Evidence status: DOCUMENTED LEGISLATIVE ORIGIN. Massachusetts created the current statewide long-acting-opioid treatment-agreement mandate in Chapter 52 of the Acts of 2016.
Chapter 52 of the Acts of 2016
Section 23 added M.G.L. c.94C §18A as part of Massachusetts’ 2016 substance-use treatment, education, and prevention legislation.
What §18A added
The new section required additional evaluation before the first outpatient prescription of an extended-release long-acting opioid in a non-abuse-deterrent form and required a written pain-management treatment agreement when an extended-release or long-acting opioid is used during long-term pain management.
Medical-record requirement
The 2016 law required the agreement to be filed in the patient’s medical record or electronic health record.
Other measures in the same legislation
Chapter 52 also expanded prescriber education, established a voluntary non-opiate directive, changed opioid-prescribing and monitoring policy, and created other prevention and treatment measures.
Earlier professional rules
Massachusetts professional boards had already adopted narrow hydrocodone-only extended-release agreement rules in 2014. The 2016 statute added a separate statewide statutory layer for extended-release or long-acting opioids in long-term pain management.
Why origin matters
The core §18A mandate is statutory. Removing it requires legislative amendment rather than solely changing a licensing-board regulation or clinical guideline.
Primary source
Reviewed: October 4, 2026.