Approval of Final Opioid Prescribing Rules

For Immediate Release from the New Hampshire Board of Medicine (dated April 8, 2016)

On April 6, 2016, the New Hampshire Board of Medicine (BOM) approved a Final Proposal on Opioid Prescribing, for New Hampshire medical practitioners licensed by the BOM, after fully considering public comment and committee comments by the office of legislative services. The final proposal is scheduled for review by the Joint Legislative Committee on Administrative Rules (JLCAR) at its April 15, 2016 meeting. If approved by JLCAR the rules will be adopted by the (BOM) at its next meeting and would be effective the following day.

During the rulemaking process, initiated immediately after the adoption of the emergency rules that went into effect on November 6, 2015, the BOM has worked to gather meaningful input from practitioners and patients alike in order to craft effective standards for prescribing Schedule II, III and IV opioids. In written public comments received by the Board, a limited number of practitioners were concerned with various aspects of the rules but the BOM believes its final proposal balances a patient’s need for appropriate pain treatment with the practitioner’s ability to assess the benefits and risks of opioid treatment options.

Given recent attention regarding the final draft of the rules, the BOM believes a misimpression may have been created. To clarify, the rules do not prevent a licensed practitioner from prescribing opioids in daily doses of 100 mg morphine equivalent or higher. The rules, however, require a practitioner to document consideration of having the patient treated by an appropriate specialist where the patient is receiving high doses of morphine equivalents for longer than three months. This requirement is based on the reality that opioid pain medication use presents serious risks, including overdoses and opioid use disorders.

The rules are intended to ensure that practitioners and their patients have tools available for safe and effective treatments, but which also give consideration to curbing the adverse effects related to opioid drugs, including diversion of the drugs. The BOM encourages practitioners to develop sound clinical relationships with their patients through an understanding of the patient’s clinical situation, their functioning and their life context and believes these rules fulfill its mandate of protecting the public from the very real public health challenge facing New Hampshire. The final proposal is attached.

Contact: Sarah Blodgett, Acting Executive Director 
               (603) 271-6985 or