New Hampshire Code of Administrative Rules
Den - State Board of Registration of Funeral Directors and Embalmers
Chapter Den 500 - ETHICAL AND PROFESSIONAL DUTIES
Part Den 503 - OPIOID PRESCRIBING
Section Den 503.04 - Acute Pain

Universal Citation: NH Admin Rules Den 503.04

Current through Register No. 40, October 3, 2024

If opioids are indicated and clinically appropriate for prescription for acute pain, prescribing licensees shall:

(a) Conduct and document an examination of the oral cavity and associated structures and a medical history;

(b) Consider the patient's risk for opioid misuse, abuse, or diversion and prescribe for the lowest effective dose for less than 30 days;

(c) Document the prescription and rationale for all opioids;

(d) Ensure that the patient has been provided information that contains the following:

(1) Risk of side effects, including addiction and overdose resulting in death;

(2) Risks of keeping unused medication;

(3) Options for safely securing and disposing of unused medication; and

(4) Danger in operating motor vehicle or heavy machinery;

(e) Comply with all federal and state controlled substances laws, rules, and regulations;

(f) Complete a board-approved risk assessment tool, such as the evidence based screening tool Screener and Opioid Assessment for Patients with Pain (SOAPP);

(g) Document the consideration of non-pharmacological modalities and non-opioid therapy, and an appropriate pain treatment plan which includes the type of drug, the dosage, and the duration of the prescription;

(h) Utilize a written informed consent that explains the following risks associated with opioids:

(1) Addiction;

(2) Overdose and death;

(3) Physical dependence;

(4) Physical side effects;

(5) Hyperalgesia;

(6) Tolerance; and

(7) Crime victimization;

(i) In an emergency department, urgent care setting, or walk-in clinic:

(1) Not prescribe more than the minimum amount of opioids dentally necessary to treat the patient's dental condition. In most cases, an opioid prescription of 3 or fewer days is sufficient, but a licensee shall not prescribe for more than 7 days; and

(2) If prescribing an opioid for acute pain that exceeds a board-approved limit, document the dental condition and appropriate clinical rationale in the patient's medical record; and

(j) Not be obligated to prescribe opioids for more than 30 days, but if opioids are indicated and appropriate for persistent, unresolved acute pain that extends beyond a period of 30 days, the licensee shall work in concert with the patient's primary care physician or a licensed pain management program, and shall continue to adhere to the terms of Den 503.05 for establishing a pain management program.

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