In response to the opioid epidemic, individual states have developed and adopted voluntary guidelines or recommendations for the treatment of acute and chronic non-cancer pain. Based on research done on the state where you will practice clinically, include the following:
Provide the name of your practicing state’s organization, group or task force that created guidelines or recommendations for pain management therapies and education.
Briefly describe an overview of its development and include a web address where this information can be found. If your state does not have guidelines, discuss a federal guideline. (Note: you may need to contact your state’s board of nursing, pharmacy, or medicine if you cannot locate it on your own).
Some states have multiple organizations or initiatives (ex: Ohio) in place to combat the opioid epidemic and advocate for safer opioid prescribing. Explore whether your state has other resources, groups or organizations where prescribers can reference best practices for pain management treatment. If applicable, provide a brief overview of the group’s recommendations or initiatives. If your state does not have another state-specific resource, discuss the guidelines published by the American Pain Society OR Centers for Disease Control and Prevention.
Discuss when the use of opioids is appropriate and for what duration should they be prescribed? Provide a reference for your response. (This question is worth 13 points. 5 points for when opioids are appropriate, 5 points for a safe duration of use, and 3 points for a current edition APA formatted reference.)
State specific laws on controlled substance prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe controlled substances. Based on research done on the state where you will practice clinically, include the following:
Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe controlled substances in your state.
Discuss the provisions of the law, rule, code, or statute with regard to the following:
Conditions or limits on prescribing schedule I-V controlled substances.
Requirements (if any) in documentation for treating acute and chronic pain.
Are there specific requirements for advanced practice nurses to reference the state’s prescription drug monitoring database before prescribing a controlled substance? If so, what are they?
State Prescription Drug Monitoring Program (PDMP):
Research your state’s PDMP* and provide the following information:
Name of the state’s program.
Website for the state PMDP.
Discuss the registration requirements and process.
Discuss the standards and procedures for the access and review of database information.
State specific laws on medical devices prescribing for the nurse practitioner:
Research your state laws on advanced practice nurses’ authority to prescribe medical devices. These are also called Durable Medical Equipment (DME). Based on research done on the state where you will practice clinically, include the following:
Identify the law, rule, code, or statute that describes the advanced practice nurse’s authority to prescribe medical devices or DME in your state.
Discuss the provisions of the law, rule, code, or statute regarding the following:
Conditions or limits on prescribing medical devices or DME.
State-Specific Opioid Guidelines or Recommendations
State: California
Organization: California Medical Association (CMA)
Website: https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/SACB/CDPH%20Document%20Library/Prescription%20Drug%20Overdose%20Program/PrescribingGuidelines4.26.17Compliant.pdf
Development: The CMA Opioid Prescribing Guidelines were developed by a workgroup of experts in pain management, addiction medicine, and public health. The guidelines were based on a review of the latest scientific evidence and were informed by input from clinicians, patients, and other stakeholders. The guidelines were first published in 2016 and are updated regularly.
Overview: The CMA Opioid Prescribing Guidelines provide recommendations for the safe and effective use of opioids for the treatment of acute and chronic pain. The guidelines cover a wide range of topics, including when to initiate opioid therapy, how to choose the right opioid and dose, and how to monitor patients for adverse effects. The guidelines also include recommendations for discontinuing opioid therapy when it is no longer necessary.
Other State Resources
Organization: California Department of Public Health (CDPH)
Website: https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/SACB/Pages/Opioids.aspx
Overview: The CDPH is leading the state’s response to the opioid epidemic. The CDPH website provides a variety of resources for clinicians, patients, and the public, including:
Use of Opioids for Pain Management
When is the use of opioids appropriate?
Opioids are appropriate for the treatment of:
For what duration should opioids be prescribed?
Opioids should be prescribed for the shortest possible duration necessary to achieve pain relief. For acute pain, opioids should be prescribed for no more than 3-7 days. For chronic pain, opioids should be prescribed for the shortest possible duration that is effective, with regular re-evaluation of the need for continued use.
Reference:
State-Specific Laws on Controlled Substance Prescribing for the Nurse Practitioner
Law: California Business and Professions Code, Division 2, Chapter 4.5, Article 2, Section 2836.5
Provisions of the law:
State Prescription Drug Monitoring Program (PDMP)
Name of the state’s program: California Prescription Drug Monitoring Program (CURES)
Website: https://www.ojp.gov/ncjrs/virtual-library/abstracts/prescription-drug-monitoring-program-california-state-profile
Registration requirements and process:
Standards and procedures for the access and review of database information:
State-Specific Laws on Medical Device Prescribing for the Nurse Practitioner
Law: California Business and Professions Code, Division 2, Chapter 6.5, Article 6, Section 3036
Provisions of the law:
Conditions or limits on prescribing medical devices or DME: