Are you on top of Nevada’s New Opioid Laws?
New year, new you. Particularly if the “you” in question is a physician who prescribes opioids.
Thanks to Nevada’s Assembly Bill 474, new laws surrounding opioid prescription, perhaps the nation’s most progressive laws of the kind, went into effect Jan. 1 – though it’s unclear how the new law will be policed. Due to several complaints about the new law already, the state’s Board of Medical Examiners has agreed to convene a committee to determine the regulations for how the new law be enforced.
In an effort to do its part to help curb the nationwide opioid epidemic, Nevada has thrown itself into the fray with a suite of laws that put several restrictions on how prescribers can dispense opioids – already to the consternation of several medical professionals. So yes, long story short, your job is going to be harder as long as this is the law of the land. But take the time to pore over the new requirements, because penalties for violating them can go from fines, all the way up to loss of license.
First, and this shouldn’t be so bad, healthcare providers, already required to participate in continuing education, have to dedicate at least two hours of that time to addiction training. Fair enough.
There’s now a requirement that, just like a communicable disease, providers who know or suspect a patient of drug overdose have to report that to the proper authority, like their chief medical officer.
The real meat of the bill, though, is in how opioids are prescribed. To start with, initial prescriptions can’t exceed 14 days and must be accompanied by a risk assessment; and new opioid patients can’t be prescribed more than 90 morphine milligram equivalents per day.
If a change is made to the treatment plan and the prescription would extend over 30 days, that requires the patient to sign a narcotics agreement which includes consenting to random drug testing. Doctors are also required to conduct another risk assessment to figure out the root cause of the pain, and consider referring the patient to pain management, if a prescription would stretch beyond 90 days.
Prescriptions can’t be increased without meeting the patient in person or via telehealth and, finally, combined prescriptions can’t exceed 365 days.
The good news is that this is going to help keep opioids out of the hands of bad actors seeking to game the system for pleasure or profit. The bad news is, for everyone else, opioids are now a tangle of red tape that can, and almost certainly will, add hours to workweeks.
The Bill was drafted after it was reported that 465 Nevada residents died from opioid related causes and opioid related hospitalizations had increased 150 percent from 2013. The reporting requirement will assist law makers in tracking the efficacy of these new laws.
The Board of Medical Examiners’ work group could take up to six months to omplement these regulations. In the meantime, though, opioid prescribers must comply with the new law, as Gov. Brian Sandoval told the Las Vegas Review-Journal, “This is the law, and it’s not going to change, and we’re going to ensure that there’s compliance with it.