Effective April 26, 2018, The Opioid Epidemic Act (OEA) changes drastically the requirements for healthcare professionals licensed to prescribe Drug Enforcement Agency (DEA Schedule II opioid medications. Here is a summary of the changes:
- An initial prescription for scheduled to opioids in circumstances following a surgical procedure, which is defined as medications not prescribed in the previous 60 days, is limited to a fourteen (14)-day supply.1
- An initial prescription for scheduled to opioids in circumstances NOT following a surgical procedure, which is defined as medications not prescribed in the previous 60 days, is limited to a five (5)-day supply. 1
- Healthcare professionals are prohibited from issuing a new prescription that exceeds 90 morphine milligram equivalents (MME) day.1,2
- If a new prescription for greater than 90 MME is issued, the prescriber must also issue a prescription for naloxone or another opioid antagonist.
- E–prescribing for all DEA Scheduled II opioids will be REQUIRED in Arizona Maricopa and Pima Counties on January 1, 2019, and in all other Arizona Counties on July 1, 2019.
- Healthcare professionals authorized to prescribe DEA Schedule II opioids are required to complete a minimum of 3 hours of opioid–related continuing medical education (CME) each license renewal cycle.
- The exemption from review in the Arizona Prescription Monitoring Program (PMP) for patients receiving a prescription for DEA Schedule II opioids for less than five (5) days if the PMP had been checked within the previous thirty (30) days has been eliminated.
These changes will significantly alter the prescribing practices of all licensed healthcare professionals who choose to treat acute and chronic pain syndrome with opioid medications. All healthcare professionals and their patients should become keenly familiar with the new requirements in the Opioid Epidemic Act to avoid interruption of care.
The Summit Team
1 Exemptions: Active oncology diagnoses, traumatic injury, palliative care, hospice or end–of–life care, skilled nursing facility care, treatment of burns, treatment of infant’s being weaned off of steroids after hospital discharge, and treatment of substance abuse
2 Ninety (90) Morphine Milligram Equivalents (MMEs): Oxycodone 60 mg, hydrocodone 90 mg, fentanyl transdermal patch 37.5 mcg/hr, hydromorphone (oral) 18 mg, codeine 600 mg; healthcare professionals who are board–certified in pain management may prescribe greater than 90 MME; healthcare professionals who are NOT board–certified in pain management may prescribe greater than 90 MME only after consultation with healthcare professionals who are boards–certified in pain management (If a consulting healthcare professional who is board–certified in pain management is unavailable within 48 hours of request for consultation, a healthcare professional may prescribe greater than 90 MME and subsequently arrange the consultation; teleconference consultation is permissible.)