The advanced registered nurse practitioner shall assess and document the appropriateness of continued use of the current treatment plan if the patient's response to, or compliance with, the current treatment plan is unsatisfactory. The advanced registered nurse practitioner shall consider tapering, changing, discontinuing treatment, or referral for a substance use disorder evaluation when:

1. (1) The patient requests;
2. (2) The patient experiences a deterioration in function or pain;
3. (3) The patient is noncompliant with the written agreement;
4. (4) Other treatment modalities are indicated;
5. (5) There is evidence of misuse, abuse, substance use disorder, or diversion;
6. (6) The patient experiences a severe adverse event or overdose;
7. (7) There is unauthorized escalation of doses; or
8. (8) There is continued dose escalation with no improvement in pain, function, or quality of life.

[Statutory Authority: RCW 18.79.800 and 2017 c 297. WSR 18-20-086, § 246-840-4935, filed 10/1/18, effective 11/1/18.]