Providers treating acute pain subject to tougher opioid-prescription rules

Dr. Nicole Alexander-Scott
MEDICAL PROVIDERS prescribing opioids to individuals with acute pain are subject to new, tougher regulations, according to the R.I. Department of Health. RIDOH Director Nicole Alexander-Scott, pictured, says the new regulations will help ensure "we’re only prescribing what’s actually needed for the treatment of acute pain.” / PBN FILE PHOTO/RUPERT WHITELEY

PROVIDENCE – Medical providers prescribing opioids to individuals with acute pain are subject to new, tougher regulations, according to the R.I. Department of Health, which announced that these new regulations, intended to make opioid prescriptions safer, are an integral part of the strategic plan developed by Gov. Gina M. Raimondo’s Overdose Prevention and Intervention Task Force.

“These updated pain-management regulations focus on dosing limitations to help reshape how we, as health care providers, had been taught how to approach opioid therapy, and to make sure that we’re only prescribing what’s actually needed for the treatment of acute pain,” RIDOH Director Dr. Nicole Alexander-Scott said in a statement. “While we work to minimize unnecessary prescribing of opioids for acute pain, it is essential that patients’ chronic-pain needs are appropriately and compassionately treated. Although opioid prescribing in Rhode Island decreased by 16 percent between 2013 and 2015, which was the largest drop in the nation, the regulations were updated to ensure that acute pain and chronic pain are treated differently.”

These updates do not affect the long-term treatment for patients with chronic pain, such as individuals with cancer-associated pain diagnoses and patients in palliative/nursing home care. Just as a patient with diabetes would not be abruptly removed from diabetes medication, a patient receiving opioids for chronic pain should not be removed too abruptly from pain medication, but transitioned safely and slowly to an acceptable alternative. Acute pain, such as that from dental work, a broken bone and certain back injuries, occurs quickly and generally lasts no longer than a few days, weeks or months.

The updated regulations for acute-pain management include these key terms:

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  • Initial prescriptions for acute pain must be limited to 20 doses and no more than 30 morphine milligram equivalents per day.
  • Prohibits long-acting or extended-release opioids for initial prescriptions for acute pain.
  • Documents the results of a thorough medical history, developing a treatment plan, and accessing the Rhode Island Prescription Drug Monitoring Program for relevant prescription-monitoring information, all before issuing an initial prescription for acute pain.
  • Requires continuing education training for prescribers on topics such as appropriate prescribing for pain, pharmacology, potential for dependence and alternatives to opioids for pain management.

RIDOH’s original pain-management regulations were developed in 2015, as part of the prevention strategy of the Task Force’s strategic plan, which also focuses on treatment, rescue and recovery. The goal of the strategic plan is to reduce the number of overdose deaths in Rhode Island by one-third within three years, reported RIDOH.

With a focus on treating substance-use disorder as one more lifelong, chronic disease – without judgment or criticism – Rhode Island offers alternative treatment choices for individuals transitioning away from opioids. Six Centers of Excellence provide medication-assisted treatment counseling, peer support and vocational counseling, and a 24/7 recovery and treatment support hotline is available, as well, at (401) 942-STOP (7867).

On May 11 and 18, DOH and The Warren Alpert School of Medicine of Brown University will offer education sessions on the interdisciplinary treatment of pain. For more information, contact Brown CME Office at (401) 863-3337 or To register online, click HERE.

Nancy Kirsch is a PBN contributing writer.



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