORM CONTROLLED SUBSTANCES ACT (Revises sections of the uniform controlled substances act to remove specific opioid dosage requirements and revise the uniform controlled substances act in accordance with current standards of professional practice.)

H7923

2026 -- H 7923
========
LC005258
========

STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
____________
A N A C T
RELATING TO FOOD AND DRUGS -- UNIFORM CONTROLLED SUBSTANCES ACT

Introduced By:
Representative Matthew S. Dawson

Date Introduced:
February 27, 2026

Referred To:
House Health & Human Services
(Dept. of Health)
It is enacted by the General Assembly as follows:
1
SECTION 1. Section 21-28-1.02 of the General Laws in Chapter 21-28 entitled "Uniform
2
Controlled Substances Act" is hereby repealed:
3

21-28-1.02. Definitions. [Effective until January 1, 2023; see Sunset Provision note.]
4

Unless the context otherwise requires, the words and phrases as defined in this section are
5
used in this chapter in the sense given them in the following definitions:
6

(1) “Administer” refers to the direct application of controlled substances to the body of a
7
patient or research subject by:
8

(i) A practitioner, or, in his or her presence by his or her authorized agent; or
9

(ii) The patient or research subject at the direction and in the presence of the practitioner
10
whether the application is by injection, inhalation, ingestion, or any other means.
11

(2) “Agent” means an authorized person who acts on behalf of, or at the direction of, a
12
manufacturer, wholesaler, distributor, or dispenser; except that these terms do not include a
13
common or contract carrier or warehouse operator when acting in the usual and lawful course of
14
the carrier’s or warehouse operator’s business.
15

(3) “Apothecary” means a registered pharmacist as defined by the laws of this state and,
16
where the context requires, the owner of a licensed pharmacy or other place of business where
17
controlled substances are compounded or dispensed by a registered pharmacist; and includes
18
registered assistant pharmacists as defined by existing law, but nothing in this chapter shall be
19
construed as conferring on a person who is not registered as a pharmacist any authority, right, or

1
privilege that is not granted to him or her by the pharmacy laws of the state.
2

(4) “Automated data processing system” means a system utilizing computer software and
3
hardware for the purposes of record keeping.
4

(5) “Certified law enforcement prescription drug diversion investigator” means a certified
5
law enforcement officer assigned by his or her qualified law enforcement agency to investigate
6
prescription drug diversion.
7

(6) “Computer” means programmable electronic device capable of multi-functions,
8
including, but not limited to: storage, retrieval, and processing of information.
9

(7) “Control” means to add a drug or other substance or immediate precursor to a schedule
10
under this chapter, whether by transfer from another schedule or otherwise.
11

(8) “Controlled substance” means a drug, substance, immediate precursor, or synthetic
12
drug in schedules I — V of this chapter. The term shall not include distilled spirits, wine, or malt
13
beverages, as those terms are defined or used in chapter 1 of title 3, nor tobacco.
14

(9) “Co-prescribing” means issuing a prescription for an opioid antagonist along with a
15
prescription for an opioid analgesic.
16

(10) “Counterfeit substance” means a controlled substance that, or the container or labeling
17
of which, without authorization bears the trademark, trade name, or other identifying mark, imprint,
18
number, or device, or any likeness of them, of a manufacturer, distributor, or dispenser, other than
19
the person or persons who in fact manufactured, distributed, or dispensed the substance and that
20
thereby falsely purports or is represented to be the product of, or to have been distributed by, the
21
other manufacturer, distributor, or dispenser, or which substance is falsely purported to be or
22
represented to be one of the controlled substances by a manufacturer, distributor, or dispenser.
23

(11) “CRT” means cathode ray tube used to impose visual information on a screen.
24

(12) “Deliver” or “delivery” means the actual, constructive, or attempted transfer of a
25
controlled substance or imitation controlled substance, whether or not there exists an agency
26
relationship.
27

(13) “Department” means the department of health of this state.
28

(14) “Depressant or stimulant drug” means:
29

(i) A drug that contains any quantity of:
30

(A) Barbituric acid or derivatives, compounds, mixtures, or preparations of barbituric acid;
31
and
32

(B) “Barbiturate” or “barbiturates” includes all hypnotic and/or somnifacient drugs,
33
whether or not derivatives of barbituric acid, except that this definition shall not include bromides
34
and narcotics.

LC005258 - Page 2 of 21
1

(ii) A drug that contains any quantity of:
2

(A) Amphetamine or any of its optical isomers;
3

(B) Any salt of amphetamine and/or desoxyephedrine or any salt of an optical isomer of
4
amphetamine and/or desoxyephedrine, or any compound, mixture, or preparation of them.
5

(iii) A drug that contains any quantity of coca leaves. “Coca leaves” includes cocaine, or
6
any compound, manufacture, salt, derivative, mixture, or preparation of coca leaves, except
7
derivatives of coca leaves, that do not contain cocaine, ecgonine, or substance from which cocaine
8
or ecgonine may be synthesized or made.
9

(iv) Any other drug or substance that contains any quantity of a substance that the attorney
10
general of the United States, or the director of health, after investigation, has found to have, or by
11
regulation designates as having, a potential for abuse because of its depressant or stimulant effect
12
on the central nervous system.
13

(15) “Director” means the director of health.
14

(16) “Dispense” means to deliver, distribute, leave with, give away, or dispose of a
15
controlled substance to the ultimate user or human research subject by or pursuant to the lawful
16
order of a practitioner, including the packaging, labeling, or compounding necessary to prepare the
17
substance for that delivery.
18

(17) “Dispenser” is a practitioner who delivers a controlled substance to the ultimate user
19
or human research subject.
20

(18) “Distribute” means to deliver (other than by administering or dispensing) a controlled
21
substance or an imitation controlled substance and includes actual constructive, or attempted
22
transfer. “Distributor” means a person who so delivers a controlled substance or an imitation
23
controlled substance.
24

(19) “Downtime” means that period of time when a computer is not operable.
25

(20) “Drug addicted person” means a person who exhibits a maladaptive pattern of
26
behavior resulting from drug use, including one or more of the following: impaired control over
27
drug use; compulsive use; and/or continued use despite harm, and craving.
28

(21) “Drug Enforcement Administration” means the Drug Enforcement Administration,
29
United States Department of Justice or its successor.
30

(22) “Federal law” means the Comprehensive Drug Abuse Prevention and Control Act of
31
1970, (84 stat. 1236) (see generally 21 U.S.C. § 801 et seq.), and all regulations pertaining to that
32
federal act.
33

(23) “Hardware” means the fixed component parts of a computer.
34

(24) “Hospital” means an institution as defined in chapter 17 of title 23.

