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The Board for Professional Medical Conduct
The New York State Board for Professional Medical Conduct (Board) recognizes that principles of quality medical practice dictate that the people of the State of New York have access to appropriate and effective pain relief. The appropriate application of up-to-date knowledge and treatment modalities can serve to improve the quality of life for those patients who suffer from pain as well as reduce the morbidity and costs associated with untreated or inappropriately treated pain. The Board encourages physicians1 to view effective pain management as a part of quality medical practice for all patients with pain, acute or chronic, including pain as a result of terminal illness. All physicians should become knowledgeable about effective methods of pain treatment as well as statutory requirements for prescribing controlled substances. This policy statement has been developed to clarify the Board’s position on pain control, specifically as related to the use of controlled substances, to alleviate physician uncertainty and to encourage better pain management.
The Board recognizes that controlled substances, including opioid analgesics, are often essential in the treatment of acute pain due to trauma or surgery and chronic pain, whether due to cancer or non-cancer origins. The medical management of pain should be guided by current knowledge and acceptable medical practice which includes the use of both pharmacologic and non-pharmacologic modalities. Pain should be assessed and treated promptly and appropriately with clear documentation. The Board also recognizes that tolerance and physical dependency are normal consequences of sustained use of opioid analgesics and are not synonymous with addiction.
The Board considers prescribing, administering, or dispensing controlled substances for pain to be for a legitimate medical purpose if based on accepted medical practice of the treatment of pain and sound clinical grounds. The physician’s patient management will be evaluated by taking into account whether the diagnostic and therapeutic methodologies are appropriate for the patient’s individual needs.
The Board is obligated under the laws of the State of New York to protect the public health and safety. The Board recognizes that inappropriate prescribing of controlled substances, including opioid analgesics, may lead to drug diversion and abuse by individuals who seek drugs for other than legitimate medical use. Physicians should be aware that the Board will not tolerate the use of such drugs for illegitimate purposes.
The Board’s mission is to promote appropriate management of the patient’s pain for its duration while addressing other aspects of the patient’s functioning, including physical, psychological, social, and work-related factors.
1. For the purposes of this document, the term physicians shall refer to physicians, medical residents, physician assistants and specialist assistants.