Colorado guidelines of professional practice for controlled substances
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 COLORADO GUIDELINES OF PROFESSIONAL PRACTICE FOR CONTROLLED SUBSTANCES  H  EALTH CARE PROFESSIONALS WHO PRESCRIBE, DISPENSE, AND ADMINISTERThe Colorado Prescription Drug Abuse Task Force was organized in 1984 to prevent and eliminate prescription drug abuse in Colorado. This non-profit corporation is a consortium of private and public agencies including the Colorado Medical Society and other medical societies, the Colorado Department of Human Services, the Colorado Nurses Association, the Colorado Veterinary Medical Association, the Colorado Hospital Association, the U.S. Drug Enforcement Administration and many other law enforcement agencies, and the state regulatory boards for professional practice. Goals of the Task Force are to: 1) develop and distribution guidelines for health professionals who administer and prescribe controlled substances, 2) implement professional education programs, 3) improve coordination among private and public agencies concerned about prescription drug abuse, 4) monitor prescription drug abuse in the state, and 5) evaluate public policy related to controlled substances. This project was made possible by a grant from The Alcohol and Drug Abuse Division of The Colorado Department of Human Services. Appreciation is extended to the U.S. Drug Enforcement Administration. The Colorado Prescription Drug Abuse Task Force sincerely acknowledges the efforts of the Professional Standards Committee for their dedication to the quality and usefulness of these guidelines. The Colorado Prescription Drug Abuse Task Force appreciates the efforts of the Missouri Task Force on the Misuse, Abuse, and Diversion of Prescription Drugs. Their earlier manual served as a model for this publication. ^ HEALTH CARE PROFESSIONALS WHO PRESCRIBE, DISPENSE, AND ADMINISTER Prepared by the Professional Standards Committee Colorado Prescription Drug Abuse Task Force Committee Co-Chairpersons: Shirley J. Terry, M.S., R.N., CAC III, NCAC II James Woodard, R.N., C.F.N.C. ^ Scott Collier, DEA James Duke, M.D. Rita Morrill, R.Ph. Donna Heath, B.S.N., R.N. Charles D. Sintek, R.Ph., M.S., BCPS Colorado Prescription Drug Abuser Task Force Director: Jody Gingery, M.Ed, R.N. (1984 – 2006) ^ Valdis Kalnins, R.Ph. Jody Gingery, M.Ed., R.N. Denver, Colorado December 1999 Third Edition PREFACE A major goal of the Colorado Prescription Drug Abuse Task Force is to develop guidelines which reflect consensus about what constitutes responsible prescribing and administration of controlled substances easily abused or misused by the patient or the professional. The Professional Standards Committee was given responsibility for determining guidelines for health care professionals who prescribe, dispense or administer controlled substances. Committee membership is comprised of representatives from health care professionals and various agencies which regulate health professionals. These guidelines were reviewed by the Colorado Board of Medical Examiners, the Colorado Board of Nursing, the Colorado Nurse Health Program of the Board of Nursing, the Colorado Board of Pharmacy, and the Colorado Board of Dentistry, but they are not binding as rules or regulations. These guidelines are meant to serve as an aid to the exercise of professional judgment and responsibility. They have been designed as a prevention tool. Individual patient circumstances may support modification or consultation with specialists in the field. Providers should also consult manufacturer’s prescribing information for drugs with which they are not familiar. Special thanks for review and editing of the final draft goes to the following professionals:
Michael P. Ernest, M.D. Ben Rich, J.D., Ph.D. Ernest E. Moore, M.D. Scott J. Hompland, D.O. Charles E. Lee, D.D.S.
Thomas Morgan, M.D. Nancy Hestor, Ph.D., R.N. Ben Rich, J.D., Ph.D. Scott J. Hompland, D.O. Ernest E. Moore, M.D.
Ben Rich, J.D., Ph.D. Scott J. Hompland, D.O. Ernest E. Moore, M.D. Donna Lindsey, R.N., C.A.R.N., CAC III, C.E.A.P.
Ben Rich, J.D., Ph.D. Scott J. Hompland, D.O. Ernest E. Moore, M.D.
The Ad Hoc Task Force on Intractable Pain in Nursing Home Residents of the Health Facilities Section of the Colorado Department of Public Health and Environment.
A very special thanks goes to James Duke, M.D., Anesthesiologist, Denver Health Medical Center, for his valuable contribution to the scripting of Section B and to Ernest E. Moore, M.D., FACS, Chief Dept. of Surgery, Denver Health Medical Center, Prof. & Vice Chair of Surgery, UCHSC, for Tables B & C included in Section B. ^ SECTION A 1 SECTION B 16 SECTION C 31 SECTION D 35 SECTION E 44 SECTION F 46 SECTION G 50 APPENDIX A 56 APPENDIX B 60 The abuse of prescription drugs, especially controlled substances, is a serious social and health problem in Colorado and in the United States. As a healthcare professional, you share responsibility for solving the prescription drug abuse and diversion problem.
The purpose of this guide is to help you meet these responsibilities by providing a clear and concise reference for the appropriate prescribing of controlled substances which have a demonstrated potential for inappropriate use and dependence formation. It is recognized that occasional clinical situations may require therapeutic approaches that do not fit exactly into the guidelines. Use of controlled substances in exception to these guidelines may be considered after:
Keep in mind that this guide provides only a summary of key points. For answers to specific questions, consult the appropriate law or agency. Sources for additional information are listed on page 14. |
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