Nevada doctors voice concerns over opioid law implementation

LAS VEGAS — Nevada’s new opioid prescription law is only days old but doctors already are worried about how it might be implemented.

Physicians, lawyers and others expressed concerns this week to the state medical and dental boards over draft disciplinary rules for doctors who write improper prescriptions for pain medications, the Las Vegas Review-Journal reported.

“We appreciate the regulation, we appreciate the fact that something is being done to control an enormous problem, but I think as a group we feel it is a bit too broad and has been extended way too far,” Cole Sondrup, a Las Vegas physician, told the boards on Wednesday.

Under the law, doctors must limit initial prescriptions for opioids and other controlled substances used for pain management to two weeks and perform a risk assessment on the patient.

After a month of the prescription, doctors must enter into a written agreement with the patient and the patient must consent to random drug testing and list other drug use. The law also states that doctors are expected to have a diagnosis for patients’ pain after three months.

Under the proposed disciplinary rules, doctors who violate the new law five times would lose their licenses. The threshold on losing a license would be reduced to three violations by 2020.

The proposed rules don’t specify what conduct constitutes a violation that could lead to losing a medical license, and the law places a paperwork burden on doctors, according to several doctors who attended the meeting. The doctors also voiced concerns that they could be punished for relatively minor mistakes or employee errors.

Some doctors said the added paperwork and threat of random drug testing have caused longtime patients to mistrust their doctors.

“Just the other day, I had a patient tell me point-blank they’re not going to sign the forms, they don’t want to do initial testing, and they would just go to the street to get their narcotics,” said Andrew Pasternak, founder of Silver Sage Center for Family Medicine in Reno.

Members of the state medical board will discuss the rules and call for another workshop session after they’re rewritten, said Ed Cousineau, executive director of the board. The rules will be finalized by late spring, he said.

“There’s always going to be unintended consequences,” Cousineau said. “We have to basically, as a medical board, follow our directives. AB 474 is now the law, and the interpretation of that is something that’s obviously a big issue.”