LC005258 - Page 3 of 21
1

(25) “Imitation controlled substance” means a substance that is not a controlled substance,
2
that by dosage unit, appearance (including color, shape, size, and markings), or by representations
3
made, would lead a reasonable person to believe that the substance is a controlled substance and,
4
which imitation controlled substances contain substances that if ingested, could be injurious to the
5
health of a person. In those cases when the appearance of the dosage unit is not reasonably sufficient
6
to establish that the substance is an “imitation controlled substance” (for example in the case of
7
powder or liquid), the court or authority concerned should consider, in addition to all other logically
8
relevant factors, the following factors as related to “representations made” in determining whether
9
the substance is an “imitation controlled substance”:
10

(i) Statement made by an owner, possessor, transferor, recipient, or by anyone else in
11
control of the substance concerning the nature of the substance, or its use or effect.
12

(ii) Statements made by the owner, possessor, or transferor, to the recipient that the
13
substance may be resold for substantial profit.
14

(iii) Whether the substance is packaged in a manner reasonably similar to packaging of
15
illicit controlled substances.
16

(iv) Whether the distribution or attempted distribution included an exchange of or demand
17
for money or other property as consideration, and whether the amount of the consideration was
18
substantially greater than the reasonable value of the non-controlled substance.
19

(26) “Immediate precursor” means a substance:
20

(i) That the director of health has found to be, and by regulation designated as being, the
21
principal compound used, or produced primarily for use, in the manufacture of a controlled
22
substance;
23

(ii) That is an immediate chemical intermediary used, or likely to be used, in the
24
manufacture of those controlled substances; and
25

(iii) The control of which is necessary to prevent, curtail, or limit the manufacture of that
26
controlled substance.
27

(27) “Laboratory” means a laboratory approved by the department of health as proper to
28
be entrusted with controlled substances and the use of controlled substances for scientific and
29
medical purposes and for the purposes of instruction.
30

(28) “Manufacture” means the production, preparation, propagation, cultivation,
31
compounding, or processing of a drug or other substance, including an imitation controlled
32
substance, either directly or indirectly or by extraction from substances of natural origin, or
33
independently by means of chemical synthesis or by a combination of extraction and chemical
34
synthesis and includes any packaging or repackaging of the substance or labeling or relabeling of

LC005258 - Page 4 of 21
1
its container in conformity with the general laws of this state except by a practitioner as an incident
2
to his or her administration or dispensing of the drug or substance in the course of his or her
3
professional practice.
4

(29) “Manufacturer” means a person who manufactures but does not include an apothecary
5
who compounds controlled substances to be sold or dispensed on prescriptions.
6

(30) “Marijuana” means all parts of the plant cannabis sativa L., whether growing or not;
7
the seeds of the plant; the resin extracted from any part of the plant; and every compound,
8
manufacture, salt, derivative, mixture, or preparation of the plant, its seeds or resin, but shall not
9
include the mature stalks of the plant, fiber produced from the stalks, oil or cake made from the
10
seeds of the plant, any other compound, manufacture, salt, derivative, mixture, or preparation of
11
mature stalks, (except the resin extracted from it), fiber, oil or cake, or the sterilized seed from the
12
plant which is incapable of germination. Marijuana shall not include “industrial hemp” or
13
“industrial hemp products” which satisfy the requirements of chapter 26 of title 2, nor shall it
14
include products that have been approved for marketing as a prescription medication by the U.S.
15
Food and Drug Administration and legally prescribed.
16

(31) “Narcotic drug” means any of the following, whether produced directly or indirectly
17
by extraction from substances of vegetable origin, or independently by means of chemical synthesis
18
or by a combination of extraction and chemical synthesis:
19

(i) Opium and opiates.
20

(ii) A compound, manufacture, salt, derivative, or preparation of opium or opiates.
21

(iii) A substance (and any compound, manufacture, salt, derivative, or preparation of it)
22
that is chemically identical with any of the substances referred to in subsections 31(i) and (31)(ii).
23

(iv) Any other substance that the attorney general of the United States, or his or her
24
successor, or the director of health, after investigation, has found to have, and by regulation
25
designates as having, a potential for abuse similar to opium and opiates.
26

(32) “Official written order” means an order written on a form provided for that purpose
27
by the Drug Enforcement Administration under any laws of the United States making provision for
28
an official form, if order forms are authorized and required by federal law, and if no order form is
29
provided, then on an official form provided for that purpose by the director of health.
30

(33) “Opiate” means any substance having an addiction-forming or addiction-sustaining
31
liability similar to morphine or being capable of conversion into a drug having addiction-forming
32
or addiction-sustaining liability.
33

(34) “Opioid analgesics” means and includes, but is not limited to, the medicines
34
buprenophine, butorphanol, codeine, hydrocodone, hydromorphone, levorphanol, meperidine,

LC005258 - Page 5 of 21
1
methadone, morphine, nalbuphine, oxycodone, oxymorphone, pentazocine, propoxyphene as well
2
as their brand names, isomers, and combinations, or other medications approved by the department.
3

(35) “Opioid antagonist” means naloxone hydrochloride and any other drug approved by
4
the United States Food and Drug Administration for the treatment of opioid overdose.
5

(36) “Opium poppy” means the plant of the species papaver somniferum L., except the
6
seeds of the plant.
7

