Pain management clinics at which a majority of patients are
treated for chronic pain are subject to Chapter 168 of the Act, unless
otherwise exempted. In determining if the clinic is treating a majority
of patients for chronic pain, one of the primary indicators is the
prescribing of opioids. The Board will utilize the following definitions
in making that determination:
(1) Acute pain--the normal, predicted, physiological
response to a stimulus such as trauma, disease, and operative procedures.
Acute pain is time limited to no later than 30 days from the date
of the initial prescription for opioids during a period of treatment
related to the acute condition or injury. Acute pain does not include,
chronic pain, pain being treated as part of cancer care; pain being
treated as part of hospice or other end-of-life care; pain being treated
as part of palliative care; or post-surgical, post-procedure, or persistent
non-chronic pain.
(2) Chronic pain--pain that is not relieved with acute,
post-surgical, post-procedure, or persistent non-chronic pain treatment.
This type of pain is associated with a chronic pathological process
that causes continuous or intermittent pain for no less than 91 days
from the date of the initial prescription for opioids. Medical practices
treating this type of pain patient may be subject to Chapter 168 of
the Act.
(3) Post-surgical, post-procedure, persistent non-chronic
pain--pain that occurs due to trauma caused by the surgery or procedure;
or an underlying condition, disease, or injury causing persistent
non-chronic pain. These types of pain last 90 days or less, but more
than 30 days, from the date of initial prescriptions for opioids during
a period of treatment.
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