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HB 737

Public Health - Nonopioid Advance Directives

2025 Regular Session Introduced by Heather Bagnall Tudball

Maryland bill creates legal advance directives allowing patients to refuse opioid pain management, binding providers to honor these preferences except during medical emergencies.

Hearing 2/19 at 1:00 p.m.
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Bill Summary · HB 737

Legislative bill overview

HB 737 establishes a framework for "nonopioid advance directives" in Maryland, allowing patients to prospectively document their preference to receive pain management without opioid medications. The bill would create legal recognition and medical provider obligations to respect these directives in clinical settings.

Why is this important

The opioid crisis has created legitimate concerns about overprescribing, yet some patients genuinely need effective pain management options. This bill addresses a tension in healthcare: respecting patient autonomy over treatment while ensuring providers have flexibility to address medical emergencies. It reflects growing interest in alternative pain management approaches and patient-centered decision-making.

Potential points of contention

  • Medical necessity exceptions: Unclear whether advance directives would be binding during emergencies (e.g., post-surgical pain, acute injury) when nonopioid alternatives may be insufficient, potentially creating liability concerns for providers
  • Alternative pain management access: The bill's effectiveness depends on whether Maryland has adequate infrastructure for nonopioid pain management (physical therapy, medication alternatives, palliative care), which may be limited or unevenly available
  • Implementation burden: Healthcare providers may face documentation and compliance costs, and questions remain about how directives interact with existing medical records systems and liability frameworks

Compiled from official sources — confirm details with the bill’s official record.

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