{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-2-309i","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-2-309I","heading":"Prescription limits and rules for opioid drugs – Copay","body":"and other insurance requirements – Informed consent process.\n\nA. A practitioner shall not issue an initial prescription for\n\nan opioid drug in a quantity exceeding a seven-day supply for\n\ntreatment of acute pain. Any opioid prescription for acute pain\n\nshall be for the lowest effective dose of an immediate-release drug.\n\nB. Prior to issuing an initial prescription for an opioid drug\n\nin a course of treatment for acute or chronic pain, a practitioner\n\nshall:\n\n1. Take and document the results of a thorough medical history,\n\nincluding the experience of the patient with nonopioid medication\n\nand nonpharmacological pain-management approaches and substance\n\nabuse history;\n\n2. Conduct, as appropriate, and document the results of a\n\nphysical examination;\n\n3. Develop a treatment plan with particular attention focused\n\non determining the cause of pain of the patient;\n\n4. Access relevant prescription monitoring information from the\n\ncentral repository pursuant to Section 2-309D of this title;\n\n5. Limit the supply of any opioid drug prescribed for acute\n\npain to a duration of no more than seven (7) days as determined by\n\nthe directed dosage and frequency of dosage; provided, however, upon\n\nissuing an initial prescription for acute pain pursuant to this\n\nsection, the practitioner may issue one (1) subsequent prescription\n\nfor an opioid drug in a quantity not to exceed seven (7) days if:\n\na. the subsequent prescription is due to a major surgical\n\nprocedure or \"confined to home\" status as defined in\n\n42 U.S.C., Section 1395n(a),\n\nb. the practitioner provides the subsequent prescription\n\non the same day as the initial prescription,\n\nc. the practitioner provides written instructions on the\n\nsubsequent prescription indicating the earliest date\n\non which the prescription may be filled, otherwise\n\nknown as a \"do not fill until\" date, and\n\nd. the subsequent prescription is dispensed no more than\n\nfive (5) days after the \"do not fill until\" date\n\nindicated on the prescription;\n\n6. In the case of a patient under the age of eighteen (18)\n\nyears, enter into a patient-provider agreement with a parent or\n\nguardian of the patient; and\n\n7. In the case of a patient who is a pregnant woman, enter into\n\na patient-provider agreement with the patient.\n\nC. No less than seven (7) days after issuing the initial\n\nprescription pursuant to subsection A of this section, the\n\npractitioner, after consultation with the patient, may issue a\n\nsubsequent prescription for the drug to the patient in a quantity\n\nnot to exceed seven (7) days, provided that:\n\n1. The subsequent prescription would not be deemed an initial\n\nprescription under this section;\n\n2. The practitioner determines the prescription is necessary\n\nand appropriate to the treatment needs of the patient and documents\n\nthe rationale for the issuance of the subsequent prescription; and\n\n3. The practitioner determines that issuance of the subsequent\n\nprescription does not present an undue risk of abuse, addiction or\n\ndiversion and documents that determination.\n\nD. Prior to issuing the initial prescription of an opioid drug\n\nin a course of treatment for acute or chronic pain and again prior\n\nto issuing the third prescription of the course of treatment, a\n\npractitioner shall discuss with the patient or the parent or\n\nguardian of the patient if the patient is under eighteen (18) years\n\nof age and is not an emancipated minor, the risks associated with\n\nthe drugs being prescribed, including but not limited to:\n\n1. The risks of addiction and overdose associated with opioid\n\ndrugs and the dangers of taking opioid drugs with alcohol,\n\nbenzodiazepines and other central nervous system depressants;\n\n2. The reasons why the prescription is necessary;\n\n3. Alternative treatments that may be available; and\n\n4. Risks associated with the use of the drugs being prescribed,\niction and overdose associated with opioid\n\ndrugs and the dangers of taking opioid drugs with alcohol,\n\nbenzodiazepines and other central nervous system depressants;\n\n2. The reasons why the prescription is necessary;\n\n3. Alternative treatments that may be available; and\n\n4. Risks associated with the use of the drugs being prescribed,\n\nspecifically that opioids are highly addictive, even when taken as\n\nprescribed, that there is a risk of developing a physical or\n\npsychological dependence on the controlled dangerous substance, and\n\nthat the risks of taking more opioids than prescribed or mixing\n\nsedatives, benzodiazepines or alcohol with opioids can result in\n\nfatal respiratory depression.\n\nThe practitioner shall include a note in the medical record of\n\nthe patient that the patient or the parent or guardian of the\n\npatient, as applicable, has discussed with the practitioner the\n\nrisks of developing a physical or psychological dependence on the\n\ncontrolled dangerous substance and alternative treatments that may\n\nbe available. The applicable state licensing board of the\n\npractitioner shall develop and make available to practitioners\n\nguidelines for the discussion required pursuant to this subsection.