RULE 092.00.18-002 - Prescribing Controlled Substances
RULE 092.00.18-002. Prescribing Controlled Substances
092.00.1-13. PRESCRIBING CONTROLLED SUBSTANCES
25. A controlled substance will mean a Schedule II-V drug as defined in the Prescription Drug Monitoring Program Act.
A. Examination of the patient and need for prescribing a controlled substance.
(1) Nonpharmacologic treatment or drugs that are not classified as a controlled substance will be given consideration prior to treatment with controlled substances. Prior to initiating treatment with a controlled substance, the licensed veterinarian will perform a history and physical examination appropriate to the presenting complaint and conduct an assessment of the patient's history as part of the initial examination.
(2) The medical record for prescribing controlled substances will include signs or presentation of the pain or condition, a presumptive diagnosis for the origin of the pain or condition, a physical examination appropriate to the presenting complaint, a treatment plan, and the medications prescribed to include the date, type, dosage, and quantity prescribed.
(3) If a controlled substance is necessary for treatment, the licensed veterinarian will prescribe it in the lowest effective dose appropriate to the size and species of the animal for the least amount of time.
(4) If the prescribing is within the accepted standard of care, a licensed veterinarian may prescribe a controlled substance for the management of behavioral disorders, neurological disorders, acute pain, chronic pain, terminal illnesses, or other chronic conditions.
B. For prescribing an opioid, the initial dose will not exceed a ten (10) day supply.
(1) For prescribing an opioid for the management of pain after the initial ten (10) day supply, the patient will be seen and evaluated for the continued need for an opioid.
(2) For any prescribing of an opioid beyond ten (10) days, the licensed veterinarian will develop a treatment plan for the patient, which will include measures to be used to determine progress in treatment, further diagnostic evaluations or modalities that might be necessary, and the extent to which the disorder, pain, or condition is associated with physical impairment.
(3) For the continued prescribing of an opioid, the patient will be seen and reevaluated at least every six (6) months. The justification for such prescribing will be documented in the patient record.
C. Prior to prescribing or dispensing a controlled substance, the licensed veterinarian will document a discussion with the owner about the known risks and benefits of treatment with a controlled substance, the responsibility for the security of the drug, and proper disposal of any unused drug.
D. Continuation of treatment with controlled substances will be supported by documentation of the continued benefit from the prescribing. For the continued prescribing of controlled substances that are not opioids, the patient will be seen and reevaluated at least every twelve (12) months. If the patient's progress is unsatisfactory, the licensed veterinarian will assess the appropriateness of the continued use of the current treatment plan and consider the use of other therapeutic modalities.(12/21/2018)
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