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DHHR Announces Implementation of New Opioid Prescribing Requirements

The Free Press WV

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.”

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