(37) “Ounce” means an avoirdupois ounce as applied to solids and semi-solids, and a fluid
8
ounce as applied to liquids.
9

(38) “Person” means any corporation, association, partnership, or one or more individuals.
10

(39) “Physical dependence” means a state of adaptation that is manifested by a drug class
11
specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction,
12
decreasing blood level of the drug, and/or administration of an antagonist.
13

(40) “Poppy straw” means all parts, except the seeds, of the opium poppy, after mowing.
14

(41) “Practitioner” means:
15

(i) A physician, osteopath, dentist, chiropodist, veterinarian, scientific investigator, or other
16
person licensed, registered, or permitted to distribute, dispense, conduct research with respect to or
17
to administer a controlled substance in the course of professional practice or research in this state.
18

(ii) A pharmacy, hospital, or other institution licensed, registered, or permitted to distribute,
19
dispense, conduct research with respect to, or to administer a controlled substance in the course of
20
professional practice or research in this state.
21

(42) “Printout” means a hard copy produced by computer that is readable without the aid
22
of any special device.
23

(43) “Production” includes the manufacture, planting, cultivation, growing, or harvesting
24
of a controlled substance.
25

(44) “Qualified law enforcement agency” means the U.S. Food and Drug Administration,
26
Drug Enforcement Administration, Federal Bureau of Investigation, Office of Inspector General of
27
the U.S. Department of Health & Human Services, or the Medicaid Fraud and Patient Abuse Unit
28
in the Office of the Attorney General.
29

(45) “Researcher” means a person authorized by the director of health to conduct a
30
laboratory as defined in this chapter.
31

(46) “Sell” includes sale, barter, gift, transfer, or delivery in any manner to another, or to
32
offer or agree to do the same.
33

(47) “Software” means programs, procedures, and storage of required information data.
34

(48) “Synthetic drugs” means any synthetic cannabinoids or piperazines or any synthetic

LC005258 - Page 6 of 21
1
cathinones as provided for in schedule I.
2

(49) “Ultimate user” means a person who lawfully possesses a controlled substance for his
3
or her own use or for the use of a member of his or her household, or for administering to an animal
4
owned by him or her or by a member of his or her household.
5

(50) “Wholesaler” means a person who sells, vends, or distributes at wholesale, or as a
6
jobber, broker agent, or distributor, or for resale in any manner in this state any controlled
7
substance.
8
SECTION 2. Sections 21-28-1.2, 21-28-3.20 and 21-28-3.20.1 of the General Laws in
9
Chapter 21-28 entitled "Uniform Controlled Substances Act" are hereby amended to read as
10
follows:
11

21-28-1.02.
Definitions. [Effective January 1, 2023; see Sunset Provision note.]

12
Definitions.
13
Unless the context otherwise requires, the words and phrases as defined in this section are
14
used in this chapter in the sense given them in the following definitions:
15
(1)
"Acute pain" means the normal, predicted physiological response to a noxious
16
chemical, thermal, or mechanical stimulus and typically is associated with invasive procedures,
17
trauma, and disease. Acute pain is generally pain of less than thirty (30) days duration.
18

(2)
“Administer” refers to the direct application of controlled substances to the body of a
19
patient or research subject by:
20
(i)
A practitioner

Practitioners
, or, in
his or her

a practitioner's
presence by
his or her

their

21
authorized agent; or
22
(ii) The patient or research subject at the direction and in the presence of the practitioner
23
whether the application is by injection, inhalation, ingestion, or any other means.
24

(2)
(3)
“Agent” means an authorized person who acts on behalf of, or at the direction of, a
25
manufacturer, wholesaler, distributor, or dispenser; except that these terms do not include a
26
common or contract carrier or warehouse operator when acting in the usual and lawful course of
27
the carrier’s or warehouse operator’s business.
28

(3)
(4)
“Apothecary” means a registered pharmacist as defined by the laws of this state and,
29
where the context requires, the owner of a licensed pharmacy or other place of business where
30
controlled substances are compounded or dispensed by a registered pharmacist; and includes
31
registered assistant pharmacists as defined by existing law, but nothing in this chapter shall be
32
construed as conferring on a person who is not registered as a pharmacist any authority, right, or
33
privilege that is not granted to him or her by the pharmacy laws of the state.
34

(4)
(5)
“Automated data processing system” means a system utilizing computer software

LC005258 - Page 7 of 21
1
and hardware for the purposes of record keeping.
2

(6) “Chronic intractable pain” means pain that is excruciating, constant, incurable, and of
3
such severity that it dominates virtually every conscious moment, and/or produces mental and
4
physical debilitation. A diagnosis and written documentation of chronic intractable pain made by a
5
physician licensed in the State of Rhode Island specializing in pain management, oncology, or
6
similar specialty defined in regulations promulgated by the department shall constitute proof that
7
the patient suffers from chronic intractable pain.
8

(7) “Chronic pain” means a pain of greater than or equal to ninety (90) days duration,
9
excluding chronic intractable pain.
10

(5)
(8)
“Computer” means programmable electronic device capable of multi-functions,
11
including, but not limited to: storage, retrieval, and processing of information.
12

(6)
(9)
“Control” means to add a drug or other substance or immediate precursor to a
13
schedule under this chapter, whether by transfer from another schedule or otherwise.
14

(7)
(10)
“Controlled substance” means a drug, substance, immediate precursor, or synthetic
15
drug in schedules I — V of this chapter. The term shall not include distilled spirits, wine, or malt
16
beverages, as those terms are defined or used in chapter 1 of title 3, nor tobacco.
17

(8)
(11)
“Co-prescribing” means issuing a prescription for an opioid antagonist along with
18
a prescription for an opioid analgesic.
19

(9)
(12)
“Counterfeit substance” means a controlled substance that, or the container or
20
labeling of which, without authorization bears the trademark, trade name, or other identifying mark,
21
imprint, number, or device, or any likeness of them, of a manufacturer, distributor, or dispenser,
22
other than the person or persons who in fact manufactured, distributed, or dispensed the substance
23
and that thereby falsely purports or is represented to be the product of, or to have been distributed
24
by, the other manufacturer, distributor, or dispenser, or which substance is falsely purported to be
25
or represented to be one of the controlled substances by a manufacturer, distributor, or dispenser.
26

