Pain Management - Washington State Dept of Health

Pain management care often includes the use of opioid drugs. Overdose deaths and hospitalizations involving prescription pain medicines have dramatically increased in Washington State over the last 16 years.

The Washington State legislature is concerned with this trend and in 2010 passed a law in response to these concerns. The intent of this law is to keep you safe and give your health care provider the best practices in pain management.

What professions are impacted by the law and rules?

Five boards and commissions were required to adopt rules on chronic pain management. The impacted professions are:

When is all this effective?

The law was effective June 20, 2010. The rules are effective:

January 2, 2012 for medical physicians and physician assistants; and
July 1, 2011 for osteopathic physicians and physician assistants, advanced registered nurse practitioners, dentists, and podiatrists.

Can I keep my current health care provider?

Yes. The law and rules do not require that you change your health care provider. Your health care provider doesn’t have to stop seeing you. Nothing should change for you. Under certain circumstances your health care provider may seek consultation from a pain specialist.

What does my health care provider have to do to keep caring for me and my chronic pain needs?

It depends on your health care provider and the status of your care and needs. Talk to your health care provider.

He or she may need some continuing education on pain management.
He or she may need to consult with a pain specialist, or you may be referred to a pain specialist for a consultation.
If your care and pain are stable, and you are on the same dosage of medication, your health care provider might only have to document this status in your patient record.

What are opioid prescription pain medicines?

Opioids are medicines that a health care provider prescribes to relieve moderate to severe pain. Some examples of these controlled substances are codeine, fentanyl, oxycodone, methadone, hydrocodone, and morphine.

Do I have to change my pain medicine?

The law and rules do not require a change; but that is a decision between you and your health care provider.

Do I have to consult with a pain specialist?

Not necessarily. It depends on your health care provider, your medical history, and the plan for your care.

You may be referred to see a pain specialist, or
Your health care provider may consult with a pain specialist over the telephone or electronically, or
There may be an audio-visual evaluation done between you, your health care provider, and a pain specialist.
There are consultation exemptions for special circumstances and the health care provider.

Is there a listing of pain specialists?

The state does not license by specialty and the department does not have a list of pain specialists. State or national pain organizations may have this information.

If I need the consultation, who pays for it?

The law and rules do not specify who pays for a consultation. As with other medically necessary consultations, you should check with your insurance carrier or referring provider.

What if I’m taking other drugs?

Tell your health care provider and pharmacist about all other drugs you are taking. It may be extremely dangerous to combine pain medications with other prescription and over-the-counter drugs. If you have more than one provider, make sure they all know about all of the medications and drugs you are taking. This includes any vitamin supplements.

Can I drink alcohol while taking pain medication?

Talk to your health care provider. Alcohol may have unintended consequences. It could stop your breathing and cause death.

What are some signs of pain medicine overdose?

Trouble breathing, confusion, can’t wake up, blue lips or blue fingernails, clammy or cool skin. More serious effects include seizure and coma. An overdose may result in death.

What can I do to ensure my chronic pain care continues?

Have a conversation with your health care provider about your needs and goals.

You may want to write questions you would like to ask your health care provider.

How can I keep my medication secure?

Unintentional poisoning death rates have risen by 395% over the past 16 years. It is your responsibility to keep your medications secure in your home and while you travel. These medications are intended for you alone. You should never share them or take them from others. This is illegal. Talk to your health care provider about how to keep you and your family safe.

To dispose of unwanted medication, ask your pharmacy for a drop-off location near you. If you can’t drop off unused medication, put household waste or garbage in the bottle and throw it away in its original childproof and watertight bottle. Do not flush it down the toilet.