Opioid Prescribing Information

Prescribing Laws

• What state laws govern opioid prescribing?

Prescribing Laws Resources

Pennsylvania Opioid Data Dashboard

PA Prescription Drug Diversion: Suspicious Activity Report

Naloxone

• When should I offer Naloxone?
• Can a patient obtain Naloxone without a prescription?
• What types of Naloxone are available?
• Where can I find more information about Naloxone?

Naloxone Resources

Pennsylvania Department of Health Naloxone Information

Naloxone Standing Order

Prescribe to Prevent

NEXT Distro Free Naloxone

Overdose Prevention and Response Toolkit

Naloxone FAQs|CDC

Fact Sheet: Clinicians

e-Prescribing

• Am I able to issue a hand-written prescription for a controlled substance?
• Are there any exceptions to the e-Prescribing law?
• What is a temporary technological or electrical failure?
• What should I do if I experience a temporary technological or electrical failure?
• If I have internet access but do not have an EHR, or vice versa, do I qualify for a statutory exception?
• If a patient is in the emergency department or a health care facility, is an e-prescribing exception automatic?
• Does a fax meet the requirements for e-prescribing?
• I don’t meet one of the standard exceptions listed, but I can’t comply with the e-prescribing requirements. What should I do?
• What are the penalties if I violate Act 96?
• If I am cited for a violation of Act 96 but don’t feel I’ve done anything wrong, am I able to appeal?

e-Prescribing Resources

PAMED’s e-Prescribing Quick Consult

e-Prescribing FAQs 
(PA Department of Health)

e-Prescribing Exemption Form

CMS Electronic Prescribing For Controlled Substances (EPCS) Program

Prescribing Limits in an Emergency Department, Urgent Care Center, or for a Patient in Observation Status

• Are there any limits on prescribing opioids to patients being treated in health care facilities?
• Who does Act 122 apply to?
• What are the prescribing limits for these facilities?
• Are there any exceptions to this prescribing limit?
• What documentation is required if I exceed the prescribing limit?
• If I see a patient in one of these facilities, can I write an opioid prescription with refills?
• If I treat a patient in one of these facilities that I suspect has a substance use disorder, what should I do?
• What are the penalties if I violate Act 122?

Prescribing Limits Resources

Treatment of Pain in an Emergent Setting

Treatment Atlas

DDAP – Substance Use Disorder Treatment 

Prescribing Limits for Minors

• What are the prescribing limits for minors?
• Who is considered an “authorized adult” for the purpose of providing consent to prescribe an opioid?
• Are there requirements that must be met prior to issuing an opioid prescription to a minor?
• Is there a standardized consent for that I must use?
• Are there any exceptions to the seven-day limit?
• Are there any other exceptions regarding the prescribing of opioids to minors?
• What are the penalties if I violate Act 125?

Prescribing Limits for Minors Resources

Prescribing Opioids to Minors FAQs
(PA Board of Medicine)

Consent Form to Prescribe Opioids to Minors

Safe Prescribing of Opioids in Pediatric and Adolescent Populations

Voluntary Non-Opioid Directive

• Can a patient refuse a prescription for opioids?
• Is there a specific form a patient must use for a non-opioid directive?
• How is the PNOD executed?
• How long is a PNOD valid?
• Must a PNOD be signed for each practitioner the patient sees?
• Are there any exemptions to a voluntary non-opioid directive?
• What are the penalties if I violate a voluntary non-opioid directive?

Voluntary Non-Opioid Directive Resources

Pennsylvania Patient Non-Opioid Directive (PNOD) and Information Sheet

Opioid Treatment Agreements

• What is an opioid treatment agreement?
• What are my requirements under Act 112 regarding treatment agreements?
• Is there a required form that must be used for treatment agreements?
• Is urine drug testing a required component of the treatment agreement?
• How often must urine drug testing be conducted?
• Are there exceptions to the urine drug test requirements?
• What steps must a prescriber take to meet the professional judgement exception for the urine drug test requirements?
• What if the patient refuses a urine drug test?
• May I terminate the agreement?
• What are the penalties if I violate this law?

Opioid Treatment Agreements Resources

PAMED’s Opioid Treatment Agreement Quick Consult

Opioid Treatment Agreement FAQs
(PA Department of Health)

Sample Opioid Treatment Agreement 
(PA Department of Health)

Opioid Agreement Checklist
(PA Department of Health)

Treatment Agreement Overview
(PA Department of Health)

Pennsylvania Prescribing Guidelines for Treating Non-Cancer Pain
(PA Department of Health)

Prescribing Guidelines

• Are there any resources to assist in the prescribing of opioids?
• Am I required to adhere to the Prescribing Guidelines?

Prescribing Guidelines Resources

CDC Clinical Practice Guideline for Prescribing Opioids for Pain

Calculating Total Daily Dose of Opioids for Safe Dosage

Treating Chronic Non-Cancer Pain

Treatment of Pain in an Emergent Setting Setting

Opioid Dispensing Guidelines

Obstetrics & Gynecology Opioid Prescribing Guidelines

Geriatric Pain Opioid Use and Safe Prescribing

Use of Addiction Treatment Medications in the Treatment of Pregnant Patients with Opioid Use Disorder

Safe Prescribing Benzodiazepines for Acute Treatment of Anxiety & Insomnia

Safe Prescribing of Opioids in Orthopedics and Sports Medicine

Safe Prescribing of Opioids in Pediatric and Adolescent Populations

Safe Prescribing for Workers' Compensation

Treating Pain in Patients with OUD

Guidelines for Safe Administration of Low-Dose Ketamine

Treatment of Acute and Chronic Pain in Patients with Sickle Cell Disease

Central Nervous System Stimulants in Adults

Central Nervous System Stimulants in Pediatric Patients