Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi & South Carolina

Introduction

Current state policies vary considerably, including the extent to which they permit opioid therapy for patients with chronic pain.  The rapid increase in state pain-related policy should be monitored closely and pain professionals and their organizations should actively influence the development of state pain policies.  Various state policies are discussed below.

Alabama

• Statute .........................................................................

Arkansas

• Regulation ...................................................................

• Regulation 2(6) & Informed Consent ........................

Florida

• Statute .......................................................................

• Guidelines .................................................................

Georgia

In 1991, the Georgia Composite State Board of Medical Examiners stated that the diagnosis of pain should be based on the patient's history and a physical examination, not simply on the assertion of the patient.  The treatment plan should reflect the use of other modalities of treatment, including appropriate referrals and their results, and document the reasons that past modalities have been inappropriate or ineffective.  The physician should determine that the patient is not taking opioids for nontherapeutic purposes and should obtain the informed consent of the patient before using opioids.  Furthermore, the patient should be monitored regularly, and the physician should have adequate control of the drug supply, including detailed records of each drug dose, amount, and number of refills.  The physician should maintain regular contact with the patient's family to assess treatment effectiveness.  Adequate records should be maintained.

• Guidelines .................................................................

Louisiana

• Regulation ..................................................................

Mississippi

Unlike other states which have specifically passed legislation or policy statements to help address physician's concerns about regulatory scrutiny and discuss the proper use of controlled substances in the treatment of pain, the state of Mississippi continues to remain in the minority by remaining silent on the issue.

South Carolina

In February 1999, South Carolina became the first state to adopt the Federation of State Medical Board's Guidelines for the Use of Controlled Substances in the Treatment of Pain.  The model guidelines: state that effective pain management is part of good medical practice; address physician's concerns about regulatory scrutiny by clarifying the board's policy; explain how the board distinguishes legitimate medical practice from unprofessional conduct; and encourage physician education by providing references to clinical practice guidelines that are available.  The SBMMSC guidelines provide a reasonable set of recommended parameters based on principles of good medical practice for physicians' use of controlled substances for pain management.

• Guidelines ..................................................................