1 of 1
HOUSE DOCKET, NO. 3147 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 2164
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Carole A. Fiola
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to patient assessment and notification prior to prescribing certain medications.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Carole A. Fiola6th Bristol1/11/2023Brian W. Murray10th Worcester1/25/2023Paul A. Schmid, III8th Bristol2/1/2023Vanna Howard17th Middlesex2/1/2023Paul McMurtry11th Norfolk2/15/2023 1 of 4
HOUSE DOCKET, NO. 3147 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 2164
By Representative Fiola of Fall River, a petition (accompanied by bill, House, No. 2164) of
Carole A. Fiola and others relative to patient assessment and notification prior to prescribing
certain medications. Public Health.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 4814 OF 2021-2022.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
_______________
An Act relative to patient assessment and notification prior to prescribing certain medications.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 1 of chapter 94C of the General Laws, as amended by section 8 of
2chapter 260 of the acts of 2020, is hereby amended by inserting after the definition of “Agent”
3the following definition:-
4 “Benzodiazepine”, any substance or drug that: (i) contains a benzene ring fused to a 7
5member diazepine ring; (ii) results in the depression of the central nervous system; (iii) is
6primarily intended to treat insomnia, convulsions and anxiety; and (iv) is used for muscle
7relaxation and pre-operation treatment, including alprazolam, clonazepam, diazepam, lorazepam
8and temazepam. 2 of 4
9 SECTION 2. Said section 1 of said chapter 94C, as so amended, is hereby further
10amended by inserting after the definition of “Narcotic drug” the following definition:-
11 “Non-benzodiazepine hypnotic”, any substance or drug that produces effects similar to
12that of a benzodiazepine and is primarily intended to treat insomnia, including zaleplon,
13zopiclone and zolpidem.
14 SECTION 3. Section 18A of said chapter 94C, as appearing in the 2018 Official Edition,
15is hereby amended by striking out subsection (a) and inserting in place thereof the following
16subsection:-
17 (a) Prior to prescribing an extended-release long-acting opioid in a non-abuse deterrent
18form for outpatient use for the first time, a practitioner registered under section 7, not including
19veterinarians, shall conduct a review with a patient, and if the patient is a minor, the patient’s
20parent or legal guardian, including: (i) an evaluation of the patient's current condition, risk
21factors, history of mental health or substance use disorder, if any, and whether the patient has
22taken or is currently taking medication to treat said disorder; (ii) an assessment of alternative
23treatments that may be available; and (iii) a discussion with the patient and, if the patient is a
24minor, the patient’s parent or legal guardian, of the risks associated with the medication,
25including, but not limited to the risks of addiction and overdose associated with opioid drugs.
26Following the review the practitioner, not including veterinarians, shall, in a form prescribed by
27the commissioner, obtain the patient’s written informed consent, and, if the patient is a minor,
28the written informed consent of the patient’s parent or legal guardian for the prescription of an
29extended-release long-acting opioid. The form shall be written in a manner designed to permit a
30person unfamiliar with medical terminology to understand its purpose and content, and shall 3 of 4
31include information regarding: (i) misuse and abuse of opioids by adults and children; (ii) risk of
32dependency and addiction; and (iii) risks associated with long-term use of the medication.
33 SECTION 4. Said chapter 94C is hereby amended by inserting after said section 18A the
34following section:-
35 Section 18A1/2. Prior to prescribing a benzodiazepine or a non-benzodiazepine hypnotic
36for the first time, a practitioner registered under section 7, not including veterinarians, shall
37conduct a review with a patient, and if the patient is a minor, the patient’s parent or legal
38guardian, including: (i) an evaluation of the patient's current condition, risk factors, history of
39mental health or substance use disorder, if any, and whether the patient has taken or is currently
40taking medication to treat said disorder; (ii) an assessment of alternative treatments that may be
41available; and (iii) a discussion with the patient and, if the patient is a minor, the patient’s parent
42or legal guardian, of the risks associated with the medication. Following the review, the
43practitioner, not including veterinarians, shall, in a form prescribed by the commissioner, obtain
44the patient’s written informed consent, and, if the patient is a minor, the written informed consent
45of the patient’s parent or legal guardian for the prescription of a benzodiazepine or non-
46benzodiazepine hypnotic. The form shall be written in a manner designed to permit a person
47unfamiliar with medical terminology to understand its purpose and content and shall include
48information regarding: (i) misuse and abuse of benzodiazepines and non-benzodiazepine
49hypnotics by adults and children; (ii) risk of dependency and addiction; and (iii) risks associated
50with long-term use of the medication.
51 SECTION 5. Said chapter 94C is hereby further amended by striking out section 18C and
52inserting in place thereof the following section:- 4 of 4
53 Section 18C. Prior to prescribing an opioid contained in Schedule II or any other opioid
54pain reliever for the first time, a practitioner registered under section 7, not including
55veterinarians, shall conduct a review with a patient, and if the patient is a minor, the patient’s
56parent or legal guardian, including: (i) an evaluation of the patient's current condition, risk
57factors, history of mental health or substance use disorder, if any, and whether the patient has
58taken or is currently taking medications to treat any such disorders; (ii) an assessment of
59alternative treatments that may be available; and (iii) a discussion with the patient and, if the
60patient is a minor, the patient’s parent or legal guardian, of the risks associated with the
61medication, including, but not limited to the risks of addiction and overdose associated with
62opioid drugs. Prior to issuing a third prescription for an opioid contained in Schedule II or any
63other opioid to a patient, the practitioner, not including veterinarians, shall conduct another
64review with the patient, and if the patient is a minor, the patient’s parent or legal guardian,
65including: (i) an assessment of alternative treatments that may be available; and (ii) a discussion
66with the patient and, if the patient is a minor, the patient’s parent or legal guardian, of the risks
67associated with the medication, including but not limited to the risks of addiction and overdose
68associated with opioid drugs. Following each review, the practitioner, not including
69veterinarians, shall, in a form to be prescribed by the commissioner, obtain the patient’s written
70informed consent, and, if the patient is a minor, the written informed consent of the patient’s
71parent or legal guardian. This form shall be written in a manner designed to permit a person
72unfamiliar with medical terminology to understand its purpose and content and shall include
73information regarding: (i) misuse and abuse of opioids by adults and children; (ii) risk of
74dependency and addiction; and (iii) risks associated with long-term use of the medication.