# West Virginia — State Opioid Initial Prescribing Limits

For West Virginia, initial supply days is seven-day supply; applies to is Schedule II opioid drugs; practitioners 7 days initial, emergency room and urgent care 4 days, minors 3 days, dentists and optometrists 3 days; exception provision is the limitations in this section do not apply to cancer patients, patients receiving hospice care from a licensed hospice provider, patients receiving palliative care, a patient who is a resident of a long-term care facility; citation is 16-54-4, recorded from its source on 2026-08-18.

- **state:** West Virginia _(our reading, not quoted from the source)_
- **initial supply days:** seven-day supply _(verified: appears in the quote below)_
- **applies to:** Schedule II opioid drugs; practitioners 7 days initial, emergency room and urgent care 4 days, minors 3 days, dentists and optometrists 3 days _(our reading, not quoted from the source)_
- **exception provision:** the limitations in this section do not apply to cancer patients, patients receiving hospice care from a licensed hospice provider, patients receiving palliative care, a patient who is a resident of a long-term care facility _(verified: appears in the quote below)_
- **citation:** 16-54-4 _(verified: appears in the quote below)_

## What the source says

> (c) A health care practitioner may not issue an initial Schedule II opioid drug prescription to a minor for more than a three-day supply and shall discuss with the parent or guardian of the minor the risks associated with Schedule II opioid drug use and the reasons why the prescription is necessary. (d) A dentist or an optometrist may not issue a Schedule II opioid drug prescription for more than a three-day supply. (e) A practitioner, other than a dentist or an optometrist, may not issue an initial Schedule II opioid drug prescription for more than a seven-day supply. The prescription shall be for the lowest effective dose which in the medical judgement of the practitioner would be the best course of treatment for this patient and his or her condition. (f) Prior to issuing an initial Schedule II opioid drug prescription, a practitioner shall: (1) Take and document the results of a thorough medical history, including the patient’s experience with nonopioid medication, nonpharmacological pain management approaches, and substance abuse history; (2) Conduct, as appropriate, and document the results of a physical examination. The physical exam should be relevant to the specific diagnosis and course of treatment, and should assess whether the course of treatment would be safe and effective for the patient. (3) Develop a treatment plan, with particular attention focused on determining the cause of the patient’s pain; and (4) Access relevant prescription monitoring information under the Controlled Substances Monitoring Program Database. (g) Notwithstanding any provision of this code or legislative rule to the contrary, no medication listed as a Schedule II opioid drug as set forth in §60A-2-206 of this code, may be prescribed by a practitioner for greater than a 30-day supply: Provided, That two additional prescriptions, each for a 30-day period for a total of a 90-day supply, may be prescribed if the practitioner accesses the West Virginia Controlled Substances Monitoring Program Database as set forth in §60A-9-1 et seq. of this code: Provided, however, That the limitations in this section do not apply to cancer patients, patients receiving hospice care from a licensed hospice provider, patients receiving palliative care, a patient who is a resident of a long-term care facility, or a patient receiving medications that are being prescribed for use in the treatment of substance abuse or opioid dependence.

## Source

- https://code.wvlegislature.gov/16-54-4/

Last verified: 2026-08-18. Review by: 2027-08-18.
Part of [State Opioid Initial Prescribing Limits](https://referencesource.org/state-opioid-prescribing-limits/).