a nationwide breakdown of pain management and prescription ... · "25 legal medical marijuana...

© 2019 athenahealth, Inc.

"Legality of cannabis by U.S. jurisdiction." Wikipedia, The Free Encyclopedia. www.wikipedia.com, 2019.

"25 Legal Medical Marijuana States and DC: Laws, Fees, and Possession Limits." ProCon.org: The Leading Source for Pros & Cons of Controversial Issues. www.ProCon.org, 2016.

"Medical Marijuana." The National Organization for the Reform of Marijuana Laws (NORML). www.NORML.org, 2016.

National Cannabis Industry Association, News & Resources, State Policy Map. https://thecannabisindustry.org, 2019.

"PDMP Data Collection Frequency." The Prescription Drug Monitoring Program Training and Technical Assistance Center, The Heller School for Social Policy and Management, Brandeis University. http://pdmpassist.org, 2019.

Sources include information found in NAMSDL documentation, Pew Charitable Trusts documentation, and individual state information found in (but not limited to) enacted state statutes, formally-issued state regulations, board of medicine/pharmacy guidelines, and consumer a�airs division documents.

"Overview of State Pain Management and Prescribing Policies." The National Alliance for Model State Drug Laws (NAMSDL). www.namsdl.org, 2019.

“Prescription Drug Physical Examination Requirements.” The Centers for Disease Control and Prevention (CDC). www.cdc.gov, 2019.

Additional sources include individual state information found in (but not limited to) enacted state statutes, formally-issued state regulations, and board of medicine/pharmacy guidelines, 2019

Sources include individual state information found in (but not limited to) enacted state statutes, formally-issued regulations, and board of medicine/pharmacy guidelines.

Independent research performed by Victor L Shopov, MBA, Healthcare Policy Consultant.

Research is current as of April 2019.

Please contact [email protected] with updates or information that may be relevant to this document. This document is intended for educational purposes only and does not constitute legal advice or opinion.

A nationwide breakdown of pain management and prescription regulationsState laws and policies around opioid prescriptions span a wide spectrum, from continuing medical education requirements to limits on how many pills physicians can prescribe. Explore the di�erent ways states are working to manage the opioid epidemic, and how the policies relate to prescribing patterns.

0% 5% 15%10%

2.3%

4%

4.7%

4.9%

5.1%

5.2%

5.9%

6.1%

6.2%

6.2%

6.3%

6.3%

6.5%

6.6%

6.6%

6.9%

7%

7.1%

7.3%

7.8%

8%

8%

8.1%

8.6%

9%

9%

9.1%

10.2%

12.5%

5.5%

8.5%

8.4%

*No client makes up more than 35% of visits or patients in the state; at least 6 clients per state; at least 20,000 visits between January and May, 2018. Source: athenaResearch

*No client makes up more than 35% of visits or patients in the state; at least 6 clients per state; at least 20,000 visits between January and May, 2018. Source: athenaResearch

How the regulations line up with opioid prescription rates, state by state

How state opioid prescribing rates compare, policy by policy

Legalized medical marijuana

*Recreational marijuana use legalized

34 / 51 (50 states + District of Columbia) 50 / 51 (50 states + District of Columbia)



Daily, 3 business days, weekly, County-level (daily)

3-7 days, 8-14 days, 30+ days

Frequency of updates to prescription drug monitoring programs

Continuing medical education required for clinicians who prescribe controlled substances

Substance abuse disorder assessment or evaluation required prior to opioid prescription

Regulations mandate or allow pharmacists to check ID before dispensing prescriptions

Day supply limits to written prescriptions for opioids and/or schedule II drugs unrelated to extenuating circumstances

How state-by-state laws and policies vary around prescription pain management

Percent of adult (18-64) commercial patients with an opioid prescription, January to May 2018*

ME*

NH

RICT

DE

MA*

VT*

MD

DC*

NJ

NY

SC

GA

VA

PA

NC

AL

WV

OH

MI*

TN

MS

KY

IN

IL

AR

LA

MO

IA

MN

KS

OK

TX FL

NE

SD

ND

NM

CO*

WY

MT

AZ

UT

NV*

ID

CA*

AK*HI

OR*

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WI

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Percent of adult (18-64) commercial patients with an opioid prescription, January to May, 2018.*

0% 5% 15%

New Jersey

Connecticut

New York

New Hampshire

Massachusetts

Pennsylvania

Florida

Iowa

Texas

Ohio

Nevada

Illinois

West Virginia

Colorado

New Mexico

Washington

Louisiana

California

Mississippi

North Carolina

Wyoming

Michigan

Georgia

Kentucky

Utah

Nebraska

Alabama

Alaska

Tennessee

Idaho

Oregon

South Carolina

Missouri

Oklahoma

Arkansas

Arizona

Delaware

District of Columbia

Hawaii

Indiana

Kansas

Maine

Maryland

Minnesota

Montana

North Dakota

Rhode Island

South Dakota

Vermont

Virginia

Wisconsin

10%

N/A, insu�icient data

NJ

CT

NY

NH

MA

PA

FL

IA

TX

OH

NV

IL

WV

CO

NM

WA

LA

CA

MS

NC

WY

MI

GA

KY

UT

NE

AL

AK

TN

ID

OR

SC

MO

OK AR


NJ

CT

NY

NH

MA

PA

FL

IA

TX

OH

NV

IL

WV

CO

NM

WA

LA

CA

MS

NC

WY

MI

GA

KY

UT

NE

AL

AK

TN

ID

OR

SC

MO

OK AR

NJ

CT

NY

NH

MA

PA

FL

IA

TX

OH

NV

IL

WV

CO

NM

WA

LA

CA

MS

NC

WY

MI

GA

KY

UT

NE

AL

AK

TN

ID

OR

SC

MO

OK AR

Substance abuse disorder assessment or evaluation required prior to opioid prescription

NJ

CT

NY

NH

MA

PA

FL

IA

TX

OH

NV

IL

WV

CO

NM

WA

LA

CA

MS

NC

WY

MI

GA

KY

UT

NE

AL

AK

TN

ID

OR

SC

MO

OK AR


NJ

CT

NY

NH

MA

PA

FL

IA

TX

OH

NV

IL

WV

CO

NM

WA

LA

CA

MS

NC

WY

MI

GA

KY

UT

NE

AL

AK

TN

ID

OR

SC

MO

OK AR


NJ

CT

NY

NH

MA

PA

FL

IA

TX

OH

NV

IL

WV

CO

NM

WA

LA

CA

MS

NC

WY

MI

GA

KY

UT

NE

AL

AK

TN

ID

OR

SC

MO

OK AR

Day supply limits to written prescriptions for opioids and/or schedule II drugs

3-7 days

18-14 days

30+ days

4.6%

9.2%

9.7%

Some restrictions apply



Daily

3 business days

Weekly

County-level only (daily)

Day supply limits to written prescriptions for opioids and/or schedule II drugs

3-7 days

8-14 days

30+ days

Substance abuse disorder assessment required prior to opioid prescription





Daily

3 business days

Weekly

County-level only (daily)


a nationwide breakdown of pain management and prescription ... · "25 legal medical marijuana...

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