(10)
(13)
“CRT” means cathode ray tube used to impose visual information on a screen.
27

(11)
(14)
“Deliver” or “delivery” means the actual, constructive, or attempted transfer of a
28
controlled substance or imitation controlled substance, whether or not there exists an agency
29
relationship.
30

(12)
(15)
“Department” means the department of health of this state.
31

(13)
(16)
“Depressant or stimulant drug” means:
32
(i) A drug that contains any quantity of:
33
(A) Barbituric acid or derivatives, compounds, mixtures, or preparations of barbituric acid;
34
and

LC005258 - Page 8 of 21
1
(B) “Barbiturate” or “barbiturates” includes all hypnotic and/or somnifacient drugs,
2
whether or not derivatives of barbituric acid, except that this definition shall not include bromides
3
and narcotics.
4
(ii) A drug that contains any quantity of:
5
(A) Amphetamine or any of its optical isomers;
6
(B) Any salt of amphetamine and/or desoxyephedrine or any salt of an optical isomer of
7
amphetamine and/or desoxyephedrine, or any compound, mixture, or preparation of them.
8
(iii) A drug that contains any quantity of coca leaves. “Coca leaves” includes cocaine, or
9
any compound, manufacture, salt, derivative, mixture, or preparation of coca leaves, except
10
derivatives of coca leaves, that do not contain cocaine, ecgonine, or substance from which cocaine
11
or ecgonine may be synthesized or made.
12
(iv) Any other drug or substance that contains any quantity of a substance that the attorney
13
general of the United States, or the director of health, after investigation, has found to have, or by
14
regulation designates as having, a potential for abuse because of its depressant or stimulant effect
15
on the central nervous system.
16

(14)
(17)
“Director” means the director of health.
17

(15)
(18)
“Dispense” means to deliver, distribute, leave with, give away, or dispose of a
18
controlled substance to the ultimate user or human research subject by or pursuant to the lawful
19
order of a practitioner, including the packaging, labeling, or compounding necessary to prepare the
20
substance for that delivery.
21

(16)
(19)
“Dispenser” is a practitioner who delivers a controlled substance to the ultimate
22
user or human research subject.
23

(17)
(20)
“Distribute” means to deliver (other than by administering or dispensing) a
24
controlled substance or an imitation controlled substance and includes actual constructive, or
25
attempted transfer. “Distributor” means a person who so delivers a controlled substance or an
26
imitation controlled substance.
27

(18)
(21)
“Downtime” means that period of time when a computer is not operable.
28

(19)
(22)
“Drug addicted person” means a person who exhibits a maladaptive pattern of
29
behavior resulting from drug use, including one or more of the following: impaired control over
30
drug use; compulsive use; and/or continued use despite harm, and craving.
31

(20)
(23)
“Drug Enforcement Administration” means the Drug Enforcement
32
Administration, United States Department of Justice or its successor.
33

(21)
(24)
“Federal law” means the Comprehensive Drug Abuse Prevention and Control Act
34
of 1970, (84 stat. 1236) (see generally 21 U.S.C. § 801 et seq.), and all regulations pertaining to

LC005258 - Page 9 of 21
1
that federal act.
2

(22)
(25)
“Hardware” means the fixed component parts of a computer.
3

(23)
(26)
“Hospital” means an institution as defined in chapter 17 of title 23.
4

(24)
(27)
“Imitation controlled substance” means a substance that is not a controlled
5
substance, that by dosage unit, appearance (including color, shape, size, and markings), or by
6
representations made, would lead a reasonable person to believe that the substance is a controlled
7
substance and, which imitation controlled substances contain substances that if ingested, could be
8
injurious to the health of a person. In those cases when the appearance of the dosage unit is not
9
reasonably sufficient to establish that the substance is an “imitation controlled substance” (for
10
example in the case of powder or liquid), the court or authority concerned should consider, in
11
addition to all other logically relevant factors, the following factors as related to “representations
12
made” in determining whether the substance is an “imitation controlled substance”:
13
(i) Statement made by an owner, possessor, transferor, recipient, or by anyone else in
14
control of the substance concerning the nature of the substance, or its use or effect.
15
(ii) Statements made by the owner, possessor, or transferor, to the recipient that the
16
substance may be resold for substantial profit.
17
(iii) Whether the substance is packaged in a manner reasonably similar to packaging of
18
illicit controlled substances.
19
(iv) Whether the distribution or attempted distribution included an exchange of or demand
20
for money or other property as consideration, and whether the amount of the consideration was
21
substantially greater than the reasonable value of the non-controlled substance.
22

(25)
(28)
“Immediate precursor” means a substance:
23
(i) That the director of health has found to be, and by regulation designated as being, the
24
principal compound used, or produced primarily for use, in the manufacture of a controlled
25
substance;
26
(ii) That is an immediate chemical intermediary used or likely to be used in the manufacture
27
of those controlled substances; and
28
(iii) The control of which is necessary to prevent, curtail, or limit the manufacture of that
29
controlled substance.
30

(26)
(29)
“Laboratory” means a laboratory approved by the department of health as proper
31
to be entrusted with controlled substances and the use of controlled substances for scientific and
32
medical purposes and for the purposes of instruction.
33

(27)
(30)
“Manufacture” means the production, preparation, propagation, cultivation,
34
compounding, or processing of a drug or other substance, including an imitation controlled

LC005258 - Page 10 of 21
1
substance, either directly or indirectly or by extraction from substances of natural origin, or
2
independently by means of chemical synthesis or by a combination of extraction and chemical
3
synthesis and includes any packaging or repackaging of the substance or labeling or relabeling of
4
its container in conformity with the general laws of this state except by a practitioner as an incident
5
to his or her administration or dispensing of the drug or substance in the course of his or her
6
professional practice.
7

