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Greetings from the Division of
Professions and Occupations,
On Monday, May 21, 2018, Governor John
Hickenlooper signed Senate Bill 18-22 Clinical
Practice for Opioid Prescribing. The bill went into effect immediately upon the Governor’s
signature. This new state law limits the number of opioid pills a
healthcare provider can prescribe and affects physicians, physician assistants,
advanced practice registered nurses with prescriptive authority, dentists,
optometrists, podiatrists, and veterinarians.
Under the new law, 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.
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 PDMP 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.
In addition, the bill requires the
Colorado Department of Public Health and Environment to report on the PDMP
integration of health systems and the results and effects of the prescriber
report cards.
The Colorado Medical Board, State Board of Nursing, Colorado Dental Board, State Board of Veterinary Medicine, State Board of Optometry, Colorado Podiatry Board and the Colorado Board of Pharmacy will be reviewing rules and policies
to assess the need for any changes. In addition, the Boards will be conducting
outreach and education to help licensees better understand and implement
SB18-22. Please watch your respective Board’s website for the most updated
information.
If you have questions, please contact
your respective Board by e-mail at the address below:
dora_medicalboard@state.co.us
dora_nursingboard@state.co.us
dora_dentalboard@state.co.us
dora_optometryboard@state.co.us
dora_pharmacyboard@state.co.us
dora_podiatryboard@state.co.us
dora_veterinarymedicineboard@state.co.us
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