New Nevada drug law deals with opioid prescriptions

New patients will be limited to a 14-day initial prescription for opioid pain medicines under a new law taking effect Jan. 1.

AB474 was one of Gov. Brian Sandoval’s priority measures in the 2017 session. It’s an attempt to help both doctors and patients reduce opioid abuse in Nevada.

Dubbed the Prescription Drug Abuse Prevention Act, the law doesn’t prevent providers from prescribing pain drugs or limit how much they can prescribe. But it does require they have reasons for prescribing.

That includes having much more extensive discussions with patient to ensure they understand the inherent risks of powerful pain killers and are aware of other potential treatments for pain.

Elyse Monroy of Health and Human Services said the law adds a number of factors that must be considered before prescribing the drugs including assessing the patient’s risk for abuse, conducting a physical exam and developing an evidence-based diagnosis and treatment plan.

It also mandates that more information be put on the prescription label including the patient’s date of birth, the diagnosis code for the medical problem being treated, the fewest number of days the controlled substance should be consumed in and the practitioner’s Drug Enforcement Administration number.

She said the doctor has to enter a treatment agreement with the patient if prescriptions continue for more than 30 days and says that no patient should be prescribed pain drugs for more than 365 days.

“If medically necessary, prescribers must document why they are going over the 365-day limit,” she said.

She said the law is intended to give Nevada a way of identifying and defining over prescribing.

Dr. Stephanie Woodard said many prescribers are already doing much of what the law requires.

Dr. Daniel Burkhead, a pain management specialist in Las Vegas, said the bill establishes good practices for prescribing pain medications and isn’t intended to prevent patients from getting appropriate treatment of pain.

But he said it requires a real diagnosis of why the prescriptions are being written.

“A generic diagnosis such as low back pain is no longer acceptable,” he said.

Paul Edwards of the Pharmacy Board said once the law is in place, all practitioners in the state will have to enroll in the Prescription Drug Monitoring Program to keep their DEA license to prescribe controlled substances. Currently, more than 85 percent are already in that program that’s designed to prevent addicts from getting medications from multiple doctors and to identify practitioners who are possibly prescribing too many of those drugs to their patients. But he said the emphasis is on working with doctors and dentists to ensure they’re prescribing drugs appropriately, not on law enforcement.