89R4878 CJD-F     By: Bucy H.B. No. 1791       A BILL TO BE ENTITLED   AN ACT   relating to the duties of a prescriber issuing an opioid   prescription to treat acute pain.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  The heading to Section 481.07636, Health and   Safety Code, is amended to read as follows:          Sec. 481.07636.  PRESCRIBING OPIOID FOR ACUTE PAIN;   PRESCRIPTION LIMITS.            SECTION 2.  Section 481.07636, Health and Safety Code, is   amended by adding Subsection (b-1) and amending Subsection (c) to   read as follows:          (b-1)  A prescriber who prescribes an opioid to a person for   the treatment of acute pain shall also prescribe to the person an   opioid antagonist.          (c)  Subsections  [Subsection] (b) and (b-1) do [does] not   apply to a prescription for an opioid approved by the United States   Food and Drug Administration for the treatment of substance   addiction that is issued by a practitioner for the treatment of   substance addiction.          SECTION 3.  Subchapter C, Chapter 481, Health and Safety   Code, is amended by adding Section 481.07637 to read as follows:          Sec. 481.07637.  ALTERNATIVE TREATMENTS FOR ACUTE PAIN. (a)     In this section, "acute pain" has the meaning assigned by Section   481.07636.          (b)  When issuing an opioid prescription for acute pain, a   prescriber shall also consider referring or prescribing any of the   following pain management services to a patient, based on the   prescriber's clinical judgment and the availability of the   treatment:                (1)  chiropractic treatment;                (2)  physical therapies;                (3)  occupational therapies;                (4)  physical medicine and rehabilitation; or                (5)  osteopathic manipulation.          (c)  This section does not require that all of the treatments   under Subsection (b) be exhausted before the patient may receive a   prescription for an opioid.          SECTION 4.  Section 481.003(a), Health and Safety Code, is   amended to read as follows:          (a)  The director may adopt rules to administer and enforce   this chapter, other than Sections 481.074, 481.075, 481.0755,   481.0756, 481.076, 481.0761, 481.0762, 481.0763, 481.07635,   481.07636, 481.07637, 481.0764, 481.0765, 481.0766, 481.0767,   481.0768, and 481.0769.  The board may adopt rules to administer   Sections 481.074, 481.075, 481.0755, 481.0756, 481.076, 481.0761,   481.0762, 481.0763, 481.07635, 481.07636, 481.07637, 481.0764,   481.0765, 481.0766, 481.0767, 481.0768, and 481.0769.          SECTION 5.  Section 554.051(a-1), Occupations Code, is   amended to read as follows:          (a-1)  The board may adopt rules to administer Sections   481.074, 481.075, 481.0755, 481.0756, 481.076, 481.0761, 481.0762,   481.0763, 481.07635, 481.07636, 481.07637, 481.0764, 481.0765,   481.0766, 481.0767, 481.0768, and 481.0769, Health and Safety Code.          SECTION 6.  Section 565.003, Occupations Code, as amended by   Chapters 1105 (H.B. 2174) and 1166 (H.B. 3284), Acts of the 86th   Legislature, Regular Session, 2019, is reenacted to read as   follows:          Sec. 565.003.  ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING   APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE.  Unless   compliance would violate the pharmacy or drug statutes or rules in   the state in which the pharmacy is located, the board may discipline   an applicant for or the holder of a nonresident pharmacy license if   the board finds that the applicant or license holder has failed to   comply with:                (1)  Subchapter C, Chapter 481, Health and Safety Code;                (2)  Texas substitution requirements regarding:                      (A)  the practitioner's directions concerning   generic substitution;                      (B)  the patient's right to refuse generic   substitution; or                      (C)  notification to the patient of the patient's   right to refuse substitution;                (3)  any board rule relating to providing drug   information to the patient or the patient's agent in written form or   by telephone; or                (4)  any board rule adopted under Section 554.051(a)   and determined by the board to be applicable under Section   554.051(b).          SECTION 7.  This Act takes effect September 1, 2025.