What is Phentermine?
Phentermine is a weight loss medication that was first marketed in 1959. Phentermine is both commonly prescribed by doctors and can be purchased over the counter at some stores and pharmacies. As a drug, it is classified as an anorectic, or an appetite suppressant. Phentermine is essentially a stimulant drug similar to the class of drugs that are commonly known as amphetamines.
Phentermine is one of that most popular class of drugs in a group of obesity medications because they have fewer side effects than other types of diet medications. Phentermine works as an appetite suppressant by affecting the central nervous system . Phentermine directly affects the hypothalamus gland in the brain, which is the portion of the brain that is responsible for controlling your appetite.
The most common side effects of Phentermine are headaches, dizziness and dry mouth. Other side effects can include insomnia and a sense of nervousness. Commonly, people who are prescribed Phentermine take it for about 16 weeks before the doctor will reevaluate their weight loss. Some patients are prescribed Phentermine as a short-term treatment used in addition to diet and exercise for obesity and some patients are prescribed it as a long-term treatment for obesity.
The Legal Status of Phentermine under Ohio Law and Regulation
In Ohio, the legal status of this drug has been categorized as a strict Schedule IV controlled substance. This regulation falls under the authority of the Ohio Board of Pharmacy and the Ohio Department of Health. As such, any illicit distribution will be deemed a serious offense. Phentermine is a highly effective stimulant that suppresses appetite by increasing catecholamine levels in the body. There are three types of phentermine drugs currently available which include, Adipex-P, Dexedrine and Ionamin. Only Adipex-P is legally prescribed in Ohio, as the FDA has prevented the prescription of the latter two drugs. As previously stated, this drug is regulated as a Schedule IV drug in Ohio. Schedule II drugs are regarded as the most dangerous and addictive controlled substances. Schedule IV drugs, however, are regarded as relatively safe when compared to other drugs in previous scheduling categories. As such, these drugs are harder to obtain and are only distributed through licensed physicians and pharmacies. Phentermine falls under the category of Schedule IV controlled substances in Ohio. In some cases, Schedule V and Schedule VI drugs may be permitted for select uses.
Prescribing and Dispensing Requirements
Before doctors can prescribe phentermine in Ohio, they must evaluate the patient thoroughly to determine if the medication is appropriate for their situation. Only those who are at a maximum of 20%-25% over their ideal weight for their height (or have a Body Mass Index [BMI] of 30+) can receive a prescription for phentermine. This is not just a physical evaluation for obesity but also some general medical clearance to ensure that things like diabetes, high blood pressure, and heart issues are accounted for.
Physicians in Ohio must also theoretically supervise their patients’ treatment while the patient takes phentermine through this prescription. For many, this means that the patient returns to the physician for weekly weigh-ins or appointments, where their vitals are taken and their weight is recorded. While this has gotten some pushback in the past, it is the manner in which doctors lend an extra layer of support that can help ensure that patients are safe and healthy while they use phentermine for weight loss.
In order for doctors to issue a phentermine prescription, they cannot be affiliated with any kind of government health care program, and those who are often find themselves barred from specifically prescribing certain medications to the enrollees. On top of this, they must also obtain a Drug Enforcement Administration (DEA) registration number, since phentermine is a controlled substance.
While there is no strict limit for how often a physician can prescribe and refill phentermine prescriptions, they should be careful to avoid unintentional abuse of the drug.
Pharmacies and Dispensaries
Not surprisingly, the rules about dispensing phentermine are quite strict. Ohio pharmacies may only dispense those drugs approved by HHS, which, of course, includes phentermine. Pharmacists are required to document the medical reasons for dispensing the drug to the patient. While patients should certainly follow through with their doctor’s recommendations and ask questions of the pharmacist when necessary, it is also important for pharmacists, on behalf of their pharmacies, to be aware of the specific laws and regulations that apply to Ohio pharmacies with respect to dispensing control substances.
Pharmacies must be properly licensed in Ohio. They must have two years of experience in the area of pharmacy practice, and they must also complete proper continuing education requirements prescribed by the State Board of Pharmacy. Again, this continuing education applies to dispensing drugs for weight loss, such as phentermine.
Pharmacies, and especially their pharmacists, typically keep detailed records of each drug that is dispensed to patients. These can become quite useful in the event of an audit or disciplinary hearing. The Ohio Board of Pharmacy further provides that sales invoices must be retained for records for a period of three years. Detailed records include the serial number, quantity, date of dispensing and the prescribed directions, along with the prescriber’s name, the patient’s name, the pharmacy’s name and address, and the dispensing pharmacist’s name.
Other records must be kept as well, including an:
Pharmacists may also wish to keep a separate record of prescription orders that have been issued for any methadone, buprenorphine and/or phentermine. These require separate records in order to comply with federal and state requirements. Ohio pharmacies should have procedures in place to comply with audit requirements, and those procedures should be reviewed occasionally to make sure that they are being followed.
