14-118 C.M.R. ch. 11, § 6 - Limits on Opioid Medications Prescribing and Exemptions to Limits

A. LIMITS ON OPIOID MEDICATION PRESCRIBING Prescribers are required to comply with limits on opioid medication prescribing as set forth in:

32 MRSA §2210(1) (Nurses and Nursing)

32 MRSA§2600-C(1) (Osteopathic Physicians)

32 MRSA §3300-F(1) (Board of Licensure in Medicine)

32 MRSA §18308(1) (Dental Professionals)

32 MRSA §4878(1) (Veterinarians)

32 MRSA §3657(1) (Podiatrists)

B. EXEMPTIONS TO LIMITS ON OPIOID MEDICATION PRESCRIBING

Prescribers are exempt from the limits on opioid medication prescribing established in this rule if:

1. Pain associated with active and aftercare cancer treatment. Providers must document in the medical record that the pain experienced by the individual is directly related to the individual's cancer or cancer treatment;

2. Palliative care in conjunction with a serious illness;

3. End-of-life and hospice care;

4. Medication-Assisted Treatment for substance use disorder;

5. A pregnant individual with an pre-existing prescription for opioids in excess of the 100 Morphine Milligram Equivalent aggregate daily limit. This exemption applies only during the duration of the pregnancy;

6. Acute pain for an individual with an existing opioid prescription for chronic pain. The seven day prescription limit applies;

7. Individuals pursuing an active taper of opioid medications, with a maximum taper period of six months, after which time the opioid limitations will apply, unless one of the additional exceptions in this subsection apply; or

8. Individuals who are prescribed a second opioid after proving unable to tolerate a first opioid, thereby causing the individual to exceed the 100MME limit for active prescriptions. For this exemption to apply, each individual prescription must not exceed 100 MME. Dispenser shall provide patients with guidance on proper disposal of the first prescription.

Notes

14-118 C.M.R. ch. 11, § 6