In January, a new law took effect that requires opioid prescribers to also offer prescriptions for opioid-overdose reversal drugs such as naloxone. The California Medical Association (CMA) received numerous calls from physicians regarding the ambiguity of the new requirements.

The California Legislature recently enacted a bill that clarifies the circumstances under which physicians are required to offer opioid-overdose reversal drugs. Effective September 5, 2019, AB 714 specifies that the requirement to offer naloxone applies only if the patient is receiving a prescription for an opioid or benzodiazepine medication.

If a patient is receiving such a prescription, the law requires that the prescriber offer naloxone or other similar drug if:

• The prescription dosage for the patient is 90 or more morphine milligram equivalents of an opioid medication per day
• An opioid medication is prescribed within a year from the date a prescription for benzodiazepine has been dispensed to the patient
• The patient presents with an increased risk for opioid overdose, including a patient with a history of opioid overdose, a patient with a history of opioid use disorder, or a patient at risk for returning to a high dose of opioid medication to which the patient is no longer tolerant.

In addition, the law now specifies that the education physicians must provide patients who are prescribed naloxone or other similar drug must be about opioid overdose prevention and use of the opioid reversal drug. Physicians do not need to provide the education if the patient declines or if the patient has received the education within the past 24 months.

The new law further clarifies that the requirement to offer naloxone do not apply when the opioid or benzodiazepine medication is being administered in a facility or prescribed to a patient who is terminally ill.

To learn more about prescribing controlled substances, including this new requirement, see CMA health law library document #3201, "Controlled Substances: Prescribing."

This document, as well as the rest of CMA’s online health law library, is available free to members at cmadocs.org/health-law-library. Nonmembers can purchase documents for $2 per page.

Contact: CMA Legal Information Line, (800) 786-4262 or legalinfo@cmadocs.org.