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ARIZONA HOUSE OF REPRESENTATIVESFifty-fifth Legislature Second Regular Session |
Senate: HHS DP 8-0-0-0 | 3rd Read 27-0-3-0
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SB 1162: opioid prescriptions; intractable pain; exceptions
Sponsor: Senator Barto, LD 15
Caucus & COW
Overview
Expands the list of exemptions from the 90-morphine milligram equivalent (MME) limit on opioids prescriptions to include patients experiencing intractable or chronic intractable pain or receiving opioid treatment for perioperative surgical pain.
History
Laws 2018, First Special Session, Chapter 1, Sec. 29 outlines requirements for prescribing, administering and dispensing schedule II-controlled substances. It prohibits a health professional authorized to prescribe controlled substances from issuing a new prescription order to be filled or dispensed for a patient outside of a health care institution for a schedule II-controlled substance that is an opioid and that exceeds 90 MMEs per day and outlines exceptions.
If a health professional believes that a patient requires more than 90 MME per day and the patient is not included in the statutory exemptions, then the health provider must first consult with a licensed osteopathic physician or medical doctor board-certified in pain or an opioid assistance and referral call service designated by the Arizona Department of Health Services. The health professional may issue a prescription for more than 90 MME per day if the opioid assistance and referral call service or consulting physician agrees with the higher dose.
If the consulting physician is not available within 48 hours after the request, the health professional may prescribe the amount that they believe the patient requires and subsequently have the consultation. Consultation may be done by telephone or through telehealth (A.R.S. § 32-3248.01).
Provisions
1.
Exempts patients experiencing
intractable or chronic intractable pain or receiving opioid treatment for
perioperative surgical pain from the 90 MME per day limit on opioid
prescriptions. (Sec. 1)
2. Defines chronic intractable pain as pain that meets both of the following:
a) Is excruciating, constant, incurable and of such severity that it dominates virtually every conscious moment; and
b) Produces mental and physical debilitation. (Sec. 1)
3. Defines intractable pain to mean a pain state that persists beyond the usual course of an acute disease or healing of an injury or surgery or that results from a chronic disease or condition causing continuous or intermittent pain over a period of months or years. (Sec. 1)
Amendments
Committee on Health and Human Services
1. Removes a patient experiencing intractable pain from the list of exemptions and its definition.
2. Specifies that a patient is exempted from the 90-MME limit if receiving opioid treatment for perioperative care following an inpatient surgical procedure.
3. Clarifies that the 90-MME limit does not apply to a patient with chronic intractable pain once the patient has tried doses of less than 90-MME that have been ineffective at addressing the patient's pain.
4. Defines established health professional-patient relationship.
5. Makes conforming changes.
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SB 1162
Initials AG Page 0 Caucus & COW
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