New Mexico Administrative Code › Title 16 - OCCUPATIONAL AND PROFESSIONAL LICENSING › Chapter 5 - DENTISTRY (DENTISTS, DENTAL HYGIENISTS, ETC.) › Part 57 - MANAGEMENT OF PAIN WITH CONTROLLED SUBSTANCES › Section 16.5.57.8 - GUIDELINES

Current through Register Vol. 35, No. 13, July 16, 2024
The following regulations shall be used by the board to
				  determine whether a dentist's prescriptive practices as consistent with the
				  appropriate treatment of pain.
A. The
				treatment of pain with drugs or controlled substances is a legitimate dental
				practice when accomplished in the usual course of professional practice. It
				does not preclude treatment of patients with addicition, 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 or 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 dentist 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) A dentist 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
				dentist 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 dentist 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 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 dentist. The dentist
				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 dentist and one pharmacy
				whenever possible.
(7) In addition,
				a dentist 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 specilize in pain control.
(8) If, in a dentist's opinion, a patient is
				seeking pain medication for reasons that are not medically justified, the
				dentist is not required to prescribe controlled substances for the
				patient.
(9) A dentist who
				prescribes, distributes or dispenses an opioid analgesic for the first time to
				a patient shall advise the patient on the risks of overdose and inform the
				patient of the availability of an opioid antagonist. With respect to a patient
				to whom an opioid analgesic has previously been prescribed, distributed or
				dispensed by the dentist, the dentist shall advise the patient on the risks of
				overdose and inform the patient of the availability of an opioid antagonist on
				the first occasion that the dentist prescribes, distributes or dispenses an
				opioid analgesic each calendar year.
(10) A dentist who prescribes an opioid
				analgesic for a patient shall co-prescribe an opioid antagonist if the amount
				of opioid analgesic being prescribed is at least a five-day supply. The
				prescription for the opioid antagonist shall be accompanied by written
				information regarding the temporary effects of the opioid antagonist and
				techniques for administering the opioid antagonist. That written information
				shall contain a warning that a person administering the opioid antagonist
				should call 911 immediately after administering the opioid
				antagonist.