(28)
(31)
“Manufacturer” means a person who manufactures but does not include an
8
apothecary who compounds controlled substances to be sold or dispensed on prescriptions.
9

(29)
(32)
“Marijuana” means all parts of the plant cannabis sativa L., whether growing or
10
not; the seeds of the plant; the resin extracted from any part of the plant; and every compound,
11
manufacture, salt, derivative, mixture, or preparation of the plant, its seeds or resin, but shall not
12
include the mature stalks of the plant, fiber produced from the stalks, oil or cake made from the
13
seeds of the plant, any other compound, manufacture, salt, derivative, mixture, or preparation of
14
mature stalks, (except the resin extracted from it), fiber, oil or cake, or the sterilized seed from the
15
plant which is incapable of germination. Marijuana shall not include “industrial hemp” or
16
“industrial hemp products” which satisfy the requirements of chapter 26 of title 2, nor shall it
17
include products that have been approved for marketing as a prescription medication by the U.S.
18
Food and Drug Administration and legally prescribed.
19

(30)
(33)
“Narcotic drug” means any of the following, whether produced directly or
20
indirectly by extraction from substances of vegetable origin, or independently by means of
21
chemical synthesis or by a combination of extraction and chemical synthesis:
22
(i) Opium and
opiates

opioids
.
23
(ii) A compound, manufacture, salt, derivative, or preparation of opium or
opiates

opioids
.
24
(iii) A substance (and any compound, manufacture, salt, derivative, or preparation of it)
25
that is chemically identical with any of the substances referred to in subsections (30)(i) and (30)(ii).
26
(iv) Any other substance that the attorney general of the United States, or his or her
27
successor, or the director of health, after investigation, has found to have, and by regulation
28
designates as having, a potential for abuse similar to opium and
opiates

opioids
.
29

(31)
(34)
“Official written order” means an order written on a form provided for that
30
purpose by the Drug Enforcement Administration under any laws of the United States making
31
provision for an official form, if order forms are authorized and required by federal law, and if no
32
order form is provided then on an official form provided for that purpose by the director of health.
33

(32) “Opiate” means any substance having an addiction-forming or addiction-sustaining
34
liability similar to morphine or being capable of conversion into a drug having addiction-forming

LC005258 - Page 11 of 21
1
or addiction-sustaining liability.
2

(33)
(35)
“Opioid
analgesics
” means and includes, but is not limited to, the
medicines
3
buprenophine,

United States Food and Drug Administration approved medications
butorphanol,
4
codeine, hydrocodone, hydromorphone, levorphanol, meperidine, methadone, morphine,
5
nalbuphine, oxycodone, oxymorphone, pentazocine, propoxyphene as well as their brand names,
6
isomers, and combinations, or other medications approved by the department.
Opioid medications
7
include partial opioid agonists such as buprenorphine.
8

(34)
(36)
“Opioid antagonist” means naloxone hydrochloride and any other drug approved
9
by the United States Food and Drug Administration for the treatment of opioid overdose.
10

(37) “Opioid therapy” means to prescribe, administer, or dispense controlled substances
11
not prohibited by law for a therapeutic purpose to a person diagnosed and treated by a practitioner
12
for a condition by any route of administration.
13

(35)
(38)
“Opium poppy” means the plant of the species
papaver somniferum L.

Papaver
14
somniferum L.
, except the seeds of the plant.
15

(36)
(39)
“Ounce” means an avoirdupois ounce as applied to solids and semi-solids, and a
16
fluid ounce as applied to liquids.
17

(37)
(40)
“Person” means any corporation, association, partnership, or one or more
18
individuals.
19

(38)
(41)
“Physical dependence” means a state of adaptation that is manifested by a drug
20
class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction,
21
decreasing blood level of the drug, and/or administration of an antagonist.
22

(39)
(42)
“Poppy straw” means all parts, except the seeds, of the opium poppy, after
23
mowing.
24

(40)
(43)
“Practitioner” means:
25
(i) A physician, osteopath, dentist, chiropodist, veterinarian, scientific investigator, or other
26
person licensed, registered, or permitted to distribute, dispense, conduct research with respect to or
27
to administer a controlled substance in the course of professional practice or research in this state.
28
(ii) A pharmacy, hospital, or other institution licensed, registered or permitted to distribute,
29
dispense, conduct research with respect to, or to administer a controlled substance in the course of
30
professional practice or research in this state.
31

(41)
(44)
“Printout” means a hard copy produced by computer that is readable without the
32
aid of any special device.
33

(42)
(45)
“Production” includes the manufacture, planting, cultivation, growing, or
34
harvesting of a controlled substance.

LC005258 - Page 12 of 21
1

(43)
(46)
“Researcher” means a person authorized by the director of health to conduct a
2
laboratory as defined in this chapter.
3

(44)
(47)
“Sell” includes sale, barter, gift, transfer, or delivery in any manner to another, or
4
to offer or agree to do the same.
5

(45)
(48)
“Software” means programs, procedures, and storage of required information
6
data.
7

(46)
(49)
“Synthetic drugs” means any synthetic cannabinoids or piperazines or any
8
synthetic cathinones as provided for in schedule I.
9

(50) “Therapeutic purpose” means the use of opioids for the treatment of pain, opioid use
10
disorder in appropriate doses as indicted by the patient’s medical record, or other uses defined by
11
the department of health in regulations such as, but not limited to, other uses approved by the United
12
States Food and Drug Administration. Any other use is non-therapeutic.
13

(47)
(51)
“Ultimate user” means a person who lawfully possesses a controlled substance for
14
his or her own use or for the use of a member of his or her household, or for administering to an
15
animal owned by him or her or by a member of his or her household.
16

(48)
(52)
“Wholesaler” means a person who sells, vends, or distributes at wholesale, or as
17
a jobber, broker agent, or distributor, or for resale in any manner in this state any controlled
18
substance.
19

21-28-3.20.
Authority of practitioner to prescribe, administer, and dispense
Authority
20
of practitioner to prescribe, administer, and dispense -- Acute pain and opioid use disorder.
21
(a)(1)
A practitioner

