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

1. (a) Conduct and document a physical examination and history;
2. (b) Consider the patient’s risk for opioid misuse, abuse, or diversion and prescribe for the lowest effective dose for a limited duration;
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 Screener and Opioid Assessment for Patients with Pain (SOAPP);
7. (g) Document an appropriate pain treatment plan and consideration of non-pharmacological modalities and non-opioid therapy;

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 medically necessary to treat the patient’s medical condition. In most cases, an opioid prescription of 3 or fewer days shall be 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 medical 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 conduct an in-office follow-up with the patient prior to issuing a new opioid prescription

Source. #6717, eff 3-24-98, EXPIRED: 3-24-06 New. #9342, eff 12-9-08, EXPIRED: 12-9-16 New. #12108, INTERIM, eff 2-21-17, EXPIRED: 8-20-17 Source. #12060, eff 1-1-17; ss by #14260, eff 8-2-25, EXPIRES: 8-2-35 (formerly Opt 504) (See Chapter 500 Revision Note)