Nurse practitioners and doctors in Washington state are being advised not to rapidly taper chronic-pain patients down from opioids.
The recommendation is coming from the state Department of Health and Human Services. The agency is raising concerns that abruptly tapering patients down from opioids or discontinuing their prescriptions can cause serious harm from withdrawals, uncontrolled pain, psychological distress and even suicide.
The agency announced the recommendation on Wednesday.
The new rule comes after confusion from a state law that was passed in 2017 and went into effect on Jan. 1 this year, said Doctor Malcolm Butler, Columbia Valley Community Health chief medical officer. Some prescribers "over-interpreted" the law and reduced patients' dosage suddenly, Butler said. It may have even give some an excuse to quit working with chronic-pain patients.
"Some providers were never comfortable working with chronic pain patients or addicted patients and used the new law to tell their patients, 'I have to taper you down, or I can no longer prescribe for you' or just, 'the laws have changed and I am no longer willing to prescribe for you,'" Butler said.
The new rules require that providers consult with a pain specialist before giving patients prescriptions of more than 120 milligrams per day, according to health and human services news release.
The rules give patients three months to consult with a pain specialist.