Practitioners
, in good faith and in the course of
his or her

their

22
professional practice only, may prescribe, administer, and dispense controlled substances
not
23
prohibited by law for a therapeutic purpose
, or
he or she
may cause the controlled substances to be
24
administered
by a nurse or intern
under
his or her

their
direction
and supervision

after completing
25
a comprehensive assessment of pain experienced by a patient and/or for opioid use disorder
.
26

(2) Opioid therapy must only be initiated for acute pain when the patient is unresponsive
27
to non-opioid therapies or if, based on clinical assessment, the benefits of opioid therapy for acute
28
pain outweigh risks.
29

(2)
(3)
When issuing
an initial

a
prescription for an
opiate

opioid
to an adult patient, a
30
practitioner
shall not exceed the maximum daily dose requirements established by the department
31
of health

must prescribe the lowest effective dosage of an immediate-release opioid in a quantity
32
sufficient to treat the expected duration of pain. A practitioner must not write an initial prescription
33
for an opioid in a quantity exceeding a seven (7) day supply for treatment of acute pain
.
34

(3)
(4)

Except as provided in subsection (a)(4) of this section, a

A
practitioner
must

LC005258 - Page 13 of 21
1
prescribe the lowest effective dosage of an immediate-release opioid in a quantity sufficient to treat
2
the expected duration of pain to a minor, and
shall not issue an
opiate

opioid
prescription
to a minor

3
for more than twenty (20) doses at any time.
4

(5)
Prior to issuing an
opiate

opioid
prescription
to a minor
, a practitioner shall discuss
5
with the
parent or guardian of the minor

patient, or parent or guardian of the patient if the patient
6
is under the age of 18,
the risks associated with
opiate

opioid
use
, non-opioid pain treatment
7
alternatives,
and the reasons why the prescription is necessary. The practitioner shall document his
8
or her discussion with the
patient, or
parent or guardian
of the patient if the patient is under the age
9
of eighteen (18),
in the medical record
and must offer naloxone with the prescription
.
The
10
practitioner must adhere to the consent to care requirements as provided in § 23-4.6-1.
11

(4)
(6)

Notwithstanding the limitations referenced in subsection (a)(3) of this section, if, in
12
the professional medical judgment of a practitioner, a greater dosage or supply of an opiate is
13
required to treat the minor patient’s acute medical condition or is necessary for the treatment of
14
chronic pain management, sickle cell related pain, intractable pain treatment as defined in chapter
15
37.4 of title 5, pain associated with a cancer diagnosis, or for palliative care, then the practitioner
16
may issue a prescription for the quantity needed to treat the acute medical condition, chronic pain,
17
sickle cell related pain, intractable pain, pain associated with a cancer diagnosis, or pain
18
experienced while the patient is in palliative care, provided that this dosage shall not exceed the
19
maximum daily dosage permitted for the treatment of this pain as set forth in the department of
20
health regulations.
The
medical
condition triggering the prescription of an
opiate shall

opioid must

21
be documented in the
minor
patient’s medical record, and the practitioner
shall

must
indicate that
22
a non-
opiate

opioid
alternative
had been ineffective or
was not appropriate to address the medical
23
condition.
24

(5) Notwithstanding subsections (a)(2) and (a)(3) of this section, this section shall not apply
25
to medications designed for the treatment of substance abuse or opioid dependence.
26
(b) The
prescription-

prescription drug
monitoring program
shall

must
be reviewed prior
27
to starting any opioid. A
prescribing
practitioner, or designee as authorized by § 21-28-3.32(a)(3),
28
shall

must
review the
patient's prescribed controlled substance use in the

prescription-

prescription
29
drug
monitoring program prior to
refilling or
initiating opioid therapy
with an intrathecal pump
,
30
including opioid therapy delivered through an intrathecal pump, or refilling a prescription for
31
opioid medications. The practitioner must also obtain a history of any prescribed and/or dispensed
32
methadone and/or buprenorphine prior to initiating or refilling any opioid prescription.
For patients
33
the prescribing practitioner is maintaining

being maintained
on continuous opioid therapy for pain
34
for three (3) months or longer, the
prescribing
practitioner
shall

must
review information from the

LC005258 - Page 14 of 21
1
prescription-

prescription drug
monitoring program at least every three (3) months. Documentation
2
of that review
shall

must
be noted in the patient’s medical record.
3

(c) The director of health shall develop regulations for prescribing practitioners on
4
appropriate limits of opioid use in acute pain management. Initial prescriptions of opioids for acute
5
pain management of outpatient adults shall not exceed thirty (30) morphine milligram equivalents
6
(MMEs) total daily dose per day for a maximum total of twenty (20) doses, and, for pediatric
7
patients, the appropriate opioid dosage maximum per the department of health.
8

(d)
(c)
For the purposes of this section, acute pain management shall not include
9
management or treatment for
chronic pain
, chronic intractable pain

management
, pain associated
10
with a cancer diagnosis,
pain related to sickle cell disease,
palliative or
nursing home

end-of-life

11
care
, intractable or chronic intractable pain, as provided in § 5-37.4-2,
or other
exception

exceptions

12
in accordance with department of health regulations.
13

(e)
(d)

Subsection

Subsections (a) and
(c)
of this section
shall not apply to medications
14
designed

prescribed and/or dispensed
for the treatment of substance
abuse

use disorder
or opioid
15
dependence.
16

(f)
(e)

On or before September 1, 2018, the

The
director of health
shall

may
develop, and
17
make available to healthcare practitioners, information on best practices for co-prescribing opioid
18
antagonists to patients. The best practices information shall identify situations in which co-
19
prescribing an opioid antagonist may be appropriate
.
, including, but not limited to:
20

(1) In conjunction with a prescription for an opioid medication, under circumstances in
21
which the healthcare practitioner determines the patient is at an elevated risk for an opioid drug
22
overdose;
23

(2) In conjunction with medications prescribed pursuant to a course of medication therapy
24
management for the treatment of a substance use disorder involving opioids; or
25

