Under Senate Bill 18-22 Clinical Practice for Opioid Prescribing, a prescriber must limit a patient’s initial prescription of an opioid to a seven-day supply, if the prescriber has not written an opioid prescription for the patient in the last 12 months. The prescriber may exercise discretion in including a second fill for a seven-day supply.

These limits do not apply, if, in the judgment of the prescriber, the patient:

• Has chronic pain that typically lasts longer than 90 days or past the time of normal healing, as determined by the prescriber, or following transfer of care from another prescriber who prescribed an opioid to the patient;
• Has been diagnosed with cancer and is experiencing cancer related pain; or
• Is experiencing post-surgical pain, that, because of the nature of the procedure, is expected to last more than 14 days.
• Is undergoing palliative care or hospice care focused on providing the patient with relief from symptoms, pain and stress resulting from a serious illness in order to improve quality of life. (This exemption is allowed for physicians, physician assistants and advanced practice registered nurses only.)

After the first prescription, the prescriber is required to check the Prescription Drug Monitoring Program (PDMP) database before

prescribing any additional opioids for the same patient. Failure to check the PDMP constitutes unprofessional conduct if the prescriber repeatedly fails to comply with this new requirement. The second fill requirement to check the PDMP does not apply when a patient:

• Is receiving the opioid in a hospital, skilled nursing facility, residential facility, or correctional facility;
• Has been diagnosed with cancer and is experiencing cancer related pain; or
• Is undergoing palliative care or hospice care;
• Is experiencing post-surgical pain, that, because of the nature of the procedure, is expected to last more than 14 days;
• Is receiving treatment during a natural disaster or during an incident where mass casualties have taken place; or has received only a single dose to relieve pain for a single test or procedure.

After the second opioid prescription, the law has no further restrictions on the healthcare provider’s prescribing practices. The new law does require a healthcare provider, or the provider’s designee, to specify the provider’s specialty upon the initial query of the PDMP.

It also states a violation of the new requirements does not constitute negligence or contributory negligence per se and does not create a private right of action or serve as the basis of a cause of action.