Evidence status: CURRENTLY PUBLISHED PRACTICE POLICY / PAGE UPDATED JUNE 30, 2021. Coastal Virginia Spine & Pain Center continues to publish its Opioid Prescribing Policy on the practice website.
What the policy requires
- Patients receiving long-term opioids must sign the practice’s narcotic agreement.
- The practice uses periodic drug testing and may call patients in for pill counts.
- The policy restricts obtaining pain medication from other physicians and use of multiple pharmacies.
- Lost opioid prescriptions are not replaced.
- Early refills are not provided.
- The practice has a zero-tolerance policy for marijuana use while receiving opioid medication from the practice.
- The policy warns against combining opioids with alcohol or benzodiazepines.
- The practice lists multiple behaviors that may lead to discharge, including medication misuse, outside pain-medication acquisition, multiple-pharmacy use, repeated refill calls, and failed urine testing.
Important current-law mismatch
The live policy states that Virginia law requires drug testing at least once every three months during the first year and every six months thereafter. That was the former Virginia physician rule. Effective January 2, 2025, current 18VAC85-21-100 instead requires testing at initiation and thereafter randomly at the practitioner’s discretion but at least once a year.
Why the distinction matters
A practice may choose to test more frequently than the statewide minimum. The problem is classification: a clinic’s stricter policy should be described as clinic policy, not as the current statewide testing schedule when the regulation has changed.
Sources
Reviewed: October 4, 2026.
Evidence boundary: The clinic page remains live, but some of its description of Virginia’s testing schedule is outdated. This record preserves both the clinic policy and the current rule.