(3) Under any other circumstances in which a healthcare practitioner identifies a patient as
26
being at an elevated risk for an opioid drug overdose.
27

(g)
(f)
The best practices information developed pursuant to
subsection (f)

subsections (e)
28
and (g)
of this section shall include guidelines for determining when a patient is at an elevated risk
29
for an opioid drug overdose
.
, including, but not limited to, situations in which the patient:
30

(1) Meets the criteria provided in the opioid overdose toolkit published by the federal
31
substance abuse and mental health service administration;
32

(2) Is receiving high-dose, extended-release, or long-acting opioid medications;
33

(3) Has a documented history of an alcohol or substance use disorder, or a mental health
34
disorder;

LC005258 - Page 15 of 21
1

(4) Has a respiratory ailment or other co-morbidity that may be exacerbated by the use of
2
opioid medications;
3

(5) Has a known history of intravenous drug use or misuse of prescription opioids;
4

(6) Has received emergency medical care or been hospitalized for an opioid overdose; or
5

(7) Uses opioids with antidepressants, benzodiazepines, alcohol, or other drugs.
6

(h) On or before September 1, 2018, the director of health and the secretary of the executive
7
office of health and human services shall develop strategies that include:
8

(1) Allowing practitioners in non-pharmacy settings to prescribe and dispense opioid
9
antagonists; and
10

(2) Ensuring that opioid antagonists that are distributed in a non-pharmacy setting are
11
eligible for reimbursement from any health insurance carrier, as defined under chapters 18, 19, 20,
12
and 41 of title 27, and the Rhode Island medical assistance program, as defined under chapter 7.2
13
of title 42.
14

(g) The director of health may promulgate regulations and identify best practices for
15
practitioners on opioid use in pain management.
16

21-28-3.20.1. Authority of practitioner to prescribe, administer, and dispense —
17
Cancer, palliative care, and chronic intractable pain.
18
(a) A practitioner, in good faith and in the course of his or her professional practice
19
managing pain associated with a cancer diagnosis, palliative or nursing home care, intractable or
20
chronic intractable pain as provided in § 5-37.4-2, or other condition allowed by department of
21
health regulations pursuant to the exception in § 21-28-3.20(d), may prescribe, administer, and
22
dispense controlled substances without regard to the CDC Clinical Practice Guideline for
23
Prescribing Opioids for Pain—United States, 2022.
24

(b) The director of health may promulgate those rules and regulations necessary to
25
effectuate the provisions of this section and ensure that rules governing pain management
26
associated with a cancer diagnosis, palliative or nursing home care, intractable or chronic
27
intractable pain as provided in § 5-37.4-2, or other condition allowed by department of health
28
regulations pursuant to the exception created in § 21-28-3.20(d), shall:
29

(1) Take into consideration the individualized needs of patients covered by this section;
30
and
31

(2) Make provisions for practitioners, acting in good faith, and in the course of their
32
profession, and managing pain associated with their patients’ illness to use their best judgment
33
notwithstanding any statute, rule, or regulation to the contrary.

may prescribe, administer, or
34
dispense controlled substances not prohibited by law for a therapeutic purpose to a person

LC005258 - Page 16 of 21
1
diagnosed and treated by a practitioner for a condition resulting in chronic intractable pain, if this
2
diagnosis and treatment have been documented in the practitioner’s medical records.
3

(b) Concern about a patient’s substance use disorder or the possibility of substance use
4
disorder in and of itself is not a reason to withhold or prohibit prescribing, administering, or
5
dispensing controlled substances for the therapeutic purpose of treatment of a person for chronic
6
intractable pain. Provided, however, practitioners must check the patient’s prescribed controlled
7
substance use in the prescription drug monitoring program, verify the patient’s methadone and/or
8
buprenorphine use, refer the patient to a substance use disorder specialist, as appropriate, and enter
9
into a written patient treatment agreement in accordance with regulations promulgated by the
10
department of health.
11

(c) The provisions of subsection (a) of this section provide no authority to a practitioner to
12
prescribe, administer, or dispense controlled substances to a person the practitioner knows or should
13
know to be using the prescribed, administered, or dispensed controlled substance non-
14
therapeutically or diverting the controlled substance to others.
15

(d) Nothing in this section shall be construed to prohibit a practitioner or pharmacist from
16
denying a prescription based on their best clinical judgment.
17

(e) Nothing in this section shall deny the right of the director of health to deny, revoke, or
18
suspend the controlled substances registration and/or license of any practitioner or discipline any
19
practitioner who:
20

(1) Prescribes, administers, or dispenses a controlled substance that is non-therapeutic in
21
nature or non-therapeutic in the manner in which it is prescribed, administered, or dispensed, or
22
fails to keep complete and accurate ongoing records of the diagnosis and treatment plan;
23

(2) Fails to keep complete and accurate records of controlled substances received,
24
prescribed, dispensed, and administered, and disposal of drugs as required by law of controlled
25
substances scheduled in the Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
26
U.S.C. §801 et seq. A practitioner must keep records of controlled substances received, prescribed,
27
dispensed, and administered, and disposal of these drugs shall include the date of receipt of the
28
drugs, the sale or disposal of the drugs by the practitioner, the name and address of the person
29
receiving the drugs, and the reason for the disposal or the dispensing of the drugs to the person;
30

(3) Writes false or fictitious prescriptions for controlled substances as prohibited by law,
31
or for controlled substances scheduled in the Comprehensive Drug Abuse Prevention and Control
32
Act of 1970, 21 U.S.C. §801 et seq.; or
33

(4) Prescribes, administers, or dispenses in a manner that is inconsistent with provisions of
34
the law, or the Comprehensive Drug Abuse Prevention and Control Act of 1970, 21 U.S.C. §801

LC005258 - Page 17 of 21
1
et seq., for any controlled substance.
2

(f) The director of health may promulgate rules and regulations necessary to effectuate the
3
provisions of this section.
4
SECTION 3. Chapter 5-37.4 of the General Laws entitled "Intractable Pain Treatment" is
5
hereby repealed in its entirety.
6
CHAPTER 5-37.4
7
Intractable Pain Treatment
8

