June 28,  2021

Washington, DC — Representatives John Curtis (R-UT) joined Reps. Tom O’Halleran (D-AZ), David B. McKinley (R-WV),  and Lisa Blunt Rochester (D-DE), to introduce the bipartisan Non-Opioid Directive (NOD) Act, which would allow patients to notify health professionals that they do not wish to be treated with opioids. 

“There’s no question Congress must keep addressing the growing opioid crisis across the US. The COVID-19 pandemic has left many socially isolated and without access to adequate behavioral health care or addiction treatment services,” said Curtis. “Equally as important is focusing on preventing addiction altogether, which is why I’m proud to support the Non-Opioid Directive Act. This commonsense legislation gives patients better control of their health care by giving them the ability to decline the use of opiates for all future health care needs. I look forward to working across the aisle to getting this important legislation signed into law.”


The COVID-19 pandemic has just exacerbated this, with an expected 30% increase in overdose deaths, estimating they could exceed over 90,000 for 2020. These deaths are primarily driven by opioids and synthetic-opioids such as fentanyl. 

According to the National Institute on Drug Abuse, nearly 50,000 people in the U.S. died from opioid involved overdoses in 2019. That same year, an estimated 10 million people misused prescription pain killers. The CDC estimates that the total “economic burden” of prescription opioid misuse alone in the U.S. is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal involvement. 

Key highlights of the legislation below:

  • Instructs the Department of Health and Human Services (HHS) to develop a non-opioid Pain Management Directive that will be included in a patient’s medical record.
  • It is voluntary. An individual may revoke a non-opioid pain management form executed by themselves at any time and in any manner. A guardian or patient advocate may also revoke the form for a minor at any time and in any manner.
  • Requires each group health plan or health insurance issuer to make the form available to each enrollee; and requires each group health plan or health insurance issuer to include a notice of the individual’s choice for non-opioid pain management to healthcare providers.
  • Requires group health plans and health insurance issuers to provide a copy of the non-opioid pain management form during annual enrollment, specifically asking the individual to opt-in or opt-out.
  • Allows an exception for providers to override the directive in the event a patient is receiving emergency treatment or receiving the opioid during surgery; and in the treating healthcare professional’s opinion, after due consideration of other options and inquiring about a history of opioid use, the administration of the opioid is medically necessary. 
  • The legislation extends full liability protections (criminal and civil) for providers who mistakenly administer an opioid when a patient has signed a directive or for failing to administer or prescribe an opioid.

To read the NOD Act bill text, click here.

To read the NOD Act one pager, click here.