Evidence status: CURRENT PRESCRIBER-EDUCATION REQUIREMENT. Massachusetts requires controlled-substance prescribers, except veterinarians, to complete pain-management and opioid-risk education as a condition of professional licensure or renewal.
Required education subjects
M.G.L. c.94C §18(e) requires education addressing:
- Effective pain management.
- Available non-opioid alternatives.
- Advantages and disadvantages of non-opioid alternatives in light of substance-misuse risk.
- Referral or prescribing options for non-opioid alternatives based on clinical judgment, generally accepted guidelines, patient preference, and consent.
- Risks of opioid misuse and addiction.
- Identification of patients at risk for substance misuse.
- Counseling on side effects, risks, addictive nature, storage, and disposal.
- Appropriate prescription quantities.
- Opioid antagonists and overdose prevention.
Non-opioid alternatives defined broadly
The statute identifies non-opioid treatment alternatives as including medications, restorative therapies, interventional procedures, behavioral-health approaches, and complementary or integrative treatments.
Professional-board implementation
Each professional licensing board subject to the requirement develops appropriate training standards in consultation with the Department of Public Health and pain-management stakeholders.
Relationship to treatment agreements
This education requirement does not itself require a patient to sign a pain contract. It shapes prescriber competency and counseling obligations and should remain separate from §18A’s written-agreement mandate.
Primary source
Reviewed: October 4, 2026.