5-37.4-1. Title.
9

This chapter shall be known and may be cited as the “Intractable Pain Treatment Act.”
10

5-37.4-2. Definitions.
11

For purposes of this chapter:
12

(1) “Chronic intractable pain” means pain that is: excruciating; constant; incurable, and of
13
such severity that it dominates virtually every conscious moment; and/or produces mental and
14
physical debilitation. A diagnosis and written documentation of chronic intractable pain made by a
15
physician licensed in the state of Rhode Island specializing in pain management, oncology, or
16
similar specialty defined in regulations shall constitute proof that the patient suffers from chronic
17
intractable pain.
18

(2) “Director” means the director of the department of health of the state of Rhode Island.
19

(3) “Intractable pain” means a pain state that persists beyond the usual course of an acute
20
disease or healing of an injury or results from a chronic disease or condition that causes continuous
21
or intermittent pain over a period of months or years. Unless the context clearly indicates otherwise,
22
the term intractable pain includes chronic intractable pain.
23

(4) “Practitioner” means healthcare professionals licensed to distribute, dispense, or
24
administer controlled substances in the course of professional practice as defined in § 21-28-
25
1.02(41).
26

(5) “Therapeutic purpose” means the use of controlled substances for the treatment of pain
27
in appropriate doses as indicated by the patient’s medical record. Any other use is nontherapeutic.
28

5-37.4-3. Controlled substances.
29

(a) A practitioner may prescribe, administer, or dispense controlled substances not
30
prohibited by law for a therapeutic purpose to a person diagnosed and treated by a practitioner for
31
a condition resulting in intractable pain, if this diagnosis and treatment has been documented in the
32
practitioner’s medical records. No practitioner shall be subject to disciplinary action by the board
33
solely for prescribing, administering, or dispensing controlled substances when prescribed,
34
administered, or dispensed for a therapeutic purpose for a person diagnosed and treated by a

LC005258 - Page 18 of 21
1
practitioner for a condition resulting in intractable pain, if this diagnosis and treatment has been
2
documented in the practitioner’s medical records.
3

(b) The provisions of subsection (a) of this section do not apply to those persons being
4
treated by a practitioner for chemical dependency because of their use of controlled substances not
5
related to the therapeutic purposes of treatment of intractable pain.
6

(c) The provisions of subsection (a) of this section provide no authority to a practitioner to
7
prescribe, administer, or dispense controlled substances to a person the practitioner knows or should
8
know to be using the prescribed, administered, or dispensed controlled substance
9
nontherapeutically.
10

(d) Drug dependency or the possibility of drug dependency in and of itself is not a reason
11
to withhold or prohibit prescribing, administering, or dispensing controlled substances for the
12
therapeutic purpose of treatment of a person for intractable pain, nor shall dependency relating
13
solely to this prescribing, administering, or dispensing subject a practitioner to disciplinary action
14
by the director.
15

(e) In coordination with §§ 21-28-3.20 and 21-28-3.20.1, the director of health may
16
promulgate rules and regulations necessary to effectuate the purpose of this chapter and ensure that
17
patients with intractable or chronic intractable pain are treated or referred to an appropriate
18
specialist.
19

(f) Nothing in this section shall be construed to prohibit a practitioner or pharmacist from
20
denying a prescription based on their best clinical judgment.
21

(g) Nothing in this section shall deny the right of the director to deny, revoke, or suspend
22
the license of any practitioner or discipline any practitioner who:
23

(1) Prescribes, administers, or dispenses a controlled substance that is nontherapeutic in
24
nature or nontherapeutic in the manner in which it is prescribed, administered, or dispensed, or fails
25
to keep complete and accurate ongoing records of the diagnosis and treatment plan;
26

(2) Fails to keep complete and accurate records of controlled substances received,
27
prescribed, dispensed, and administered, and disposal of drugs as required by law or of controlled
28
substances scheduled in the Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
29
U.S.C. § 801 et seq. A practitioner shall keep records of controlled substances received, prescribed,
30
dispensed and administered, and disposal of these drugs shall include the date of receipt of the
31
drugs, the sale or disposal of the drugs by the practitioner, the name and address of the person
32
receiving the drugs, and the reason for the disposal or the dispensing of the drugs to the person;
33

(3) Writes false or fictitious prescriptions for controlled substances as prohibited by law,
34
or for controlled substances scheduled in the Comprehensive Drug Abuse Prevention and Control

LC005258 - Page 19 of 21
1
Act of 1970, 21 U.S.C § 801 et seq.; or
2

(4) Prescribes, administers, or dispenses in a manner which is inconsistent with provisions
3
of the law, or the Comprehensive Drug Abuse Prevention and Control Act of 1970, 21 U.S.C. §
4
801 et seq., any controlled substance.
5

(h) A practitioner may administer a controlled substance prescribed by a practitioner and
6
not prohibited by law for a therapeutic purpose to a person diagnosed and treated by a practitioner
7
for a condition resulting in intractable pain, if this diagnosis and treatment has been documented in
8
the practitioner’s medical records. No practitioner shall be subject to disciplinary action by the
9
director solely for administering controlled substances when prescribed or dispensed for a
10
therapeutic purpose for a person diagnosed and treated by a practitioner for a condition resulting in
11
intractable pain, if this diagnosis and treatment has been documented in the practitioner’s medical
12
records of the patient.
13
SECTION 4. This act shall take effect upon passage.
========
LC005258
========

LC005258 - Page 20 of 21
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO FOOD AND DRUGS -- UNIFORM CONTROLLED SUBSTANCES ACT
***
1
This act would revise sections of the uniform controlled substances act to remove specific
2
opioid dosage requirements and revise the uniform controlled substances act in accordance with
3
current standards of professional practice and would repeal chapter 37.5 of title 5 relating to
4
intractable pain treatment.
5
This act would take effect upon passage.
========
LC005258
========

LC005258 - Page 21 of 21