If opioids are indicated and clinically appropriate for prescription for acute pain, prescribing licensees shall:

1. (a) Conduct and document an examination of the oral cavity and associated structures and a medical history;
2. (b) Consider the patient’s risk for opioid misuse, abuse, or diversion and prescribe for the lowest effective dose for less than 30 days;
3. (c) Document the prescription and rationale for all opioids;

4. (d) Ensure that the patient has been provided information that contains the following:

   1. (1) Risk of side effects, including addiction and overdose resulting in death;
   2. (2) Risks of keeping unused medication;
   3. (3) Options for safely securing and disposing of unused medication; and
   4. (4) Danger in operating motor vehicle or heavy machinery;
5. (e) Comply with all federal and state controlled substances laws, rules, and regulations;
6. (f) Complete a board-approved risk assessment tool, such as the evidence based screening tool Screener and Opioid Assessment for Patients with Pain (SOAPP);
7. (g) Document the consideration of non-pharmacological modalities and non-opioid therapy, and an appropriate pain treatment plan which includes the type of drug, the dosage, and the duration of the prescription;

8. (h) Utilize a written informed consent that explains the following risks associated with opioids:

   1. (1) Addiction;
   2. (2) Overdose and death;
   3. (3) Physical dependence;
   4. (4) Physical side effects;
   5. (5) Hyperalgesia;
   6. (6) Tolerance; and
   7. (7) Crime victimization;

9. (i) In an emergency department, urgent care setting, or walk-in clinic:

   1. (1) Not prescribe more than the minimum amount of opioids dentally necessary to treat the patient’s dental condition. In most cases, an opioid prescription of 3 or fewer days is sufficient, but a licensee shall not prescribe for more than 7 days; and
   2. (2) If prescribing an opioid for acute pain that exceeds a board-approved limit, document the dental condition and appropriate clinical rationale in the patient’s medical record; and
10. (j) Not be obligated to prescribe opioids for more than 30 days, but if opioids are indicated and appropriate for persistent, unresolved acute pain that extends beyond a period of 30 days, the licensee shall work in concert with the patient’s primary care physician or a licensed pain management program, and shall continue to adhere to the terms of Den 503.05 for establishing a pain management program.

Source. #11130, eff 6-29-16; ss by #12061, eff 1-1-17 (from Den 503.03); renumbered by #12167, eff 3-7-25 (formerly Den 503.04)