Evidence status: CURRENT CONTINUATION AND HIGH-DOSE FRAMEWORK. Nevada imposes additional review requirements once Schedule II-IV controlled-substance treatment for pain continues for 90 consecutive days.

At 90 days

Before continuing the prescription after 90 consecutive days, the practitioner must:

• Require a validated assessment of risk for abuse, dependency, and addiction.
• Conduct an investigation sufficient to determine an evidence-based diagnosis for the cause of pain.
• Meet with the patient in person or by telehealth to review whether continued controlled-substance treatment is medically appropriate.

90 MME and above

If the patient has received 90 morphine milligram equivalents or more per day for 90 days or longer, the practitioner must consider referral to a specialist.

Continuation above 90 MME

If the practitioner continues treatment at 90 MME or more after the required review and referral consideration, the practitioner must create and document a revised treatment plan that includes assessment of the increased risk for adverse outcomes.

Agreement is a separate layer

The 90-day review does not replace the prescription medication agreement. The agreement begins earlier—within 30 days when treatment is intended to continue beyond 30 days—and must still be maintained and updated under §639.23914.

Primary source

• NRS §639.23913

Reviewed: October 4, 2026.