PROVIDENCE – Rhode Island has updated its pain-management regulations to require doctors prescribing opioids to discuss the risks of taking the pain reliever, indicate diagnosis on the bottle and to co-prescribe naloxone to patients at higher risk of overdose.
The regulations apply to anyone who can prescribe a controlled substance, including physicians, dentists, physician assistants and advanced practice registered nurses.
R.I. Department of Health officials also firmly reiterated to health care providers that effective, non-opioid pain-management treatments are available with much less risk to patients, and that these treatments should be considered before opioids. These alternatives include nonprescription ibuprofen (i.e., Advil, Motrin) and/or acetaminophen (i.e., Tylenol), physical therapy, chiropractic care, acupuncture, massage, exercise and cognitive behavioral therapy, among other modalities.
The regulations allow for patient education to happen either through a conversation with the patient or in writing. The patient education must include a conversation that mentions:
- Risks of developing dependence and the potential of overdose or death.
- Risks related to the concurrent use of opioids and alcohol or benzodiazepines. (Benzodiazepines are sedatives, such as Xanax and Valium.)
- The effect of opioids on one’s ability to safely operate any motor vehicle.
- Patient’s responsibility to safeguard all opioid medications in a secure location.
- Alternative treatments for managing pain (non-opioid and/or nonpharmacologic options).
- Risks of relapse for those who are in recovery from substance dependence.
RIDOH has provided material to health care providers in English and Spanish that they can use to guide conversations with patients about the risks of opioids.
“Honest, direct conversation from health care providers about risks is a critical part of providing safe, quality care for patients who are prescribed opioids,” said Director of Health Dr. Nicole Alexander-Scott. “Rhode Island has made significant strides in reducing the number of opioids being prescribed, and in making sure that those prescriptions are being written and filled safely. These newest updates to our pain-management regulations will keep us moving in that direction, and will continue to reduce the number of overdoses in our state that are associated with prescription pain medication, while maintaining compassionate care for patients who deal with chronic pain. Prescribers, patients and all Rhode Islanders have a role to play in saving lives.”
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.