Georgia Board of Pharmacy Passes Emergency Rule on Synthetic Fentanyl

From the Georgia Bureau of Investigation website:

On Thursday, June 29, 2017, the Georgia State Board of Pharmacy voted to pass an Emergency Rule which regulates the newly identified synthetic fentanyl, tetrahydrofuran fentanyl, as a Schedule I substance.  This rule gives all Georgia Peace Officers the same authority as Georgia Drugs and Narcotics Agents to seize this substance. 

Last week, the GBI Crime Lab encountered acrylfentanyl in a counterfeit pill.  This is the first known instance of this new synthetic fentanyl in a counterfeit pill.  It is emphasized that pills purchased through the underground market have a high probability of containing very dangerous synthetic opioids.

As a reminder, naloxone remains the best course of action against the newer fentanyl analogues although multiple doses may be required.  In the acute overdose setting where someone has overdosed and the respiratory and nervous systems have been affected, naloxone is the drug of choice because it acts far more rapidly than other opioid reversal drugs on the market.  

Cleveland, GA  6/27/17 -The Georgia Bureau of Investigation’s Crime Lab in Cleveland, GA has identified two new fentanyl analogues, acrylfentanyl and tetrahydrofuran fentanyl.  Both of these synthetic opioids had not previously been identified by the GBI Crime Lab.  They both can be absorbed through the skin and are considered highly dangerous. 

The Forsyth County Sheriff’s Office submitted forensic drug evidence containing these two drugs to the crime lab in March of this year.  Acrylfentanyl had been on the GBI’s watchlist for the past few months. Multiple reports in other states indicated that the opioid reversal drug, naloxone, may not be effective if someone overdosed after ingesting acrylfentanyl.   

Legislation was introduced this year to outlaw acrylfentanyl in Georgia.  The law banning the substance went into effect after passage by the Georgia General Assembly and the Governor’s signature on April 17, 2017.  At this time, tetrahydrofuran fentanyl is not covered under GA law.

It is unknown how the human body will react to both drugs since they are not intended for human or veterinary use. 


Tennessee BME Updates Self/Family Prescribing Policy


The Tennessee Board of Medical Examiners (BME) recently updated its policy on prescribing to oneself and one’s family. The previous policy had been in place for 20 years and the new policy takes a more streamlined approach to address these prescribing scenarios. TMA members should be aware of these changes as they are now in effect.

The definition of “immediate family” includes one “whom a physician's personal or emotional involvement may render that physician unable to exercise detached professional judgment in reaching diagnostic or therapeutic decisions.” Based on TMA’s knowledge of previous disciplinary actions, this can include a long-term dating or live-in relationship.

With respect to prescribing to oneself, a physician should not prescribe or treat him/herself except in an emergency. Prescribing, providing or administering any scheduled drug to oneself is prohibited.

As to prescribing to an immediate family member, treatment should be reserved only for minor, self-limited illnesses or emergency situations. No scheduled drugs should be dispensed or prescribed except in emergency situations.

The policy does not specifically say so, but TMA believes that the intent of the policy is to provide interpretive guidance to physicians as to conduct that could violate the Board’s disciplinary statutes and regulations regarding prescribing. Be cognizant of the fact that the Board could bring disciplinary action against a licensee who violates the policy (and has done so in the past).

The Tennessee Board of Osteopathic Examination does not have policy addressing these prescribing situations. Information about the BME’s updated policy is provided in TMA’s member-only online Law Guide. Information is available under the topic “Prescriptions” starting on page 2. Members may also contact the TMA legal department directly with questions about the policy at 800.659.1862 or