If I just run a KASPER report does that satisfy the law? The answer is no. The law is very clear that a careful thought process, patient education and patient consent must be undertaken before prescribing controlled substances. Before prescribing a controlled substance an emergency physician must

• Conduct a history and physical
• Review KASPER
• Make a deliberate decision that a controlled substance is indeed warranted
• Avoid providing more than necessary to treat the condition
• Educate the patient about the use of controlled substances including it time limited use, the need to discontinue the controlled substance when the problem resolves and safe usage and proper disposal of any unused medications
• A written plan must be documented
• A written informed consent obtained for controlled II and III (with hydrocodone) substances

The majority of emergency department patients will fall under the category of “Initial Prescription to Treat Non-Cancer Pain”. Most emergency physicians will not be commencing LONG TERM prescribing to treat non-cancer pain or continue prescribing to treat non-cancer Pain. If your practice is unique, there are several requirements for you to abide by. They will not be covered in this module.