Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-853 - Osteopathic physicians and surgeons › OPIOID PRESCRIBING-GENERAL PROVISIONS › Section 246-853-662 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply in WAC
					 246-853-660 through
					 246-853-790 unless the context
					 clearly requires otherwise.
(1)
				  "Aberrant behavior" means behavior that indicates misuse, diversion, or
				  substance use disorder. This includes, but is not limited to, multiple early
				  refills or obtaining prescriptions of the same or similar drugs from more than
				  one osteopathic physician or other health care 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 tests of urine, hair, or other biological samples for
				  various drugs and metabolites.
(4)
				  "Cancer-related pain" means pain resulting from cancer in a patient who is less
				  than two years postcompletion of curative anti-cancer 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
				  over months or years. Chronic pain may include pain resulting from cancer or
				  treatment of cancer in a patient who is two years postcompletion of curative
				  anti-cancer treatment with no current evidence of disease.
(6) "High-dose" means 90 milligrams MED, or
				  more, per day.
(7) "High-risk" is a
				  category of patient at increased risk of morbidity or mortality, such as from
				  comorbidities, polypharmacy, history of substance use disorder or abuse,
				  aberrant behavior, high-dose opioid prescription, or the use of any central
				  nervous system depressant.
(8)
				  "Hospice" means a model of care that focuses on relieving symptoms and
				  supporting patients with a life expectancy of six months or less.
(9) "Hospital" means any institution, place,
				  building, or agency licensed by the department 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 24 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.
(10) "Low-risk" means a category of patient
				  at low risk of opioid-induced morbidity or mortality, based on factors and
				  combinations of factors such as medical and behavioral comorbidities,
				  poly-pharmacy, and dose of opioids of less than a 50 milligram morphine
				  equivalent dose.
(11) "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.
(12)
				  "Moderate-risk" means a category of patient at a moderate risk of
				  opioid-induced morbidity or mortality, based on factors and combinations of
				  factors such as medical and behavioral comorbidities, polypharmacy, past
				  history of substance use disorder or abuse, aberrant behavior, and dose of
				  opioids between 50 and 90 milligram morphine equivalent doses.
(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)
				  "Multidisciplinary pain clinic" means a facility that provides comprehensive
				  pain management and includes care provided by multiple available disciplines,
				  practitioners, or treatment modalities.
(15) "Nonoperative pain" means acute pain
				  which does not occur as a result of surgery.
(16) "Opioid analgesic" or "opioid" means a
				  drug that is either an opiate derived from the opium poppy or opiate-like that
				  is a semi-synthetic or synthetic drug. Examples include morphine, codeine,
				  hy-drocodone, oxycodone, fentanyl, meperidine, and methadone.
(17) "Palliative" means care that improves
				  the quality of life of patients and their families facing serious, advanced, or
				  life-threatening illness. With palliative care particular attention is given to
				  the prevention, assessment, and treatment of pain and other symptoms, and to
				  the provision of psychological, spiritual, and emotional support.
(18) "Pain" means an unpleasant sensory or
				  emotional experience associated with actual or potential tissue damage, or
				  described in terms of such damage.
(19) "Perioperative pain" means acute pain
				  that occurs as the result of surgery.
(20) "Prescription monitoring program" or
				  "PMP" means the Washington state prescription monitoring program authorized
				  under chapter 70.225 RCW.
(21)
				  "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 RCW, or a podiatric physician licensed under chapter 18.22
				  RCW.
(22) "Subacute pain" is
				  considered to be a continuation of pain, of six to 12 weeks in
				  duration.
(23) "Substance use
				  disorder" means a primary, chronic, neurobio-logical disease with genetic,
				  psychosocial, and environmental factors influencing its development and
				  manifestations. Substance use disorder is not the same as physical dependence
				  or tolerance 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
						18.57.285,
						18.57A.090,
						18.57.005,
						18.57A.020. 11-10-062, §
						246-853-662, filed 5/2/11, effective
						7/1/11.