Lawmakers hear bill to create non-opioid directive form so patients can opt out of opioid prescriptions

The Senate Committee on Early Childhood and Behavioral Health held a public hearing Wednesday on House Bill 3211A, which would require the Oregon Health Authority to develop a publicly available non-opioid directive form and provide specified civil and criminal immunity for individuals who do not prescribe or administer opioids based on a completed non-opioid directive.

Representative Emerson Levy, the chief sponsor, told the committee the directive is a voluntary form modeled on Michigan's program and intended to give patients an opportunity to record a preference not to receive opioid prescriptions. "In my dreams it would just be on the EPIC system," Levy said, describing a desired future state where the preference appears in a patient's electronic medical record. She said the form is revocable at any time and is aimed at preventing first opioid prescriptions that can lead to later dependence.

Levy emphasized the directive targets patients not in hospice or similar settings and said the form is meant to facilitate conversations about opioid risk outside the "heat of the moment." She told the committee, "a huge amount of fentanyl and heroin addiction start with the first prescription," and said the directive can help avoid that trajectory when appropriate. Committee members and other legislators expressed support for the concept and for tools that make patient preferences easier to document across care settings; one senator said a form can give patients "a backup to your voice" in clinical encounters.

Committee staff described the bill as requiring OHA to develop the form in electronic format and setting out the immunity language. No formal motion or committee vote occurred on HB 3211A during the hearing. The hearing was closed; the committee indicated it may take the bill up at a later work session.