Section 313-21-I - DefinitionsAs used by the Boards when evaluating practice and prescribing issues, the following terms are defined as follows:
1.Acute pain - Acute pain is the normal, predicted physiological response to a noxious chemical, thermal or mechanical stimulus and typically is associated with invasive procedures, trauma and disease. It is generally time-limited.2.Addiction - Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial and environmental factors influencing its development and manifestations. It is characterized by behaviors that include the following: impaired control over drug use, craving, compulsive use and continued use despite harm. Physical dependence and tolerance are normal physiological consequences of extended opioid therapy for pain and are not the same as addiction.3.Chronic Pain - Chronic pain is a state in which pain persists beyond the usual course of an acute disease or healing of an injury that may or may not be associated with an acute or chronic pathologic process that causes continuous or intermittent pain over months or years.4.Clinician - An allopathic (MD) or osteopathic (DO) physician, physician assistant (PA), nurse practitioner (NP) or certified nurse midwife (CNM), dentist (DMD or DDS), or podiatrist (DPM).5.Pain - An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. 6.Physical Dependence - Physical dependence is a state of adaptation manifested by drug class-specific signs and symptoms that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. Physical dependence, by itself, does not equate with addiction.7.Pseudoaddiction - the iatrogenic syndrome (medically caused) resulting from the misinterpretation of relief seeking behaviors as though they are drug-seeking behaviors that are commonly seen with addiction. The relief seeking behaviors resolve upon institution of effective analgesic therapy. 8.Substance Abuse - Substance abuse is the use of any substance(s) for non-therapeutic purposes of medication for purposes other than those for which it is prescribed.9.Tolerance - Tolerance is a physiologic state resulting from regular use of a drug in which an increased dosage is needed to produce a specific effect or a reduced effect is observed with a constant dose over time. Tolerance may or may not be evident during opioid treatment and does not equate with addiction.02-313 C.M.R. ch. 21, § I