“It is probably one of the more important bills that we have worked on in 2018,” Hawk said. “It has been my honor to lead the way on this issue.”

According to the Tennessee Department of Health and the Department of Mental Health and Substance Abuse Services, more than 7 million opioid prescriptions are filled annually in the state. This high prescription rate has led to a high overdose death rate, with 1,600 opioid related deaths occurring in Tennessee.

It is one of the highest opioid death rates in the nation.

If signed by Gov. Bill Haslam, the bill would revise various provisions in state law regarding the prescribing and dispensing of opioids and benzodiazepines and other controlled substances. It also sets new requirements on when prescribers must check a controlled substance database.

Current law says certain practitioners must check the database the first time a patient is dispensed a controlled substance, at the beginning of a new episode of treatment and at least once every 12 months after the initial prescription is written.

The new bill would redefine a new episode of treatment from a prescription not prescribed by a practitioner in the last 12 months to the last six months, and it would require the database be checked at least every six months instead of every 12.

It would also require a database check for acute care patients and “opioid naive patients,” who are patients who have not been treated with an opioid 30 days prior to the

date of treatment.

Restrictions are also placed on the prescribing of opioids.

“Under the legislation, the vast majority of incidences of opioid naive patient pain treatment will be treated by three days worth of opioids,” Hawk said. “If a doctor feels that a patient needs more than three days of an opioid, then the doctor can prescribe up to 10 days of an opioid, with the understanding that the patient understands why they may need more medication.”

According to the bill, a health care practitioner may not treat an opioid naive patient with more than a five-day supply of an opioid and shall not treat an acute care patent with more than a 30-day supply of an opioid.

In some cases where a practitioner determines more opioids may be warranted and circumstances would make it difficult for a patient to acquire a second prescription, a

second prescription could be issued simultaneously with the initial prescription.

The reason for the second prescription must be documented and can be dated no earlier than five days after the first prescription with 10 days being the latest date.

An acute care patient, described as a patient who has been treated with an opioid for fewer than 90 days during a 12-month period prior to the date of treatment by a practitioner, cannot be treated with opioids until the patient is assessed and informed consent has been obtained.

If the patient is a woman of child-bearing age, from 14 to 44, part of the informed consent process must include information about Neo-natal abstinence syndrome and specific information on how to access contraceptive services in the community. Informed consent would be required once during a six month period.

Acute patients would also not be able to be treated with opioids until the patient tried reasonable, appropriate and available non-opioid treatments for pain conditions or documenting the contradiction or intolerance of non-opioid treatments.

Hawk noted nothing in the legislation will stop care for someone who is currently in a pain management program. He said the main reason for the bill is to stop potential new addiction by limiting the initial exposure to the drugs.

The bill’s provisions take effect on July 1, and will end on July 1, 2023, with the hope Tennessee has moved passed the opioid epidemic.