An Open Letter to Our Patients
There is a new set of rules that have been signed into law and take effect November 1, 2018. Senate Bill 1446 will serve to address some of the issues surrounding abuse of prescription medication in the state of Oklahoma. This issue continues to be an ongoing problem.
Narcotics (opioids) are the most common class of drug involved in Oklahoma overdose deaths.
The upcoming changes in St. Mary’s Physician Associates practices will represent changes that are mandated in this new law. These changes include management of new narcotic prescriptions and chronic or ongoing prescriptions for opioids.
What is an acute (initial) prescription?
An initial prescription is issued to a patient who:
- Has not been issued an opioid prescription in the past year, or
- Requires a prescription for the opioid due to a surgical procedure or new injury
What must the provider do to give an initial seven-day prescription?
- Prescribe lowest effective dose not to exceed seven-day supply
- Perform medical history, physical exam and develop treatment plan
- Check the online opioid database for Oklahoma (PMP)
- Minors: Physicians/providers must enter into a patient-provider agreement with parent/guardian
- Pregnant woman: Physicians/providers must enter into a patient-provider agreement
Can a second seven-day prescription be prescribed?
Physician/provider (after consultation with patient) may issue a subsequent prescription.
- Quantity not to exceed seven days
- Must document the rationale for prescribing an additional prescription
What if you need opioids beyond the second seven-day prescription?
- If a further opioid prescription is necessary, physician and patient must enter into a pain-management written and signed agreement, which includes on-demand intermittent drug testing and no active use of non-prescribed controlled medication and street drugs, including marijuana
- Review at least every three months: course of treatment, new information about etiology of pain
- Assess patient prior to every renewal to determine whether patient experiences problems associated with dependence
- Periodically make reasonable efforts to stop use, decrease dosage and/or try other drugs to reduce abuse/dependence potential
- Review Oklahoma Opioid database (PMP)
- Monitor compliance with pain-management agreement
One hour of continuing education in pain management or in opioid use or addiction will be required annually prior to a provider renewing their license to practice medicine in the State of Oklahoma.
St. Mary’s Physician Associates has developed protocols in each of our practices to ensure compliance with the new Opioid Prescribing Law outlined in Senate Bill 1446. We thank you for your understanding as we institute these new protocols.
J. Michael Pontious, MD
Chief Medical Officer, St. Mary’s Physician Associates