Provider-Patient Changes

Assembly Bill 474, or The Controlled Substance Abuse Prevention Act, went into effect January 1, 2018. The measure was introduced by Governor Brian Sandoval during his 2017 State of the State address, and was subsequently passed through both houses of the Legislature; it was signed into law on June 16, 2017.

Assembly Bill 474 expands and updates state laws related to the reporting of drug overdoses, sets forth protocols for healthcare providers who prescribe controlled substances for the treatment of pain, and enacts the “Prescribe 365” initiative.

Because of these laws, and the penalties which physicians face if they don’t comply, patients who get pain medications for both acute and chronic pain may notice some changes in their care. Consider the following changes that may affect you as a patient:

• Before you are prescribed an initial narcotic pain medication for any reason, your healthcare provider will need to check the Prescription Drug Monitoring state database to look up your history of using controlled medications.
• Your healthcare provider will also need to have you sign an informed consent form that should include information on risks of taking narcotics, proper use of the medication, and other options to control your pain. View a copy of Humboldt General Hospital’s consent form here.
• Your healthcare provider will also need to evaluate your risk of addiction or dependency. Initial prescriptions for acute pain can only be prescribed for 14 days.
• If you require pain medications for more than 30 days, your healthcare provider will need to have you sign a Prescription Medication Agreement. The agreement should include the goals of using your controlled medication and discuss other rules your physician will have for your prescriptions meds. Rules will likely include using a single pharmacy, not sharing your medications with others or using other prescribed controlled substances, marijuana and illegal drugs.
• Finally, if you continue to need medications after 90 days, your healthcare provider will likely have you come back to the office for additional evaluation and assessment for abuse risk.

Please note that while the focus of these laws has been on opioid medications, many of these new regulations also apply to other controlled prescriptions. These include medications such as Xanax, valium, and stimulants for ADHD (Adderall, Ritalin). If you are a patient on these meds, you will likely have to work with your healthcare provider on many of these same agreements and risk of abuse assessments.