The legislature passed Engrossed Substitute House Bill 2876 during the 2010 legislative session. This bill directs five boards and commissions to adopt rules concerning management of chronic noncancer pain. These boards and commissions include the Medical Quality Assurance Commission, Nursing Care Quality Assurance Commission, Dental Quality Assurance Commission, Board of Osteopathic Medicine and Surgery, and Podiatric Medical Board.

The professions include:

• Physicians
• Physician Assistants
• Osteopathic Physicians
• Osteopathic Physician Assistants
• Advanced Registered Nurse Practitioners
• Dentists
• Podiatric Physicians

The boards and commissions are committed to protecting and improving the health of people in Washington State. Overdose deaths and hospitalizations involving prescription opioid analgesics are increasing. Washington State has a higher death rate associated with opioids than the national average.

Each board and commission has adopted their final rules and the department has officially filed the adopted rules.

The goal of the new pain management rules is to keep patients safe and give practitioners who prescribe opioids the best practices in pain management. A key component of the rules is to encourage practitioners to become better educated in the safe and effective uses of these powerful drugs. The rules contain specific mandatory elements required by the law, as well as guidance for practitioners who care for patients with chronic noncancer pain.

Some of the key points for the new rules include:

• A dosing threshold trigger for consultation with a pain specialist
• Criteria to be considered a pain specialist
• Elements for a patient evaluation
• Periodic review of a patient’s course of treatment
• Guidance for episodic care practitioners
• Consultation exemptions for special circumstances and for the practitioner
• Continuing education.

Please join our interested parties list to receive email notifications about the pain management prescribing rules. If you already belong to a listserv for one of the professions listed above, you do not need to join the pain management listserv. We will send the information to those interested parties lists as well.