New Opioid Regulations for Tennessee

Released: 07/01/2018   By: Heidi Dufrene, PharmD

Starting July 1, 2018, several new regulations went into effect for the State of Tennessee. The “TN Together” legislation is aimed at the state’s opioid epidemic and is a comprehensive plan to address opioid abuse. Although the legislation took effect July 1st, it will not be mandated until January 1, 2019. This will allow pharmacies time to update software regarding the reporting of controlled substances. The legislation focuses on three main components: prevention, treatment, and law enforcement.

Prevention focuses on placing reasonable limits on supply and dosage of prescription opioids. An initial opioid prescription is limited to a three-day supply and 180 MME total dosage. Prescriptions for more than three days have further restrictions, including the documentation of ICD-10 codes for the primary diagnosed condition. Prescribers will also be required to obtain informed consent to ensure patients understand the risks involved with opioid treatment. There are exceptions for certain situations, including palliative cancer treatment, hospice care, and chronic pain.

Treatment focuses on ensuring that Tennesseans have better access to recovery services and resources, including individuals in the criminal justice system. The regulation also involves creation of a statewide treatment collaborative to serve those struggling with opioid addiction. The state will receive an increase in funding of more than $25 million for these increased services.

Law Enforcement focuses on increased funding to aid in preventing the unlawful sale and trafficking of opioids. The legislation also increases the availability of Narcan by having all state troopers carry the medication for use in opioid overdoses.

Also effective July 1, 2018 in Tennessee, all gabapentin products are Schedule V controlled substances. This will limit the number of refills allowed on gabapentin prescriptions to a maximum of five and pharmacies must report gabapentin dispensing to the state database daily. Gabapentin products include Neurontin, Horizant, Gralise, and Fanatrex.

For further information about the TN Together legislation, see the following website: