New Mexico Administrative Code › Title 16 - OCCUPATIONAL AND PROFESSIONAL LICENSING › Chapter 17 - OSTEOPATHIC MEDICINE AND SURGERY PRACTITIONERS › Part 4 - PRESCRIBING AND DISTRIBUTION OF CONTROLLED SUBSTANCES › Section 16.17.4.8 - GUIDELINES

Current through Register Vol. 35, No. 13, July 16, 2024
The following regulations shall be used by the board to
				  determine whether an osteopathic physician's or osteopathic physician
				  assistant's prescriptive practices are consistent with the appropriate
				  treatment of pain.
A. The treatment of
				pain with various medicines or controlled substances is a legitimate medical
				practice when accomplished in the usual course of professional practice. It
				does not preclude treatment of patients with addiction, physical dependence or
				tolerance who have legitimate pain. However, such patients do require very
				close monitoring and precise documentation.
B. The prescribing, ordering, administering
				or dispensing of controlled substances to meet the individual needs of the
				patient for management of chronic pain is appropriate if prescribed, ordered,
				administered or dispensed in compliance with the following.
(1) A practitioner shall complete a physical
				examination and include an evaluation of the patient's psychological and pain
				status. The medical history shall include any previous history of significant
				pain, past history of alternate treatments for pain, potential for substance
				abuse, coexisting disease or medical conditions, and the presence of a medical
				indication or contra-indication against the use of controlled
				substances.
(2) A practitioner
				shall be familiar with and employ screening tools as appropriate, as well as
				the spectrum of available modalities, in the evaluation and management of pain.
				The practitioner shall consider an integrative approach to pain
				management.
(3) A written treatment
				plan shall be developed and tailored to the individual needs of the patient,
				taking age, gender, culture, and ethnicity into consideration, with stated
				objectives by which treatment can be evaluated, e.g. by degree of pain relief,
				improved physical and psychological function, or other accepted measure. Such a
				plan shall include a statement of the need for further testing, consultation,
				referral or use of other treatment modalities.
(4) The practitioner shall discuss the risks
				and benefits of using controlled substances with the patient, or surrogate, or
				guardian, and shall document this discussion in the record.
(5) Complete and accurate records of care
				provided and drugs prescribed shall be maintained. When controlled substances
				are prescribed, the name of the drug, quantity, prescribed dosage and number of
				refills authorized should be recorded. Prescriptions for opioids shall include
				indications for use. For chronic non-cancer pain patients treated with
				controlled substance and analgesic(s), the prescribing practitioner shall use a
				written agreement for treatment with the patient outlining patient
				responsibilities. As part of a written agreement, chronic non-cancer pain
				patients shall receive all chronic pain management prescriptions from one
				practitioner and one pharmacy whenever possible.
(6) The management of patients needing
				chronic pain control requires monitoring by the attending or the consulting
				practitioner. The practitioner shall periodically review the course of
				treatment for chronic non-cancer pain, the patient's state of health, and any
				new information about the etiology of the chronic non-cancer pain at least
				every six months. In addition, a practitioner shall consult, when indicated by
				the patient's condition, with a clinical pain expert. Consultation should occur
				early in the course of long-term treatment and at reasonable intervals during
				continued long-term treatment for assessment of benefit and need a minimum of
				once every six months.
(7) If, in a
				practitioner's medical opinion, a patient is seeking pain medication for
				reasons that are not medically justified, the practitioner is not required to
				prescribe controlled substances for the patient.