Managing Chronic Pain Patients:
Indiana Rules and Requirements
Are you following the law when managing your Indiana chronic pain patients? There are specific requirement for prescribing opioid medications that all Indiana-based providers must follow.
Over the past several years, Indiana has taken the lead in development and adopting new rules and regulations for how providers manage assessment, prescription, and ongoing monitoring of opioid medications for chronic pain patients. The rules have gone through several versions. The Final Rule was adopted in 2014 and became effective November 1, 2014. As of now, if you are a provider in the state of Indiana, and you have a patient who is already being prescribed opioids for chronic pain or if you are considering a patient as a candidate for opioid prescriptions, in almost all cases you must follow the Final Rule.
Indiana Opioid Prescribing Rules: An Overview Course.
This course on the new rules for prescribing opioids to chronic pain patients is meant to serve as a rapid introduction solely to the nuts and bolts of the Final Rule. This course is a good counterpoint to our existing course on Best Practices for Prescribing Abusable Medications. This course covers the scope, definitions, and exceptions to the rule and introduces each of the core requirements. You may also be interested in the Bitterpill Provider’s Guide produced by the Office of the State Attorney General.
Overview of the Indiana Opioid Prescribing Rules for Chronic Pain Patients

-
Do your own evaluation
-
Do your own multidimensional risk stratification
-
Discuss and document risks & benefits of various treatment options
-
Create, review, and sign a treatment agreement
-
Meet face to face with patients no less than every 4 months
-
Run INSPECT at outset of treatment plan and at least annually thereafter
-
Perform drug monitoring
-
Take specific action when MED > 60mg/day
Do you know the opioid prescribing rules? Will you make a difference?
Chronic pain is a problem. Our patients cry out for help. We want to help our patients. Pain medications, including opioid prescription medications, can help our patients. But, they can also harm them. Harm can be immediate and acute, or long term, chronic, and potentially as devastating as the initial pain. The Final Rule on prescribing requirements for chronic pain patients is meant to help all of us, providers and patients alike, by reducing the risk that attempts to help with opioid prescriptions in the end do more harm than good.
Let’s look at the opioid prescribing rules a bit more closely.