Posted by: painresearchadvocates | February 26, 2009

California Laws GUARANTEEING Pain Management

Aniwaya  Advocacy was recently made aware of  the state of pain management freedom in California. Though the laws and codes in California are very ammenable to responsible and effective prescribing, we have found out that some of the California “enforcement  officers” are not aware of their States’ own laws that PROTECT the right of the chronic pain /intractable pain patients to be medically TREATED however they and their doctors see fit. The state’s own laws also protect doctors from undue harassment and “discipline.”

In case you ever find yourself being questioned about the legality of your medical treatment, I want you to be informed. Though these statutes come from CALIFORNIA law, you probably have very similar codes in your State’s Business regulations. I’ll list the quotes  below: 

Defense for pain care quotes:

 This wording added in law AB 2198 which was chartered into law on September 20th, 2006.

 

 

SEC. 5. Section 2241.5 is added to the Business and Professions Code,

to read:

2241.5. (a) A physician and surgeon may prescribe for, or dispense or

administer to, a person under his or her treatment for a medical condition

dangerous drugs or prescription controlled substances for the treatment of

pain or a condition causing pain, including, but not limited to, intractable

pain. (emphasis added)

 

(b) No physician and surgeon shall be subject to disciplinary action for

prescribing, dispensing, or administering dangerous drugs or prescription

controlled substances in accordance with this section.

 

·         Compliance with Controlled Substances Laws and Regulations

To prescribe controlled substances, the physician and surgeon must be appropriately licensed in California, have a valid controlled substances registration and comply with federal and state regulations for issuing controlled substances prescriptions. Physicians and surgeons are referred to the Physicians Manual of the U.S. Drug Enforcement Administration and the Medical Board’s Guidebook to Laws Governing the Practice of Medicine by Physicians and Surgeons for specific rules governing issuance of controlled substances prescriptions.

·         Annotation One: There is not a minimum or maximum number of medications which can be prescribed to the patient under either federal or California law.

From the California Medical Board Publication, Guidelines for Prescribing Controlled Substances for Pain

Adopted Unanimously by the Board in 1994 and Recently Revised

“No physician and surgeon shall be subject to disciplinary action by the Board for prescribing or administering controlled substances in the course of treatment of a person for intractable pain.”

Business and Professions Code section 2241.5(c

n  Web site is www.medbd.ca.gov  

 

 

 

**no other disease has to continually fight for their right to be medically TREATED** 

**why are we suffering for drug abusers bad choices?**

California Pain Patients Bill of Rights

California Senate Bill 402

This bill establishes the Pain Patient’s Bill of Rights and states the legislative findings and declarations regarding the value of opiate drugs to persons suffering from severe chronic intractable pain.  It, among other things, authorizes a physician to refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain, the physician to inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates, and authorizes a physician who prescribes opiates to prescribe a dosage deemed medically necessary.

The people of the State of California do enact as follows:
SECTION 1. Part 4.5 (commencing with Section 124960) is added to Division 106 of the Health and Safety Code, to read:

PART 4.5. PAIN PATIENT’S BILL OF RIGHTS

124960. The Legislature finds and declares all of the following:

(a) The state has a right and duty to control the illegal use of opiate drugs

(b) Inadequate treatment of acute and chronic pain originating from cancer or non-cancerous conditions is a significant health problem.

(c) For some patients, pain management is the single most important treatment a physician can provide.

(d) A patient suffering from severe  chronic intractable pain should have access to proper treatment of his or her pain.

(e) Due to the complexity of their problems, many patients suffering from severe chronic intractable pain may require referral to a physician with expertise in the treatment of severe chronic intractable pain. In some cases, severe chronic intractable pain is best treated by a team of clinicians in order to address the associated physical, psychological, social, and vocational issues.

(f) In the hands of knowledgeable, ethical, and experienced pain management practitioners, opiates administered for severe acute and severe chronic intractable pain can be safe.

(g) Opiates can be an accepted treatment for patients in severe chronic intractable pain who have not obtained relief from any other means of treatment.

(h) A patient suffering from severe  chronic intractable pain has the option to request or reject the use of any or all modalities to relieve his or her severe chronic intractable pain.

(i) A physician treating a patient who suffers from severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve severe chronic intractable pain as long as the prescribing is in conformance with the provisions of the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.

(j.)   A patient who suffers from severe chronic intractable pain has the option to choose opiate medication for the treatment of the severe chronic intractable pain as long as the prescribing is in conformance with the provisions of the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.

(k) The patient’s physician may refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates.

124961. Nothing in this section shall be construed to alter any of the provisions set forth in the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code. This section shall be known as the Pain Patient’s Bill of Rights.

(a) A patient suffering from severe chronic intractable pain has the option to request or reject the use of any or all modalities in order to relieve his or her severe chronic intractable pain.

