New Mexico Administrative Code › Title 16 - OCCUPATIONAL AND PROFESSIONAL LICENSING › Chapter 16 - OPTOMETRIC PRACTITIONERS › Part 15 - MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES › Section 16.16.15.8 - GUIDELINES

Current through Register Vol. 35, No. 13, July 16, 2024
The following regulations shall be used by the board to
				  determine whether an optometrist's prescriptive practices are consistent with
				  the appropriate treatment of pain.
A.
				The treatment of pain with drugs or controlled substances is a legitimate
				optometric 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) An optometrist shall complete an
				evaluation. 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 for or contra-indication against the use of controlled
				substance.
(2) An optometrist 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
				optometrist 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 optometrist shall discuss the risks
				and benefits of using controlled substances with the patient, his surrogate or
				guardian, and shall document this discussion in the record.
(5) Complete and accurate records of care
				provided and drugs or controlled substances prescribed shall be maintained.
				When controlled substances are prescribed, the name of the drug, quantity,
				prescribed dosage and number of refills authorized shall be recorded.
				Prescriptions for controlled substances shall include indications for
				use.
(6) The management of patients
				needing chronic pain control requires monitoring by the optometrist. The
				optometrist shall periodically review the course of treatment for chronic pain,
				the patient's state of health, and any new information about the etiology of
				the chronic pain at least every six months. Chronic pain patients shall receive
				all chronic pain management prescriptions from one optometrist and one pharmacy
				whenever possible.
(7) In addition,
				an optometrist shall consult, when indicated by the patient's condition, with
				health care professionals who are experienced in the area of chronic pain
				control; such professionals need not be those who specialize in pain
				control.
(8) If, in an
				optometrist's opinion, a patient is seeking pain medication for reasons that
				are not medically justified, the optometrist is not required to prescribe
				controlled substances for the patient.