(a)

1. (1) Schedule II controlled substances are drugs that have a legitimate medical indication, but also have a high potential for abuse that may lead to severe psychological or physical dependence.
2. (2) Included in the list of Schedule II drugs are the stimulants amphetamines and methamphetamines and their salts and optical isomers (e.g., Adderall, Desoxyn, Dexedrine, and Vyvanse) and methylphenidate and its salts and isomers (e.g., Ritalin, Concerta, Focalin, and Daytrana).

(b)

1. (1) The Arkansas State Medical Board believes it is prudent to provide prescribing guidelines to help ensure the safety of patients in the State of Arkansas.

2. (2) Therefore, in addition to the requirement that all prescriptions for stimulants comply with both state and federal laws, this section will also require the following:

   1. (A)

(i) Prescriptions for these drugs may be written by a physician for a legitimate medical indication.

1. (ii) Such indications include attention deficit hyperactivity disorder and narcolepsy.

   1. (iii) Other off label uses may be justified with appropriate medical rationale and documentation of evidence-based research and experience.

      1. (iv) These alternative uses include, but are not limited to:

(b) (b) Augmentation of antidepressants; or

1. (c) (c) Treatment of post-stroke depression; and

   1. (B) No second or subsequent prescription for these controlled drugs may be written for the patient until the physician reassesses the patient and documents in the medical record:

      1. (i) The patient’s response to the medication;
      2. (ii) Reports from family, educators, or counselors as to the patient’s response to the medication;
      3. (iii) Record of an examination of the patient to identify possible adverse effects secondary to the medication;
      4. (iv) An informed judgment as to the overall benefit of the medication versus potential adverse or side effects; and
      5. (v) A written plan for providing scheduled refills and return visits.
      6. (c) Violations of this section may be interpreted by the board as the physician exhibiting gross negligence or ignorant malpractice and shall subject the physician to all penalties provided by Arkansas Code § 17-95-410.