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A growing number of states are implementing stricter regulations on doctors who prescribe opioids, in an effort to cut down on prescription drug abuse.

This summer, Washington state began to require that osteopathic physicians and non-physician prescribers of opioids provide written treatment plans, or “patient contracts,” that call for mandatory, periodic drug testing. The rules, which will cover all doctors beginning in January, include instructions on how to evaluate and care for patients with chronic pain not related to cancer. Under the new rules, primary care doctors must consult with board-certified pain specialists before they prescribe daily morphine-equivalent doses of 120 milligrams or higher.

“The pendulum has swung too far in terms of liberal use of opioids. Now it’s swinging back the other way,” said Mimi Pattison, MD, Chair of Washington’s Medical Quality Assurance Commission, which wrote the state’s rules. She predicted other states will follow Washington’s lead.

The Washington State Medical Association reports it has heard from some doctors who say they will not prescribe opioids because of the new rules.

In Ohio, doctors who work at pain clinics must complete 20 hours of pain medicine continuing medical education (CME) every two years, according to American Medical News. Doctors who own pain clinics must register with the state medical board, undergo random site inspections and comply with patient-tracking requirements.

In Florida and six other states, doctors cannot receive their medical license until they complete CME courses on pain management or prescribing controlled substances.

The article notes 36 states have prescription-monitoring programs, and another 12 states and the District of Columbia have enacted legislation that authorizes the programs.

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