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Oklahoma enacts opioid prescribing restrictions

Optum Workers' Comp
| May 08, 2018

Oklahoma’s governor signed Senate Bill 1446 into law on May 2, 2018. This legislation limits initial prescriptions for opioid medications to a 7 day-supply, at the lowest effective, immediate-release dosage. Practitioners may issue subsequent 7 day-supply prescriptions, however, they must provide documentation confirming the medication is necessary and appropriate to a patient’s treatment needs and does not present an undue risk of abuse, addiction or diversion.

Under this law, when prescribing Schedule II controlled substances or any opioid medication, practitioners must meet the following requirements:

  • Document patient’s medical history, including the patient’s history with non-opioid medications and non-pharmacological pain management approaches
  • Develop a treatment plan
  • Discuss risks associated with the prescribed medication(s)
  • Discuss available alternative treatments

When issuing a third prescription for opioid medications, practitioners are required to enter into a pain management agreement with the patient. Additionally, when Schedule II drugs or opioid medications are prescribed for three months or more to treat chronic pain, the practitioner is required to:

  • Review the patient’s progress
  • Assess if the patient is experiencing problems associated with dependence prior to each prescription renewal
  • Review the state’s prescription drug monitoring program database
  • Periodically make reasonable efforts (unless clinically contraindicated) to either halt use of the controlled substance, decrease the dosage or try other drugs or treatment modalities

These new prescribing requirements do not apply to patients in active treatment for cancer, receiving hospice care from a licensed hospice or palliative care, or residing in a long-term care facility. Additionally, patients prescribed medications for substance abuse or opioid dependence are exempt.

This is another great step in addressing the opioid crisis. We will continue monitoring public policy developments on this crucial topic and share updates as they impact the workers’ compensation and auto no-fault markets.

Should you have any questions on this or any other public policy issue, please contact our Government Affairs team at

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