(b) A patient who suffers from severe chronic intractable pain has the option to choose opiate medications to relieve severe chronic intractable pain without first having to submit to an invasive medical procedure, which is defined as surgery, destruction of a nerve or other body tissue by manipulation, or the implantation of a drug delivery system or device, as long as the prescribing physician acts in conformance with the provisions of the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.

(c) The patient’s physician may refuse to prescribe opiate medication for the patient who requests a treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates.

(d) A physician who uses opiate therapy to relieve severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve severe chronic intractable pain, as long as that prescribing is in conformance with the California Intractable Pain Treatment Act, Section 2241.5 of the Business and Professions Code.

(e) A patient may voluntarily request that his or her physician provide an identifying notice of the prescription for purposes of emergency treatment or law enforcement identification.

(f) Nothing in this section shall do either of the following:

(1) Limit any reporting or disciplinary provisions applicable to licensed physicians and surgeons who violate prescribing practices or other provisions set forth in the Medical Practice Act, Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, or the regulations adopted thereunder.

(2) Limit the applicability of any federal statute or federal regulation or any of the other statutes or regulations of this state that regulate dangerous drugs or controlled substances.




California Pharmacy Board
Source: Health Notes. Vol. 1, No. 1; pp. 4-5 1996.

DISPENSING CONTROLLED SUBSTANCES FOR PAIN

A Statement of the California State Board of Pharmacy

The Board understands that the ongoing use of opioids for cancer, post-surgical, and chronic pain is not what causes addiction or a patient’s desire for higher doses of pain medication. Patients suffering from extreme pain or progression of disease may require increased doses of medication; the appropriate dose is that which is required to adequately treat the pain, even if the dose is higher than usually expected. In addition, with long-term treatment of pain with opioids, patients may develop a tolerance to the drug or a dependence on the drug. These occurrences are considered “normal” and “to be expected” – they should not be confused by the licensed healthcare professional with drug addiction or be mislabeled as “drug seeking.”

The Board understands that an important part of effective pain management is ensuring that patients do not have difficulty obtaining adequate medication for pain relief. The Board recognizes that is it the professional responsibility of the pharmacist to recommend that patients in pain received appropriate, timely, and adequate drug therapy to reduce their pain.

BUSINESS AND PROFESSIONS CODE
SECTION 2220-2319

 

 

 

2220.  Except as otherwise provided by law, the Division of Medical

Quality may take action against all persons guilty of violating this

chapter.  The division shall enforce and administer this article as

to physician and surgeon certificate holders, and the division shall

have all the powers granted in this chapter for these purposes

including, but not limited to:

   (a) Investigating complaints from the public, from other

licensees, from health care facilities, or from a division of the

board that a physician and surgeon may be guilty of unprofessional

conduct.  The board shall investigate the circumstances underlying

any report received pursuant to Section 805 within 30 days to

determine if an interim suspension order or temporary restraining

order should be issued.  The board shall otherwise provide timely

disposition of the reports received pursuant to Section 805.

   (b) Investigating the circumstances of practice of any physician

and surgeon where there have been any judgments, settlements, or

arbitration awards requiring the physician and surgeon or his or her

professional liability insurer to pay an amount in damages in excess

of a cumulative total of thirty thousand dollars ($30,000) with

respect to any claim that injury or damage was proximately caused by

the physician’s and surgeon’s error, negligence, or omission.

   (c) Investigating the nature and causes of injuries from cases

which shall be reported of a high number of judgments, settlements,

or arbitration awards against a physician and surgeon.

 

 

 

2220.05.  (a) In order to ensure that its resources are maximized

for the protection of the public, the Medical Board of California

shall prioritize its investigative and prosecutorial resources to

ensure that physicians and surgeons representing the greatest threat

of harm are identified and disciplined expeditiously.  Cases

involving any of the following allegations shall be handled on a

priority basis, as follows, with the highest priority being given to

cases in the first paragraph:

   (1) Gross negligence, incompetence, or repeated negligent acts

that involve death or serious bodily injury to one or more patients,

such that the physician and surgeon represents a danger to the

public.

   (2) Drug or alcohol abuse by a physician and surgeon involving

death or serious bodily injury to a patient.

   (3) Repeated acts of clearly excessive prescribing, furnishing, or

administering of controlled substances, or repeated acts of

prescribing, dispensing, or furnishing of controlled substances

without a good faith prior examination of the patient and medical

reason  therefore.  However, in no event shall a physician and surgeon

prescribing, furnishing, or administering controlled substances for

intractable pain consistent with lawful prescribing, including, but

not limited to, Sections 725, 2241.5, and 2241.6 of this code and

Sections 11159.2 and 124961 of the Health and Safety Code, be

prosecuted for excessive prescribing and prompt review of the

applicability of these provisions shall be made in any complaint that

may implicate these provisions.

 

                                                                                                                                                                                                                                                                                                                  



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