Tighter controls on opiate prescriptions passed

A bill to tighten restrictions on dispensing opiates in Nebraska was passed by the Legislature March 29.

LB931, sponsored by Omaha Sen. Sara Howard, limits opiate prescriptions for a patient younger than 18 to no more than a seven-day supply. A medical practitioner will be required to discuss the risks associated with opiates with the patient’s parent or guardian. Exceptions to the seven-day limitation can be made for chronic pain, cancer diagnosis or palliative care.

If a health practitioner deems such an exception appropriate for a patient, he or she is required to document the medical condition requiring the pain medication in a patient’s medical record and indicate that a non-opiate alternative was not appropriate to address the condition.

The bill’s provisions will expire on Jan. 1, 2029, to allow lawmakers to revisit the need for continuation of the program.

Provisions of two additional bills addressing opiate prescriptions are included in the bill.

LB933, introduced by Omaha Sen. Brett Lindstrom, requires medical practitioners to notify patients—or a parent or guardian of a patient under 18—of the risk of addiction and overdose when prescribing opiates and other Schedule II prescription medications. The notification is required prior to the initial prescription and again before issuing a third prescription.

Under the bill, a practitioner is required to discuss the risks of addiction and overdose, including:
• the fact that controlled substances and opiates are highly addictive even when taken as prescribed;
• there is a risk of developing a physical or psychological dependence on opiates or controlled substances;
• reasons why the prescription is necessary and alternatives that may be available; and
• taking more controlled substances or opiates than prescribed, or mixing sedatives, benzodiazepines or alcohol with controlled substances or opiates, can result in fatal respiratory depression.

A medical practitioner must make note of such discussion in the patient’s medical record.

LB934, introduced by Heartwell Sen. John Kuehn, requires a person picking up an opiate prescription to provide valid photo identification unless the pharmacist has an established relationship with the patient and can positively identify him or her. A driver license, operator license, Nebraska state identification card, military identification card, alien registration card or passport are considered acceptable forms of identification.

A patient, resident or employee of a licensed health care facility is exempt from this provision if identification procedures are in place for the receipt and administration of controlled substances at the facility.

The bill passed on a 48-0 vote.