SB 22 was one of a package of bills this legislative session designed to address the epidemic of opioid misuse and abuse. This bill places limits on the amount of opioids that can be prescribed in acute situations. It was signed by the governor on May 21, and takes effect immediately.
Key provisions:
Prescribing limits
- The bill applies to prescriptions written for patients in acute situations, not those with long-term needs (chronic pain, cancer, palliative care, post-surgical pain that is expected to last longer than 14 days). While the bill does not define “acute,” it specifies the circumstances under which the limitations in the bill apply: “a patient who has not had an opioid prescription in the last 12 months by that (prescriber).”
- The initial prescription for an opioid is limited to 7 days though may include an additional 7-day fill at the prescriber’s discretion.
- The bill allows but does not require prescribers to use e-prescribing software.
PDMP check
- If the prescriber includes the second 7-day fill, he/she is required to check the Prescription Drug Monitoring Program (PDMP) database to see if the patient is receiving opioids or drugs that might react adversely with opioids (e.g. benzodiazepines, muscle relaxants) from another prescriber, unless the patient is receiving the prescription in an in-patient setting or has long-term needs (as specified above). There is no requirement to check the PDMP if the prescription is for only one 7-day fill. The prescriber is deemed to be in compliance with the law if he/she attempts to access the PDMP but it is inaccessible due to technical problems.
Opioid report cards
- The bill protects PDMP-based reports on individual prescriber behavior generated by the Dept. of Regulatory Agencies that are used to inform, educate and intervene to prevent and reduce occurrences of opioid misuse/abuse/diversion. The reports are excluded from the definition of public records; are not discoverable in criminal or administrative proceedings against a prescriber; and are not admissible in any civil, criminal or administrative proceeding against a prescriber. (DORA began disseminating these reports earlier this spring, prior to the bill’s passage.)
Prescriber protections
- The bill stipulates that failure to follow the prescribing limits or the PDMP checking requirements does not constitute negligence or grounds for suit against a prescriber, and does not by itself establish a standard of care. At the same time, compliance with the law does not by itself establish an absolute defense to any alleged breach of the standard of care.