S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9010
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              August 13, 2025
                                ___________
 
 Introduced  by  M.  of  A.  ROSENTHAL  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health law, in relation to requiring  practi-
   tioners  to  discuss  certain  risks  with  a  patient  who  is  being
   prescribed a controlled substance or an opioid analgesic

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Subdivision 9 of section 3331 of the public health law, as
 added by chapter 732 of the laws of 2022, is amended to read as follows:
   9. (a) When a patient seeks  treatment  for  any  neuromusculoskeletal
 condition  that  causes  pain, where a practitioner considers [an opioid
 treatment] PRESCRIPTION OF A SCHEDULE II CONTROLLED  SUBSTANCE  FOR  THE
 TREATMENT  OF PAIN OR ANY OTHER OPIOID DRUG WHICH IS A PRESCRIPTION DRUG
 FOR ACUTE  OR  CHRONIC  PAIN  AND  AGAIN  PRIOR  TO  ISSUING  THE  THIRD
 PRESCRIPTION  OF THE COURSE OF TREATMENT, the practitioner shall consid-
 er, discuss with the patient AS SET  FORTH  IN  PARAGRAPH  (B)  OF  THIS
 SUBDIVISION,  and,  as appropriate, refer or prescribe non-opioid treat-
 ment alternatives, based on the  practitioner's  clinical  judgment  and
 following  generally  accepted national professional or treatment guide-
 lines, and consistent with patient preference and consent, before start-
 ing a patient on opioid treatment. For the purposes of this subdivision,
 non-opioid treatment alternatives  include,  but  are  not  limited  to:
 acupuncture,  chiropractic,  massage  therapy, physical therapy, occupa-
 tional therapy, cognitive behavioral  therapy,  non-opioid  medications,
 interventional  treatments and non-clinical activities such as exercise.
 The practitioner shall inform the patient that some treatments  may  not
 be covered by the patient's health coverage.
   (b)  A  PRACTITIONER  SHALL DISCUSS WITH THE PATIENT, OR THE PATIENT'S
 PARENT OR GUARDIAN IF THE PATIENT IS UNDER EIGHTEEN YEARS OF AGE AND  IS
 NOT  AN  EMANCIPATED  MINOR,  THE  RISKS ASSOCIATED WITH THE DRUGS BEING
 PRESCRIBED, INCLUDING BUT NOT LIMITED TO:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11164-01-5
              

 A. 9010                             2
 
   (I) THE RISKS OF ADDICTION AND OVERDOSE ASSOCIATED WITH  OPIOID  DRUGS
 AND THE DANGERS OF TAKING OPIOID DRUGS WITH ALCOHOL, BENZODIAZEPINES AND
 OTHER CENTRAL NERVOUS SYSTEM DEPRESSANTS;
   (II) THE REASONS WHY THE PRESCRIPTION IS NECESSARY;
   (III) ALTERNATIVE TREATMENTS THAT MAY BE AVAILABLE; AND
   (IV)  THE RISKS ASSOCIATED WITH THE USE OF THE DRUGS BEING PRESCRIBED,
 SPECIFICALLY THAT OPIOIDS ARE  HIGHLY  ADDICTIVE,  EVEN  WHEN  TAKEN  AS
 PRESCRIBED,  THAT THERE IS A RISK OF DEVELOPING A PHYSICAL OR PSYCHOLOG-
 ICAL DEPENDENCE ON THE CONTROLLED  SUBSTANCE,  AND  THAT  THE  RISKS  OF
 TAKING  MORE  OPIOIDS  THAN PRESCRIBED, OR MIXING SEDATIVES, BENZODIAZE-
 PINES  OR  ALCOHOL  WITH  OPIOIDS,  CAN  RESULT  IN  FATAL   RESPIRATORY
 DEPRESSION.
   (C)  THE  DEPARTMENT SHALL DEVELOP AND MAKE AVAILABLE TO PRACTITIONERS
 GUIDELINES FOR THE DISCUSSION REQUIRED BY THIS SUBDIVISION.
   (D) The requirements of this subdivision shall not apply for  patients
 being  treated  under  any of the following circumstances:  treatment of
 cancer; hospice or other end-of-life care; post-surgery treatment  imme-
 diately  following a surgical procedure; or in a medical emergency.  For
 purposes of this subdivision, "medical emergency" means an acute  injury
 or illness that poses an immediate risk to a person's life or health.
   §  2.  Paragraph  (a)  of  subdivision 3 of section 3309 of the public
 health law is amended by adding a new  subparagraph  (vii)  to  read  as
 follows:
   (VII) "OPIOID ANALGESICS" MEANS THE MEDICINES BUPRENORPHINE, BUTORPHA-
 NOL,   CODEINE,  HYDROCODONE,  HYDROMORPHONE,  LEVORPHANOL,  MEPERIDINE,
 METHADONE, MORPHINE, NALBUPHINE,  OXYCODONE,  OXYMORPHONE,  PENTAZOCINE,
 PROPOXYPHENE AS WELL AS THEIR BRAND NAMES, ISOMERS AND COMBINATIONS.
   §  3. Subdivision 7 of section 3309 of the public health law, as added
 by chapter 803 of the laws of 2021, is amended to read as follows:
   7. [With] FOR the first OPIOID ANALGESIC prescription [to a particular
 patient] of [an opioid of each] A CALENDAR year THAT IS GREATER  THAN  A
 ONE WEEK'S SUPPLY, for use in a setting other than a general hospital or
 nursing  home  under  article  twenty-eight  of this chapter or facility
 under article thirty-one of the mental hygiene law, or  when  a  practi-
 tioner is prescribing a controlled substance to a patient under the care
 of  hospice as defined by section four thousand two of this chapter, the
 prescriber shall COUNSEL THE PATIENT  ON  THE  RISKS  OF  OVERDOSE,  AND
 prescribe  an  opioid  antagonist when any of the following risk factors
 are present: (a) a history of substance use disorder; (b) high  dose  or
 cumulative prescriptions that result in ninety morphine milligram equiv-
 alents  or higher per day; (c) concurrent use of opioids and benzodiaze-
 pine or nonbenzodiazepine sedative hypnotics.
   § 4. This act shall take effect immediately.