Section Nur 502.04 - Acute Pain If opioids are indicated and clinically appropriate for prescription for acute pain, prescribing licensees shall:
(a) Conduct and document a physical examination and history;(b) Prescribe the lowest effective dose for a limited duration;(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 substance laws, rules and regulations;(f) Conduct and document a risk assessment, such as the evidence-based screening tool Screener and Opioid Assessment for Patients with Pain (SOAPP);(g) Document an appropriate treatment plan and consideration of non-pharmacological modalities and non-opioid therapy;(h) Utilize a written informed consent that explains the following risks associated with opioids: (4) Physical side effects;(i) In an emergency department, urgent care setting, or walk-in clinic: (1) Not prescribe more than the minimum amount of opioids medically necessary to treat the patient's medical 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 medical 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 conduct an in-office follow-up with the patient prior to issuing a new opioid prescription.N.H. Admin. Code § Nur 502.04
Derived From Volume XXXVI Number 28, Filed July 14, 2016, Proposed by #11117, Effective 6/9/2016, Expires 6/9/2026.Amended by Volume XXXVII Number 2, Filed January 12, 2017, Proposed by #12070, Effective 1/1/2017, Expires 1/1/2027.