AMPHETAMINES, PRESCRIPTION OF

SCHEDULE II

Schedule II stimulants include: Amphetamine (Benzedrine); Dextroamphetamine (Dexedrine); Methamphetamine (Desoxyn, Methedrine); Methylphenidate (Ritalin); and Phenmetrazine (Preludin).

A physician shall not utilize a Schedule II stimulant for any purpose except:

• The treatment of narcolepsy;
• The treatment of abnormal behavioral syndrome (attention deficit
  disorder, hyperkinetic syndrome), and/or related disorders of childhood;
• The treatment of drug induced brain dysfunction;
• The differential diagnostic psychiatric evaluation of depression;
• The treatment of depression shown to be refractory to other
  therapeutic modalities, including pharmacologic approaches, such as tricyclic antidepressants and MAO inhibitors;
• As adjunctive therapy in the treatment of chronic severe pain or
  chronic severe pain accompanied by depression, in the terminal stages of diseases which are accompanied by severe pain;
• The clinical investigation of the effects of such drugs, in which case
  the physician shall submit to the State Medical Board a written investigative protocol for its review and approval before the investigation has begun.

A physician shall not utilize a Schedule II stimulant for purposes of weight reduction or control.

The physician shall not initiate or shall discontinue utilizing all controlled stimulants immediately upon ascertaining or having reason to believe that the patient has a history of or shows a propensity for alcohol or drug abuse, that the patient is pregnant, or that the patient has consumed or disposed of any controlled substance other than in strict compliance with the treating physician's directions. OAC 4731-11-03

SCHEDULE III AND SCHEDULE IV

Schedule III stimulants include: Benzphetamine (Didrex) and Phendimetrazine (Bacarate, Plegine, Prelu-2, Statobex). Schedule IV stimulants and Anorectics include: Diethylpropion (Tenuate, Tepanil); Fenfluramine (Pondimin); Mazindol (Mazanor, Sanorex); and Phentermine (Adipex-P, Fastin, Ionamin, Phentrol).

A physician shall not utilize a Schedule III or IV controlled substance for purposes of weight reduction unless it has an F.D.A. -approved indication for this purpose and then only in accordance with all of the provisions of the rules of the State Medical Board.

A physician may utilize a Schedule III or IV controlled substance for purposes of weight reduction in the treatment of obesity only as an adjunct, in accordance with the F.D.A. -approved labeling for the product, in a regimen of weight reduction based on caloric restriction, provided that the following conditions are met:

1. Before initiating treatment utilizing a Schedule III or IV controlled substance, the physician determines through review of his own records of prior treatment, or through review of the records of prior treatment which another treating physician or weight -loss program has provided to the physician, that the patient has made a substantial good -faith effort to lose weight in a treatment program utilizing a regimen of weight reduction based on caloric restriction, nutritional counseling, behavior modification, and exercise, without the utilization of controlled substances, and that said treatment has been ineffective.
2. Before initiating treatment utilizing a Schedule III or IV controlled substance, the physician obtains a thorough history, performs a thorough physical examination of the patient, and rules out the existence of any recognized contraindications to the use of the controlled substance to be utilized.
3. A physician shall not prescribe or shall discontinue utilizing a Schedule III or IV controlled substance for weight reduction if the patient has failed to lose weight while under treatment with a controlled substance over a period of fourteen (14) days, which determination shall be made by weighing the patient at least every fourteenth day, except that a patient who has never before received treatment for obesity utilizing any controlled substance who fails to lose weight during his or her first such treatment attempt may be treated with a different controlled substance for an additional fourteen (14) days.

Schedule III or IV controlled substances should not be prescribed for weight reduction if there are recognized contraindications, if the patient is pregnant, if the patient has developed a tolerance for the drug, if there is a history of drug or alcohol abuse, or if the patient is diverting the drug from its prescribed use. OAC 4731-11-04

(See also: DRUGS -CONTROLLED SUBSTANCES)

AMPHETAMINES, PRESCRIPTION OF