The West Virginia Department of Health and Human Resources (DHHR) today
announced the implementation of Senate Bill 273, also known as the Opioid
Reduction Act, effective June 7, 2018. Introduced at the request of Gov. Jim
Justice, the legislation sets limitations on opioid prescriptions and authorizes
a “nonopioid directive” patients can put in their medical files, formally
notifying health care professionals they do not want to be prescribed or
administered opioid medications.
“Thanks to Gov. Justice’s vision and the ongoing efforts of the
West Virginia Legislature, more individuals can avoid opioid addiction and
potential overdose as a result of improper prescribing,” said DHHR Cabinet
Secretary Bill J. Crouch. “This legislation also assures that providers share
critical information regarding the risks of opioids and alternative treatment
options.”
Prior to prescribing opioids, providers must first refer or
prescribe treatment alternatives such as physical therapy. If an opioid is
prescribed, it must not exceed a seven-day supply at the lowest effective dose and
the provider must explain the associated risks. In addition, the provider must
document the patient’s medical history, conduct and document a physical
examination, develop a treatment plan and access relevant prescription
monitoring information under the Controlled Substance Monitoring Program
Database.
Subsequent prescriptions may only be issued at least six days
following the initial prescription and the provider must document that it is
necessary and appropriate for the patient’s treatment. A third prescription for
ongoing treatment requires consideration of referral to a pain clinic or
specialist.
For supplies greater than seven days, a patient must sign a
narcotics contract with the prescribing provider agreeing to only get
medication from that doctor, use the same pharmacy each time and notify the
provider of any emergency where the patient is prescribed a controlled
substance. Adults receiving an initial opioid prescription in an emergency room
or urgent care facility are limited to a four-day supply of opioid pain
medicine. Minors are limited to a three-day supply.
In addition, the bill enables individuals to decline in advance
any treatment option that includes opioids. The Voluntary Nonopioid Advanced
Directive form, available at dhhr.wv.gov/Office-of-Drug-Control-Policy, will be filed in the patient’s medical records, which should be
referenced by the provider prior to opioid prescription.
“This directive is critical to patients with and without a history
of substance use disorder who wish to decline that opioids be offered or
administered to them,” said Dr. Rahul Gupta, State Health Officer and
Commissioner of DHHR’s Bureau for Public Health. “With this information,
providers can make more appropriate recommendations concerning pain
management.”