TMB Clarifies New 10-Day Limit on Opioids
By Joey Berlin

Opioid_CME

The Texas Medical Board (TMB) is trying to head off confusion about the state’s new 10-day opioid prescribing limit for acute pain, which takes effect on Sunday. 

During this year’s legislative session, lawmakers passed and Gov. Greg Abbott signed House Bill 2174. The law states that for acute pain, practitioners may not “(1) issue a prescription for an opioid in an amount that exceeds a 10-day supply; or (2) provide for a refill of an opioid.” 

TMB’s statement, released Friday, appears to address concerns that the new law means acute pain patients must be completely cut off from opioids beyond the 10-day mark. That’s not the case, according to the statement. 

“The Texas Medical Board interprets this section to mean a practitioner may write an opioid prescription for up to 10 days without a refill. However, the patient may see the practitioner in a follow up appointment and receive another opioid prescription for up to 10 days. The law does not limit how many times this may occur,” TMB’s statement said. “The Texas Medical Board does not interpret this section to limit patients to a maximum of 10 days of opioids for acute pain without the possibility of any further opioids for that specific issue or ‘episode of care.’” 

For example, TMB said, if a patient has a fracture early in the morning on Sept. 1, “The practitioner may prescribe opioids for acute pain through September 10 (10 days). The patient would need a follow up appointment with the practitioner for each 10-day period of opioid prescriptions for acute pain. Refills are not allowed.” 

Also, TMB noted, the 10-day limit doesn’t apply to a prescription for an opioid that the FDA has approved for the treatment of substance addiction, if a practitioner issues that prescription for the same reason. TMB also notes the new law defines acute pain as “the normal, predicted, physiological response to a stimulus such as a trauma, disease, and operative procedures. Acute pain is time limited.” 

The new law doesn’t apply to chronic pain, pain treatment as part of cancer care, hospice care, or other end-of-life or palliative care. 

TMB said it would provide additional guidance and clarification on the law “as soon as possible.”

Last Updated On

August 30, 2019

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Joey Berlin

Associate Editor

(512) 370-1393
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Joey Berlin is associate editor of Texas Medicine. His previous work includes stints as a reporter and editor for various newspapers and publishing companies, and he’s covered everything from hard news to sports to workers’ compensation. Joey grew up in the Kansas City area and attended the University of Kansas. He lives in Austin.

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