A Guide to State Opioid Prescribing Policies

Pain Policy and Regulation: Wyoming

Summary

Wyoming does not have a great deal of material on the use of controlled medications to treat pain. Wyoming licensees should review the Wyoming Medical Practice Act (found at http://legisweb.state.wy.us/statutes/statutes.aspx?file=titles/Title33/T33CH26.htm) and the Wyoming Uniform Controlled Substances Act, along with federal law on prescribing controlled substances.

Wyoming Board Letter

In 1996, a member of the Wyoming Board wrote a letter to Wyoming physicians discussing key issues relating to the use of controlled substances to treat pain. The substance of the letter is set forth below.

In determining the appropriateness and necessity of long-term prescribing of controlled substances, the Wyoming Board may consider the following factors:

"1. Does the record contain an ADEQUATE HISTORY and PHYSICAL including an assessment of pain, physical and psychological function? An inquiry into substance abuse history, if any, is helpful as is an assessment of underlying and co-existing diseases and conditions, and a review of any recognized medical indication for controlled substances. Additionally, the Board would look to whether attempts had been made to maintain the patient on the lowest dose possible to achieve relief and improve function.

2. Is there a TREATMENT PLAN WITH OBJECTIVE CRITERIA by which progress, if any, can be measured? Though physicians should tailor pain relief to the individual needs of each patient, goals such as pain relief and/or improved physical and psychosocial function should be included and progress toward these goals monitored.

3. Have you thoroughly discussed and DOCUMENTED the risks and benefits of controlled substance usage?

4. Have you PERIODICALLY REVIEWED the course of treatment? Any new information should be added to the record as should appropriate assessment of continued treatment and necessity of trial of other modalities.

5. Has there been a DOCUMENTED CONSULTATION WHERE APPROPRIATE? The treating physician should be willing to refer the patient for necessary evaluation and treatment to achieve goals of the treatment plan. Physicians should also pay special attention to patients at risk of misuse, diversion and/or past or potential substance abuse disorders. Physicians should also ascertain, if possible, if the patient is currently receiving prescriptions for controlled substances from any other physician.

6. DOCUMENT, DOCUMENT, DOCUMENT. The more thorough and detailed the record keeping on these patients, the more easily a physician may respond to any inquiry.

7. Assure yourself that you are in COMPLIANCE WITH FEDERAL AND STATE SUBSTANCE LAWS AND REGULATIONS. To prescribe controlled substances the physician must hold a current valid license in Wyoming, possess a controlled substance registration and comply with all Federal and State regulations for issuing controlled substances prescriptions."

According to the Wyoming Board of Medicine, "a Wyoming physician keeping these seven (7) check points in mind should encounter no difficulty with the Board of Medicine arising from prolonged prescribing of controlled substances for patients."

Wyoming Prescription Drug Monitoring Program

The Wyoming Board of Pharmacy established a Prescription Drug Monitoring Program in July 2004. The Board collects schedule II-IV controlled substance prescription information from all resident and nonresident retail pharmacies that dispense to residents of Wyoming.

Practitioners and pharmacists may obtain copies of patient profiles for any patient for whom they are providing care or services. Requests for profiles must be submitted to the Board Office by facsimile or mail on a request form provided by the Board. All requests are sent to the attention of David N. Wills. This service is offered during normal business hours, 8:00 AM to 5:00 PM, Monday through Friday. This service is not available after hours, weekends, or holidays. Upon receipt of a faxed or written request, a patient profile will be generated and faxed to the pharmacist or practitioner or, if requested, mailed. Patient profile requests received after 4:00 PM are subject to processing the next business day.