This year, Connecticut and Alaska became two of the latest U.S. states to weigh legislation that would allow patients to say no to opioid prescriptions in any health care setting, including emergency rooms and specialists’ office. The laws are designed to help people in recovery avoid an unintended relapse and to allow others to explicitly opt out of treatment with the powerful painkillers to avoid the risk of addiction, the Associated Press reports.

While patients typically have the right to make decisions about the medical care they receive, advocates of the legislation said so-called non-opioid directives would allow people to formally state in their medical records that they’re not to be prescribed or administered opioid drugs by any health care provider. The proposed law would allow those concerned about the risks of these medications to make their wishes clear about the drugs in advance — of particular importance when a patient becomes incapacitated or unresponsive.

The National Institute on Drug Abuse notes that exposure to drugs is one of the most common triggers for relapse, and the directives are seen as a way to help people in recovery avoid such a trigger in a medical setting. (According to the CDC, today, nearly half of all U.S. opioid overdose deaths involve a prescription opioid.) In Massachusetts and Pennsylvania, similar non-opioid directives were signed into law last year. 

Under the Massachusetts rule, any patient in the state (or the patient’s guardian or health care agent) can sign a one-page form that states: “I am refusing at my own insistence the offer or administration of any opioid medications including an emergency situation where I am unable to speak for myself.” By signing the voluntary form, the person also confirms that he or she understands the risks of refusing the powerful painkillers and releases health care professionals “from any responsibility for all consequences.” 

Pennsylvania’s directive, though already signed into law, is still being developed. 

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