# Virginia — State Opioid Initial Prescribing Limits

For Virginia, initial supply days is 14-day supply; applies to is Opioids for acute pain and subacute pain; exception provision is May exceed 14-day supply if extenuating circumstances are clearly documented in the medical record; mme limit is Practitioner shall carefully consider and document reasons to exceed 50 MME/day; prior to exceeding 120 MME/day, shall document reasonable justification or refer to a pain management specialist; effective date is August 8, 2018, recorded from its source on 2026-08-17.

- **state:** Virginia
- **initial supply days:** 14-day supply _(verified: appears in the quote below)_
- **applies to:** Opioids for acute pain and subacute pain _(our reading, not quoted from the source)_
- **exception provision:** May exceed 14-day supply if extenuating circumstances are clearly documented in the medical record _(verified: appears in the quote below)_
- **mme limit:** Practitioner shall carefully consider and document reasons to exceed 50 MME/day; prior to exceeding 120 MME/day, shall document reasonable justification or refer to a pain management specialist _(our reading, not quoted from the source)_
- **effective date:** August 8, 2018 _(verified: appears in the quote below)_
- **citation:** 18VAC85-21-40 _(verified: appears in the quote below)_

## What the source says

> A prescriber providing treatment for acute or subacute pain shall not prescribe a controlled substance containing an opioid in a quantity that exceeds a 14-day supply, unless extenuating circumstances are clearly documented in the medical record.

## Source

- https://law.lis.virginia.gov/admincode/title18/agency85/chapter21/section40/

Last verified: 2026-08-17. Review by: 2027-08-17.
Part of [State Opioid Initial Prescribing Limits](https://referencesource.org/state-opioid-prescribing-limits/).