\n\nE. At the time of the issuance of the third prescription for an\n\nopioid drug, the practitioner shall enter into a patient-provider\n\nagreement with the patient.\n\nF. When an opioid drug is continuously prescribed for three (3)\n\nmonths or more for chronic pain, the practitioner shall:\n\n1. Review, at a minimum of every three (3) months, the course\n\nof treatment, any new information about the etiology of the pain,\n\nand the progress of the patient toward treatment objectives and\n\ndocument the results of that review;\n\n2. In the first year of the patient-provider agreement, assess\n\nthe patient prior to every renewal to determine whether the patient\n\nis experiencing problems associated with an opioid use disorder as\n\ndefined by the American Psychiatric Association and document the\n\nresults of that assessment. Following one (1) year of compliance\n\nwith the patient-provider agreement, the practitioner shall assess\n\nthe patient at a minimum of every six (6) months;\n\n3. Periodically make reasonable efforts, unless clinically\n\ncontraindicated, to either stop the use of the controlled substance,\n\ndecrease the dosage, try other drugs or treatment modalities in an\n\neffort to reduce the potential for abuse or the development of an\n\nopioid use disorder as defined by the American Psychiatric\n\nAssociation and document with specificity the efforts undertaken;\n\n4. Review the central repository information in accordance with\n\nSection 2-309D of this title; and\n\n5. Monitor compliance with the patient-provider agreement and\n\nany recommendations that the patient seek a referral.\n\nG. 1. Any prescription for acute pain pursuant to this section\n\nshall have the words \"acute pain\" notated on the face of the\n\nprescription by the practitioner.\n\n2. Any prescription for chronic pain pursuant to this section\n\nshall have the words \"chronic pain\" notated on the face of the\n\nprescription by the practitioner.\n\nH. This section shall not apply to a prescription for a\n\npatient:\n\n1. Who has sickle cell disease;\n\n2. Who is in treatment for cancer or receiving aftercare cancer\n\ntreatment;\n\n3. Who is receiving hospice care from a licensed hospice;\n\n4. Who is receiving palliative care in conjunction with a\n\nserious illness;\n\n5. Who is a resident of a long-term care facility; or\n\n6. For any medications that are being prescribed for use in the\n\ntreatment of substance abuse or opioid dependence.\n\nI. Every policy, contract or plan delivered, issued, executed\n\nor renewed in this state, or approved for issuance or renewal in\n\nthis state by the Insurance Commissioner, and every contract\n\npurchased by the Employees Group Insurance Division of the Office of\nterm care facility; or\n\n6. For any medications that are being prescribed for use in the\n\ntreatment of substance abuse or opioid dependence.\n\nI. Every policy, contract or plan delivered, issued, executed\n\nor renewed in this state, or approved for issuance or renewal in\n\nthis state by the Insurance Commissioner, and every contract\n\npurchased by the Employees Group Insurance Division of the Office of\n\nManagement and Enterprise Services, on or after November 1, 2018,\n\nthat provides coverage for prescription drugs subject to a\n\ncopayment, coinsurance or deductible shall charge a copayment,\n\ncoinsurance or deductible for an initial prescription of an opioid\n\ndrug prescribed pursuant to this section that is either:\n\n1. Proportional between the cost sharing for a thirty-day\n\nsupply and the amount of drugs the patient was prescribed; or\n\n2. Equivalent to the cost sharing for a full thirty-day supply\n\nof the drug, provided that no additional cost sharing may be charged\n\nfor any additional prescriptions for the remainder of the thirty-day\n\nsupply.\n\nJ. Any practitioner authorized to prescribe an opioid drug\n\nshall adopt and maintain a written policy or policies that include\n\nexecution of a written agreement to engage in an informed consent\n\nprocess between the prescribing practitioner and qualifying opioid\n\ntherapy patient. For the purposes of this section, \"qualifying\n\nopioid therapy patient\" means:\n\n1. A patient requiring opioid treatment for more than three (3)\n\nmonths;\n\n2. A patient who is prescribed benzodiazepines and opioids\n\ntogether for more than one twenty-four-hour period; or\n\n3. A patient who is prescribed a dose of opioids that exceeds\n\none hundred (100) morphine equivalent doses.\n\nK. Nothing in the Anti-Drug Diversion Act shall be construed to\n\nrequire a practitioner to limit or forcibly taper a patient on\n\nopioid therapy. The standard of care requires effective and\n\nindividualized treatment for each patient as deemed appropriate by\n\nthe prescribing practitioner without an administrative or codified\n\nlimit on dose or quantity that is more restrictive than approved by\n\nthe Food and Drug Administration (FDA).","path":["OK Code","Title 63"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"a71b2c0994402150d4e94b41aed95ca8f4c37aa03a8f4901ccd3ec11dd2f8359","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-2-309h","next":"us-ok/okla.-stat.-tit.-63-63-2-310"},"notice":"GroundRules: Original legal text. Not legal advice."}