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TITLE 22EXAMINING BOARDS
PART 9TEXAS MEDICAL BOARD
CHAPTER 170PAIN MANAGEMENT
SUBCHAPTER BUTILIZATION OF OPIOID ANTAGONISTS
RULE §170.6Opioid Antagonist Prescription Guidelines

(a) A prescriber may directly or by standing order prescribe an opioid antagonist to:

  (1) a patient to whom an opioid medication is also prescribed who is at risk for an opioid-related drug overdose;

  (2) a patient at risk of experiencing an opioid-related drug overdose based on prescribing by other providers;

  (3) a family member, friend, or other person in a position to assist a person at risk for an opioid-related drug overdose;

  (4) law enforcement agencies in a position to assist persons experiencing an opioid related drug overdose.

(b) Persons at Risk of Opioid Related Drug Overdoses. The following guidelines may be used in identifying persons at risk of opioid related drug overdose and thus appropriate candidate for prescription of opioid antagonists. These guidelines include, but are not limited to:

  (1) persons being prescribed opioids;

  (2) persons receiving rotating opioid medication regimens and are thus at risk for incomplete cross-tolerance;

  (3) persons who have a history of prior opioid-drug intoxication or overdose;

  (4) persons with a legitimate need for analgesia, coupled with a suspected or confirmed history of substance abuse, dependence, or non-medical use of prescription or illicit opioids;

  (5) persons on extended release/long acting opioid medications that may increase risk for opioid overdose;

  (6) persons who have ever completed a mandatory opioid detoxification or abstinence programs;

  (7) persons recently released from incarceration with a history of past opioid use or abuse;

  (8) persons resuming opioid therapy after an interruption of opioid treatment; and

  (9) Persons who use illicit opioids and/or non prescribed opioids.


Source Note: The provisions of this §170.6 adopted to be effective July 8, 2018, 43 TexReg 4454

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