Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-922 - Podiatric physicians and surgeons › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-922-662 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply to WAC
					 246-922-660
					 through 246-922-790 unless the context clearly requires otherwise.
(1) "Aberrant behavior" means behavior that
				  indicates misuse, diversion, unauthorized use of alcohol or other controlled
				  substances, or active opioid use disorder. This includes, but is not limited
				  to: Multiple early refills or renewals or obtaining prescriptions for the same
				  or similar drugs from more than one practitioner.
(2) "Acute pain" means the normal, predicted
				  physiological response to a noxious chemical, thermal, or mechanical stimulus
				  and typically is associated with invasive procedures, trauma, and disease.
				  Acute pain is considered to be six weeks or less in duration.
(3) "Biological specimen test" or "biological
				  specimen testing" means testing of bodily fluids or other biological samples
				  including, but not limited to, urine or hair for the presence of various drugs
				  and metabolites.
(4)
				  "Cancer-related pain" means pain resulting from cancer in a patient who is less
				  than two years post-completion of curative anticancer treatment with current
				  evidence of disease.
(5) "Chronic
				  pain" means a state in which pain persists beyond the usual course of an acute
				  disease or healing of an injury, or that may or may not be associated with an
				  acute or chronic pathologic process that causes continuous or intermittent pain
				  more than twelve weeks in duration. Chronic pain includes pain resulting from
				  cancer or treatment of cancer in a patient who is two years post-completion of
				  curative anti-cancer treatment with no current evidence of disease.
(6) "Comorbidities" means a preexisting or
				  coexisting physical or psychiatric disease or condition.
(7) "Episodic care" means medical care
				  provided by a podiatric physician other than the designated primary
				  practitioner in the acute care setting, for example, urgent care or emergency
				  department.
(8) "High dose" means
				  ninety milligrams morphine equivalent dose, or more, per day.
(9) "High-risk" is a category of patient at
				  increased risk of opioid induced morbidity or mortality, based on factors and
				  combinations of factors such as medical and behavioral comorbidities,
				  polypharmacy, history of substance use disorder or abuse, aberrant behavior,
				  high dose opioid prescription, or the use of any central nervous system
				  depressant.
(10) "Hospice" means a
				  model of care that focuses on relieving symptoms and supporting patients with a
				  life expectancy of six months or less.
(11) "Hospital" means any institution, place,
				  building, or agency licensed under chapter 70.41 or 71.12 RCW, or designated
				  under chapter 72.23 RCW to provide accommodations, facilities, and services
				  over a continuous period of twenty-four hours or more, for observation,
				  diagnosis, or care of two or more individuals not related to the operator who
				  are suffering from illness, injury, deformity, or abnormality, or from any
				  other condition for which obstetrical, medical, or surgical services would be
				  appropriate for care or diagnosis.
(12) "Medication assisted treatment" or "MAT"
				  means the use of pharmacologic therapy, often in combination with counseling
				  and behavioral therapies, for the treatment of substance use
				  disorders.
(13) "Morphine
				  equivalent dose" or "MED" means a conversion of various opioids to a morphine
				  equivalent dose by the use of accepted conversion tables.
(14) "Opioid analgesic" or "opioid" means a
				  drug that is either an opiate derived from the opium poppy or opiate-like that
				  is a semisynthetic or synthetic drug. Examples include morphine, codeine,
				  hydrocodone, oxycodone, fentanyl, meperidine, tramadol, buprenorphine, and
				  methadone.
(15) "Palliative care"
				  means care that maintains or improves the quality of life of patients and their
				  families facing serious, advanced, or life-threatening illness.
(16) "Pain" means an unpleasant sensory or
				  emotional experience associated with actual or potential tissue damage, or
				  described in terms of such damage.
(17) "Pain management clinic" means a
				  facility that provides comprehensive pain management and may include care
				  provided by multiple available disciplines, practitioners, or treatment
				  modalities.
(18) "Perioperative
				  pain" means acute pain that occurs surrounding the performance of
				  surgery.
(19) "Prescription
				  monitoring program" or "PMP" means the Washington state prescription monitoring
				  program authorized under chapter 70.225 RCW.
(20) "Practitioner" means an advanced
				  registered nurse practitioner licensed under chapter 18.79 RCW, a dentist
				  licensed under chapter 18.32 RCW, a physician licensed under chapter 18.71 or
				  18.57 RCW, a physician assistant licensed under chapter 18.71A or 18.57A RCW,
				  or a podiatric physician licensed under chapter 18.22 RCW.
(21) "Refill" or "renewal" means a second or
				  subsequent filling of a previously issued prescription. For the purposes of WAC
				  246-922-660
				  through 246-922-790, refills or renewals are subject to the same limitations
				  and requirements as initial prescriptions.
(22) "Subacute pain" means a continuation of
				  pain, of six weeks to twelve weeks in duration.
(23) "Substance use disorder" means a
				  primary, chronic, neurobiological disease with genetic, psychosocial, and
				  environmental factors influencing its development and manifestations. Substance
				  use disorder is not the same as physical dependence or tolerance that are
				  normal physiological consequences of extended opioid therapy for pain. It is
				  characterized by behaviors that include, but are not limited to, impaired
				  control over drug use, craving, compulsive use, or continued use despite
				  harm.
Statutory Authority:
						RCW
						18.22.240,
						18.22.015(5).
						11-10-063, § 246-922-662, filed 5/2/11, effective
						7/1/11.