New Mexico Administrative Code › Title 16 - OCCUPATIONAL AND PROFESSIONAL LICENSING › Chapter 10 - MEDICINE AND SURGERY PRACTITIONERS › Part 14 - MANAGEMENT OF PAIN AND OTHER CONDITIONS WITH CONTROLLED SUBSTANCES › Section 16.10.14.9 - REGULATIONS FOR THE APPROPRIATE TREATMENT OF PAIN WITH CONTROLLED SUBSTANCES

Current through Register Vol. 35, No. 13, July 16, 2024
The following regulations shall be used by the board to
				  determine whether a health care practitioner'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 shall be recorded. Prescriptions for opioids shall include
				indications for use. For chronic pain patients treated with controlled
				substance 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 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 pain, the patient's state of health, and any
				new information about the etiology of the chronic pain at least every six
				months. In addition, a practitioner shall consult, when indicated by the
				patient's condition, with health care professionals who are experienced by the
				length and type of their practice in the area of chronic pain control; such
				professionals need not be those who specialize in pain control.
(7) When prescribing opioids for chronic
				pain, practitioners shall require urine drug testing when starting opioid
				therapy and shall use urine drug testing at least every six months to assess
				for prescribed medications as well as other controlled prescription drugs and
				illicit drugs.
(8) 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.