PERMANENT RULES
Date of Adoption: October 7, 1999.
Purpose: These rules will promote a better understanding of the accepted standard of practice for physicians and patients in Washington state and encourage effective treatment of chronic and intractable pain.
Statutory Authority for Adoption: RCW 18.71.017 and 18.130.050(1).
Other Authority: RCW 18.130.050(12) and 18.130.340.
Adopted under notice filed as WSR 99-18-086 on August 31, 1999.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 4, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 4, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 4, Amended 0, Repealed 0. Effective Date of Rule: Thirty-one days after filing.
October 25, 1999
Bonnie King
Executive Director
OTS-2897.5
PAIN MANAGEMENT
NEW SECTION
WAC 246-919-800
Purpose.
(1) The medical quality assurance commission recognizes that effective pain management is an essential component of quality medical care and that no single approach to the treatment of pain is exclusively correct.
(2) The commission wishes to reassure practitioners that they need not fear disciplinary action from the commission for prescribing, dispensing, or administering opioids when treating pain so long as the care provided is consistent with currently acceptable medical practices. This includes acute, chronic and intractable pain (RCW 69.50.308(g)).
(3) While many other medications may be appropriate in the treatment of pain, these regulations specifically address the use of opioids. As used in these regulations, the term opioid means any natural or synthetic medication that has morphine like activity.
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(1) The commission has adopted guidelines for the management of pain in order to acquaint practitioners with recognized national standards in the field of pain treatment.
(2) These guidelines specifically address the patient evaluation and treatment plan, informed consent, periodic reviews, use of consultations, and the necessity for maintaining accurate and complete medical records.
(3) These guidelines may be revised from time to time to reflect changes in the practice of pain management.
(4) Practitioners who cannot or choose not to treat patients who have complex or chronic pain conditions should offer appropriate referrals for those patients.
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Practitioners treating pain should be:
(1) Knowledgeable about the complex nature of pain;
(2) Familiar with the pain treatment terms used in the commission's pain treatment guidelines; and
(3) Knowledgeable about acceptable pain treatment modalities.
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(1) The practitioner's treatment will be evaluated by a review of the provided care to see if it is clinically sound and in accordance with currently acceptable medical practice regarding the treatment of pain.
(2) No disciplinary action will be taken against a practitioner based solely on the quantity and/or frequency of opioids prescribed.
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