AG announces regulatory actions addressing opioid addiction epidemic

NEWARK, NJ — As part of the state’s ongoing efforts to bring an end to New Jersey’s opioid epidemic and save lives, on Feb. 18 Attorney General Gurbir Grewal announced four actions aimed at preventing fatal overdoses and further increasing the public availability of the opioid antidote naloxone. 

The first action is a final rule recently adopted by the state Board of Medical Examiners, which requires physicians who prescribe opioids for the management of chronic pain to also prescribe naloxone to certain patients who face heightened risk of a fatal overdose.

The three other actions are proposed rules that, if adopted, will impose similar co-prescribing requirements for prescribers licensed by the Board of Dentistry, the Board of Nursing and the Board of Optometrists.

“By requiring the co-prescription of naloxone, we are ensuring that chronic pain patients and their families have ready access to a lifesaving antidote to reverse an opioid overdose,” Grewal said. “The actions announced today are the latest examples of how New Jersey is wielding its regulatory authority as a powerful tool in the fight to end the opioid epidemic and save the lives of New Jersey residents.”

Under the final rule adopted by the BME in January, physicians must co-prescribe naloxone to any patient continuously receiving opioids for chronic pain management if the patient has one or more prescriptions totaling 90 morphine milligram equivalents or more per day, or is concurrently taking an opioid and a benzodiazepine. These patients face heightened risk of a fatal overdose. Those prescribing requirements would also apply to dentists, nurses and optometrists upon the adoption of identical rules proposed by the boards that license those professionals. 

Under both the final and proposed rules, prescribers do not need to co-prescribe an opioid antidote to a patient who is currently actively being treated for cancer, receiving hospice care from a licensed hospice, receiving palliative care or residing in a long-term care facility. Additionally, prescribers do not need to co-prescribe an opioid antidote when prescribing medication for treatment of substance abuse or opioid dependence, and the requirement does not apply to medications being administered pursuant to medication orders in in-patient facilities.

The rules align with co-prescribing requirements temporarily in place under an administrative order issued by the Division of Consumer Affairs in May 2020 to address heightened concerns of fatal overdoses during the COVID-19 emergency.

“The new final rule and rule proposals we are announcing put in place a robust, clear regulatory infrastructure to guide the continued co-prescribing of naloxone to protect the health, safety and welfare of New Jerseyans,” said Kaitlin Caruso, acting director of the Division of Consumer Affairs. “The new rules will remain in effect even after the current health emergency ends, ensuring long-term, broad-based access to this life-saving prescription drug.”

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