ARIZONA STATE SENATE
Fifty-Fifth Legislature, Second Regular Session
AMENDED
opioid prescriptions; intractable pain; exceptions
Purpose
Exempts patients with perioperative surgical pain or chronic intractable pain from statutory opioid prescription dosage restrictions.
Background
Health
professionals in Arizona may not issue opioid prescriptions exceeding 90
morphine milligram equivalents (MME) per day to patients outside of a health
care institution, except those patients: 1) with an
active oncology diagnosis; 2) with a traumatic injury, not including a surgical
procedure; 3) receiving hospice care; 4) receiving
end-of-life care; 5) receiving palliative
care; 6) receiving skilled nursing facility care; 7) receiving treatment for
burns; 8) receiving
medication-assisted treatment for a substance use disorder; or 9) who are
hospitalized (A.R.S.
32-3248.01).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Expands the list of exemptions from the 90 MME per day limit on opioid prescriptions to include patients:
a) experiencing chronic intractable pain; or
b) receiving opioid treatment for perioperative surgical procedure.
2. Defines chronic intractable pain as pain that:
a) is excruciating, constant, incurable and of such severity that it dominates virtually every conscious moment; and
b) produces mental and physical debilitation.
4. Exempts a patient with chronic intractable pain from the 90 MME per day limit once the patient has:
a) an established health professional-patient relationship; and
b) tried doses of less than 90 MME per day that have been ineffective at addressing the patient's pain.
3. Defines established health professional-patient relationship as a relationship where all of the following have occurred:
a) a patient has physically presented to a health professional with a medical complaint;
b) the health professional has taken a medical history of the patient;
c) the health professional has performed a physical examination of the patient; and
d) some logical connection exists between the medical complaint, the medical history, the physical examination and the drug prescribed.
4. Makes technical and conforming changes.
5. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
Removes, from the definition of chronic intractable pain, pain that may produce a desire to commit suicide for the sole purpose of stopping the pain.
Amendments Adopted by the House of Representatives
1. Removes the exemption from the statutory opioid prescription dosage restrictions for patients with intractable pain.
2. Clarifies that persons eligible for the dosage exemption by way of receiving opioid treatment for perioperative surgical pain must be receiving perioperative care following an inpatient surgical procedure.
3. Exempts a patient with chronic intractable pain from the 90 MME per day limit once the patient has:
a) an established health professional-patient relationship; and
b) tried doses of less than 90 MME per day that have been ineffective at addressing the patient's pain.
4. Defines established health professional-patient relationship.
Senate Action House Action
HHS 1/26/22 DP 8-0-0 HHS 3/21/22 DPA 9-0-0-0
3rd Read 2/3/22 27-0-3 3rd Read 3/31/22 54-5-1
Prepared by Senate Research
March 31, 2022
MM/CC/sr