![]() likely have opioid use disorder (i.e., addiction) associated with prescription opioids, which means that many people are still at risk for negative outcomes related to this class of medications. 10 More than 2 million people in the U.S. Approximately one-third of the deaths involved prescription opioids. The figure represents a more than 2.5-fold increase in deaths in only 1 decade. Morbidity and mortality related to prescription opioid use rose in tandem with the increased over-reliance on opioids. 7 The increased use, increased dosages, and increased lengths of treatments led to over-prescribing of opioids and increased rates of opioid misuse and abuse, 8 as well as opioid use disorder and overdoses. In fact, the number of opioids prescribed quadrupled from 1999 to 2010 and continued to increase, and an estimated 20% of patients who seek care for pain-related complaints are prescribed an opioid. Previously, opioids were used primarily for severe acute pain, post-surgical pain, and end-of-life care, but, by the end of the 20th century, opioids had gained popularity for many types of pain, including chronic non-cancer pain. 5 These cravings can lead to drug-seeking behaviors and, ultimately, to drug use disorder: people may try to take the drug in a way or at a dose that was not prescribed they may attempt to take someone else’s medication or they may take it only with the intent to get “high,” not to relieve pain. Opioids can trigger powerful reward pathways and the reinforcing outcomes (especially the pleasurable effects) achieved with opioid use lead to cravings, even in the absence of pain. Mood effects such as dysphoria and euphoria also occur with opioid use. 6 While the analgesia achieved with opioids is effective, the pain control can be accompanied by a host of undesirable effects, including constipation, itching, pupillary constriction, somnolence, mental cloudiness, and respiratory depression. 5 Most often, opioids are used to treat moderate to severe pain, but some opioids are used to treat cough and diarrhea. In the United States (U.S.), opioids have been used for decades in oral, intravenous, and transdermal forms to treat both acute and chronic pain. The term “narcotic” is a legal, not medical, term that designates a group of illegal drugs. 5,6 Opioids are semi-synthetic opiates and include methadone, fentanyl, and propoxyphene. The related term, “opiate,” refers to a naturally derived alkaloid from the opium poppy, such as morphine or codeine. The term “opioid” refers to any compound that binds to an opiate receptor in the body such receptors are widely distributed throughout the central and peripheral nervous systems and are involved in pain modulation, among other activities. 4 OPIOID USE AND ABUSE IN THE UNITED STATES Every 2 years, registered technicians must obtain 20 hours of education, and 1 of these hours must be related to Texas pharmacy law. Similarly, pharmacy technicians registered in the state of Texas must also complete continuing education requirements. 1,3 The purpose of these requirements, as stated in Board Rule 295.8, is to enhance the professional competency of licensed pharmacists and protect the health and welfare of the citizens of Texas. As of January 1, 2019, at least 1 of the hours (0.1 CEUs) must be related to opioid abuse. As of January 1, 2015, at least 1 of the hours (0.1 CEUs) must be related to Texas pharmacy laws or rules. 2 Continuing education requirementsĮvery 2 years, pharmacists licensed in the state of Texas must complete at least 30 contact hours (3.0 continuing education units ) of continuing education in order to apply for license renewal. Current copies of the Texas Register can be accessed at the website of the Office of the Secretary of State of Texas. All proposed and adopted changes to pharmacy law in Texas are published in the Texas Register-the weekly bulletin for rule-making within the state. Check the Pharmacy Rules and Laws for updates concerning specific practice areas. 1Īs of the time of publication, this module supplies the most current information regarding pharmacy laws and regulations in Texas. Pharmacy Rules and Laws are found in the Texas Pharmacy Act, which is Chapters 551 through 569 of the Texas Occupations Code, and the Texas Pharmacy Rules, which are found in Chapters 281 through 315 of the TAC. Recent amendments modify definitions related to pharmacy practice, clarify operational standards for pharmacies, and update pharmacy record-keeping requirements, as well as expand the role of pharmacists in patient care and patient access to life-saving medications. This educational module addresses amendments to the Texas State Board of Pharmacy (TSBP) Rules, which are part of the Texas Administrative Code (TAC), that were adopted from 2016 to 2019. Pharmacy Laws and Regulations in Texas: Recent Updates to the Texas Pharmacy Act and the Texas Board of Pharmacy Rules INTRODUCTION
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