Prescribing rules do not force patients off meds

WMC interpretative statements provide clarity and supported by CDC release

OLYMPIA, MAY 24, 2019 – New opioid prescribing rules, effective January 2019, do not mandate that doctors taper chronic pain patients. Pain lasting more than 12 weeks is considered chronic. Nor do they set pill limits. Some doctors and patients have been misinformed that the rules would cut off patients from their prescriptions. To be clear, the opioid prescribing rules for chronic pain patients in Washington have remained largely unchanged since 2012.

Adding to this worry, is misinterpretation of CDC guidelines released in 2016. Some providers have interpreted the CDC guidelines as law, despite CDC statements to the contrary, and changed or stopped prescribing opioids. Additionally, the CDC has recently made clear their concerns regarding forced tapering based on incorrect assumptions about their 2016 guidelines.

The Washington Medical Commission (WMC), the state agency that regulates and licenses MDs and who wrote the new rules, has done outreach to ensure confusion and concern are addressed. The outreach included more than 30 presentations to hospitals statewide, an informative booklet sent to all license holders, three Twitter town halls, a live webinar and multiple co-agency events.

But, the WMC went further by issuing interpretive statements for MDs and PAs on Opioid Prescribing and Monitoring and another directly for patients. Both of these statements address the issue of tapering opioids and refusal by practitioners to continue treatment.

The statements go so far as to say, “A practitioner who refuses to treat the condition (chronic pain) properly, including the appropriate utilization of opioids when opioids are clearly indicated, would be practicing below the standard of care.” Practicing below the standard of care falls under WMC regulative authority and the Uniform Disciplinary Act.

Additionally, the statements clearly explain that tapering, “without consent of the patient or consideration of function or quality of life” is a violation of WMC prescribing rules.

“The 2019 Opioid Rules were created to address the opioid crisis in Washington that takes hundreds of lives annually. It was never our goal, nor is it permissible, to keep appropriate pain medications from people who need them, “said Micah Matthews, WMC Deputy Director. “Our interpretive statements should offer comfort and education to anyone who believes otherwise.”

For more information on the new rules and pain medication regulations, visit the WMC pain management resource page at https://wmc.wa.gov/resources/pain-management-resources.

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