Not all chronic pain patients will need their opioid prescriptions tapered. Relying on medical decision making and patient-centered treatment, the physician assistant shall consider tapering 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) The patient is receiving an escalation in opioid dosage with no improvement in their pain or function.

[Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800, and 18.130.050. WSR 25-05-091, s 246-918-900, filed 2/18/25, effective 3/21/25. Statutory Authority: RCW 18.71.017, 18.71.800, 18.71A.800 and 2017 c 297. WSR 18-23-061, § 246-918-900, filed 11/16/18, effective 1/1/19.]