Effective immediately, Virginia’s Board of Medicine has adopted emergency regulations governing the prescribing of opioids and buprenorphine. These regulations apply to doctors of medicine, osteopathic medicine, and podiatry, and to physician assistants who are treating acute and chronic pain that is not associated with cancer, hospice, palliative care, inpatient hospitals, inpatient nursing homes, or clinical trials.
Regulations for the management of acute pain include requirements for the evaluation of the patient, limitations on quantity and dosage, and medical recordkeeping. Further, the rule states that non-pharmacologic and non-opioid treatment for pain shall be given consideration prior to treatment with opioids.
Regulations for management of chronic pain include requirements for evaluation and treatment, including a treatment plan, informed consent, urine drug testing, checking the prescription monitoring program, consultation with other providers when prescribing above 120 MME/day, co-prescribing naloxone when prescribing above 120 MME/day, and medical recordkeeping.
Regulations for prescribing of buprenorphine for addiction treatment include requirements for patient assessment and treatment planning, checking the prescription monitoring program, limitations on prescribing the buprenorphine mono-product (without naloxone), pill counts, urine drug testing, dosages, consultation, and medical recordkeeping.
If you are a prescriber in Virginia, we strongly advise that you read the emergency regulations governing the prescribing of opioids and buprenorphine (see pages 23-27) in their entirety so that you may ensure that you and your staff fully understand the new requirements.
If you have specific questions about these emergency regulations, the officially designated agency contact is the Board of Medicine’s Executive Director, William L. Harp, M.D., who can be reached by telephone at (804) 367-4558 or by email at firstname.lastname@example.org.
If you are a member of AIPM and have general questions about this or any other pain-related policy, please feel free to contact me at email@example.com.