McKinley, Blunt Rochester, Curtis, and O’Halleran Introduce Bipartisan Legislation to Empower Patients to Take Control of their Pain Treatment

Bipartisan Bill Allows Patients to Choose Non-Opioids

Washington, D.C. - Today, Reps. David B. McKinley (R-W.Va), Lisa Blunt Rochester (D-DE), John Curtis (R-UT), and Tom O’Halleran (D-AZ) introduced the bipartisan Non-Opioid Directive (NOD) Act, which would allow patients to notify health professionals that they do not wish to be treated with opioids.

“The opioid epidemic has impacted the lives of nearly every West Virginian family, and throughout the pandemic it has only gotten worse,” said McKinley. “Our bipartisan bill will help patients take control of their pain treatment by giving them the ability to choose alternatives to opioids. While pain management for all patients should be handled between a patient and medical professional, opioids should not be the first or only option given.”

“The opioid epidemic has devastated Delaware communities and solving this crisis will require a comprehensive strategy. I’m proud to join with my colleagues in a bipartisan way to give doctors and patients additional tools to discuss pain management and find solutions that work best for them,” said Rep. Blunt Rochester.

“There's no question Congress must keep addressing the growing opioid crisis across the US. The COVID-19 pandemic has left many socially isolated and without access to adequate behavioral health care or addiction treatment services,” said Rep. Curtis. “Equally as important is focusing on preventing addiction altogether, which is why I'm proud to support the Non-Opioid Directive Act. This commonsense legislation gives patients better control of their health care by giving them the ability to decline the use of opiates for all future health care needs. I look forward to working across the aisle to getting this important legislation signed into law.”

“Beneath the COVID-19 pandemic, the opioid epidemic has raged on, harming communities in their entireties and taking too many of our children, loved ones, and neighbors. Our bipartisan bill empowers both patients and doctors to opt out of opioid prescriptions should they choose, enabling more Americans at risk of or in recovery from addiction to avoid potentially harmful situations,” said Rep. O’Halleran.

“Voices for Non-Opioid Choices (Voices) believes all patients should have access to safe, innovative non-opioid pain management options,” said Chris Fox, Executive Director, Voices for Non-Opioid Choices. “Voices applauds Representative McKinley for introducing legislation that would enable patients to create a non-opioid plan, which will be part of their medical record, so they can notify providers that they do not want opioids. With over 70,000 Americans dying last year from an opioid overdose, we must use all tools available to limit the amount of opioids in our communities.”


The COVID-19 pandemic has just exacerbated this, with an expected 30% increase in overdose deaths, estimating they could exceed over 90,000 for 2020. These deaths are primarily driven by opioids and synthetic-opioids such as fentanyl.

According to the National Institute on Drug Abuse, nearly 50,000 people in the U.S. died from opioid involved overdoses in 2019. That same year, an estimated 10 million people misused prescription pain killers. The CDC estimates that the total “economic burden” of prescription opioid misuse alone in the U.S. is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal involvement.

Key highlights of the legislation below:

  • Instructs the Department of Health and Human Services (HHS) to develop a non-opioid Pain Management Directive that will be included in a patient’s medical record.


  • It is voluntary. An individual may revoke a non-opioid pain management form executed by themselves at any time and in any manner. A guardian or patient advocate may also revoke the form for a minor at any time and in any manner.


  • Requires each group health plan or health insurance issuer to make the form available to each enrollee; and requires each group health plan or health insurance issuer to include a notice of the individual’s choice for non-opioid pain management to healthcare providers.


  • Requires group health plans and health insurance issuers to provide a copy of the non-opioid pain management form during annual enrollment, specifically asking the individual to opt-in or opt-out.


  • Allows an exception for providers to override the directive in the event a patient is receiving emergency treatment or receiving the opioid during surgery; and in the treating healthcare professional’s opinion, after due consideration of other options and inquiring about a history of opioid use, the administration of the opioid is medically necessary.


  • The legislation extends full liability protections (criminal and civil) for providers who mistakenly administer an opioid when a patient has signed a directive or for failing to administer or prescribe an opioid.


Last month, McKinley introduced legislation that would remove barriers to non-opioid pain management by offering alternatives to highly addictive opioids. To read more about the NOPAIN Act, click here.

To read the NOD Act bill text, click here.

To read the NOD Act one pager, click here.

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