(a) At the time of the issuance of the third prescription for a Schedule II opioid
drug the practitioner shall consider referring the patient to a pain clinic or a pain
specialist. The practitioner shall discuss the benefits of seeking treatment through a pain
clinic or a pain specialist and provide him or her with an understanding of any risks
associated by choosing not to pursue that as an option.
(b) If the patient declines to seek treatment from a pain clinic or a pain specialist
and opts to remain a patient of the practitioner, and the practitioner continues to
prescribe a Schedule II opioid drug as provided in this code, the practitioner shall:
(1) Note in the patient's medical records that the patient knowingly declined treatment
from a pain clinic or pain specialist;
(2) Review, at a minimum of every three months, the course of treatment, any new information
about the etiology of the pain, and the patient's progress toward treatment objectives
and document the results of that review;
(3) Assess the patient prior to every renewal to determine whether the patient is
experiencing problems associated with physical and psychological dependence and document
the results of that assessment; and
(4) Periodically make reasonable efforts, unless clinically contraindicated, to either
stop the use of the controlled substance, decrease the dosage, try other drugs or
treatment modalities in an effort to reduce the potential for abuse or the development
of physical or psychological dependence, and document with specificity the efforts
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