SECTION 1. Section 18C of Chapter 94C of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by striking the section in its entirety and inserting in place thereof the following new section:-

Prior to issuing the initial prescription of a Schedule II controlled dangerous substance or any other opioid pain reliever which is a prescription drug in a course of treatment for acute or chronic pain and again prior to issuing the third prescription of the course of treatment, a practitioner shall discuss with the patient, or the patient’s parent or guardian if the patient is under 18 years of age and is not an emancipated minor, the risks associated with the drugs being prescribed, including but not limited to: (1) 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; (2) the reasons why the prescription is necessary; (3) alternative treatments that may be available; and (4) risks associated with the use of the drugs being prescribed, that there is a risk of developing a physical or psychological dependence on the controlled dangerous substance, and that the risks of taking more opioids than prescribed, or making sedatives, benzodiazepines or alcohol with opioids, can result in fatal respiratory depression. The practitioner shall include a note in the patient’s medical record that the patient or the patient’s parent or guardian, as applicable, has discussed with the practitioner the risks of developing a physical or psychological dependence on the control dangerous substance and alternative treatments that may be available.

This section shall not apply to a prescription for a patient who is currently in active treatment for cancer, receiving hospice care from a licensed hospice or palliative care, or is a resident of a long term care facility, or to any medications that are being prescribed for use in the treatment of substance abuse or opioid dependence.