Possible Criminal Implications
The possession and use of Phentermine without a prescription is classified as a Schedule IV controlled substance under Ohio law. Like many other states, the possession of Phentermine without a prescription in Ohio is a first degree misdemeanor. Conviction for a first degree misdemeanor typically carries a maximum jail term of 6 months and a fine of up to $1000.00.
Particular attention should be given to the fact that a conviction of a felony of any degree can result in the loss of the right to own or possess a firearm under federal law for the rest of your life.
Possession of large amounts of Phentermine may be classified as trafficking, which is a second degree felony in Ohio unless the offender is a person who is under eighteen years of age. The penalties for trafficking in Phentermine (except Tylenol with Codeine No . 3) vary in Ohio depending on the amount being trafficked. Penalties can range from 2-8 years in prison for 40 or more grams of Phentermine to 4-10 years in prison for 1,000 or more grams of Phentermine. The penalty for a violation of attempting to traffic is one-half (1/2) of penalties applicable for trafficking in Phentermine. Convictions for attempted trafficking offenses also carry a mandatory class type II prison term.
As far back as 1980, the Ohio Attorney General’s office has prohibited the sale of "non-prescription appetite suppressants" such as Dexadrine, Didrex and Ponderax over the counter. Aranda v. State of Ohio Dept of Health, 973 F. 2d 1277 (1992). The Sixth Circuit Court of Appeals upheld Aranda, finding the regulation neither without rational basis nor disproportionate to the individual’s right of free choice.
Recent Revisions and Developments Under Ohio Law
The latest in Ohio Law regarding Phentermine
Within the last five years, Ohio has reorganized the way it schedules drugs. All of the drugs were consolidated into one group, with various tiers and varying levels of black and white regulations. Notably, the scheduling of drugs adopted the federal system without regard to state regulation. This created several issues for Ohio residents including that legal drugs such as Xanax or Ambien were still being prescribed illegally under Ohio law. Within the last year, the Ohio law has been updated to more closely resemble the former law. These changes make the scheduling of Phentermine, as degree II or III of Schedule "N" regulations as the former Schedule "III" regulations. This is not to be confused with that of the federal law.
In the new regulations, Phentermine is now a "legitimate drug." This means that a prescriber can write a prescription for a patient using painkillers as justification for prescribing Phentermine. Ohio prescribers of Phentermine no longer have to try to justify the prescription by throwing in a painkiller. The physician’s assessment of the patient is enough.
The changes also make certain Phentermine dispensed at the pharmacy level. This means that it is now possible for the drug to be billed for on regular insurance plans without the much higher copay associated with Schedule "N" drugs. It is also possible for primary physicians working in hospitals and emergency departments to routinely prescribe the drug without jeopardizing their license. In addition, physician assistants within the hospital setting are given the same latitude to prescribe Phentemine. Ohio now recognizes that the drug isn’t addictive and that it serves a useful purpose as a diet pill.
Regulation in Other States Compared to Ohio
As stated previously, many states classify phentermine as a controlled substance and its distribution is highly regulated; they also categorize it as a drug with a high risk of abuse and addiction. Under the laws of some states, its use is reserved only for under strict medical supervision at hospitals and specialized clinics. Most of these states are in the West, and include those like Nevada, Utah, Wyoming, Colorado, and Montana. Due to its highly addictive nature, California has classified phentermine in the same category as prescription-grade narcotics and stimulants. The states where the law is most restrictive are California and Montana. Within California, distribution is highly regulated, so much so that a person with an oral prescription cannot have phentermine dispensed by a pharmacy without government approval. The penalty for violation of this law can include 16 months to two years in state prison. Ohio’s laws regulating the use of phentermine are much more lenient than those of California. Here , a person may possess and use phentermine or other controlled substances under the supervision of a licensed physician without concern of being prosecuted for violation of the law. There are no restrictions on possession. Laws of other states regarding phentermine are somewhat of a mixture between Ohio’s and California’s. In particular, Michigan, Colorado, and Montana may allow possession of phentermine with a prescription. However, possession without a prescription is illegal. Penalties can vary from a few days to a few months in jail, and heavy fines may also be imposed. Phentermine is classified by the federal government as a schedule IV controlled substance, so its use throughout the U.S. is regulated by the Drug Enforcement Administration (DEA). Considering the drug’s addictive potential, it comes as no surprise that anybody with a prescription to obtain a drug labeled as a controlled substance may be required to show proof of identity, the original packaging of the drug, or a copy of a prescription. Six pills will be allowed at a time for supplies no more than nine days’ worth. This policy makes sense for a drug with a high potential for abuse or aim to prevent individuals from reselling the drug. Phentermine is not legal in Canada, Australia, France, New Zealand, the UK, or the European Union.
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