The Texas Medical Association continues to track key regulatory changes that could affect your practice, and recently submitted comments on the Texas Medical Board’s (TMB) proposed rule for the use of opioid antagonists.

The drugs can immediately reverse an opioid-related overdose, but carry their own risks and side effects.

The draft regulations lay out guidelines for what types of patients may be prescribed opioid antagonists, and for identifying people at risk for opioid-related overdoses. The rule proposal also largely parrots the language of state law that protects physicians and providers from criminal or civil liability if they prescribe opioid antagonists in good faith and in accordance with the standard of care. 

Read TMB’s draft guidelines in the Feb. 9 edition of the Texas Register (beginning on page 705).

The move comes in response to 2017 legislative directives instructing TMB to adopt guidelines for the prescription of opioid antagonists. 

Under TMB’s proposed rule, the people who may be prescribed an opioid antagonist include: 

• A patient who has a prescription for an opioid medication and is at risk for an opioid-related overdose;
• A patient at risk of experiencing an opioid-related overdose based on prescribing by someone else;
• A family member, friend, or other person who’s in a position to assist someone at risk of opioid-related overdose; and
• Law enforcement agencies who may be able to assist a person experiencing an opioid-related overdose. 

In its comments, TMA suggests some adjustments to tighten up the rules. For instance, the proposed rule’s guidelines for identifying people at risk for opioid drug overdose includes people “being prescribed high doses of opioids for long-term management of chronic pain.” TMA notes some people get addicted to opioids as first-time users, and suggests broadening that guideline to include all people being prescribed opioids.