New Jersey Governor Signs Opioid Restriction Law

Released: 02/28/2017   By: Heidi Dufrene, PharmD

New Jersey Governor, Chris Christie, signed new legislation recently to help curb the opioid epidemic in his state. The new legislation, Bill 3, limits initial opioid prescriptions for acute pain to a five-day supply and requires the prescriber to use the lowest effective dose of an immediate-release opioid. An additional five days may be added if the prescriber deems it necessary to treat continuing pain. These new prescribing limits would not apply to cancer or hospice patients.

Before prescribing a Schedule II (CII) medication, a prescriber must also document the patient’s past non-opioid medication history, non-pharmacological treatments for pain management, substance abuse history, and access the state’s Prescription Monitoring Program.

Patients that require use of an opioid beyond this initial prescribing period (the bill states this as requiring a third prescription) must also discuss a treatment plan with their prescriber. Prescribers will be required to document a discussion of the risks of chronic opioid use and enter into a pain management agreement with these patients. If patients require continued opioid use of three months or more, the prescriber must review and document, at a minimum of every three months, the course of treatment, new information on pain etiology, the patient’s progress toward treatment objectives, and assess patient for physical and psychological dependence. The prescriber must periodically make reasonable efforts to cease the use of an opioid, decrease the dosage, or try other treatments to reduce the potential for abuse or dependence unless these steps are contraindicated.
The new law also requires state-regulated health insurance entities to cover the first four weeks of substance abuse treatment without prior authorization. An additional six months may be covered if it is deemed medically necessary. Due to this ruling, any prior authorizations for medications such as buprenorphine and naltrexone must be removed.
The new law will take effect on May16, 2017. This new bill places New Jersey among a list of states who have now enacted similar laws regarding opioid prescribing. These states include Massachusetts, Connecticut, New York, Maine, Rhode Island, and Vermont.

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